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Volledige en uitgebreide samenvatting van klinische neuropsychologie

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  • Klinische neuropsychologie
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  • Vrije Universiteit Brussel (VUB)

Dit is een volledige en uitgebreide samenvatting van het vak 'Klinische neuropsychologie'. Gemaakt aan de hand van de slides en notities gemaakt in de les. ! Als er iets niet gekend moet zijn voor het examen staat dit in de voetnoten!

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  • December 20, 2023
  • 172
  • 2023/2024
  • Summary

Subjects

  • neuropsychologie
  • klinische neuropsychologie
  • master klinische psychologie

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  • Vrije Universiteit Brussel (VUB)
  • Psychologie
  • Klinische neuropsychologie
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Aurélie Weverbergh 1MA PSYCH 2023-2024
VUB


Klinische neuropsychologie
Inhoud
1 Historische inleiding ........................................................................................................ 11
1.1 Situering ................................................................................................................... 11
1.2 Geschiedenis ............................................................................................................. 13
1.2.1 Oudheid .............................................................................................................. 13
1.2.2 Oude Egypte ....................................................................................................... 13
1.2.3 Arabische wereld ................................................................................................ 14
1.2.4 Grieken en romeinen .......................................................................................... 14
1.2.4.1 Grieken ........................................................................................................ 14
1.2.4.2 Romeinen .................................................................................................... 15
1.2.5 Celtheorie (ventriculaire lokalisatie hypothese) ................................................. 16
1.2.6 Renaissance ........................................................................................................ 16
1.2.7 Eind 16de, 17de en begin 18de eeuw ..................................................................... 16
1.2.7.1 Franz Joseph Gall ........................................................................................ 17
e
1.2.8 19 eeuw ............................................................................................................. 18
1.2.8.1 Jean -Pierre Flourens ................................................................................... 18
1.2.8.2 Paul Brocca: studies met hersenletselpatiënten .......................................... 18
1.2.8.3 Wernicke: studies met hersenletselpatiënten .............................................. 19
ste
1.2.9 20 eeuw............................................................................................................ 19
1.2.9.1 Midden 20ste eeuw ....................................................................................... 20
1.2.10 Hedendaagse neuropsychologie ......................................................................... 21
2 Visuele waarneming ......................................................................................................... 24
2.1 Inleiding ................................................................................................................... 24
2.2 Fysiologie ................................................................................................................. 24
2.2.1 Van het oog naar de hersenen ............................................................................ 24
2.2.2 Visuele cortex ..................................................................................................... 25
2.3 Stadia in de visuele waarneming (functioneel) ........................................................ 26
2.3.1 Primaire schets ................................................................................................... 26
2.3.2 Perceptuele categorisatie .................................................................................... 27
2.3.3 Percept ................................................................................................................ 27
2.4 Stoornissen na hersenbeschadiging .......................................................................... 27
2.4.1 Lagere orde stoornissen ...................................................................................... 28
2.4.1.1 Visueel velddefect ....................................................................................... 28
2.4.1.2 Stoornissen in gezichtsscherpte, contrastgevoeligheid en licht-
donkeradaptatie ............................................................................................................ 30

