Psyc 4543 Exam 2

Achromatopsia

"cortical color blindness" Central disorder of color perception in part or all of visual field Anatomical area for color is in inferior occipitotemporal cortex (V4,V8) Lesion is typically embolic infarct in branches of PCA Cannot name, point to, or match colors presented visually to the affected field CAN name color for object described verbally "apples are usually ____," "inside of a cantaloupe is _____"

The Ventral pathway

"what", projects to the occipito-temporal association cortex Analyzes form with regions identifying objects, letters, and faces Syndromes: pure alexia, visual object agnosia, prosopagnosia

Dorsal Pathway

"where", projects to the parieto-occipital association cortex Analyzes motion and spatial relations between objects, between body and objects Syndromes: Motion blindness, and Balint's (ocular apraxia, optic ataxia, simultanagnosia) and simultanagnosia (one object at a time)

semantic memory

- knowledge of general info, not temporally coded, not dependent on particular time or place Knowing what a sandwich Is Includes info about words, symbols, grammatical rules, ideas Memory tests not designed to measure semantic memory, though performance on memory tests are facilitated by semantic knowledge

Learning (encoding)

- process of acquiring new information, or process that modifies subsequent behavior

Unilateral MTL damage =

= Less severe deficits that tend to be material specific Left MTL = Verbal Right MTL = non-verbal, topographic

Prosopagnosia

A special case of visual object agnosia- specific to faces Unable to recognize familiar faces, Can Identify a face as a face (able to describe it and name features of a face) Cannot recognize face as belonging to a particular individual Rely on hair, peripheral features, clothes, voice, context Not restricted to faces (generic recognition intact but impaired specific recognition when object belongs in a class for which specificity is important) Bilateral lesions in lingual and fusiform gyri or subjacent white matter Not RH lesions alone-- split-brain and RH patients able to recognize faces Defect in recognition considered a defect in ability of visual stimulus to trigger memories of the historical context (PET imaging demonstrates activation in L anterior temporal pole for both famous faces and landmarks)

Dorsal pathway disorders

Balint's and simultanagnosia Optic ataxia, optic apraxia

Clive Wearing

Clive Wearing suffered from Viral Encephalitis Memory lasted for about 30seconds- he was "officially awake, before he was In a lucid state" Only could remember his wife- not even that he had children Still could play music from implicit memory

Types of TBI

Contact- object striking head or brain striking skull Injury to scalp, fracture to skull, surface contusions Coup- countrecoupe injuries Acceleration-deceleration- sudden motion without significant physical contact These forces can produce tissue compression, tissue stretching (tensile), or shearing (tissue sliding over other tissue) Diffuse Axonal Injury Microscopic damage may not be visible on imaging Caused by rotational acceleration of the brain- axons pulled apart, swollen Penetrating injury Firearms most common Intracranial hematomas Most common cause of death, clinical deterioration Epidural hematomas Clotted blood collects between bone and dura Can grow quickly and created pressure against brain Subdural hematomas Caused by rupture of bridging veins in subdural space Associated with high morbidity and mortality Subarachnoid hemorrhage Can lead to hydrocephalus if blocks flow to CSF

Connections in the frontal lobe

Cortical connections Association cortices of temporal, parietal, occipital and limbic Subcortical Orbitomedial connects with amygdala Prefrontal projects to basal ganglia via head of caudate Connections to the anteromedial temporal, hippocampus Connections to mediodorsal nucleus of thalamus

Behaviors and cognitive abilities of the frontal lobe

Critical for sophisticated decision making Subtle social interactions we engage in Divergent thinking "seat of personality and Intellect" RIO (Restraint, Initiative, Order) Restraint- Judgment, Foresight, Perseverance, Delaying Gratification, Inhibiting socially inappropriate responses, concentration, self-awareness Initiative- Motivation to pursue positive or productive activites Curiosity, Spontaneity, Motivation, Drive, Creativity, Shifting cognitive set, mental flexibility Order- Sequencing, Organization, Planning, Working memory, Temporal order, Perspective taking, Abstract reasoning

