Dit is een uitgebreide samenvatting voor het vak 'Biologische grondslagen: Neuropsychologie en psychofarmacologie' van de Open Universiteit.
De samenvatting omvat de te studeren hoofdstukken van het boek, de extra hoofdstukken van Kenemans, de colleges van Erik Scherder en de opdrachten van YouLe...
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SAMENVATTING
NEUROPSYCHOLOGIE EN
PSYCHOFARMACOLOGIE
BIOLOGISCHE GRONDSLAGEN
1
,INHOUD
Thema 1 - Introductie ...................................................................................................................................... 12
1.1 - Historische mijlpalen ......................................................................................................... 12
INTRODUCTIE ........................................................................................................................................ 12
Hoofdstuk 1 - Klinische neuropsychologie: een historische schets .............................................. 12
1.1 INLEIDING........................................................................................................................................ 12
1.2 DE CELTHEORIE ............................................................................................................................... 13
1.3 DESCARTES: EEN ONGEDEELDE GEEST ........................................................................................... 14
1.4 GALL EN HET LOKALISATIEVRAAGSTUK .......................................................................................... 14
1.5 DE CLINICOANATOMISCHE METHODE ............................................................................................ 15
1.6 HOLISME ......................................................................................................................................... 17
1.7 LURIA: EEN GLOBAAL MODEL ......................................................................................................... 17
1.8 EEN EERSTE AANZET: DE TESTBATTERIJ .......................................................................................... 20
1.9 DE NEUROPSYCHOLOGIE ALS ZELFSTANDIGE DISCIPLINE .............................................................. 20
Arthur Benton .......................................................................................................................... 21
1.10 COGNITIEVE NEUROPSYCHOLOGIE ............................................................................................... 21
1.10.1 Modules ........................................................................................................................ 21
1.10.2 Neurale netwerken ....................................................................................................... 23
1.10.3 Neurobeeldvorming ...................................................................................................... 23
1.11 NEUROPSYCHOLOGIE IN NEDERLAND .......................................................................................... 24
1.12 TOT BESLUIT .................................................................................................................................. 24
Verwerkingsopdrachten ............................................................................................................ 25
1.2 - Neuropsychologische wetenschappelijke aanpak ............................................................... 26
INTRODUCTIE ........................................................................................................................................ 26
Hoofdstuk 3 - Neuropsychologie: de wetenschappelijke aanpak................................................. 26
3.1 INLEIDING........................................................................................................................................ 26
3.2 VRAAGSTELLINGEN ......................................................................................................................... 26
3.2.1 Klinisch neuropsychologische vraagstellingen................................................................ 27
3.2.2 Fundamentele vraagstellingen ....................................................................................... 28
3.3 ONDERZOEKSOPZET ........................................................................................................................ 28
3.3.1 Substractie ...................................................................................................................... 28
3.3.2 Enkelvoudige en dubbele dissociatie .............................................................................. 29
Hans-Lukas Teuber en de dubbele dissociatie ......................................................................... 30
3.4 SINGLE-CASE STUDIE (ONDERZOEKSMETHODE)............................................................................. 30
3.4.1 Vooronderstellingen ....................................................................................................... 30
3.4.2 Designs ............................................................................................................................ 32
3.5 BELOOPSTUDIES .............................................................................................................................. 32
3.5.1 Longitudinale versus crosssectionele studies ................................................................. 32
Salthouse over longitudinale designs ...................................................................................... 32
3.5.2 Behandelstudies.............................................................................................................. 33
Aspecifiek effect ...................................................................................................................... 33
Multiple baseline ..................................................................................................................... 33
Controletaak ............................................................................................................................ 33
Cross-over ................................................................................................................................ 34
Itemspecifieke training ............................................................................................................ 34
Randomisatietoets ................................................................................................................... 34
Test-hertestprobleem .............................................................................................................. 34
Generalisatie ............................................................................................................................ 35
Kwaliteitscriteria ...................................................................................................................... 35
Verwerkingsopdrachten ............................................................................................................ 36
1.3 - Neuropsychologische praktijk ............................................................................................ 37
INTRODUCTIE ........................................................................................................................................ 37
Hoofdstuk 2 - De neuropsychologische praktijk .......................................................................... 37
2.1 INLEIDING........................................................................................................................................ 37
