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Summary Brain Damage ()
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Detailed summary of the Neuropsychology master course of Brain Damage (PSY4061/PSY4407), includes all the relevant literature discussed in tutorials.
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BRAIN DAMAGEPSY4061
Mélanie Faltz
Year 2018-2019
,Table of contents
TASK 1: History of Neuropsychology ................................................................................................... 3
1. The main paradigm shifts.................................................................................................................. 4
2. Timeline........................................................................................................................................... 11
TASK 2: Neuropsychological assessment ........................................................................................... 12
1. What do we have to consider when using these tests? ................................................................. 13
2. What are some common biases and what indicates such a bias?.................................................. 14
3. What are the components of a NP assessment? ............................................................................ 16
4. What are the common tests in NP assessments? ........................................................................... 18
5. Which domains are usually tested? ................................................................................................ 18
TASK 3: Traumatic Brain Injuries ...................................................................................................... 19
1. The value of a meta-analysis........................................................................................................... 20
2. Interpretation of a meta-analysis ................................................................................................... 20
3. The workings of a contrecoup ........................................................................................................ 21
4. How a TBI affect long-term cognitive and behavioral functioning? ............................................... 21
5. The process for immediate examination of a TBI ........................................................................... 24
TASK 4: Cerebrovascular Accidents ................................................................................................... 26
1. Different types of cerebral vascular accidents ............................................................................... 27
2. Different phases of a stroke............................................................................................................ 28
3. Main cerebral arteries and their impact on function if compromised ........................................... 29
4. Language disorders due to a stroke ................................................................................................ 30
5. Recovery after a stroke ................................................................................................................... 32
TASK 5: Plasticity ............................................................................................................................. 34
1. Repair mechanisms of neuroplasticity ............................................................................................ 35
2. Compensation mechanisms of neuroplasticity............................................................................... 36
3. Difference in lateralization between brain injury in young and in elderly people ......................... 37
4. Phantom pain and sensation .......................................................................................................... 39
5. Treatments of phantom pain .......................................................................................................... 40
TASK 6: Epilepsy .............................................................................................................................. 41
1. Manifestations of epilepsy and the different kinds of seizures ...................................................... 42
2. Causation and triggering of a seizure ............................................................................................. 45
3. Treatment opportunities ................................................................................................................ 45
4. Neural mechanisms......................................................................................................................... 47
5. Changes induced by treatment vs by disorder itself ...................................................................... 48
6. Long-term effects after a diagnosis ................................................................................................ 49
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,TASK 7: Functional recovery ............................................................................................................ 50
1. Predictive factors of functional recovery ........................................................................................ 51
2. Mechanisms of functional recovery................................................................................................ 52
3. Restitution vs compensation .......................................................................................................... 53
4. Spontaneous (non-learning-dependent) mechanisms of recovery ................................................ 55
5. Rehabilitation approaches .............................................................................................................. 57
TASK 8: Cognitive Control................................................................................................................. 58
1. Functions mediated by the prefrontal cortex ................................................................................. 59
2. Different cognitive control models ................................................................................................. 61
3. Consequences of a PFC damage (cognitive control deficit) ............................................................ 62
4. How the thalamus relates function to the PFC ............................................................................... 65
5. Memory impairments after PFC damage........................................................................................ 66
6. How NP testing can tell us more about PFC damage...................................................................... 66
TASK 9: Korsakoff syndrome and CTE ............................................................................................... 68
1. Risk factors of Korsakoff’s’ syndrome ............................................................................................. 69
2. KS: behavioral, neurochemical and structural factors .................................................................... 69
3. Definition of CTE and its symptoms ................................................................................................ 72
4. Biases and complications when researching a complicated issue .................................................. 73
2
,TASK 1: History of Neuropsychology
Matter of Approach
PROBLEM STATEMENT: Development of the understanding of neuropsychology over time paradigm
shift
LEARNING GOALS:
1) What are the main paradigm shifts in neuropsychology?
2) Where are we now?
LITERATURE
• Kolb & Wishaw (2015). Chapter 1: The development of neuropsychology. (selective reading)
Luria, A. R. (1964). Neuropsychology in the local diagnosis of brain damage. Cortex, 1, 3–18.
Kolb & Wishaw (2015). Chapter 3: Organization of the nervous system; Chapter 10: Principles of neocortical
function
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,1. The main paradigm shifts
People knew what the brain looked like long before they had any idea of what it did. Very early in human
history, hunters must have noticed that all animals have a brain and that the brains of different animals,
including humans, although varying greatly in size, look quite similar.
1.1. Perspectives on the Brain and Behavior
THE BRAIN VS THE HEART
Since earliest times, people have puzzled over how behavior is produced. Their conclusions are preserved
in the historical records of many different cultures. Among the oldest surviving recorded hypotheses are
those of two Greeks, Alcmaeon of Croton (ca. 500 B.C.) and Empedocles of Acragas (ca. 490–430 B.C.).
