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psych 119L
neuropsychology
| Question | Answer |
|---|---|
| where does aphasia occur? | all Left Hemisphere |
| an acquired disorder of language? | Aphasia |
| Pre-rec for aphasia? | Someone has already learned how to speak/comprehend/read/write before the damage |
| Language is the ability to? | speak, comprehend, read, write |
| Facts about Paul Broca? | 1861 – Paris, France – Paul Broca |
| What type of analysis did Broca use? | post-mortem |
| Broca’s Area responsible for? | speech production |
| Location of Broca's Area? | Left Posterior – Inferior Frontal Lobe |
| 1861 marked the beginning of ? | modern functional localization |
| Speech is slow and hesitant, great difficulty in speaking, understand but not speak | Broca’s Aphasia / Expressive Aphasia |
| - Special difficulty with Conjunction Words – don’t understand | Agrammatism, i.e. and, but, by, or, etc. |
| – another scientist who collected data on 30 patients with experessive aphasia? | Dax, 1830’s findings ignored, same as Broca |
| 1874? | Carl Wernicke |
| Location of Wernicke's Area? | Posterior First Temporal Gyrus |
| Function of Wernicke's? | Critical for language comprehension |
| Wernicke’s Aphasia? | Patient speaks fluently, but they do not make any sense Patient does not understand a single word said to them |
| Track of fibers that travels between Broca and Wernicke | Arcuate Fasiculus |
| Location of Arcuate (lobe)? | In the Parietal Lobe |
| damage to Arcuate Fasiculus (aka Dissociative Aphasia)results in? | Conduction Aphasia |
| Conduction Aphasia Symptoms? | 1) Inability to repeat sequences of words spoken by the examiner 2) Issues with processing and producing same words |
| What can patients with Conduction Aphasia do? | 1) No problems in memory 2) Recite alphabet, days of the week |
| track of fibers connecting 2 areas in the same hemisphere | Fasiculus |
| inability to retrieve single words from the mental lexicon while speaking | Anomia |
| Who can have anomia? | Broca aphasics, Conduction |
| Difficulty of word types for patients with anomia? | Nouns >, Verbs >, Adjectives > (Hardest to retrieve are nouns and DEC order) |
| • Nouns, like names, are difficult because? | they are HIGHLY specific, NOT redundant |
| word substitution errors? | Paraphasias |
| Anomics make..? | paraphasias |
| difficulty retrieving single words (type of anomia)? | Word Production Anomia |
| Damage done where in word production Anomics? | Damage to Broca and Arcuate Fasiculus |
| How do we know Patient knows what he or she wants to say, but just cannot produce it? | If we prompt them, then they DO know - need cues |
| Cannot look at an object and name it? | Word Selection Anomia |
| Damage to ? | left temporal-occipital junction |
| Word Selection Anomia patients benefit from cues? | NO |
| They can… | Can provide a functional description of the object i.e. its used to drink water |
| Implications of Word Selection Anomia for how we ? | store words, in our mental lexicon |
| Do they benefit from the examiner giving them the word they are looking for? | NO |
| Everything the same as Word Selection, but also CANNOT even provide the description of the word they are looking for | Semantic Anomia (most severe) |
| Damage for Semantic Anomia done to? | Angular gyrus and peri-angular gyrus (area around the angular) |
| Lose the symbolic meaning of the word they are looking for | Semantic Anomia |
| What 2 are far more severe than the anomias? | Broca’s and Wernicke’s Aphasia |
| Paraphasias? | particular word errors made in anomics, word substitution (5 types) |
| 5 types of Paraphasias? | 1) Phonemic Paraphasia 2) Verbal 3) Phonosemantic Blends 4) Neologistic 5) Perceptually Influenced Semantic Erros? |
| Problem is with the sound, words that rhyme? | Phonemic Paraphasia “I put the plate on the maple” (instead of table) |
| Word Production Anomics are most prevalent? | with Phonemic Paraphasia |
| Saying “Taj Mahal” instead of “Pyramids”, “Sea Horse” for “Unicorn”? | Verbal Paraphasia / Semantic Paraphasia -Found in any of the anomias |
| Semantic/verbal paraphasia shows? | Shows words in our mental lexicon are stored in categories |
| Ex. Show patient a picture of an igloo, the patient calls it an “eskloot” | Phonosemantic Blends Blend the word “Eskimo” and “igloo” |
| Patients simply invent/make up words | Neologistic Paraphasia |