1

,Aurélie Weverbergh 1MA PSYCH 2023-2024
VUB
2.4.1.2.1 Gezichtsscherpte ..................................................................................... 30
2.4.1.2.2 Contrastgevoeligheid .............................................................................. 30
2.4.1.2.3 Licht-donker adaptatie ............................................................................ 30
2.4.1.3 Stoornissen in de kleurwaarneming ............................................................ 30
2.4.1.4 Stoornissen in de bewegingswaarneming ................................................... 30
2.4.2 Hogere orde stoornissen ..................................................................................... 31
2.4.2.1 Apperceptieve agnosieën ............................................................................ 31
2.4.2.1.1 Visuele vormagnosie .............................................................................. 31
2.4.2.1.2 Ventrale simultaanagnosie/ apperceptieve agnosie ................................ 31
2.4.2.2 Associatieve agnosieën ............................................................................... 31
2.4.2.3 Prosopagnosie ............................................................................................. 31
2.4.2.3.1 Discussie: expertise ................................................................................ 32
2.4.3 Overige visuele stoornissen ................................................................................ 33
2.4.3.1 Blindsight .................................................................................................... 33
2.4.3.2 Visuele illusies en hallucinaties .................................................................. 33
2.4.3.3 Corticale blindheid ...................................................................................... 33
2.4.3.4 Palinopsie .................................................................................................... 33
3 Auditieve waarneming ..................................................................................................... 34
3.1 Fysiologie: van het oor naar de hersenen ................................................................. 34
3.2 Auditieve stoornissen ............................................................................................... 34
4 Tactiele waarneming/ lichamelijke perceptie ................................................................... 35
4.1 Stoornissen lichamelijke perceptie ........................................................................... 35
5 Smaak en reukperceptie ................................................................................................... 36
5.1 Stoornissen ............................................................................................................... 36
6 Ruimtelijke cognitie ......................................................................................................... 37
6.1 Inleiding ................................................................................................................... 37
6.1.1 Ruimtelijke perceptie ......................................................................................... 37
6.1.2 Ruimtelijke aandacht .......................................................................................... 37
6.1.3 Ruimtelijke representaties .................................................................................. 38
6.1.4 Ruimtelijk geheugen .......................................................................................... 39
6.1.4.1 Ruimtelijk werkgeheugen ........................................................................... 39
6.1.4.2 Objectlocaties .............................................................................................. 39
6.1.4.3 Leren en onthouden van een route .............................................................. 40
6.1.5 Visuoruimtelijke praxis ...................................................................................... 40
6.2 Stoornissen na hersenbeschadiging .......................................................................... 40
6.2.1 Ruimtelijke perceptie ......................................................................................... 40
6.2.1.1 Verstoorde perceptie van lijnoriëntatie: ...................................................... 40

2

,Aurélie Weverbergh 1MA PSYCH 2023-2024
VUB
6.2.1.2 Simultaanagnosie ........................................................................................ 41
6.2.2 Ruimtelijke aandacht .......................................................................................... 42
6.2.2.1 Neglect ........................................................................................................ 42
6.2.3 Ruimtelijk geheugen .......................................................................................... 44
6.2.3.1 Stoornissen van het ruimtelijk werkgeheugen: ........................................... 44
6.2.3.2 Stoornissen van het objectlocatiegeheugen: ............................................... 44
6.2.3.3 Stoornissen bij het leren van een route en topografische kennis: ............... 45
6.2.3.4 Links-rechtsverwarring: Gerstmannsyndroom: .......................................... 45
6.2.4 Ruimtelijke praxis .............................................................................................. 45
6.2.4.1 Constructieve apraxie .................................................................................. 45
6.2.4.2 Optische ataxie: ........................................................................................... 46
6.2.4.3 Balintsyndroom ........................................................................................... 46
7 Aandacht, executieve functies en sociale cognitie ........................................................... 47
7.1 Aandacht ................................................................................................................... 47
7.1.1 Selectiviteit van aandacht ................................................................................... 47
7.1.1.1 Gerichte aandacht ........................................................................................ 47
7.1.1.2 Verdeelde aandacht ..................................................................................... 47
7.1.1.3 Dual process theory ..................................................................................... 48
7.1.2 Intensiteit van aandacht ...................................................................................... 49
7.1.2.1 Alertheid ..................................................................................................... 49
7.1.2.2 Volgehouden aandacht ................................................................................ 49
7.1.3 Neuro-anatomische correlaten ............................................................................ 50
7.2 Executieve functies .................................................................................................. 50
7.2.1 Een paraplubegrip .............................................................................................. 51
7.2.2 Lokalisatie .......................................................................................................... 51
7.3 Stoornissen: aandacht en executieve functies .......................................................... 51
7.3.1 Aandacht ............................................................................................................. 51
7.3.2 Executieve functies ............................................................................................ 52
7.3.3 Ziektebeelden ..................................................................................................... 52
7.4 Sociale cognitie ........................................................................................................ 52
7.4.1 Emotionele processen ......................................................................................... 53
7.4.1.1 Basale emoties ............................................................................................ 53
7.4.1.2 Secundaire sociale of morele emoties ......................................................... 53
7.4.2 Sociaal-cognitieve processen ............................................................................. 53
7.4.3 Stoornissen ......................................................................................................... 54
7.4.4 Lokalisatie van sociale cognitie in het brein ...................................................... 54
8 Neuraal herstel en neuropsychologische revalidatie ........................................................ 56

