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Block 3.6. Neuropsychology (Clinical Specialization): Problem 3 Executive Functioning, English summary €6,49   In winkelwagen

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Block 3.6. Neuropsychology (Clinical Specialization): Problem 3 Executive Functioning, English summary

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Summary of PRoblem 3 referring to executive functioning, detailed summary of the articles and chapters of the course. The grade obtained for the course was 8.6.

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  • 22 maart 2021
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  • 2019/2020
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Chapter 22: Attention
Attention & Consciousness
 Attention: selective focus and narrowing to a part of sensory environment or a class of stimuli (e.g. sensory input,
motor info, memories, internal states)
 Unconscious
 Conscious
 Consciousness: awareness and meta-awareness related to the ability to organize sensory and motor abilities
 People with neglect have also cognitive and behavioral neglect
 Main difference: attention focus on specific features of the world and consciousness is not selective (gist of the
world)

Attention
Automatic and Conscious processing

 Automatic process, covert: unconscious, non-intentional, involuntarily, without awareness or interference
 It can be innate trait or obtained by training
 Bottom-up : stimulus centered, e.g. stopping at a red light
 Conscious, overt: effortful, control, attentive
 Top-down : conceptually driven, relies on info in memory e.g. searching for street sign

Treisman’s Feature Search model-Feature integration theory

 Feature search: “Pop-out effect” search is independent of number of distractors, target has a pop out feature
e.g. extra tail
 Serial search: person scans, distractor dependent
 Conjunction search: focused attention, serial process, searching for
particular combinations, similarities between targets-distractors e.g. form
and color differences or thick line and form.
Attention:
1. Pre-attentive stage: stimuli is presented, feature search (biological sign)
2. Attentive stage: is directed to the fixation point-attention spotlight, and all
features are integrated to form a unitary object
3. Perceived (object file)  stored in memory (object recognition)
o Odd-face task: sad faces faster detected than happy faces (evolutionary
perspective
Neurophysiological evidence

 Neuronal selective attention (V4 & TE – ventral system): pre-training  neurons respond to stimuli in all
locations, post-training  neuron responds only to stimulus in a specific location, ignoring the extra info
 Selective attention: when a task is more demanding and requires extra attention, firing is increased and neuros
change their stimulus selectivity
 Pulvinar complex (thalamus) reward = more activity, projections, maybe involved in Treisman’s attention
 Divided attention: bottleneck of attention, when a task is more demanding we stop any other task to focus on that,
we pay attention to one task per time, if we try to divide attention (multitask) performance suffers
 Parallel processing: serial processing (brief cycles of scene processing), cross-modal (sensory interaction,
decrease in one system increase in other)  if one modality requires extra attention = performance drops
 Functional evidence: moving target expt  i)shift attention, ii) stimulus fixation, when fixation increase in
posterior parietal cortex, left pc was active if stimuli was present in right fields, right pc active in both cases
 Selective attention: V4, V3, TE, PP
 Divided attention: DLFPC (different activation in selective and bimodal), ACC, PP
 Parietal: location, Occipitotemporal: features


Attention networks

, Networks Function/Location Modulation
 RAS (reticular activating system): maintain alertness
Noradrenergic system
Alerting  Noradrenergic projections from locus coeruleus brain stem 
(norepinephrine)
forebrain (preparation for rapid stimulus detection)
 Main function is prioritizing of sensory input (modality, location)
Dorsal = top-down, visuospatial Ventral = bottom-up, re-orienting
o Location: frontal eye o Location: TPJ,VPFC
Orienting fields, IPS, right- o Additions: pulvinar cortex Cholinergic system
lateralized (Th)  Treisman
o Lesions: neglect o Function reduction of
competing sensory info
Two networks with top-down functions
1. DLPFC - parietal network: instructions in the start of task,
moment-to-moment
Dual executive Dopamine
2. AC (medial frontal) – anterior insula: sustained activity during
a task
 Not universally accepted, some prefer single executive system


 Self-control/regulation: prefrontal and ACC
 Impaired networks: stress interferes with DLPFC, AC and
parietal lobe activation
 Increase of global synchrony in the brain during attention

Inattention
A. Absence of visual attention
1. Inattention blindness: do not realize event that happens
simultaneously with their task (Gorilla)
2. Change blindness: inability to realize changes of the presence, identity and location of objects in scenes
 Person change, items appear/disappear take seconds to notice
3. Attentional blink: inability to monitor a 2nd target after 500ms of the 1st, does not allow awareness of second
 The notice all of them if they are told to
o WHY?: unattended stimuli are not processed, executive attentional network selectively activate areas in
ventral stream people with lesions have problems with conscious attention.
B. Sensory Neglect: right parietal (both left and right field), left neglect can occur (no back-up)
 Prism adaptation: great improvements, even two hours after removal superior to googles
o Frontal lesions disrupt prism adaptation, frontal lobes are central in controlling movement through
corollary discharge (sign from motor to sensory system indicating movement was produced)
o Neglect can also occur from frontal lobe lesions
o Frontal attention influences the way we perceive space

Executive functioning as a predictor of stroke
rehabilitation outcomes, Beckett
Objective: The purpose of this research was to assess the contribution of executive functioning (EF) at
discharge to the prediction of functional status at several time points between discharge from a stroke
rehabilitation unit and 12months, in comparison with depression, mental status, comorbidity, and pain
at discharge, and daily functioning prior to admission
Results: Executive functioning, depression, and pre-admission ADL functioning were strong
predictors of outcome at all five time points, while neither comorbidity nor mental status were
retained in any regression models. Pain at discharge was a significant predictor at discharge and
6month follow-up.
Conclusions: Executive functioning and depression are robust predictors of functional status following
stroke rehabilitation. Although not consistently a significant predictor, pain might also be a useful
addition to predictive models.

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