| Errors that are made when looking at pictures | Perceptually Influenced Semantic Errors |
| Example of Perceptually Influenced? | See an “steering wheel” and call it a “flower” |
| Left hemispheres damages are FAR more pronounced because? | they often have language issues |
| Someone is deaf and mute, but knows sign language and has damage in Brocas? | Will have difficulty in producing sign language, slow!!! |
| Application of the Aphasia? | Same applies to Wernicke’s Aphasia and all the Anomias |
| Difficulty in pointing to colors named by the examiner | Color Aphasia |
| 3 Facts about Color Aphasia patients? | 1) Difficulty in saying/pronouncing the names of colors 2)No specific damage in the brain where the damage is located 3)Can be seen with any of the anomias/aphasias |
| Complete loss of the ability to read due to acquired damage? | Alexia |
| 2 Types of Alexia? | 1) Literal Alexia / Letter Blindness 2) Verbal Alexia / Word Blindness |
| Cannot say the name of individual letters | 1) Literal Alexia / Letter Blindness Cannot say “T”, but can say “Tee” |
| whole words cannot be read, ONLY single letters | Verbal Alexia / Word Blindness Can read single letters |
| Different types of Alexias can be seen with different types of aphasia, because? | No specific location |
| Loss of the ability to write | Agraphia (Sometimes it can be partial or sometimes it can be complete) |
| Cannot read, but CAN write | Alexia without Agraphia |
| Alexia without Agraphia Shows? | dissociation of reading and writing |
| • Published a paper on Alexia without Agraphia | Dejerine – French Neurologist 1892 |
| Patient can read what written on his back and palm, showing? | Showed that the mental-visual lexicon was intact with this patient |
| HANDEDNESS | |
| Percent right/left handed? | 90% of the world population is right-handed, 10% left-handed |
| Lateralization of language in left-handed and right handed? | 96% of right-handers, language is assumed to be lateralized to the Left Hemisphere while 4% lateralized to Right Hemi |
| Left-handed people percent lateralization? | 70% of left-handed people on Left Hemi, with 15% on the Right Hemi, and the remaining 15% bilaterally localized |
| What is handedness? | The predominant use of one hand for most activities Important in writing and eating |
| Test that determines someone’s handedness | Harris-Test of Lateral Dominance |
| Measures other important factors such as legedness, eyedness Done HOW? | Cover face, and look between 2 hands |
| Ambidextrous people are usually? | Left-handed people |
| Our handedness is under control of? | ***Genetic Control*** |
| Handedness In Primates? | 1) They do have handedness 2) 50/50 right/left |
| Only humans are unique that we have? | a preference for certain hand use |
| Somehow handedness is related to ? | language localization |
| Test Used before anterior-temporal lobe lobectomy (epilepsy alleviation) | Wada Test |
| anterior-temporal lobe lobectomy removes? | Involves removal of most of Hippocampus and Amygdala on one side |
| Wada Test to determine? | memory capacities of the un-removed Hippocampus |
| Process of Wada Test? | Anesthetize one hemisphere for 4-6 minutes, by injecting sodium-anatol into the Carotid of either side |
| 96% of the time, patients couldn’t... | patients count not speak when the Left Hemi was put to sleep |
| 4% of the time, | patients could not speak when the right hemi slept |
| These percentages represent a population of vague Functional Reorganization | vague Functional Reorganization |
| Handedness develops between the ages of 3 and 5 | of 3 and 5 Up until that age, children switch |
| Recovery/Improvement from aphasia faster? | They improve faster if the person is Left Handed!!! |
| second fastest recovery? | Patients who have a first degree relative who is Left Handed |
| Slowest recovery patients? | Right-handed people without any first degree Left Handed relatives |
| IMPLIES? | relationship with language and the way it is organized in the brain |
| Left handers survey, 1970’s, done by? | Paul Bakan |
| Paul Bakan looked at? | 1)Looked at left handed people who did not have familial left handed relatives |
| FOUND? | Left handedness appeared most often in the first born of a mother, particularly if the first born was a male |
| Argued that during birth, | the pressure of the canal would cause some kind of damage to the Left Hemisphere, which leads to R. Hemi preference (L. Hand) |
