BCS 242 Clinical Neuropsychology • Course Overview/Housekeeping • What is Neuropsychology? – Historical Approaches – The Scientific Era & Principle of Double Dissociation – Emergence of Clinical Neuropsychology as a Specialty
Academic Honesty • You are responsible for knowing the College of Arts, Sciences and Engineering and course policies on academic honesty. • I take violations of academic honesty seriously. Suspected violations will be pursued vigorously following the College’s procedures for suspected cases of academic dishonesty Some Categories of Academic Dishonesty • Cheating: Using unauthorized information or sources for an assignment or exam. • Assisting others in academic dishonesty • Falsifying Information • Interfering with others’ access to legitimate course materials This is not an all-inclusive list. For more information, visit the URL below. http: //www. rochester. edu/college/honesty
Date Topic Reading Assigned to Topic Thurs 8/31 Introduction and History Zillmer, Spiers & Culbertson, Ch. 1 History of Neuropsychology Tues 9/5 Purposes and Practices of Zillmer, Spiers & Culbertson, Ch. 3 Neuropsychological Assessment and Diagnosis Assessment (p. 63 -79) Thurs 9/7 Interpretation of Zillmer, Spiers & Culbertson, Ch. 3 Neuropsychological Assessment and Diagnosis Information (p. 79 -89) *Schoenberg & Scott, Ch. 1 The Neuropsychology Referral and Answering the Referral Question Tues 9/12 Functional neuroanatomy Zillmer, Spiers & Culbertson, Ch. 5 Functional and behavior Neuroanatomy *Ch. 4 Cells of Thought (pp. 94 -99, 106 -113), Ch. 6 Cerebral Specialization Thurs 9/14 Sensory-Motor Function Zillmer, Spiers & Culbertson, Ch. 7 Somatosensory, Chemical and Motor Systems *Elias & Saucier, Ch. 5 – Sensorimotor Function (pp. 140 -166) Tues 9/19 Visuospatial Function, Zillmer, Spiers & Culbertson, Ch. 8 Vision and Agnosia Language (pp. 200 -215) *Elias & Saucier, Ch. 6 Visual System Thurs 9/21 In class review session Tues 9/26 EXAM I
Thurs 9/28 Arousal, Awareness and Attention Tues 10/3 Speech/Language Function Guest Speaker: Ben Chernoff Thurs 10/5 Learning & Memory Tues 10/10 NO CLASS FALL BREAK Thurs Executive Function 10/12 Kolb & Wishaw, Ch. 22 Attention, Imagery and Consciousness (pp. 465 -476) *Zillmer, Spiers & Culbertson, Ch. 9 Memory, Attention, Emotion, and Executive Functioning (pp. 240 -246) *Elias & Saucier, Ch. 11 Disorders of Attention and Consciousness (pp. 367 -376) Kolb & Wishaw, Ch. 19 Language (pp. 515 -519, 524544) *Price, The anatomy of language Rains GD, Ch. 10 Memory Systems *Zillmer, Spiers & Culbertson, Ch. 9 Memory, Attention, Emotion, and Executive Functioning (pp. 225 -240) Rains GD, Ch. 12 The prefrontal cortex (pp. 339 -363) *Zillmer, Spiers & Culbertson, Ch. 9 Memory, Attention, Emotion, and Executive Functioning (pp. 246 -249) *Neylan: Mr. Phineas Gage's famous Injury Tues 10/17 Epilepsy – disease effects Langfitt Cognition in “Atlas of the Epilepsies” Guest Speaker: John Langfitt, Zillmer, Spiers & Culbertson Ch. 16 Alterations of Ph. D. Consciousness (pg 463 -474) Thurs Epilepsy treatment – treatment Chelune, Functional Adequacy and Reserve 10/19 effects Guest Speaker: John Langfitt, Ph. D Tues 10/24 EXAM II
Thurs 10/26 Cognitive Neuropsychology: Using MRI to study Neurosurgery Patients Guest Speaker: Ben Chernoff Tues 10/31 Normal Aging, MCI, and AD Caramazza Is Cognitive Neuropsychology possible? Zillmer, Spiers & Culbertson Ch. 14 Normal Aging and Dementia: Alzheimer’s Disease Thurs 11/2 Cerebrovascular Disorders Zillmer, Spiers & Culbertson Ch. 12 and Vascular Dementia Cerebrovascular Disorders (pp. 342 -357) *Haaland Swanda Vascular Dementia (Morgan & Ricker, Ch. 19) Tues 11/07 Depression Langenecker et al. Neuropsychology of Depression and Related Mood Disorders (Grant and Adams Ch 22) Thurs Traumatic Brain Injury Roebuck-Spencer and Sherer Moderate and Severe 11/09 Guest Speaker: Marc traumatic brain injury (Morgan and Ricker Ch. 21) Gaudette, Psy. D. Tues 11/14 Cognitive Rehabilitation Mateer & Sira Practical rehabilitation strategies in the context of clinical neuropsychology feedback (Morgan and Ricker Ch. 49) *Zillmer, Spiers & Culbertson, Ch. 13 (pp. 385 -398) Thurs EXAM III 11/16
