| CHAPTER I |
Introduction to Clinical Neuropsychology
Historical perspective
Localisation pg 33-36
Phrenology - Gall (17-1800s)
Phineas Gage - left frontal lobe, behaviour inhibition. (17-1800s)
Broca’s area - left frontal lobe, language production (1800s)
Wernicke’s area - left temporal lobe, language comprehension (1800s). Wernicke
also found out about the connections between different language area’s in the brain, and
when these connections are damaged it can cause problems where (f.e.) people can
understand and speak, but not repeat spoken words (conduction aphasia).
Aphasia, agnosia, apraxia, amnesia - terms coined in the 1800s
Lissauer (1800s) - object recognition is in two stages; apperception and association.
Apperception: the structure and characteristics of an object are perceived and
recorded. Association: the features are linked to knowledge or conceptual information
stored in the brain’s semantic system.
Experimental Psychology pg 36-38
Wundt (18-1900s) - founder experimental psychology. Standardisation of
measurement. Not applicable to patients with brain injury.
Donders (1800s) - founder of chronometric analysis of mental processes. Developed
several reaction time tasks (simple/detection, choice/discrimination, go-no-go/inhibition)
and said the differences between said tasks say things about cognitive functions:
subtraction method.
Galton (18-1900s) - psychometrics development. Comparing an individual to a
representative group.
Binet (18-1900s) - developed first IQ test. Then stanford-binet test for army
recruitment.
Modern day
Luria’s functional theory pg 38-41
All brain areas are involved in 3 core functions
(units), that interact with each other;
(1) subcortical brain areas + brainstem: regulation
of arousal and attention (regulation/activation)
(2) posterior brain areas: processing information
entering through the senses (input)
(3) anterior brain areas: planning and organising
actions (output)
1
, Unit 2 and 3 have primary, secondary and tertiary
processing zones, or ‘stages’ that the information
goes through. For instance, input through the eyes
(modality-specific/primary) gets processed and
analysed (secondary) and then integrated with
information from other senses (not modality-
specific/tertiary).
Furthermore, linguistic processes happen in the
left-hemisphere, and non-linguistic processes in the right-hemisphere.
So Luria’s model says:
A type of processing takes place in a functional unit within one hemisphere in an
hierarchically ordered zone.
This model is now outdated and the hierarchical processing zones are unsupported
by empirical evidence, but he formed the basis of measuring cognitive (sub)functions in a
systematic way.
Geschwind’s behavioral neurology pg 42
Geschwind (, Kaplan and Goodglass) (1900s) examined brain functions in patients
with brain injuries. Functional, interconnected centers exist in the brain. Dissociation:
selective loss in cognitive functioning - Patient A with a lesion in region X is impaired on
task A but not task B. Double dissociation - Patient B with lesion in region Y is impaired on
task B but not on task A. This provides a strong argument for functional differentiation
(ch2).
Development of neuropsychological tests pg 42-44
Benton (1900s) developed several standardised methods for motor, sensory,
visuospatial, language and memory impairments, and to localise brain damage before
brain imaging. His standardised methods improved the sensitivity, specificity and
reliability of neuropsychological testing.
Milner (1918) expanded on memory functions, studying Henry Molaison (H.M. Ch7)
who suffered severe memory impairment after bilateral temporal lobectomy. Also
researched frontal lobe in memory and temporal organisation, and developed new tasks
to examine cognitive functions.
Kaplan and Goodglass (1900s) developed tests aimed at measuring language
disorders (incl the Boston Naming Test) and focused on carefully observing patients’
behaviour during tests (now known as the Boston Process Approach).
The International Neuropsychological Society (INS) was founded in 1967.
The first edition of Neuropsychological Assessment was published by Lezak (1976).
Development of Cognitive Theory (case studies) pg 44-45
After WWII the Brain Injuries Unit was established (UK): research characterised by
use of case studies.
Zangwill (1900s) - research on memory (assessment) through case studies. He
examined cognitive (dys)functions by brain-injuries and helped with lost abilities. He
systematically put assessment and intervention into the NHS.
