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Summary Exam 1 Neuropsychology UvA Year 1
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Summary of Neuropsychology Exam 1 as part of the course Clinical Psychology & Neuropsychology
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W1.1CHAPTER 2.1, 2.4, 2.5 & 2.6 (KESSELS, ELING, PONDS, SPIKMAN &
ZANDVOORT) – NEUROPSYCHOLOGY IN PRACTICE
Franz: One of the first psychologists to focus systematically on patients with brain injuries
- Used experimental psychological research methods when working with patients with
brain disorder in order to find out more about the relationship between the brain and
behaviour – Different from predecessors who based their work on observations
- Combined research involving patients with research conducted on animals
- Substitution: A term used by Franz to describe the plasticity of the brain
- New phrenology: A term used by Franz to describe function localisation
- Used the principles of behaviourist learning psychology – Education (= the unlearning
of undesirable behaviours) and re-education (= the learning of new patterns of
behaviour)
Over the last few years much attention has also been given to the emotional and behavioural
disorders resulting from brain injury
The professional field:
- Hospitals:
- Short-term care
- Aim is to identify the cause of cognitive complaints or to assess the effects of a
brain injury that has already been identified through the use of
neuropsychological diagnostics
- Psychoeducation is important
- Complaint oriented
- Rehabilitation centres:
- Emphasis is on treatment rather than diagnostics
- Multidisciplinary
- Mental health care
- Residential homes, nursing homes and supported housing
- Focus on assessment and support by family members and other people who are
directly involved with the patient
- Forensic institutions:
- Always takes place within a legal framework
- Referral questions are usually related to explanatory diagnostics, or are used to
support a treatment assessment
CHAPTER 3.1, 3.2, 3.3 & 3.6 (KESSELS, ELING, PONDS, SPIKMAN &
ZANDVOORT) – NEUROPSYCHOLOGY: THE SCIENTIFIC APPROACH
Single-case studies are quite common in neuropsychological research, as brain damage can
vary greatly and individuals should not be regarded as a ‘random sample’ of a population
,Fields of neuropsychology:
1. Clinically oriented neuropsychological research: Focus is on neuropsychological
performance, diagnostics and treatment
- Neuropsychological diagnostic assessment – Empirical cycle
- Test battery: A set of tests designed to be administered as a unit in order to
obtain a comprehensive assessment of a particular factor or phenomenon
- Experimental tests: Tasks that are specifically designed for research that is
focused on more specific aspects of cognitive functioning (E.g.: the stroop
task, in which the ability to inhibit cognitive interference is assessed)
- Issues with clinical psychological instruments:
- The value of the conclusions is largely dependent on the quality of the
tests and questionnaires used
- Interpretation issues/validity problems (E.g.: a reduced performance by
a patient with epilepsy may have a very different cause to the same
level of performance on a test by a patient with traumatic brain injury)
- So many different aspects that play a role many neuropsychological
constructs that it is not feasible to study them systematically by using a
battery of standardised tests
- Missing values: When no data value is stored for a variable in an
observation
2. Fundamental neuropsychological research: Focus is on achieving a better
understanding of underlying cognitive disorders and the related brain structures –
Usually measured with experimental paradigms
Research methodologies:
- Subtraction: When a measure of the duration of a particular process can be found by
obtaining two measurements of time that include the process and subtracting one from
the other (E.g.: if the activation of the simple condition is subtracted from the image of
the complex condition, what remains is the activation that is specific to the complex
condition) (Donders) – Unreliability can be solved through factorial designs
- Dissociation: Method to demonstrate that sub-processes are independent of each other
- Single dissociation: When a lesion in brain structure A disrupts function X but
not function Y – Function X and function Y are independent of each other in
some way
- Double dissociation: When a lesion in brain structure A impairs function X but
not Y, and a lesion to brain structure B impairs function Y but spares function
X – Specific inference about brain function and function localisation (Teuber)
- Crawford: Statistical tests should also be performed to determine 1)
whether the score on one task differs significantly from the standard, 2)
whether the score for the other task does not deviate from the standard,
and 3) whether the scores on each of the two tasks also differ
significantly from each other
Test-retest effect: The change in test scores as a result of retaking the same or alternate
