Neuropsychology lectures and book
,Index
Lecture 1 – The Neuropsychologist ........................................................................................................ 4
What is a neuropsychologist and what do they do ....................................................................... 4
How do brain lesions led to the modern understanding of brain function and organization. .... 7
Neuroanatomy: Blood flow, neurons, & major structures ........................................................... 9
Things from the book.................................................................................................................... 13
Lecture 2 – The (further) organization of the brain ............................................................................. 19
How neurons function, transmit & integrate information.......................................................... 19
Mechanisms of neuronal change ................................................................................................. 22
Recording brain activity: Sling-cell recordings, & neuroimaging devices ................................... 25
Things from the book.................................................................................................................... 27
Lecture 3 – Lateralization and plasticity of the brain .......................................................................... 33
Human brain development .......................................................................................................... 33
Age-related disorders ................................................................................................................... 39
Lateral cerebral organization ....................................................................................................... 41
Human brain plasticity and differences in cerebral organization ............................................... 43
Things from the book.................................................................................................................... 46
Lecture 4 – The occipital lobe ............................................................................................................... 54
What is vision? .............................................................................................................................. 54
Anatomy ........................................................................................................................................ 57
A theory of occipital lobe function............................................................................................... 59
Visual disorders............................................................................................................................. 61
Things from the book.................................................................................................................... 62
Lecture 5 – The temporal lobe ............................................................................................................. 66
Topic entryway: Temporal lobe epilepsy ..................................................................................... 66
Temporal lobe function & networks ............................................................................................ 69
Disorders and symptom assessments .......................................................................................... 71
Things from the book.................................................................................................................... 73
Lecture 6 – The parietal lobe ................................................................................................................ 77
Parietal lobe anatomy & function ................................................................................................ 77
Disorders and symptom assessment ........................................................................................... 80
Things from the book.................................................................................................................... 84
Lecture 7 – The frontal lobe ................................................................................................................. 88
Frontal lobe anatomy and function ............................................................................................. 88
Disorders and symptoms assessments ........................................................................................ 91
Things from the book.................................................................................................................... 95
,Lecture 8 - The human (social) brain and its disorders ....................................................................... 99
The human social brain ................................................................................................................ 99
Things from the book.................................................................................................................. 104
Lecture 9 – Practice exam ................................................................................................................... 109
,Lecture 1 – The Neuropsychologist
Overview
- What is a neuropsychologist and what do they do
- How brain lesions led to the modern understanding of brain function and organization
- Neuroanatomy: Blood flow, neurons, and major structures
What is a neuropsychologist and what do they do
What is a neuropsychologist?
- A clinician and/or scientist who…
o Uses neurology, neuroscience, and psychology.
o To understand how behaviors correlate with brain function.
o To assess ‘normal’ and ‘impaired’ cognitive, social, physical, and emotional
functioning.
▪ Neuropsychologist usually work with both ‘healthy typical’ people as well as
with people that have some ‘impairment’.
▪ The impairments are usually neurological disorders, but more recently other
disorders are included as well.
- Neuropsychology is usually clinical in nature.
o Neuropsychologists are not medical doctors.
o But they do clinical tasks that are usually diagnostic → They look at the symptoms of
the patients and how they can describe the disorder.
o Neuropsychologists may be giving referrals to specialists for treatments.
o Research tasks may include investigating causes of a disorder, its
brain/behavioral/cognitive processes, its diagnostic approaches, the efficacy of
treatments (how well they work), etc.
Donald Hebb
- Considered the father of neuropsychology.
o Hebbian theory → Neural pathways develop based on experiences → As pathways
are used more, they become faster and stronger.
▪ This turned out to be true.
- Early neuropsychology was closely linked to brain injury and dementia research and
diagnosis.
o Relationship between loss of brain function (because of brain injury) and change in
thoughts/behaviors easier to observe.
o Modern neuropsychology includes a variety of disorders.
▪ For example, the teacher works mostly with brain imaging of social cognition
and started in autism research and never worked on dementia.
Neurological examination
- First it starts with patient’s history.
o How long are the symptoms present.
o What is your life like (background).
o History of other disease (also of the family).
- Then you look at state of awareness.
