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Neuropsychology
Neuropsychology
Unit-3 The Cerebrum and the Cerebral Hemispheres and their Functions
Unit-2 Consciousness and Neuro Chemical Process and Higher Cerebral Functions
Structure
1.0 Introduction
1.1 Objectives
1.2 Introduction to Neuropsychology
1.2.1 Historical Perspective of Neuropsychology
1.2.2 Clinical Neuropsychology
1.2.3 Central Nervous System
1.2.4 Functioning of the Nervous System
1.3 Definition and Concept of Neuropsychology
1.4 Neuropsychology and other Disciplines
1.5 Functions of Neuropsychologists
1.6 Major Domains of Neuropsychological Functioning
1.6.1 Referrals to Neuropsychologists for Neuropsychological Examination
1.6.2 Information Obtained from Neuropsychological Reports
1.6.3 Applications of Neuropsychological Examinations
1.6.4 Technical Limitations and Issues in Neuropsychological Evaluation
1.7 Neuropsychological Test Selection
1.7.1 Problems in Assessing Executive Functions
1.8 Let Us Sum Up
1.9 Unit End Questions
1.10 Suggested Readings
1.0 INTRODUCTION
This unit deals with neuropsychology, its definition and descriptions. It starts
with introduction to neuropsychology, followed by historical perspectives of
neuropsychology, clinical neuropsychology, what it is and a description of theme,
followed by a description of the central nervous system and its functioning. Then
we move on to definitions of neuropsychology and its concepts. Then we
differentiate it from other related disciplines, followed by the functions of
neuropsychologists. Then we deal with the domains of neuropsychological
functioning and the reasons for referrals to neuropsychologists for
neuropsychological examination. Then we describe what the reports contain based
on the neuropsychological examination, what are the applications of
neuropsychological examination and the various limitations to neuropsychological
test applications. Then we move on to neuropsychological test selection and the
problems one faces in assessing executive functions and how to overcome the
same.
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Neuropsychology
1.1 OBJECTIVES
After completing this unit, you will be able to:
• Define neuropsychology;
• Conceptualise neuropsychology;
• Describe the various aspects related to neuropsychology;
• Explain historically how neuropsychology came about;
• Describe the central nervous system and its functioning;
• Explain the functions of neuropsychologists;
• Elucidate the major domains of neuropsychological functioning;
• Describe when a person is to be referred to neuropsychologist for testing;
and
• Analyse the application of neuropsychology examination to different areas.
The methods that neuropsychology uses to study many of these aspects include
both experimental and objective scientific methods. Neuropsychology compares
the performance among persons with known differences in their biological brain
structures and attempts to find out the various sources that cause the variations
in the brain which all produce differences in individual behaviours. These sources
include the following:
1) biological factors (e.g., genetic, diseases, and injuries)
2) psychological factors (e.g., learned behaviours and personality) and
3) social factors (e.g., economics, family structure, and cultural values).
Most persons may have come across people who are very old having tremors in
their hands and unable to have proper motor coordination, and many would have
also come across persons having tics and speech problems and quite a few would
have come across persons lying in coma for days on in the hospital bed. All these
conditions are related to neurological pathology. In other words these are related
to certain neurological problems or brain related dysfunctions. At the same time
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there are also many behavioural aspects related to these dysfunctions. Many Introduction, Definiton and
Description of
behaviours can be traced to certain areas of the brain and if those areas of the Neuropsychology
brain are attended to, then probably the person’s behaviour could also be changed.
However whether they will become normal or not depends on a large number of
factors. All that one could state is that there would be a change and that too more
towards the positive direction.
Thus one may state that Neuropsychology is the study of brain behaviour
relationships. It makes assessment, understands the problem and suggests
modifications to certain aspects, like for instance memory areas. Neuropsychology
seeks to understand how the brain, through structure and neural networks,
produces and controls behaviours and mental processes, including emotions,
personality, thinking, learning and remembering, problem solving, and
consciousness. The field is also concerned with how behaviour may influence
the brain and related physiological processes, as in the emerging field of psycho
neuro immunology (the study that seeks to understand the complex interactions
between brain and immune systems, and the implications for physical health).
Mind-Body Dualism
Descartes (1596-1650) introduced the concept of a separate mind and body. He
believed that all mental functions were located in the pineal gland, a small centrally
located brain structure which is now believed to play a role in sleep wake and
dark light cycles. The dualist philosophy suggested a complete split between
mental and bodily processes, and explained automatic bodily reflexes (body)
while purposeful behaviours were a product of free will (mind).