3

,Aurélie Weverbergh 1MA PSYCH 2023-2024
VUB
8.1 Neuraal herstel .......................................................................................................... 56
8.1.1 Neuroplasticiteit ................................................................................................. 56
8.1.2 Inleiding ............................................................................................................. 56
8.1.3 Acute fase ........................................................................................................... 57
8.1.3.1 Het oedeem ................................................................................................. 57
8.1.3.2 Neurale shock .............................................................................................. 58
8.1.3.3 Diaschisis/ functionele deactivering ........................................................... 58
8.1.4 De adaptiefase .................................................................................................... 59
8.1.4.1 Lokale reorganisatie/ neurofysiologische adaptatie .................................... 59
8.1.4.1.1 Negatieve veranderingen ........................................................................ 59
8.1.4.1.2 Positieve veranderingen:......................................................................... 61
8.1.4.1.3 Cognitieve revalidatie ............................................................................. 64
8.1.4.2 Functionele adaptatie .................................................................................. 65
8.1.4.3 Neurale bypass ............................................................................................ 65
8.1.4.4 Redundantie (anatomische reorganisatie of ‘unmasking’).......................... 66
8.1.5 Factoren die het neuraal herstel beïnvloeden ..................................................... 67
8.1.5.1 Cognitieve reserve (CR) ............................................................................. 68
8.1.5.2 Breinreserve ................................................................................................ 69
8.2 Neuropsychologische revalidatie ............................................................................. 69
8.2.1 Inleiding ............................................................................................................. 69
8.2.2 Cognitieve revalidatie ........................................................................................ 71
8.2.2.1 Twee belangrijke modellen van cognitieve revalidatie............................... 72
8.2.2.1.1 Restauratieve model ............................................................................... 72
8.2.2.1.2 Compensatoire model ............................................................................. 75
9 Neuropsychologie van cerebrovasculaire aandoeningen ................................................. 79
9.1 Bloedvatensysteem ................................................................................................... 79
9.2 Inleiding ................................................................................................................... 80
9.2.1 Risicofactoren ..................................................................................................... 80
9.2.2 2 grote groepen ................................................................................................... 80
9.3 Herseninfarct/ ischemische CVA ............................................................................. 81
9.3.1 Omschrijving ...................................................................................................... 81
9.3.2 Etiologie ............................................................................................................. 81
9.3.2.1 Thrombus .................................................................................................... 81
9.3.2.2 Een embolus ................................................................................................ 81
9.3.2.3 Algemeen .................................................................................................... 83
9.3.3 Behandelingen .................................................................................................... 84
9.3.4 Types .................................................................................................................. 84