What does damage to the MTL do

Damage to MTL disrupts the encoding process (transfer from attentional stores to long-term storage) Still unclear whether affects the process of retrieval

Common Nonverbal Memory Tests

Drawing Designs WMS visual reproduction, Benton Visual Retention Test, Rey-Osterrieth

Glasgow Coma Scale

Eyes opening, verbal response, motor response Within 48 hours of event Severe = 3-8 Moderate = 9-12 Mild = 13-15

Recall conditions

Free- spontaneous recall of info without cues or aids "tell me...." "draw..." Cued- retrieval of info with help of a cue "there were X on the list of words; can you tell me those" *draw part of the cue* Recognition- target from memory is among array of options; maximally aids retrieval by providing info Retrieval formats help specify the source of the "memory" problem

Tell about H.M.

H.M.- 27 years old, underwent an operation in which the bilateral medial temporal lobes, including the hippocampal formations and parahippocampal gyri, were resected in an attempt to control his medically-refractory epileptic seizures Following the surgery, his seizures improved but he had severe memory problems, with no other significant deficits Unable to learn new facts or recall new experiences (anterograde) Able to recall events from childhood and up to several years prior to the surgery Unable to recall events in approximately 11 year span leading up to the surgery Personality and general intelligence were normal (FSIQ = 110) Able to learn certain tasks that did not require conscious (explicit) recall Mirror drawing, primed word exposure Medial temporal lobectomy, removed about 8cm of medial temporal lobes and amygdalae on both sides Did not remember the last thing he said in a conversation, his birthday party Semantic learning is Impaired in amnesia Tested with previously learned words from before his surgery and words added to the dictionary years after the surgery, assessed learning

What is the pathway of the Papez Circuit

Hippocampus --> fornix--> mammillary bodies--> anterior thalamic nuclei --> cingulate cortex--> entorhinal cortex--> hippocampus

Central Pathway

Inside of the cortex, retinogeniculate tract, geniculocarine tract, entire length of cortex to most posterior Retinogeniculate pathway Geniculocalcarine pathway

Geniculocalcarine pathway

Lateral geniculate, Meyer's loop, superior optic radiations, primary visual cortex

Epidemiology of TBI

Males 2:1 females Highest risk by age = 0-4 years, 15-19 years "shaken baby" Adults 65+ highest rates of TBI related hospitalization and death Causes Falls (28%) Motor vehicle crashes (20%) Being struck by or against objects (19%) Assaults (11%) 2.5 million people sustain TBI 50,000 die from TBI 475,000 are among infants, children (0-14) 43% of those hospitalized experience long term disability Severe TBI causes highest mortality rates In first year, survivors more likely to die from complications (seizures, pneumonia, etc) $76.5 billion in 2010 Direct expenditures, work-related losses and disability

Common Verbal Memory Tests

Memory for Stories (WMS Logical memory) Word- lists Rey AVLT, CVLT (has groups of words, but are not common words)

Anterograde

Memory for events occurring after specified point in time (onset of injury); refers to new learning

Neurotransmitter frontal lobe involvement

NT projections- Frontal lobe receive projections from multiple subcortical and brainstem modulatory NT systems Dopamine Acetylcholine Serotonin Norepinephrine Histamine

Ogden's chapter 10 case studies

Neil, 22yo sustained a severe TBI 3 years previously. crashed his motor bike and was "a 25-year-old baby" Rehabilitation "hit or miss" the western world. The availability of good rehabilitation services for the severely head-Injured does, of course, vary across and within countries, but even those regions fortunate enough to be well endowed with such facilities often find it impossible to provide for the increasing number of TBI victims who survive because of improved acute care. Hard to establish and maintain because head-Injured population is often viewed as a burden on society. It's very expensive. Sam, who got better through a long process of rehabilitation Made a friend who also had TBI of some kind and he motivated him to go to the gym with him which helped Sam's mental health and sense of independence. He's a rare success story and found ways to cope with his TBI to be almost normal functioning, but It took a lot of work and support from family members. During rehabilitation in order to see improvement Sam need external help, he could not teach himself since he had mild anterograde amnesia and needed help learning the words for memorization and recall after. There was great improvement in the amount of words he could recall when someone helped him learn it.