Descartes subscribed to some of Galen’s theories (that the brain was a reservoir
of fluid, in which the fire displaces the skin, which pulls a tiny thread, which
opens a pore in the ventricle allowing the “animal spirit” to flow through a hollow
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Neuropsychology tube, which inflates the muscle of the leg, causing the foot to withdraw. This
would now be described as a reflex, for which Descartes is credited.
Phrenology
Gall (1758-1828) introduced the idea that the brain was comprised of separate
organs, each localised and responsible for a basic psychological trait. These traits
controlled complex mental faculties, such as Cautiousness, Combativeness and
Agreeableness, and simpler functions, such as Memory, Calculation Ability and
Color Perception. Phrenology correlated the mental faculties described by
philosophers with the development of specific brain areas. The development of
these brain areas, called cerebral organs, resulted in skull prominences. These
bumps could be analysed and a Phrenology practitioner could determine the
subject’s personality and intelligence from analysis of the skull, called
cranioscopy.
Followers of phrenology categorised individuals on the basis of skull, and brain
size. Men were believed to have larger “social regions” with more “pride, energy,
and self-reliance”, as compared to female skulls which were thought to possess
more inhabitivness, that is love of home, a lack of firmness and self esteem.
However research has shown that there is no relationship between the bumps on
the skull and the underlying brain tissue, nor is there a relationship between the
size of an area of brain and the size of the function that it supports. Although he
was almost completely incorrect, Gall’s Phrenology represents the beginning of
the strong modern day localisationist doctrine.
The peripheral nervous system (PNS) connects the central nervous system (CNS)
to sensory organs such as the eye and ear, other organs of the body, muscles,
blood vessels and glands. The peripheral nerves include the 12 cranial nerves,
the spinal nerves and roots, and what are called the autonomic nerves that are
concerned specifically with the regulation of the heart muscle, the muscles in
blood vessel walls, and glands.
We can consider the brain as a central computer that controls all bodily functions.
The nervous system can be likened to a network that relays messages back and
forth from the brain to different parts of the body. It does this via the spinal cord.
The spinal cord runs through the back and has threadlike nerves which branch
out to every organ and body part. These transmit all messages to the body from
the brain and vice versa.
Imagine yourself touching a hot iron, immediately you wince and pull your hand
back.
What happened, let us see. The moment you touched the hot iron, the nerves in
your skin sent a message of pain to the brain. The brain immediately sends back
a message asking the muscles in your hands to pull back. All this happens in a
split second before you even realise what is going on.
The forebrain is the largest and contains the cerebrum that is the area with folds
and grooves and a certain other structures beneath it.
The spinal cord, on the other hand, is a long bundle of nerve tissue about 18
inches long and ¾ inch thick. It extends from the lower part of the brain down
through spine. Along the way, various nerves branch out to the entire body. These
are called the peripheral nervous system.
Both the brain and the spinal cord are protected by bone: the brain by the bones
of the skull, and the spinal cord by a set of ring-shaped bones called vertebrae.
They’re both cushioned by layers of membranes called meninges as well as a
special fluid called cerebrospinal fluid. This fluid helps protect the nerve tissue,
keep it healthy, and remove waste products.
The brain is made up of three main sections: the forebrain, the midbrain, and the
hindbrain.
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Neuropsychology The cerebrum contains all information about us, that is our intelligence, memory,
personality, emotion, speech, and ability to feel and move.
The cerebrum also contains four lobes, that is frontal, parietal, temporal and
occipital lobes. The cerebrum is also divided into two halves, the right and the
left hemispheres. These hemispheres are connected by a band of nerve fibres,
called as corpus collosum. This helps in the two hemispheres communicating
with each other.
It must be kept in mind that the two hemispheres have different functions to
perform, that is while the left hemisphere is considered to be logical, analytical
and objective, the right side is considered to be more intuitive, creative and
subjective. For example, when you are doing maths, you are using your left
hemisphere, and when you listen to music you are using the right hemisphere.
Until now we were discussing the inner parts of the cerebrum. Now let us see
what its outer parts are like. The outer layer of the cerebrum is called the cortex.
You know we have five senses, vision, hearing, touch, taste and smell. Information
collected by these 5 senses are sent by the spinal cord to the cortex. Cortex is
also known as the gray matter. The information then is directed to other parts of
the nervous system for further processing. For example in the case of touching
the hot iron, not only the hand is withdrawn, but the information is sent to the
memory to make sure that you don’t do it again.
The messages received from the sensory organs like eyes, nose, tongue, skin and
ears are carried to the cortex by the thalamus which is in the inner part of the
forebrain.
