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What is Neuropsychology. Study of brain–behavior relations (sometimes referred to as functional localization) Functional Lateralization – refers to notion that a function may depend on one side (hemisphere) of the brain. Definition of Clinical Neuropsychologist.

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slide1

What is Neuropsychology

Study of brain–behavior relations (sometimes

referred to as functional localization)

Functional Lateralization – refers to notion that

a function may depend on one side

(hemisphere) of the brain

definition of clinical neuropsychologist
Definition of Clinical Neuropsychologist
  • A clinical neuropsychologist is a professional psychologist who applies principles of assessment and intervention based upon the scientific study of human behavior as it relates to normal and abnormal functioning of the central nervous system. The clinical neuropsychologist is a doctoral-level psychology provider of diagnostic and intervention services who has demonstrated competence in the application of such principles for human welfare following:
slide4
A doctoral degree in psychology from an accredited university training program.
  • An internship, or its equivalent, in a clinically relevant area of professional psychology.
  • The equivalent of two (fulltime) years of experience and specialized training, at least one of which is at the post-doctoral level, in the study and practice of clinical neuropsychology and related neurosciences. These two years include supervision by a clinical neuropsychologist .
  • A license in his or her state or province to practice psychology and/or clinical neuropsychology independently, or is employed as a neuropsychologist by an exempt agency.
slide5

Different types of

Neuropsychologists/ Subareas

􀁺 Experimental neuropsychologists – work to understand

the neural bases of cognition by doing studies

– Experimental neuropsychology = cognitive neuropsychology or cognitive neuroscience

􀁺 Clinical neuropsychologists – work in health-related

settings (e.g., hospitals, clinics) with patients

– Involved in diagnosis

– Involved in rehabilitation (e.g., designing programs)

– May be involved in research

– Clinical neuropsychology

slide6

How do we study brain-behavior

relations? (Techniques)

Invasive

– Lesion

– Inject radioactive tracer

Non-invasive

– Brain-imaging to see what regions are active during specific mental task

– Record activity of cells to determine what activity makes them respond

– Present information to different hemispheres and see which side does task better or faster

slide7

Why study brain-behavior

relations?

􀁺 Diagnostic purposes

􀁺 Rehabilitation purposes

􀁺 Intellectual curiosity

slide8

Methods in

Neuropsychology

slide9

Method of converging operations:

Use a number of different methods and

populations

􀂄 Evidence obtained from a set of

experiments converge on the same

conclusion

– e.g., fMRI and lesion studies

slide10

Research considerations:

􀂄 What type of participants?

􀂄 How will we gather information about

their brains?

􀂄 How will be measure behavior?

slide11

Research Participants:

􀂄 (1) Patients with lesions

􀂄 (2) Healthy Individuals

􀂄 (3) Animals

slide12

Patients with lesions

  • 􀂄 Question: What functions supported by this
  • neural site?
  • 􀂄 Studies need to include patients with lesions
  • to a specific site and patients with lesions to a
  • different site
  • 􀂄 ‘Double dissociation’ - lesions have converse
  • effects on two distinct cognitive functions
  • 􀂄 Allow one to conclude that structures/
  • functions are independent
slide13

􀂄 Question: What neural sites are

associated with a particular deficit?

– e.g., Memory impairment associated with

damage to:

– Brenda Milner’s work with temporal lobe epilepsy and memory where hippocampus was found to be important for learning

slide14

Problems with lesion method

􀂄 Brain damage messy in humans

(1) People vary in their genetic and

environmental characteristics

• e.g., differ in education, onset of dementia

– Lesions vary in their extent and origin

• Stroke vs tumor vs bullet

(2) Lesion does not allow us to observe directly the function served by the lesioned site

slide15

􀂄 Only know how brain performs without

that particular area

􀂄 We can infer the site may be critical but we can not identify all the areas that may be involved

􀂄 Site may not be critical in performing a particular function: rather, may contain axons that connect regions that must interact for correct performance

– Disconnection syndrome

• Split brain

• Conduction aphasia

slide16

Associated problem:

single cases or groups

􀂄 Groups of patients may be so hetergeneous in their

behavior that ‘group average’ is meaningless

– Argues for single case approach

􀂄 Problem with single case approach

– Is pattern observed representative of people in

general?

– Does not allow one to rule out random error

slide17

􀂄 Use multiple case approach, validating

research findings on a series of patients, or

􀂄 Follow-up findings from single-case with

group studies

slide18

(2) Neurologically intact

Individuals

􀂄 These persons provide the control group that allows us to determine thedegree to which performance of brain damaged people is compromised

􀂄 Well-designed studies must include appropriate control group

3 animal populations
(3) Animal Populations
  • 􀂄 Allows for control over
  • – Environmental conditions/experience
  • – Size and nature of lesions
  • – Genetic differences, etc.
gathering information about the brain techniques
Gathering Information aboutthe Brain:Techniques
  • 􀂄 CT Scans
  • – Uses series of X-ray beams through head.
  • Images developed
  • on sensitive film. Shows anatomical image

of brain density.