De eerste klinisch neuropsychologen ...................................................................................... 37
2
, 2.2 HET NEUROPSYCHOLOGISCH ONDERZOEK ..................................................................................... 38
2.2.1 Diagnostische cyclus ....................................................................................................... 38
2.2.2 Verwijzing en vraagstelling ............................................................................................. 38
Vraagstellingen in de neuropsychologische praktijk ............................................................... 38
2.2.3 Anamnese ....................................................................................................................... 38
2.2.4 Heteroanamnese ............................................................................................................ 39
2.2.5 Observatie ....................................................................................................................... 39
2.2.6 Tests en vragenlijsten ..................................................................................................... 40
2.2.7 Interpretatie.................................................................................................................... 41
Prevalentie, sensitiviteit en specificiteit .................................................................................. 41
2.2.8 Rapportage...................................................................................................................... 42
2.3 BETROUWBAARHEID EN VALIDITEIT ............................................................................................... 42
2.3.1 Betrouwbaarheid ............................................................................................................ 42
2.3.2 Validiteit .......................................................................................................................... 43
2.3.3 Stoorfactoren .................................................................................................................. 43
2.3.4 Onderpresteren .............................................................................................................. 43
2.4 NEUROPSYCHOLOGISCHE BEHANDELING ....................................................................................... 44
2.5 WERKVELD ...................................................................................................................................... 44
2.5.1 Ziekenhuis ....................................................................................................................... 44
2.5.2 Revalidatiecentrum ......................................................................................................... 45
2.5.3 Geestelijke gezondheidszorg (ggz).................................................................................. 45
2.5.4 Verzorgings- of verpleeghuis of begeleide woonvorm ................................................... 46
2.5.5 Forensische instelling...................................................................................................... 46
2.6 POSITIE EN PROFESSIONELE ONTWIKKELING ................................................................................. 46
2.7 TOT BESLUIT .................................................................................................................................... 47
Hoofdstuk 5 - Herstel en behandeling ........................................................................................ 48
5.1 INLEIDING........................................................................................................................................ 48
5.2 HERSTEL EN PLASTICITEIT ............................................................................................................... 48
5.2.1 Herstelniveaus na hersenletsel ....................................................................................... 48
5.2.2 Vormen van plasticiteit ................................................................................................... 49
Constantin von Monakow over diaschisis ............................................................................... 50
5.2.3 Het stimuleren van plasticiteit na hersenletsel .............................................................. 50
5.3 LEREN EN LEERBAARHEID ............................................................................................................... 51
5.3.1 Wat is leren? ................................................................................................................... 51
5.3.2 Niveaus van leerbaarheid: het ICIDH-model .................................................................. 52
De op neuropsychologisch functioneren toegespitste ICF-definities ...................................... 52
5.3.3 Hiërarchie van neuropsychologische interventiemethoden .......................................... 53
5.4 NEUROPSYCHOLOGISCHE REVALIDATIE ......................................................................................... 54
5.4.1 Twee modellen ............................................................................................................... 54
5.4.2 Trainings- en behandelvormen ....................................................................................... 54
Verwerkingsopdrachten ............................................................................................................ 56
1.4 - Anatomie en beeldvorming ................................................................................................ 58
INTRODUCTIE ........................................................................................................................................ 58
Hoofdstuk 4 - Beeldvorming van de hersenen ............................................................................ 58
4.1 ONTWIKKELING VAN HET BEELDVORMEND ONDERZOEK DOOR DE TIJD ...................................... 58
4.1.1 CT-scan ............................................................................................................................ 58
4.1.2 SPECT- en PET-technieken .............................................................................................. 59
4.1.3 MRI .................................................................................................................................. 59
4.1.4 MEG en EROS .................................................................................................................. 59
4.2 STRUCTURELE BEELDVORMING ...................................................................................................... 59
4.2.1 CT-scan: beeldvorming .................................................................................................... 59
4.2.2 MRI-scan: MRI als techniek ............................................................................................. 60
4.3 STRUCTURELE BEELDVERWERKING: image processing .................................................................. 61
4.3.1 Volumetrie en VBM ........................................................................................................ 61
4.3.2 Cortical thickness ............................................................................................................ 61
4.3.3 DTI ................................................................................................................................... 62
4.3.4 MRS ................................................................................................................................. 62
3
