Introduction to Clinical Neuropsychology - summary (grade 8.5)
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Course
Inleiding in Klinische Neuropsychologie
Institution
Tilburg University (UVT)
Book
Fundamentals of Human Neuropsychology
This is a summary of the course Intro to Clinical Neuropsychology written in the year 2023/2024, from which I received the grade 8.5.
It is based on the lectures, while covering the most important parts of the book. It includes pictures and graphs present in the book. Some parts of chapters are ...
Lecture 1
Early neuropsychology
- from 10 000 BC – skull trepanation (poking holes in the skull to make he
‘evil spirits go out’
- Edwin Smith Papyrus – observation that brain damage could result in
symptoms in other parts of the body (case studies from military battle field)
- Hippocrates – noticed a man who lost ‘memory for letters’, skull trauma
often coincided with hemiparesis on other side of the body (cannot move
that half)
- Plato – localized different qualities of soul in different parts of the body
(proposal of one-to-one relationship function and brain location)
- Herophilus – localized intelligence in brain ventricles (dominant view until
the 18th century)
- Galen – first lesion studies – brain receives sensory information and has
motor control – fluid energies from ventricles
- Rene Descartes – dualism – pineal gland as seat of the soul –
interaction between mind and body
- In 1800s – idea that mental functions are localized in specific parts of the
brain (cerebral localization)
- Phrenology (Gall) – skull parts important for specific functions
o Cortex sends instructions to the spinal cord to command
muscles to move
o Localization of function
o Relation between skull surface features and person’s mental
faculties
o Cranioscopy – measuring bumps and depressions of a skull –
determining fitness to attend uni/get a job
- Bouillaud -speech localized in the frontal lobes, lateralization
- Broca – ‘tan’, left frontal lobe – localized speech – Broca’s area, Broca’s
aphasia, nonfluent aphasia, expressive
- Wernicke – auditory cortex (behind Broca’s area), connection between
hearing and speech functioning – temporal lobe aphasia – fluent,
Wernicke’s aphasia – fluent speech, but no logic to it
- Penfield – localization through electrodes – Penfield procedures – taking
epileptic focus out – seeing what would happen if it was inactive,
Homunculus – still used to map cortical function (during operations)
- Animal studies – many functions are distributed, connections between
neurons as basis for learning (and consciousness)
o Hebb – new or strengthened connections -> together represent a
memory (cell assemblies) – plasticity
- 1950s – information processing (computer models) – interactive, parallel
processes
, - 1980s – neuroimaging – connectionism (distributed function) – lower level
localized (sensory, motor), higher level (memory, language) – result of
interconnections between brain aeas
Neuropsychological assessment – measure brain and cognition
Neuroimaging – relation symptoms and brain pathology, diagnostics
Neuroanatomy
- The higher the level, the higher the function -> lower levels mediate
function
- Forebrain – neocortex, basal ganglia, limbic system, olfactory bulb, lateral
ventricles
- Brainstem (midbrain and hindbrain, diencephalon) – thalamus,
hypothalamus, pineal body, third ventricle, tectum, tegmentum, cerebral
aqueduct, cerebellum, pons, fourth ventricle, medulla oblongata
- Spinal cord
o Reflexes in limbs and torso – extension and flexion -> different
sensory fibers mediate different reflexes – also rhythmic walking
movements
o Segments correspond to regions of the body – dermatomes:
cervical nerves, thoracic nerves, lumbar nerves, sacral nerves
o Entering posterior root – bring sensory information from sensory
receptors
o Leaving anterior root – carry motor information to the muscles
o Collateral branches of sensory neurons – may cross to the other
side
o White-matter fiber tracts – carry information to and from the brain
Hindbrain
- Cerebellum – motor coordination, motor learning – posture, postural
reflexes, balance, skilled motor activity
- Reticular formation – ascending system – arousal, activating system
- Medulla – vital functions (breathing, cardiovascular)
- Pons (bridges input to and from the forebrain
Forebrain
Limbic system
- Self-regulatory behaviors – incl. emotion, emotional episodic memory,
spatial behavior, social behavior
- It is a circuit, not just a lobe – connected to cortical regions
- Hippocampus, amygdala, thalamus, hypothalamus, cingulate gyrus, fornix,
hypothalamus
- Amygdala – emotion
- Hippocampus – personal memory
- Cingulate cortex – sexual behavior
, Basal ganglia
- Structural components – caudate nucleus, putamen, globus pallidus
- Also substantia niagra
- Functions related to movement and learning
o Control and intensity of voluntary movement
o Integrating simple movements into patterns
o Simple learning processes (associative learning)
- Huntington’s – progressive dysfunction and death of cells of the basal
ganglia – hyperkinetic syndrome (excessive movement), hyperactive DA
system
o Movement symptoms – excessive, involuntary
o Cognitive – attention, memory, executive function, dementia
o Mood and personality – personality changes, paranoia, psychosis,
depression, mania
Cortex
- Ridges – gyri
- Clefts – sulci
Crossed brain
- Each hemisphere typically receives input and sends output to the
contralateral side of the body
- Visual system – combined in one eye
Conduction aphasia – sounds and movement are retained, speech is impaired
because it cannot be conducted from one region to the other
- Connection of regions important
- Alexia – loss of ability to read
- Apraxia – inability to make sequences of movements
- Binding problem – philosophical question, how the brain ties single and
varied sensory and motor events together into a unified perception of
behavior
- Visual form agnosia – not recognizing shapes of objects – ventral stream
– conscious visual perception
- Ataxia – problems with reaching for objects (guiding actions) – dorsal
stream – unconscious visual processes
Support and protection
- CNS lies within bony encasements, SNS and ANS – lie outside them
- CNS surrounded by meninges – dura mater, arachnoid membrane, pia
mater
- CSF – protects brain and spinal cord
- Blood brain barrier – protects brain and spinal cord, limits movement of
chemical from the rest of the body into the CNS, protects from toxic
substances and infection
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