Disorders that affect the frontal lobe

Neurologic Head injury, stroke, Pick's/frontotemporal dementia, Parkinson's, Huntingtion's, Lobotomy, Alcohol use disorders Psychiatric Schizophrenia, Depression, OCD, ADHD, Psychopathy

Visual Object agnosia

Normal visual percept stripped of its meaning Person with normal visual perception unable to recognize a class of stimuli Someone says they do not know what they are looking at, test: Able to draw the object, able to match object with drawing or picture, able to describe the object (with exception of color) How to determine that it isn't a naming (word-finding) deficit Not able to describe Its function, not able to match it with other stimuli of similar category

Retinogeniculate pathway

Optic nerve, optic chiasm, optic tracts, lateral geniculate

Developmental prosopagnosia

Originally thought to be rare, but actually more common (1 in 50 people) Inability or difficulty recognizing faces, individuals fail to develop normal face processing abilities, despite normal perception Individuals learn to develop compensatory strategies, can fail in unexpected situations

Peripheral pathway

Outside of the cortex, anterior, eyes and retina Lens, Retina (contains photoreceptors), Macula (contains fovea), Optic Disk (no rods or cones, becomes blindspot)

Selective reminding test

Paired Associations Up-down, Brown-honesty, goose-harness

MTL Anatomy

Perirhinal- visual memory Parahippocampal- spatial memory Entorhinal- unclear specificity Amygdala- emotion mediated memories Bilateral damage = global amnesia Unilateral = material specific amnesia

frontal lobe anatomy

Prefrontal area- anterior part, "higher cognitive functions" (personality) Premotor area- modifies motor movements, stores motor programs Anterior of the primary motor strip, posterior to the prefrontal area Primary motor- nerve cells that produce voluntary movement Cingulate sulcus- inferior medial portion- superior to corpus callosum Dorsolateral, superior portion Orbitofrontal- inferior portion

Ventral pathway disorders

Pure alexia Visual object agnosia Prosopagnosia

Complex Figure (memory test)

Recognition of Nonverbal Stimuli Benton Visual Retention Test- recognition format WMS Faces, Continuous Visual Memory Test

Malloy 2001 reading

Several functional subdivisions now have been identified: Primary motor area, Premotor area, Frontal eye fields, Dorsolateral prefrontal area, Orbital prefrontal area, and medial area composed of the supplementary motor area and anterior cingulate gyrus Each of these frontal zones has extensive connection with posterior cortical and subcortical structures (thalamic nuclei and basal ganglia) Motor areas Large lesions to the motor area result in flaccid hemiplegia on the contralateral side of the body- resolves into spastic hemiplegia Tests by the bedside, squeeze the examiners finger and tap test Premotor subsystem Lesions in the premotor area result in the inability to use sensory feedback to modify movements smoothly and apraxia. The dorsolateral subsystem is responsible for executive functions. EXIT test FAS test= COWA-- list of words cannot include proper names Within task perseveration- repeating a previous word on the same letter list without awareness or self-correction Between-task perseveration- repeating words beginning with a previous letter Non-verbal or figural fluency task- patients produce as many nonrepresentational drawings as possible. Draw a figure within a grid of lines (Increases reliability) by Ruff TinkerToy test Peaks and Plateaus ++0++0 test Orbital Prefrontal System Anosmia- disinhibited personality change and failure on NP test of inhibition are reliable signs Smell assessments Go/no-Go Stroop Test Supplementary motor and anterior cingulate gyrus Anterior cingulate gyrus lesion = akinetic mutism- patient fails to respond to environmental stimuli and remains inert. Stroop Test