Tues 11/21 Hormones and cognition Thurs 11/23 Tues 11/28 NO CLASS Thanksgiving Pediatric Neuropsychological Assessment Guest Speaker: Heather Adams, Ph. D. Multiple Sclerosis Thurs 11/30 Tues 12/05 Parkinson’s Disease Thurs 12/07 Tues 12/13 Huntington’s Disease EXAM IV - FINAL Sherwin Estrogen and Cognitive Function *Henderson Estrogens, Memory and Alzheimer’s Disease Zillmer, Spiers & Culbertson, Ch. 10 (pp. 270274) O’Neill & Beaulieu Neuropsychological and Educational Testing Thornton and De. Freitas The neuropsychology of Multiple Sclerosis (Morgan & Ricker, Ch. 31) Mc. Pherson and Cummings Neuropsychological aspects of Parkinson’s Disease and Parkinsonism (Grant & Adams Ch. 9) Paulsen and Mikos Huntington’s disease (Morgan & Ricker, Ch. 32)
Introductory questions • What is Neuropsychology? • What is clinical neuropsychology? • Goals of this class
What controls behavior? • Plato (427 -347 BC): brain hypothesis • Aristotle (384 -322 BC): cardiac hypothesis • LIMITED EVIDENCE
The Brain Hypothesis • Clinical experience and observation influence beliefs • Hippocrates (460 -377 BC) • Galen (129 -199 AD)
How does the brain constrain mental events? • Vesalius (1514 -1564): – Brain matter, and not ventricles, mediates mental processes • Descartes (1596 -1659): – “By transmitting information from the soul (in the pineal gland) to nerves and muscles”
Some Questions • How does the brain give rise to behavior? • Which structures are involved in perceiving, interpreting and responding to stimuli? • Which of these structures are essential vs involved? • How are signals received, transmitted and compiled to generate perceptions, thoughts and actions? • How are these signals transmitted and interpreted between structures?
Phrenology • Gall and Spurzheim – (1758 -1828) & (1776 -1832) – First global theory of how the brain works – Cortex and gyri composed of functioning cells, connected with brainstem and spinal cord – Found that cortex projects to spinal cord, and can control bx through projections to spinal cord – Recognized two hemispheres connected by corpus callosum – Examined external features of skull to correlate bumps and depressions with behavior
How does brain structure constrain mental events? Some Early Answers • Pre-scientific (anecdotal observation, uncontrolled experiments) – Lateralization/Localization • Different regions generate different behaviors (Broca, Wernicke, Gall) – Equipotentiality • Many different regions are capable of generating many different behaviors (Flourens, Lashley, Kennard, Basser) – Hierarchy • More complex behaviors arise from coordination & integration of more elemental processes (Jackson, Luria)
How does brain structure constrain mental events? Modern Answers • Scientific (systematic observation, controlled experiments and ‘experiments of nature’) – Double dissociation of lesions/structures and deficits/activation provides strong support for localization and hierarchical organization of function – Double dissociation requires that “symptom A occurs with lesions in one structure but not with those in another, and that symptom B occurs with lesions of the other but not the one” – Teuber, 1959
Principle of Double Dissociation Is function X specific to structure A? A/X? Lesion Task X A Impaired B Intact B/Not X?