4

,Aurélie Weverbergh 1MA PSYCH 2023-2024
VUB
9.4 Hersenbloeding/ hemorragisch CVA ....................................................................... 86
9.4.1 Omschrijving ...................................................................................................... 86
9.4.2 Subarachnoïdale bloeding (SAB) ....................................................................... 86
9.4.2.1 Etiologie ...................................................................................................... 86
9.4.2.2 Behandeling ................................................................................................ 86
9.4.2.3 Neuropsychologie na SAB .......................................................................... 87
9.5 Intracerebrale bloeding (ICB) .................................................................................. 88
9.5.1 Etiologie ............................................................................................................. 88
9.5.2 Behandeling ........................................................................................................ 89
9.5.3 Overzicht ............................................................................................................ 89
9.6 Problemen na CVA .................................................................................................. 89
9.6.1 Lichamelijke problemen ..................................................................................... 89
9.6.1.1 Vermoeidheid .............................................................................................. 90
9.6.2 Neuromotorische problemen .............................................................................. 91
9.6.3 Neuropsychologische problemen ....................................................................... 91
9.6.3.1 Cognitieve stoornissen ................................................................................ 91
9.6.3.2 Emotionele en gedragsveranderingen ......................................................... 93
10 Traumatisch hersenletsel .................................................................................................. 96
10.1 Inleiding ................................................................................................................... 96
10.2 Omschrijving ............................................................................................................ 96
10.3 Classificatie o.b.v. hersenletsel ................................................................................ 97
10.3.1 Contusio cerebri: ................................................................................................ 97
10.3.2 Commotio cerebri ............................................................................................... 98
10.3.2.1 Post-commotioneel syndroom .................................................................... 98
10.3.3 Whiplash............................................................................................................. 98
10.3.3.1 Licht THL vs. whiplash .............................................................................. 98
10.3.4 Verklaring post-commotioneel syndroom .......................................................... 99
10.4 Classificatie o.b.v. schedelletsel ............................................................................. 100
10.4.1 Open schedelletsel : .......................................................................................... 100
10.4.2 Gesloten schedelletsel ...................................................................................... 100
10.5 Coma/ loss of consciousness (LOC) ...................................................................... 100
10.5.1 Glasgow Coma Scale (GCS) ............................................................................ 101
10.6 Post-traumatische amnesie (PTA) .......................................................................... 102
10.7 Pathofysiologie ....................................................................................................... 103
10.7.1 Primaire letsels ................................................................................................. 103
10.7.2 Secundaire letsels: ............................................................................................ 104
10.7.3 Chronische traumatische encefalopathie (CTE) ............................................... 106

5

,Aurélie Weverbergh 1MA PSYCH 2023-2024
VUB
10.8 Neuropsychologische problemen na een contusio cerebri ..................................... 106
10.8.1 Cognitieve stoornissen ..................................................................................... 107
10.8.1.1 Aandachtsstoornissen ................................................................................ 107
10.8.1.2 Geheugenstoornissen ................................................................................ 107
10.8.1.3 Visueel-ruimtelijke stoornissen ................................................................ 108
10.8.1.4 Taalstoornissen ......................................................................................... 108
10.8.1.5 Executieve stoornissen .............................................................................. 108
10.8.2 Emotionele veranderingen................................................................................ 108
10.8.2.1 Primaire emotionele veranderingen .......................................................... 108
10.8.2.2 Secundaire (of reactieve) emotionele veranderingen ................................ 108
10.8.3 Gedragsveranderingen ...................................................................................... 108
10.8.4 Anosognosie ..................................................................................................... 109
11 Neuropsychologie van de frontale hersenkwab ............................................................. 110
11.1 Inleiding ................................................................................................................. 110
11.1.1 Anatomie en functionele organisatie ................................................................ 110
11.2 Primaire motorische cortex .................................................................................... 111
11.3 Premotorische cortex .............................................................................................. 112
11.4 Area van Broca ....................................................................................................... 113
11.5 Frontale oogbewegingszone ................................................................................... 113
11.6 Prefrontale cortex ................................................................................................... 114
11.6.1 Aandachtsstoornissen ....................................................................................... 114
11.6.1.1 Sohlberg & Mateer .................................................................................... 114
11.6.1.2 Van Zomeren & Brouwer ......................................................................... 114
11.6.1.3 Norman & Shallice ................................................................................... 115
11.6.2 Geheugenstoornissen ........................................................................................ 116
11.6.2.1 Een gestoord werkgeheugen (Baddeley) .................................................. 116
11.6.2.2 Confabulaties ............................................................................................ 117
11.6.2.3 Een gestoord prospectief geheugen (Baddeley & Wilson) ....................... 118
11.6.3 Executieve stoornissen ..................................................................................... 118
11.6.3.1 Executieve functies ................................................................................... 118
11.6.3.2 Invloed van executieve stoornissen op het geheugen ............................... 119
11.6.3.3 Verschillende visies .................................................................................. 119
11.6.3.4 Veel voorkomende executieve stoornissen ............................................... 119
11.6.4 Emotionele en gedragsveranderingen .............................................................. 122
11.6.4.1 Frontale syndromen .................................................................................. 122
11.6.4.2 Fronto-subcorticale circuits....................................................................... 123
12 Taal ................................................................................................................................. 124