  • – CSF < brain tissue < blood < bone
  • – Darker < …………………….> Lighter
slide21
􀂄 Advantage:
  • – Can be used with most people
  • 􀂄 Disadvantage:
  • – Uses radiation
  • – Dye may cause allergic reaction
  • – Results do not have a high spatial resolution
  • – Structure of brain only
slide22
MRI
  • 􀂄 Anatomical image of substances such as water or fat - give picture of tissue density
  • 􀂄 Relies on passing an external radio frequency

pulse to disrupt the magnetic fields of nuclei

and distort the behaviors of atoms

  • 􀂄 When atoms fall back in line, they re-emit the

radio-frequency signal which is detected by a

receiver coil

  • 􀂄 The frequency of this signal reflects the

number of elements in the nucleus and the

effect of the surrounding material

advantages
Advantages
  • 􀂄 Does not require X-rays or radioactive

material

  • 􀂄 Safe, painless, non-invasive
  • 􀂄 Result is high resolution
disadvantages
Disadvantages
  • 􀂄 Expensive
  • 􀂄 Cannot be used in patients with metallic

devices, like clips, pacemakers, or

possibly orthopedic pins

  • 􀂄 Cannot be used with claustraphobic

patients

  • 􀂄 Assesses structure only
functional mri
Functional MRI
  • 􀂄 In fMRI, MR signal measures functional

characteristics of brain

  • 􀂄 Detects changes in blood flow to

particular areas of the brain

  • 􀂄 Provides both an anatomical and

functional view of the brain

advantages26
Advantages
  • 􀂄 Noninvasive - radiation needed
  • 􀂄 Multiple scans can be done on an

individual so can examine changes over time (e.g., learning)

– Provides a good measure of brain activity over seconds

  • 􀂄 Provides a good spatial resolution
disadvantages27
Disadvantages
  • Cannot localize processes in time better

than 1 second

– fMRI does not image neural activity but rather response of vascular system to oxygen demand and this can lag functional activation as well as extend beyond period when activation occurred

slide28
PET
  • Also provides a functional image of brain activity
  • 􀂄 Radioactive substance (e.g., glucose)

introduced into blood

  • 􀂄 Radioactive molecule becomes stable by releasing positron, collides with electron, annihilate each other -producing energy - PET detects this energy
slide29
􀂄 PET detects how much of the brain fuel

(oxygen, glucose) is being used by different regions

  • 􀂄 Areas that are metabolically active emit

lots of energy; those that are less active

emit less energy

slide30
􀂄 Advantages

Good at examining functioning of a variety of

neurotransmitters

  • 􀂄 Disadvantages

Involves radiation

Provides image of brain activity averaged over very long time periods (e.g., minutes whereas cognitive decisions occur in msec)

  • Typically, data on task is averaged across many people
  • Not very good at determining location of function in a given person (does not provide high spatial

resolution)

slide31
EEG
  • 􀂄 Electrical activity of the brain
  • 􀂄 Provides information about general

state of person (e.g., awake)

  • 􀂄 Good at detecting various clinical

disorders

– e.g., sleep, seizures

slide32
􀂄 Provides accurate measures of activity

on a millisecond basis

  • 􀂄 But poor at localizing activity
  • 􀂄 Does not provide information about

subcortical structures

event related potentials erp
Event Related Potentials(ERP)
  • 􀂄 Recording of brain’s activity that are linked to

the occurrence of an event (stimulus)

  • 􀂄 Provides information linked to processes

such as memory and attention

  • 􀂄 Examine components of the waveform

recorded on the scalp such as

– P300 - S must respond to target stimulus (‘b’ not ‘d’, blank sound) - appears to measure attention, updating of memory

neuropsychological assessment
NeuropsychologicalAssessment
  • 􀂄 Allows one to separate cognitive functions

(e.g., STM vs LTM)

  • 􀂄 Profile patient strengths and weaknesses

– diagnosis

  • 􀂄 Provide a baseline to evaluate change

– e.g., remediation, improvement, decline

  • 􀂄 Make statements about prognosis
slide35
􀂄 Fixed batteries

(e.g., Haltead-Reitan, Luria-Nebraska)

  • 􀂄 Flexible battery
  • 􀂄 Generally measure IQ (Wechsler tests)
  • 􀂄 Also measure executive function,

attention, memory, language, spatial

ability, motor, sensory function, emotional function

slide36
􀂄 Need good normative data
  • 􀂄 Pre-morbid Estimation

e.g., NART, WTAR