, o Alert, drowsy, stupor, confused.
o Speech abnormalities, facial asymmetries, body posture.
▪ Facial asymmetries can for example indicate a stroke.
o Emotions → Agitated, anxious, depressed, apathetic, restless.
- There is also a physical examination.
o Blood pressure, brain imaging (looking for lesions and brain shrinking), reflexes, pain,
muscle movement, coordination, smell, etc.
- This kind of neurological examination helps to look at more classic neurological disorders.
o Strokes, injuries, and lesions may show asymmetry, loss of function.
o Parkinson’s may show loss of smell and motor changes.
o Dementia may show memory loss, disorientation, or agitation.
This neurological exam was the classic clinical approach in the clinical psychology but in the fifties till
seventies this changed.
- In 1950 Roy Grinker started to apply “bio” to psychology.
- In 1977 George L. Engel proposed a medical perspective and applied “social” to medicine.
o This was seen as very radical because they thought that with medicine you should
treat the organ that is affected (the brain) and not the social problems.
- This led to the development of the biopsychosocial model.
Biopsychosocial model of neuropsychological assessment.
- Neuropsychological assessment:
o Combines many tests depending on patients’ symptoms.
o May include IQ, cognitive, and psychometric tests.
- Biopsychosocial model:
o Social support networks (friends, family) influence health outcomes.
▪ Idea → When you feel supported and feel you are getting the right
treatment, the medical outcome will be better.
o Patients’ sense of wellbeing influence outcomes.
o Sometimes a mismatch between the patients’ needs and their social network (e.g.,
patient wanted to stay home, family thinking they should work) or environment
(e.g., needing a quiet place to sleep but living somewhere noisy) can add stress that
may impair healing.
How did the biopsychosocial model change neuropsychology?
- Premise → A person is not made of isolated organs, but
functions as a whole.
- You need good biological, social, AND psychological
circumstances to have good mental health.
Example from dementia
- Dementia
o Umbrella term for impaired memory, cognition, and decision-making.
▪ Common causes → Alzheimer’s, Huntington’s disease, multiple sclerosis
(MS).
o Symptoms include poor mood and perception.
▪ May include depression, apathy, and hallucinations.
, - Neurological examination → Neuropsychiatric Inventory (NPI).
o Used to characterize dementia in the clinic.
o Assesses frequency and severity of symptoms.
o Assesses changes in behavior.
▪ Is it getting worse? Disease progression?
- Biopsychological perspective in dementia:
o Usually applied after the neurological examination as
part of treatment plan.
o External triggers are assessed through history interview.
▪ For example, one study found that 80% of
dementia symptoms had external triggers.
o Social support and environmental well-being are also considered in treatment plan.
Biopsychosocial perspective helped lead to other social-clinical models.
- Part of our social well-being is our cultural fit.
o Beliefs from our community shape our experience of medicine.
o Sometimes there is a mismatch between you and the culture in your surrounding
which can lead to social distress → Has influence on how well you can handle other
kinds of distress.
- Not all symptoms are symptoms.
o Certain beliefs are cultural.
o Sometimes hallucinations are even considered culturally appropriate (spiritual).
▪ However, these hallucinations are often not seen as real hallucinations by
medical standards.
▪ So, depending on background something can be a medical hallucination or a
spiritual hallucination that is part of their culture.
▪ This was ignored for a very long time and therefore a lot of people were
being treated as if they had psychiatric problems even though they had just
spiritual hallucinations (cultural differences) and not medical ones.
- Cultural Formulation Interview (CFI).
o Used to determine whether something is
pathological or cultural.
o This form tries to help the clinicians to understand
the language (culture) of the patient → What kind of
words does the patient use to describe the symptoms
and does these words mean the same to the clinician.
▪ The clinicians are often searching for certain
words that patients use to describe their
symptoms but because of cultural differences
the patient could use other words.
Example from dementia and considering culture.
- Might assess whether apparent ‘hallucinations’ or ‘delusions’ are considered odd by family
members.
o Do the experiences described have a cultural place?
- Might assess relationship to healthcare system.
o More about the psychosocial aspects of cultural diversity.
o Do they believe that Western biomedicine is a valid approach?