Another organ within the forebrain is called the hypothalamus which controls
the pulse, thirst, appetite and sleep which are automatic processes. It also controls
the pituitary gland associated with growth of the body, metabolism etc.
The midbrain is located underneath the middle of the forebrain, acts as a master
coordinator for all the messages going in and out of the brain to the spinal cord.
The hindbrain sits underneath the back end of the cerebrum, and it consists of
the cerebellum, pons, and medulla.
The cerebellum is also called as the “little brain” because it looks like a small
version of the cerebrum. The cerebellum is responsible for balance, movement,
and coordination.
The pons and the medulla, along with the midbrain, are often called the brainstem.
The brainstem takes in, sends out, and coordinates all of the brain’s messages. It
also controls many of the body’s automatic functions, like breathing, heart rate,
blood pressure, swallowing, digestion, and blinking.
It is also called as the nerve cell. (e.g., a gland or muscle) where the response
occurs. The cranial nerves handle head and neck sensory and motor activities,
except the vagus nerve, which conducts signals to visceral organs. Each spinal
nerve is attached to the spinal cord by a sensory and a motor root.
At birth, the nervous system contains all the neurons you will ever have, but
many of them are not connected to each other. As you grow and learn, messages
travel from one neuron to another over and over, creating connections, or
pathways, in the brain.
To take an example, when you learnt to drive the cycle it was so difficult and
took time but once you leant you do not have to think to cycle, but cycling comes
automatically to you. That means a pathway has been established.
In young children, the brain is highly adaptable; in fact, when one part of a
young child’s brain is injured, another part can often learn to take over some of
the lost function. But as we age, the brain has to work harder to make new neural
pathways, making it more difficult to master new tasks or change established
behaviour patterns. That’s why many scientists believe it’s important to keep
challenging your brain to learn new things and make new connections. It helps
keep the brain active over the course of a lifetime.
Memory is another complex function of the brain. The things we have learned,
seen are first processed in the cortex, and then, if we sense that this information
is important enough to remember permanently, it is passed inward to other regions
of the brain (such as the hippocampus and amygdala) for long-term storage and
retrieval. As these messages travel through the brain, they too create pathways
that serve as the basis of our memory.
Different parts of the cerebrum are responsible for moving different body parts.
The left side of the brain controls the movements of the right side of the body,
and the right side of the brain controls the movements of the left side of the
body. When you press the accelerator with your right foot, for example, it’s the
left side of your brain that sends the message allowing you to do it.
A part of the peripheral nervous system called the autonomic nervous system is
responsible for controlling many of the body processes we almost never need to
think about, like breathing, digestion, sweating, and shivering. The autonomic
nervous system has two parts: the sympathetic and the parasympathetic nervous
systems.
The sympathetic nervous system prepares the body for sudden stress, like if you
see a robbery taking place. When something frightening happens, the sympathetic
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Neuropsychology nervous system makes the heart beat faster so that it sends blood more quickly to
the different body parts that might need it. It also causes the adrenal glands at the
top of the kidneys to release adrenaline, a hormone that helps give extra power
to the muscles for a quick getaway. This process is known as the body’s “fight or
flight” response.
The parasympathetic nervous system does the exact opposite: It prepares the
body for rest. It also helps the digestive tract move along so our bodies can
efficiently take in nutrients from the food we eat.
Because the brain controls just about everything, when something goes wrong
with it, it is often serious and can affect many different parts of the body. Inherited
diseases, brain disorders associated with mental illness, and head injuries can all
affect the way the brain works and upset the daily activities of the rest of the
body.
Problems that can affect the brain include brain tumours, cerebral palsy, epilepsy
meningitis and encephalitis, migraine headaches, and mental illnesses. Another
important problem is head injury which may be caused by many factors including
accidents.
Self Assessment Questions
1) Define Neuropsychology and state its characteristic features.
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2) Trace the history of neuropsychology.
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3) What is clinical neuropsychology? Discuss
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4) Describe the Central nervous system and elucidate its functions.
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Introduction, Definiton and
1.3 DEFINITION AND CONCEPT OF Description of
Neuropsychology
NEUROPSYCHOLOGY
Neuropsychology, as mentioned earlier is the study of (and the assessment,
understanding, and modification of) brain-behaviour relationships.
Neuropsychology seeks to understand how the brain, through structure and neural
networks, produces and controls behaviour and mental processes, including
emotions, personality, thinking, learning and remembering, problem solving,
and consciousness. The field is also concerned with how behaviour may influence
the brain and related physiological processes, as in the emerging field of
psychoneuroimmunology (the study that seeks to understand the complex
interactions between brain and immune systems, and the implications for physical
health).