6

,Aurélie Weverbergh 1MA PSYCH 2023-2024
VUB
12.1 Taal en spraak ......................................................................................................... 124
12.1.1 Spraak ............................................................................................................... 124
12.1.2 Taal ................................................................................................................... 124
12.2 Taal en cognitie ...................................................................................................... 124
12.2.1 Mentale lexicon ................................................................................................ 125
12.2.2 Gesproken taal .................................................................................................. 125
12.3 Taalstoornissen: symptomen .................................................................................. 126
12.3.1 Stoornissen in de taalproductie ........................................................................ 126
12.3.1.1 Woordvindingsproblemen......................................................................... 126
12.3.1.2 Problemen in zinsbouw ............................................................................. 127
12.3.2 Stoornissen in taalbegrip .................................................................................. 128
12.3.2.1 Problemen op klank- en woordniveau ...................................................... 128
12.3.2.2 Problemen op zinsniveau .......................................................................... 128
12.4 Taalstoornissen ....................................................................................................... 128
12.4.1 Afasie ............................................................................................................... 128
12.4.1.1 6 syndromen .............................................................................................. 129
12.4.1.1.1 Afasie van Brocca ............................................................................... 129
12.4.1.1.2 Afasie van Wernicke: ......................................................................... 129
12.4.1.1.3 Conductie-afasie: ................................................................................ 129
12.4.1.1.4 Transcorticale afasie: .......................................................................... 129
12.4.1.1.5 Globale afasie ..................................................................................... 129
12.4.1.1.6 Amnestische of anomische afasie: ...................................................... 129
12.4.1.1.7 Overzicht ............................................................................................ 130
12.4.1.2 Hersengebieden ......................................................................................... 130
12.5 Spraakstoornissen ................................................................................................... 131
12.5.1.1.1 Dyspraxie ............................................................................................ 131
12.5.1.1.2 Dysartrie ............................................................................................. 132
12.6 Lees en schrijfstoornissen ...................................................................................... 132
12.6.1 Leesstoornissen ................................................................................................ 132
12.6.2 Schrijfstoornissen ............................................................................................. 133
13 Actie en motoriek ........................................................................................................... 134
13.1 Inleiding ................................................................................................................. 134
13.2 Organisatie van het motorische systeem ................................................................ 134
13.2.1 Neuro-anatomische hiërarchie .......................................................................... 134
13.2.1.1 Cortico-spinale projecties ......................................................................... 135
13.3 Representatie van bewegingen ............................................................................... 136
13.4 Representatie van bewegingsdoelen....................................................................... 137

7

,Aurélie Weverbergh 1MA PSYCH 2023-2024
VUB
13.5 Stoornissen ............................................................................................................. 138
13.5.1 Rubberenhandillusie ......................................................................................... 138
13.5.2 Cerebrale parese ............................................................................................... 139
13.5.3 Apraxie ............................................................................................................. 139
13.5.3.1 Ideationele apraxie .................................................................................... 139
13.5.3.2 Ideomotorische apraxie ............................................................................. 139
13.5.3.3 Andere indelingen ..................................................................................... 140
13.5.4 Alien hand syndrome ....................................................................................... 140
13.5.4.1 Anarchic hand syndrome (AHS) ............................................................... 141
13.6 Samengevat ............................................................................................................ 141
14 Geheugen ........................................................................................................................ 142
14.1 Inleiding ................................................................................................................. 142
14.2 Taxonomie van het geheugen ................................................................................. 142
14.2.1 Structuren/ systemen en processen ................................................................... 142
14.2.2 Multimodale model van Atkinson en Shiffrin: seriële verwerking .................. 143
14.2.2.1 Sensorisch geheugen ................................................................................. 143
14.2.2.2 Korte termijn geheugen ............................................................................. 143
14.2.2.2.1 Model van Baddeley: werkgeheugen ................................................. 144
14.2.2.3 Lange termijn geheugen ............................................................................ 145
14.2.2.3.1 Indeling Squire (2004) ........................................................................ 146
14.2.2.3.2 Declaratief lange termijn geheugen .................................................... 147
14.2.2.3.3 Niet-declaratief lange termijngeheugen .............................................. 150
14.3 Geheugen en hersenstructuren................................................................................ 150
14.4 Stoornissen ............................................................................................................. 151
14.4.1 Amnesie en amnestisch syndroom ................................................................... 152
14.4.2 Neurodegeneratieve aandoeningen .................................................................. 152
14.4.2.1 Delirium .................................................................................................... 152
14.4.2.2 Dementie ................................................................................................... 153
14.4.2.2.1 MCI ..................................................................................................... 153
14.4.2.2.2 Soorten dementie ................................................................................ 155
14.4.2.2.3 Dementie van het alzheimertype ........................................................ 155
14.4.2.2.4 Fronto-temporale dementie (FTD) ..................................................... 156
14.4.2.2.5 Lewy Body dementie (DLB) .............................................................. 157
14.4.2.2.6 Ziekte van Parkinson (PD) ................................................................. 157
14.4.2.2.7 Andere subcorticale dementies ........................................................... 157
14.4.2.2.8 Samengevat ......................................................................................... 159
14.4.2.3 Korsakoff syndroom ................................................................................. 159

