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College aantekeningen B&C 2: Clinical Neuropsychology (SOW-PSB2BC10EA)
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Brain & CognitionHoorcollege 1
Clinical Neuropsychology
“Scientific area that studies the relations between brain and behaviour especially the clinical
applicability of assessment, treatment, and care of individuals with (presumed) cognitive
(dys)function as a result of developmental disorders, neurological disorders (brain diseases
or damage), or psychiatric disorders.”
Behaviour in a broad sense
Behavioral symptoms might be latent variables that objectively can be assessed through
tests. But it is also important that you take notice of subjectively observable aspects of the
patient by him/herself or significant others.
Before and after neuroimaging
In the late 1960s neuroimaging was developed. That had a big impact on neuropsychological
assessment. Before this, they thought that many functions in the brain worked
independently. Now we know that they are related to each other.
Before neuroimaging they measured the skull and looked at dents and bumps. After this
they worked with systematic patient descriptions, after patients had died.
Clinical neuropsychology
- Has become highly relevant in modern-day (mental) health care
o Increase in people with brain damage or dysfunction.
▪ Decrease in mortality rates because of improvements in medical care
▪ Aging
▪ More interest in quality of life
o → a clinical neuropsychologist is a scientist practitioner whose focus lies on
behavior and cognition
o → a clinical neuropsychologist is not a brain researcher
- The brain has ‘persuasion’. Neuropsychology and the brain are ‘fancy’. They get in
the news etc.
,The international Classification of Functioning-ICF
ICF is useful in clinical neuropsychology
- Description of consequences of brain disease/disorder at three different levels:
impairment – limitation – restriction (‘handicap’)
- Identify moderating factors
- Relevant for understanding subjective complaints and problems in daily life (school –
work – social functioning)
- Identify target for treatment or optimalisation
Example
,Hoorcollege 2 “Memory disorders – Amnesic syndrome, Korsakoff’s
syndrome and other alcohol-related cognitive disorders”
Are memory problems a sign of brain damage?
- Adjusting to changes in routine
- Repeated checking of whether plans have been carried out
- Forgetting what has just been said (by the person themselves or by others)
- Reading the newspaper
- Forgetting to state important information
- Forgetting routes and locations of objects
- Repeating stories, questions, anecdotes
- Finding words (‘tip of tongue’)
- Learning a new skill
These are signs that reflect forgetfulness that can happen to all of us. When do we see these
as deficits? When they start to interfere with your daily life. And also not happening once,
but more often/worsen over time.
Memory
Definition: ability to encode information, store it and retrieve it
Encoding → storage → retrieval. In all of these 3 phases there can go something wrong.
Procedural learning → memory for procedures, learning to do something (writing a bike)
Episodic memory → a type of long-term memory that involves conscious recollection of
previous experiences together with their context in terms of time, place, associated
emotions, etc.
Semantic memory → a type of long-term memory involving the capacity to recall words,
concepts, or numbers, which is essential for the use and understanding of language.
, Neuroanatomical structures involved in memory processes
Three highlighted are most important for memory
Episodic memory formation
Transition from WM to LTM
- How is the transition from working memory (prefrontal) to long-term memory
achieved?
- Information must be permanently stored → episode formation
- ‘Binding’: associative working memory (memories that go together)
o Episodic buffer: involved in LTM encoding
o Also involved in the retrieval of previously encoded knowledge
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