| ALSO, the last born would also be what handed? | L. Handed, because Mother is less healthy |
| What gender is more left handed? | more left-handed Males |
| Males are neurologically ....? | weaker than females |
| Gender that is far more prevalent in miscarriages ? | Males |
| High percent of Spontaneous left handed people in? | neurological patients |
| “too much testosterone in the amniotic fluid produced by the mother can lead to the condition where the left hemisphere doesn’t fully develop” | Norman Geschwind |
| Edinburgh Test – tests for? | handedness |
| the loss of the ability to carry out purposeful movements due to brain damage? | Apraxia (Patients who are able to move and not paralyzed) |
| Liepmann (1900’s) - First neurologist to ? | define and describe different type of Apraxia |
| Type of Apraxias | 6 Types |
| Inability to carry out spoken commands that are symbolic/non-symbolic | Ideomotor Apraxia |
| Ex. Inability to wave goodbye when instructed to do so. Show the loss of? | Loss of symbolic, as well as non-symbolic “put your hand under your chin” – cannot do |
| Damage done in Ideomotor Apraxia? | DAMAGE to the junction of the posterior part of the left temporal and parietal lobes |
| Loss of the ability to use objects | Ideational Apraxia Ex. Lock and key, hammer and nail |
| Damage where? | Left or Right Posterior Parietal Lobes |
| Loss of the ability to dress properly knowledge of how to get dressed | Dressing Apraxia |
| Damage in Dressing Apraxia? | Damage: Left Hemisphere Parietal lobe |
| Not able to carry out movements in the face | Facial Apraxia |
| Type of Damage? | Bilateral damage |
| Cannot wink, or smile when told to do so, HOWEVER | However, they will SMILE spontaneously upon hearing a joke |
| SO, this implies? | different pathways are responsible for emotion |
| Stand like a boxer – will not be able to change posture | Trunkal Apraxia, Bilateral damage |
| Inability to sing, whistle, or hum | Motor Amusia / Avocalia |
| Symptoms? | Vocal apraxia in movements of the tongue, larynx - can speak but selectively cannot sing |
| Damage Vocal Apraxia | Damage Damage: varied regions in the brain, no specific localization |
| Apraxia in the movements of the head to indicate ‘yes’ or ‘no’ | This selective apraxia has no specific name Damage: varied regions, just don’t know where |
| Sex Differences | |
| Are Brains of men and women are not different | not that different |
| Who outerforms Right Hemi tasks | are ones that men outperform women in -Use different strategies, take longer |
| What tasks are men better at? | Men – better at mental rotation tasks, visuo-soatial |
| Queen of Sex Differences? | Dorin Kimura |
| She differentiated between ? | Personal Space and Extrapersonal Space |
| o MEN – better at ? | extrapersonal space tasks Outside of the home |
| o WOMEN – better at? | personal space tasks |
| Tasks the Women are better than men?(3) | 1) Rhyming 2) Reading (faster, word recognition) 3) can use More words |
| It is a theory that was used to explain why women were not as good as men in visual-spatial tasks | The Crowding Out Effect |
| What explanation does the crowding effect have? | Left Hemi functions “invaded” the right hemisphere, and did not allow right hemi functions to develop |
| Problem with the theory? | Ex. Women are better than men in verbal tasks….however, only in a few specific verbal tasks (Kimura’s response) |
| So, If women are not as good as men in visuo-spatial tasks due to Crowding Out effect, we would expect to see more incidents of women with aphasia when damage is done to the right hemi | Kimura |
| Was that true? | WRONG – no evidence for this |
| Distance between Wernicke and Broca in M/F? | • Also found using the same data – discovered that within the left hemisphere, the anatomical distance between Broca’s area and Wernicke’s area is shorter in Men…farther apart in women |
| Implication of distance for men? | if there was a stroke in the left hemi, there is a greater chance for men to have both areas damage |
| Quickly placing pegs into holes | Purdue Pegboard Test |
| How do women do in this test? | Better and faster than men in this test |
| Women are better at? | 1) faster in making hand postures 2) faster at picking out differences bw pages 3) faster in making hand postures |
| Brain Damage | |
| What do they Measure of patients with damage | Intelligence Quotient (IQ) |