What is the key structure for memory

The hippocampus

Tests used for executive functioning

Working memory Digits backwards, months backwards Perseveration and set-shifting ability Luria Reciprocal Coordination & Alternating sequences Flippling hands up and down on table Fist to flat hand Trailmaking B, Trailmaking- go from 1-A-2-B-3-C... Wisconsin Card Sort Inhibition Auditory or visual go-no go tests Stroop Flexibility FAS, figure generation FAS are the letters that the test use, "say as many words that start with the letter __ (F,A, or S) Seeing if the patient can stay on set, and avoid using inappropriate (disinhibition) words like "shit""****""*******" that should not be used in this professional setting Abstract Reasoning Similarities, proverb interpretation, logic

declarative (explicit) memory

directly accessible to conscious recollection Facts, data, knowledge, meaning of words Retrieval is often intentional

Bilateral MTL damage =

global amnesic syndrome Marked anterograde memory deficit (global) for Declarative info grades retrograde deficit Immediate recall (uninterrupted rehearsal) intact.

Optic Ataxia

impairment of visually guided hand movements Lesions centered around intraparietalsulcus Bilateral lesions to dorsal occipitoparietalregion results in full Balint's

Optic apraxia

impairment of voluntary eye mvmt

Simultanagnosia

inability to perceive more than one object at a time

nondeclarative (implicit) memory

learning demonstrated through performance; several different memory systems distinct from declarative Procedural (skill learning), Priming, Classical Conditioning

Retrograde

memory for events predating specified point in time (oneset of injury)

episodic memory

memory for specific events, episodes in one's life, info assigned to particular point in time Recollection of the Subway sandwich you ate yesterday Most memory tests are testing episodic memory

What is TBI

nondegenerative, noncongenitally insult to the brain resulting from external mechanical force applied to the cranium and the intracranial contents, leading to temporary or permanent impairments, functional disability, or psychosocial maladjustment

If Recall = Recognition (equally poor) in a recall condition this means...

problem is in the encoding (learning) process-- (Alzheimer's, Korsakoff's, "MTL" memory problems)

If Recognition > Free Recall in a recall condition this means..

problem is in the retrieval process (Parkinson's, Huntington's)

Papez circuit

produce similar memory deficits (though less severe retrograde deficits) Fornix Mammillary bodies (in hypothalamus, associated with Korsakoff's amnesia) Anterior thalamic nuclei Papez Circuit Acquisition of rapid consolidation of particular kinds of associations Several passes of an "event" through the circuit leads to physical changes in neurons that consolidate the memory Once sufficiently strengthened, recall is independent of the hippocampus INJURY prevents NEW memories, but cannot erase consolidated or OLD memories

short-term memory

recall info immediately after presentation or during uninterrupted rehearsal Limited capacity (7+- 2)

long-term memory

recall of info after delay interval during which attention is focused away from target items Extraordinarily large capacity

Memory (recall)

the "record" left by a learning process, measured as amount of information retained on recall Asking someone to recall information does not discriminate between problem in learning (encoding) vs problem in memory (retrieval

H.M. had a deficit in what

the transfer of information for STM to LTM

recollection vs familiarity

when retrieval acts is accompanied by an experience of direct, deliberate, reference to a prior episode, It engenders a conscious "recollective" experience. In contrast, some successful acts of retrieval lack this experience and reflect nondeclarative aspects of learning (familiarity) Methods to distinguish these 2 types of experiences, Including the process dissociation procedure and the remember-know-guess paradigm have been developed amidst debate regarding the degree to which recollection and familiarity reflect independent processes

LOOK AT TABLE FOR VISUAL DISORDERS

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