, 4.4 FUNCTIONELE BEELDVORMING ...................................................................................................... 62
4.5 HET METEN VAN ELEKTRISCHE SIGNALEN ...................................................................................... 63
Hans Berger en het EEG ........................................................................................................... 63
4.5.1 Elektro-encefalografie (EEG) ........................................................................................... 63
4.5.2 Magneto-encefalografie (meg) ....................................................................................... 64
4.6 HET METEN VAN HEMODYNAMISCHE SIGNALEN........................................................................... 64
4.6.1 fMRI................................................................................................................................. 65
4.7 FUNCTIONELE BEELDVERWERKING ................................................................................................ 65
4.8 TOEPASSING .................................................................................................................................... 66
4.9 TOT BESLUIT .................................................................................................................................... 66
Hersenstructuren ...................................................................................................................... 67
College van Erik Scherder - Deel 1 .............................................................................................. 70
INLEIDING.............................................................................................................................................. 70
OPDELING VAN HET BREIN ................................................................................................................... 70
Onderste laag ........................................................................................................................... 70
Middelste laag.......................................................................................................................... 70
Bovenste laag ........................................................................................................................... 70
Hersenhelften .......................................................................................................................... 71
AROUSAL ............................................................................................................................................... 71
Thalamus .................................................................................................................................. 71
Hersenschors ........................................................................................................................... 71
DUALE TAKEN ........................................................................................................................................ 72
COMA .................................................................................................................................................... 72
GEVOLGEN VAN EEN HERSENLETSEL .................................................................................................... 72
Verwerkingsopdrachten ............................................................................................................ 73
Thema 2 - Psychofarmacologie ........................................................................................................................ 75
INTRODUCTIE ........................................................................................................................................ 75
2.1 - Wat zijn psychofarmaca? ................................................................................................... 75
INTRODUCTIE ........................................................................................................................................ 75
Hoofdstuk 1 K - Wat zijn psychofarmaca? .................................................................................. 75
INLEIDING.............................................................................................................................................. 75
Pijltjesgif .................................................................................................................................. 75
1.1 INNAME........................................................................................................................................... 76
1.2 DOSERING ....................................................................................................................................... 77
1.3 BIJWERKINGEN EN THERAPEUTISCH VENSTER ............................................................................... 77
1.4 TITREREN EN TOLERANTIE .............................................................................................................. 78
1.5 ONDERZOEK NAAR DE WERKING VAN PSYCHOFARMACA ............................................................. 78
1.6 PLACEBOCONTROLE ........................................................................................................................ 78
1.7 STEEKPROEVEN EN STATISTIEK ....................................................................................................... 79
Hoe waarschijnlijk is de bijwerking: de odds-ratio .................................................................. 79
1.8 PREKLINISCH EN KLINISCH ONDERZOEK ......................................................................................... 80
Wie moet fase-3-onderzoek uitvoeren? .................................................................................. 80
Verwerkingsopdrachten ............................................................................................................ 81
2.2 - Neurotransmissie............................................................................................................... 82
INTRODUCTIE ........................................................................................................................................ 82
Hoofdstuk 4 K - Neurotransmissie .............................................................................................. 82
INLEIDING.............................................................................................................................................. 82
4.1 DE SYNAPS....................................................................................................................................... 82
4.2 BESCHIKBAARHEID VAN NEUROTRANSMITTERS: AANGRIJPINGSPUNTEN VOOR PSYCHOFARMACA
.............................................................................................................................................................. 82
4.3 DE POSTSYNAPTISCHE PROCESSEN................................................................................................. 84
Het elektro-encefalogram (EEG) .............................................................................................. 85
4.4 BLOKKEREN EN BEÏNVLOEDEN ........................................................................................................ 85
4.5 SCHAKELINGEN ............................................................................................................................... 86
4.6 TWEE VORMEN VAN NEUROTRANSMISSIE..................................................................................... 87
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