8

,Aurélie Weverbergh 1MA PSYCH 2023-2024
VUB
14.4.2.4 Posttraumatische amnesie ......................................................................... 159
14.4.2.5 Transient Global Amnesie (TGA) ............................................................ 160
14.4.2.6 Functionele/ psychogene amnesie ............................................................. 160
14.4.2.7 Psychiatrische aandoening: depressie ....................................................... 160
14.4.2.8 Maglinering ............................................................................................... 160
15 Epilepsie en hersentumoren............................................................................................ 161
15.1 Epilepsie ................................................................................................................. 161
15.1.1 Omschrijving .................................................................................................... 161
15.1.2 Pathofysiologie van de epileptische aanvallen ................................................. 161
15.1.3 Classificatie ...................................................................................................... 162
15.1.3.1 Aanvalsclassificatie ................................................................................... 162
15.1.3.1.1 Tonisch-clonische aanval ................................................................... 162
15.1.3.1.2 Abscence ............................................................................................. 163
15.1.3.2 Epilepsiesyndromen .................................................................................. 163
15.1.4 Behandeling ...................................................................................................... 164
15.1.4.1 Anti-epileptica........................................................................................... 164
15.1.4.2 Neurochirurgische behandeling ................................................................ 165
15.1.4.3 Nervus vagusstimulatie ............................................................................. 165
15.1.4.4 Deep brain stimulation .............................................................................. 165
15.1.4.5 Ketogeen dieet .......................................................................................... 165
15.1.5 Neuropsychologische gevolgen........................................................................ 165
15.1.5.1 Netwerktheorie .......................................................................................... 166
15.1.5.2 Anti-epileptica........................................................................................... 166
15.1.6 Cognitief functioneren ...................................................................................... 166
15.1.7 Psychiatrische stoornissen ................................................................................ 167
15.1.8 Psychosociale effecten ..................................................................................... 168
15.2 Intra- en extracraniële tumoren .............................................................................. 169
15.2.1 Intracraniële tumoren ....................................................................................... 169
15.2.1.1 Primaire hersentumoren ............................................................................ 169
15.2.1.2 Secundaire hersentumoren( metastasen) ................................................... 169
15.2.1.3 Cognitieve stoornissen .............................................................................. 170
15.2.1.3.1 Tumor als oorzaak .............................................................................. 170
15.2.1.3.2 Neurochirurgie als oorzaak ................................................................. 170
15.2.1.3.3 Radiotherapie als oorzaak ................................................................... 170
15.2.1.3.4 Medicatie als oorzaak ......................................................................... 171
15.2.1.3.5 Neuropsychiatrische symptomen en vermoeidheid als oorzaak ......... 171
15.2.2 Extracraniële tumoren ...................................................................................... 172

9

, Aurélie Weverbergh 1MA PSYCH 2023-2024
VUB
15.2.2.1 Voorbeeld: borstkanker ............................................................................. 172
15.2.3 Intra-en extracraniële tumoren ......................................................................... 172
15.2.3.1 Stemmingsstoornissen en vermoeidheid ................................................... 172




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