| Most famous test? Webster’s Adult IQ test (WAIS) – many subtests | Webster’s Adult IQ test (WAIS) – many subtests Verbal Scale & Performance Scale |
| • Left Hemi Damage: score significantly lower on verbal scale than performance scale | Men |
| • Right Hemi Damage: score significantly? | lower on performance than verbal |
| o WOMEN | |
| Women with Left Hemi Damage: score? | LOW on both performance and verbal |
| Women with Right Hemi Damage: show ? | NO decline in verbal or performance |
| Hemi Field tests in Normal subjects | Visual information is flashed quickly right or left visual field |
| Right Hemisphere task? | compare spatial patterns |
| score significantly better scores in the Left visual field than their Right visual field? | Men |
| How about Women? | SAME as men, BUT mean have a higher mean of correct responses than men in the left visual field |
| SHOWING? | – men are just a little bit better at visual spatial tasks |
| Frontal Lobes | |
| Human frontal lobe size? | proportionally larger frontal lobes than any other lobe (1/3 of the brain) |
| Only Humans have what area? | Broca’s Area (in the frontal lobe) |
| Frontal lobes are CRITICAL for: | 1) Planning Ahead - cant do Mazes if damages 2) Executive functions 3) Working Memory 4) Novel Situation 5) Monitoring 6) sustained attention |
| To formulate goals, to have intentions, and to carry out the intention? | Executive Function, Conductor of the brain |
| The frontal lobe ability to shift set? | Decision-making process, dealing with ambiguous situations, changing sets to make a decision |
| Sustained attention is Controlled by the? | ‘frontal eye fields’ |
| Frontal Eye Fields – part of, and sit? | Frontal Lobe, in front of the motor cortex |
| Damage to Frontal Lobe Symptoms (6) | 1) disinhibition 2) Perseveration 3) Inappropriate Behavior 4) Embellishment 5) Confabulations |
| Being unkempt, saying the wrong words at the wrong time, not dressing correctly | Disinihibiton |
| The inability to shift cognitive mental set, To get stuck in doing the same task | Perseveration |
| Doing and saying things at the wrong time and place | Inappropriate Behavior |
| • Inappropriate added details in a conversation | Embellishments |
| Fabricated, invented stories, No intent to deceive or lie | Confabulations |
| • Frontal lobes fully mature between the ages .... | of 15 – 19 years of age |
| o Meaning the axons become Fully Myelinated | become Fully Myelinated |
| o Railroad nail went through his left eye-socket and took out his frontal lobe | Phineas Gage |
| American neurologist who first described the frontal love damage | 1868 – Harlow, |
| the death of neurons in the brain, for known and unknown reasons | Dementia |
| What happens in dementia? Sometimes neurons shrivel, and the connectivity fails | Sometimes neurons shrivel, and the connectivity fails |
| Most common Example ? | Alzheimer’s Disease (AD) |
| Hallmarks of the disease? | 1) Presence of neuritic plaques and neurofibrillary tangles |
| in the neuropil, the brain tissue that does not contain neurons | Plaques, made up of protein |
| Cytoskeleton of the neuron collapses and leaves a tangle | Neurofibrillary Tangles |
| Unique symptoms to AD? | These symptoms are not unique to AD patients, but far more abundant in AD patients (usually happens with age) |
| o Dementia location? | to the Entorhinal Cortex |
| Entorhinal cortex is the...? | is the gateway to the Hippocampus |
| Far less WHAT in the AD brain? Why? | Acetylcholine because they have loss of neurons in the Nucleus Basalis of Maynert (brainstem) |
| Less ACH impairs? | attention |
| What 2 other NT's low? | Lower NE and serotonin |
| The disease targets the? | large neurons in the brain, affects connectivity |
| The larger the neuron, the longer ? | the axon |
| Causes of AD | 1) Not known 2) Hereditary component present (sometimes hits before the age of 40) 3)Very low rate of AD in India |
| Why very low rate of AD in India? | Curry with the ingredient of “tunaric”, which has positive effects on the brain, ANTIOXIDANTS! Protective effects. |
| Avoid AD by being intellectually active, learning new things, because? | Forcing all the NT’s in the brain to be functioning which increases blood supply to the brain, nutrients |
| • Frontal-Temporal Dementia (FTD) | |
| Frontal Lobe and Temporal Lobe neuronal loss and atrophy, not the first symptom? | “Memory is NOT the first symptom” |