2
Introduction to Clinical Neuropsychology
Historical perspective
Localisation pg 33-36
Phrenology - Gall (17-1800s)
Phineas Gage - left frontal lobe, behaviour inhibition. (17-1800s)
Broca’s area - left frontal lobe, language production (1800s)
Wernicke’s area - left temporal lobe, language comprehension (1800s). Wernicke
also found out about the connections between different language area’s in the brain, and
when these connections are damaged it can cause problems where (f.e.) people can
understand and speak, but not repeat spoken words (conduction aphasia).
Aphasia, agnosia, apraxia, amnesia - terms coined in the 1800s
Lissauer (1800s) - object recognition is in two stages; apperception and association.
Apperception: the structure and characteristics of an object are perceived and
recorded. Association: the features are linked to knowledge or conceptual information
stored in the brain’s semantic system.
Experimental Psychology pg 36-38
Wundt (18-1900s) - founder experimental psychology. Standardisation of
measurement. Not applicable to patients with brain injury.
Donders (1800s) - founder of chronometric analysis of mental processes. Developed
several reaction time tasks (simple/detection, choice/discrimination, go-no-go/inhibition)
and said the differences between said tasks say things about cognitive functions:
subtraction method.
Galton (18-1900s) - psychometrics development. Comparing an individual to a
representative group.
Binet (18-1900s) - developed first IQ test. Then stanford-binet test for army
recruitment.
Modern day
Luria’s functional theory pg 38-41
All brain areas are involved in 3 core functions
(units), that interact with each other;
(1) subcortical brain areas + brainstem: regulation
of arousal and attention (regulation/activation)
(2) posterior brain areas: processing information
entering through the senses (input)
(3) anterior brain areas: planning and organising
actions (output)
1
, Unit 2 and 3 have primary, secondary and tertiary
processing zones, or ‘stages’ that the information
goes through. For instance, input through the eyes
(modality-specific/primary) gets processed and
analysed (secondary) and then integrated with
information from other senses (not modality-
specific/tertiary).
Furthermore, linguistic processes happen in the
left-hemisphere, and non-linguistic processes in the right-hemisphere.
So Luria’s model says:
A type of processing takes place in a functional unit within one hemisphere in an
hierarchically ordered zone.
This model is now outdated and the hierarchical processing zones are unsupported
by empirical evidence, but he formed the basis of measuring cognitive (sub)functions in a
systematic way.
Geschwind’s behavioral neurology pg 42
Geschwind (, Kaplan and Goodglass) (1900s) examined brain functions in patients
with brain injuries. Functional, interconnected centers exist in the brain. Dissociation:
selective loss in cognitive functioning - Patient A with a lesion in region X is impaired on
task A but not task B. Double dissociation - Patient B with lesion in region Y is impaired on
task B but not on task A. This provides a strong argument for functional differentiation
(ch2).
Development of neuropsychological tests pg 42-44
Benton (1900s) developed several standardised methods for motor, sensory,
visuospatial, language and memory impairments, and to localise brain damage before
brain imaging. His standardised methods improved the sensitivity, specificity and
reliability of neuropsychological testing.
Milner (1918) expanded on memory functions, studying Henry Molaison (H.M. Ch7)
who suffered severe memory impairment after bilateral temporal lobectomy. Also
researched frontal lobe in memory and temporal organisation, and developed new tasks
to examine cognitive functions.
Kaplan and Goodglass (1900s) developed tests aimed at measuring language
disorders (incl the Boston Naming Test) and focused on carefully observing patients’
behaviour during tests (now known as the Boston Process Approach).
The International Neuropsychological Society (INS) was founded in 1967.
The first edition of Neuropsychological Assessment was published by Lezak (1976).
Development of Cognitive Theory (case studies) pg 44-45
After WWII the Brain Injuries Unit was established (UK): research characterised by
use of case studies.
Zangwill (1900s) - research on memory (assessment) through case studies. He
examined cognitive (dys)functions by brain-injuries and helped with lost abilities. He
systematically put assessment and intervention into the NHS.
2