Neuropsychology is the basic scientific discipline that studies the structure and
function of the brain related to specific psychological processes and overt
behaviours. The term neuropsychology has been applied to lesion studies in
humans and animals.
It has also been applied to efforts to record electrical activity from individual
cells (or groups of cells) in higher primates (including some studies of human
patients).
Neuropsychology is scientific in its approach.
• It is closely related to cognitive psychology in that it also considers the
mind as information processing system
• It is closely related to cognitive science.
• It is considered eclectic
• It overlaps with some areas of neuroscience
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Neuropsychology • It is also closely associated to philosophy of mind
• It ofcourse is associated closely with neurology
• Psychiatry draws a lot from neurology
• By using artificial neural networks it is considered close to computer science
also.
Neuropsychology seeks to gain knowledge about brain and behaviour
relationships through the study of both healthy and damaged brain systems. It
seeks to identify the underlying biological causes of behaviours, from creative
genius to mental illness, that account for intellectual processes and personality.
Clinical neuropsychology seeks such understanding, particularly, in the case of
how damaged or diseased brain structures alter behaviours and interfere with
mental and cognitive functions.
A normal IQ score, or even high test scores in specific areas, do not rule out
brain injury. First, if a person has a 130 IQ before the injury and a 100 IQ after,
this would clearly establish injury. More significantly, many profoundly brain
injured survivors, maintain an average IQ near their pre-morbid levels. It is not
their average scores that are significant, but the pattern of such scores. The IQ
only measures certain brain functions, those primarily cognitive in nature. The
neuropsychological examination is designed to evaluate a comprehensive cross
section of brain function.
• Processing speed
• Visual-spatial organisation
• Visual-motor coordination
• Planning, synthesising, and organising abilities
Neuropsychological tests, with very few exceptions, were not developed with an
eye toward ecologic validity. They were developed as indicators of brain function
or dysfunction and generally were validated against neurosurgical, neurologic,
and neuroradiologic data. Nevertheless, many tests have proven to be good
predictors of future behaviour and, therefore, have demonstrated ecologic validity.
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Neuropsychology A qualitative process approach may improve the ecologic validity of the
neuropsychological test battery. For example, testing the limits with measures of
memory and executive functioning allows the examiner to understand better
what a person can do under relatively ideal circumstances. The test itself may
have little demonstrable ecologic validity, but an accurate analysis and insightful
interpretation of findings can be highly valid from an ecologic perspective.
A score on any test can be a true positive, false positive, true negative, or false
negative.
False negative on the other hand refers to the lack of sensitivity, without regard
to specificity of the test.
The Stroop Test, for example, shows a relatively high level of specificity, with a
high true negative rate (95.7%) and low false positive rate (4.3%). However, its
sensitivity is questionable, as it has a relatively low true positive rate (30.8%)
and high false negative rate (69.2%).
It must be kept in mind that each test has strengths and weaknesses in its ability
to detect a minimal CNS dysfunction (sensitivity) while being able to indicate a
specific CNS dysfunction (specificity).
Measures of cognitive and motor processing that are not timed are generally less
sensitive to diffuse dysfunctions but are very useful in identifying specific brain
lesions.
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As is known, the neuropsychological examination is generally conducted within Introduction, Definiton and
Description of
calm and quiet testing rooms where the subject is clearly presented with the task Neuropsychology
to be completed, is informed of time restrictions, and is prompted to start and
stop behaviours. Under these conditions, a subject may achieve a score that
indicates no executive dysfunctions, although the individual may be particularly
drained from the mental exertion.
Completing tasks in the real world, however, requires several executive functions
that are not tested in traditional neuropsychological examination, including
recognising that a task must be completed, starting the task, switching tasks,
adapting to changes, and stopping a task.
The field emerged through the work of Paul Broca and Carl Wernicke , both of
whom identified sites on the cerebral cortex involved in the production or
comprehension of language.
The nervous system is the System of specialised cells (neurons, or nerve cells)
which conduct stimuli from a sensory receptor through a network to the site. A
neuron consists of any of the impulse-conducting cells that constitute the brain,
spinal column, and nerves, consisting of a nucleated cell body with one or more
dendrites and a single axon.
The field is also concerned with how behaviour may influence the brain and
related physiological processes, as in the emerging field of psychoneuro-
immunology (the study that seeks to understand the complex interactions between
brain and immune systems, and the implications for physical health).