| Behavioral symptom hallmarks = (4) | passivity, flat affect, disinhibition (rudeness), some depression |
| = language becomes progressively worse, that how it is usually noticed? | Semantic Aphasia (symptom of frontal-temporal dementia) |
| variant of Frontal temporal dementia (FTD) | Lewy Body disease |
| Behavioral symptoms occur? | early |
| • Lewy Bodies are called ? | ‘Inclusions’ = Things inside neurons that should not be there |
| progressive pre-senile dementia? | Pick’s Disease |
| Death occurs in Pick's disease occurs how long after diagnosis? | 3 to 5 years after onset |
| Onset typically around ? | 65, but can strike at 27 |
| where are the mutations on Pick's Disease? | Mutations on chromosomes 3 and 17 |
| Symptoms of Pick's Disease? | Non-fluent aphasia, anomia, monosyllabic speech (short one syllable words “yes”), semantic dementia |
| Personality change? | including disinhibition |
| Damage to? | Frontal Lobes |
| UNAFFECTED symptoms? (2) | 1) memory 2) Visuo-spatial functions |
| Visuo-spatial functions, spatial perception tests how fine. What must NOT be damaged in the brain? | Posterior parietal lobe must be fine |
| Unique presence of what in Pick's disease? | Pick’s bodies |
| the hand cannot be controlled, the hand does anything it wants? | Alien Hand Syndrome |
| genetic? | NO |
| The problem is? | damage in the brain |
| Who first described Alien Hand Syndrome? | First described by Dr. Goldstein, 1908 |
| 3 Major Symptoms of alien? | 1) Autonomous motor activity perceived as involuntary movement 2) Feeling of foreignness 3) Personification of hand |
| Damage to the corpus callosum and the above 3 symptoms called? | Intermanual Conflict |
| Frontal Lobe damage + Alien Hand has another 3 symptoms: | 1) Grasping 2) Impulsive Groping 3) Grasp Reflex |
| Purposeless levitation of one of the arms, damage where? | Damage to the Parietal Lobe + Alien Example of when motor control goes awry |
| Anatomical Asymmetries | |
| Sylvian Fissure size difference? | The Left Sylvian Fissure (lateral sulcus) is larger than the Right Sylvian fissur |
| Planum Temporale size difference? | Larger on the Left than on the Right |
| Function of Planum Temporale? | Audition |
| People with perfect pitch have a perfect? | Planum Temporale |
| 1968 – published a paper in the Journal Science where they discussed asymmetries in the brain? | Normal Geshwin & Levitsky |
| Left Side: what % had a larger planum in Left Hemi? | 65% of the sample had a larger Left Temporale |
| o Only what % had the Right Temporale larger the left? | 11% larger Right |
| % had no significant Right/Left difference? | 24 % |
| MAIN POINT ? | = Size does not predict localization |
| who did Post-Mortem Analysis of fetus brain size? | Dr. Wada |
| Planum Temporale is larger on the left than the right as early as ? | 31 weeks into pregnancy (31/40) |
| This early development Shows ? | a predisposition to language/sound |
| Planum temporale asymmetries only present in? | humans |
| Chimps/Orangutan have a slightly larger? | Left sylvian fissue |
| Fluid-filled areas with CSF? | Ventricles |
| The Posterior LEFT Lateral ventricle is larger than the Right Posterior Lateral Ventricle. What is this area called? | This region is called the “horn” of the left lateral ventricle |
| Horn is in the ______ lobe? | Occipital |
| Which occipital lobe is larger? | We have a larger Right Occipital Lobe than left |
| Right Hemisphere is more dependent on? | visual input |
| Violinists who began paying before age 8, have a larger? | somatosensory area than normal |
| Experience can control the size of an area, called? | Plasticity |
| evidence for gender difference in corpus callosum | No conclusive evidence in sex-differences for Corpus Callosum - not larger in women or men |
| Anatomical Language | |
| Who are known to be our closest relatives? | Chimpanzees |
| Where do humans have a large gap? | Humans have a large gap between Soft Palate and Epiglottis, chimps soft palate touches the Epiglottis |
| Human Larynx is (dropped) lower and closer to our lungs, in order to? | where it passes and allows to make sound |
| Allows for the air and food to mix, which makes what bad response? | gagging/choking possible |
| Around age ?, the larynx drops to the point of an adult | 7 |
| For the first 3months of life, most babies do choke or gag |
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