cognitive ability test under comparable conditions
,CHAPTER 4 (KESSELS, ELING, PONDS, SPIKMAN & ZANDVOORT) –
NEUROIMAGING
History of medical imaging techniques:
- Post-mortem research
- 19th century → Golgi: Demonstrated the existence of individual neurons – Ramón y
Cajal: Showed that brain cells form independent units that communicate
- 20th century – Brodmann: Described the cerebral cortex by its cytoarchitecture (= the
study of the cellular composition of the central nervous system's tissues under the
microscope) by identifying 52 areas
- 1919 → Pneumoencephalography: An invasive technique in which cerebral fluid is
removed and replaced by air in the brain ventricles, so that the brain shows up more
clearly on X-ray images (Dandy)
↓ Replaced by
Echoencephalography: Technique in which sound pulses/ultrasounds are delivered to
the skull and the reflected pulses are recorded
- 1970s → Computed axial tomography (CAT)/computed tomography (CT): A
radiographic technique for quickly producing, detailed, three-dimensional images of
the brain or other soft tissues by passing an X-ray beam through the tissue from many
different locations (Cormack & Hounsfield)
- 1980s → Single-photon emission computed tomography (SPECT)/Positron emission
tomography (PET): Nuclear medical imaging techniques that use a radioactive
substance (called a tracer) to look for disease or injury in the brain by measuring
specific receptors
- 1980s → Magnetic resonance imaging (MRI) (Mansfield & Lauterbur)
Neuroimaging falls into two broad categories: structural imaging and functional imaging
STRUCTURAL IMAGING
Approaches that are specialised for the visualisation and analysis of anatomical properties of
the brain; particularly useful for detecting brain damage and abnormalities
Structural imaging methods:
- Computed tomography (CT): A whole series of photos is taken, but the position of the
source of the X-rays and the camera is constantly changing as the equipment rotates
around the patient’s head, making it possible to see every part of the head in detail as a
series of thin slices → The images are combined using a mathematical algorithm, and
a computer software can superimpose two-dimensional images to form a three-
dimensional image
- Advantages: CT is the only option for patients with contraindications to MRI,
such as metal implants, claustrophobia or obesity; high resolution; different
angles can be displayed
- Disadvantages: Lower spatial resolution (= the number of pixels used in the
construction of an image) than MRI; risks associated with exposure to
potentially carcinogenic X-rays; lower image quality than MRI
, - Magnetic resonance imaging (MRI): MRIs produce a strong magnetic field that forces
positively charged protons in hydrogen atoms in the body to align with that field →
When a radiofrequency current is pulsed through the patient, the protons are
stimulated, and spin out of equilibrium, straining against the pull of the magnetic field
→ When the radiofrequency current is turned off, the MRI sensors are able to detect
the energy released as the protons realign with the magnetic field → The time it takes
for the protons to realign with the magnetic field, as well as the amount of energy
released, changes depending on the environment and the chemical nature of the
molecules → The difference between various types of tissues can be told based on
these magnetic properties → A T1-weighted scan of the whole head is used for brain
anatomy, whereas T2-weighted images are used to make white matter visible
- MRI image processing:
- Volumetric magnetic resonance imaging (VMRI): Used to determine
the volume of the brain (i.e. the total amount of grey and white matter,
the amount of cerebrospinal fluid, and the number of nuclei in the
brain) by means of T1-weighted MRI scans of the whole brain → By
labelling voxels (= three-dimensional pixels) that belong to a certain
type of tissue (= binary segmentation), the voxels can be counted and
multiplied by their size in order to determine the volume → Voxel
based morphometry (VBM): Used to ascertain the density across white
and grey matter for each voxel
- Cortical thickness studies + Cortical surface studies
- Diffusion tension imaging (DTI): Used to detect white matter pathways
→ The freedom of movement of water molecules is restricted in tissues
(= anisotropic), so a molecule in the axon of a neuron has a lower
likelihood of crossing the membrane, and a greater likelihood of
moving in the longitudinal direction of the axon → By calculating the
fractional anisotropy (= the degree of anisotropy), white matter
pathways can be reconstructed on the basis of this directional
information → Voxel-based analysis (VBA): Used to ascertain the
density of white matter tracts
- Magnetic resonance spectroscopy (MRS): Provides information about
metabolic changes
- Advantages: High spatial resolution; very accurate; not harmful; can
distinguish grey and white matter
- Disadvantages: Long scan times; more expensive; very noisy; may induce
claustrophobia
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