Principle of Double Dissociation • Single-dissociation of deficits Lesion A B Task X Task Y A/X? Impaired Intact Impaired B/Y?
Principle of Double Dissociation • Single-dissociation of deficits Lesion A B Task X Task Y A/X Impaired Intact Impaired B/Y • Double-dissociation of deficits Lesion Task X Task Y A Impaired Intact B Intact Impaired • Inconsistent with Equipotentiality – A is NOT more critical for overall function (Y is intact with A) – Task Y NOT harder (Intact when A is damaged)
Double Dissociations in Neuropsychology Lesion A Task X Lesion Y Task Y Left Hemisphere Language Skills Right Hemisphere Visuo-spatial Skills Broca’s Area Speech Production Wernicke’s Area Language Comprehension Superior Parietal Lobe Visual Attention Inferior Parietal Lobe Object Recognition Hippocampus Memory for Events Lateral Neocortex Memory for Names
Emergence of Clinical Neuropsychology • Clinical Neuropsychology – application of human neuropsychological knowledge to assist in the diagnosis and management of cognitive deficits in people • Response to a Clinical Need – identify cognitive abilities and disabilities for reintegration and rehabilitation of WW II wounded – accurate diagnosis of brain disorders (e. g. , strokes, tumors) in pre-imaging era
Emergence of Clinical Neuropsychology • New Questions – – – Is the behavior a sign of brain damage/disease? What areas of the brain/disease mechanisms are involved? How severe is the dysfunction? What cognitive processes account for the deficit? How can the patient adapt to deficits to minimize functional impact? – Will the patient return to work or independent living?
Added Value of Clinical Psychology • Background & Training in – – – Theories of cognitive and behavioral function Standardized assessment of individual differences Quantitative analysis Experimental design Actuarial prediction Behavioral treatment methods
Early Contributions to Clinical Neuropsychology • Ward Halstead & Ralph Reitan – developed battery of tests with standard administration & scoring given to all patients – empirically-derived cutoffs discriminated brain-damaged from non-brain damaged patients – lateralized and localized lesions based on sensory-motor asymmetries – limited assessment of higher cognitive functions or underlying processing impairments
Early Contributions to Clinical Neuropsychology • David Wechsler – refined existing IQ tests, using multiple subtests assessing different aspects of verbal and visual-spatial skills – developed clinical tests of attention and verbal and visual memory – rigorous psychometric design and large normative samples improved precision – neuropsychologists identified subtest profiles associated with focal brain lesions
Profile of Patient with Visual-Spatial Deficits after Right Hemisphere Stroke Normal Range
Early Contributions to Clinical Neuropsychology • Edith Kaplan – early colleague of Geschwind, influenced by Luria – developed flexible, non-standard assessment approaches – focus on analysis of error types to describe deficits in underlying, hierarchical cognitive processes (i. e. , ‘process approach’) – tasks tailored to patient or question, well-suited to rehabilitative goals of identifying compensatory strategies – limited normative database for discriminating subtle impairment from normal
Draw a clock
“Draw a clock and set the hands to ten past eleven” Language Deficit Planning Deficit Perceptual Deficit
Скачать презентацию BCS 242 Clinical Neuropsychology Course Overview Housekeeping
7538708ddb10fa02a4449c8c8fa008ed.ppt