Alcmaeon located mental processes in the brain and so subscribed to the brain hypothesis; Empedocles
located them in the heart and so subscribed to what could be called the cardiac hypothesis.
The relative merits of those two hypotheses were debated for the next 2000 years. Early Greek and Roman
physicians, such as Hippocrates (ca. 460–377 B.C.) and Galen (A.D. 129–ca. 199), influenced by their
clinical experience, described aspects of the brain’s anatomy and argued strongly for the brain
hypothesis.
Galen went to great pains to refute the cardiac hypothesis, pointing out not only that brain damage
impairs function but also that the nerves from the sense organs go to the brain and not to the heart. He
also reported on his experiences in attempting to treat wounds to the brain or heart. He noted that
pressure on the brain causes the cessation of movement and even death, whereas pressure on the heart
causes pain but does not arrest voluntary behavior.
MENTALISM – Aristotle
The Greek philosopher (348–322 BC) was the first person to develop a formal theory of behavior. He
proposed that a nonmaterial psyche was responsible for human thoughts, perceptions, and emotions and
for such processes as imagination, opinion, desire, pleasure, pain, memory, and reason. The psyche was
independent of the body but, in Aristotle’s view, worked through the heart to produce action (psyche =
mind).
Mentalism: meaning “of the mind”, the philosophical position that a person’s mind is responsible for
behavior. It has wielded great influence on modern neuropsychology: many terms—sensation,
perception, attention, imagination, emotion, memory, and volition among them—are still employed as
labels for patterns of behavior.
Mentalism also influenced people’s ideas about how the brain might work because, inasmuch as the mind
was proposed to be nonmaterial and so have no parts, the brain was thought to work as a whole. This idea
was used as an argument against subsequent proposals that different parts of the brain might have
different functions.
K&W p. 5
DUALISM – Descartes
Modern thinking about how the brain controls behavior began with René Descartes (1596– 1650), a
French anatomist and philosopher who described a relation between the mind and the brain. Descartes
proposed that the body is like these machines (programmed to react to exterior input). It is material and
thus clearly has spatial extent, and it responds mechanically and reflexively to events that impinge on it.
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, Described as nonmaterial and without spatial extent, the mind, as Descartes saw it, was different from
the body. The body operated on principles similar to those of a machine, but the mind decided what
movements the machine should make. Descartes located the site of action of the mind in the pineal body,
a small structure high in the brainstem.
For Descartes, the cortex was not functioning neural tissue but merely a covering for
the pineal body. People later argued against Descartes’s hypothesis by pointing out
that, when the pineal is damaged, there are no obvious changes in behavior.
The position that mind and body are separate but can interact is called dualism, to
indicate that behavior is caused by two things. Descartes’s dualism originated what came to be known as
the mind–body problem. To understand the mind–body problem, consider that for the mind to affect the
body, it must expend energy, adding new energy to the material world. The spontaneous creation of new
energy violates a fundamental law of physics, the law of conservation of matter and energy. Thus, dualists
who argue that mind and body interact causally cannot explain how.
K&W p. 5
MATERIALISM – Darwin
The modern perspective of materialism is the idea that rational behavior can be fully explained by the
working of the nervous system without any need to refer to a nonmaterial mind (//Descartes). This
perspective had its roots in the evolutionary theories of two English naturalists, Alfred Russell Wallace
(1823–1913) and Charles Darwin (1809–1892).
Both Darwin and Wallace looked carefully at the structures of plants and animals and at animal behavior.
Despite the diversity of living organisms, they were struck by the number of similarities and common
characteristics. For example, the skeleton, muscles, internal organs, and nervous systems of humans,
monkeys, and other mammals are remarkably similar. These observations support the idea that living
things must be related, an idea widely held even before Wallace and Darwin. But more importantly, these
same observations led to the idea that the similarities could be explained if all animals evolved from a
common ancestor.
In Darwin’s terms, all living things are said to have common descent. As the descendants of that original
organism spread into various habitats through millions of years, they developed structural and behavioral
adaptations that suited them for new ways of life. At the same time, they retained many similar
characteristics that reveal their relatedness to one another.
The nervous system is one such common characteristic. It is an adaptation that emerged only once in
animal evolution. Consequently, the nervous systems of living animals are similar because they are
descendants of that first nervous system. For those animals with brains, the brains are related because all
animals with brains are descendants from the first animal to evolve a brain.
Some people reject the idea that the brain is responsible for behavior, because they think it denies the
teaching of their religion that the nonmaterial soul will continue to exist after their bodies die. Others
regard the biological explanation of brain and behavior as being neutral with respect to religion. Many
behavioral scientists with strong religious beliefs see no contradiction between those beliefs and using
the scientific method to examine the relations between the brain and behavior. Today, when
neuroscientists use the term mind, most are not referring to a nonmaterial entity but are using the term
as shorthand for the collective functions of the brain. (K&W p.7)
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