21
Neuropsychology The neuropsychologist uses objective tools -neuropsychological tests to tie the
biological and behavioural aspects together. Through the use of tests, the clinical
neuropsychologist is able to differentiate whether or not a behavioural abnormality
is more likely caused by a biological abnormality in the brain or by an emotional
or learned process.
Todd E. Feinberg and Martha J.Farah (2003). (2nd edition). Behavioural Neurology
and Neuropsychology. McGraw Hill Medical Publishing Division, New York.
Warren H Lewis (editor) (2000). (2oth edition) Gray’s Anatomy of the Human
Body Anatomy of the Human Body New York: Bartleby.com
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Introduction, Definiton and
UNIT 2 NEUROPSYCHOLOGY AND OTHER Description of
Neuropsychology
DISCIPLINES
Structure
2.0 Introduction
2.1 Objectives
2.2 Concept and Definition of Neuropsychology
2.2.1 Historical Perspective
2.2.2 Approaches to Neuropsychology
2.3 Neuropsychology and Neuroscience
2.4 Cognitive Neuropsychology and Neuroscience
2.5 Biological Psychology and Neuropsychology
2.6 Cognitive Psychology and Neuropsychology
2.7 Neurobiology and Neuropsychology
2.8 Neuropsychology and Neurophysiology
2.9 Neurology and Neuropsychology
2.10 Comparative Neuropsychology and Neuropsychology
2.11 Scientific Study of the Nervous System
2.12 Cognitive Neuroscience and Neuropsychology
2.13 Behavioural Neurology
2.14 Behavioural Neuroscience
2.14.1 Broca’s and Wernicke’s Areas
2.15 Let Us Sum Up
2.16 Unit End Questions
2.17 Suggested Readings
2.0 INTRODUCTION
In this unit we are going to deal with neuropsychology as related to other
disciplines like neurosciences, neurobiology and so on. We start with concept
and definition of neuropsychology providing certain historical aspects as to how
neuropsychology came about. Then we deal with the various approaches to
neuropsychology. We then present the relationship of neuropsychology to various
other disciplines. In this we start with neuroscience as related to neuropsychology,
followed by cognitive neuropsychology, and then cognitive psychology as related
to neuropsychology. Then we turn on to biological psychology, neurobiology,
neurology etc. and bring their relatedness to neuropsychology. Then we take up
behavioural neuroscience and point out how neuropsychology explains behaviour
in terms of the various parts of the brain and its functions.
2.1 OBJECTIVES
After completing this unit, you will be able to:
• Define neuropsychology;
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Neuropsychology • Describe neuropsychology in terms of its characteristic features;
• Explain historically the emergence of neuropsychology;
• Describe the methods used in neuropsychology; and
• Elucidate the relationship between neuropsychology and other disciplines.
In parallel with this research, work with brain damaged patients by Paul Broca
suggested that certain regions of the brain were responsible for certain functions.
At the time Broca’s findings were seen as a confirmation of Franz Joseph Gall’s
theory that language was localised and certain psychological functions were
localised in the cerebral cortex. The localisation of function hypothesis was
supported by observations of epileptic patients conducted by John Hughlings
Jackson, who correctly deduced the organisation of motor cortex by watching
the progression of seizures through the body.
To state briefly neuropsychology studies the structure and function of the brain
related to specific psychological processes and behaviours. The term
neuropsychology has been applied to lesion studies in humans and animals. It is
scientific in its approach and like cognitive psychology and cognitive science
considers the mind from a information sharing point of view.
They use Molecular and cell biological techniques and use biophysical recordings
using a variety of electrophysiological and optical techniques. Computerised
analysis are providing great insights into the functioning of single nerve cells, as
well as complicated networks of neurons. This multidisciplinary approach is
yielding insights into the rich complexity of mechanisms that influence how we
think, feel, and act.
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Research also focuses on information processing in vertebrate retina; structure, Neuropsychology and other
Disciplines
function, and development of auditory and visual systems; development and
regeneration in the central and peripheral nervous system; neural mechanisms
mediating higher nervous system functions, including perception, learning,
attention and decision making.
Neurology is part of medical science that deals with the nervous system and
disorders affecting it. It is a Medical specialty concerned with nervous system
function and disorders.
Clinical neurology began in the mid-19th century, when mapping of the functional
areas of the brain first began and understanding of the causes of conditions such
as epilepsy improved.
It has been argued that embracing this mind/brain monism is important for several
reasons. Firstly, rejecting dualism logically implies that all mental activities are
biological and so immediately there is a common research framework in which
understanding of and the treatment of mental suffering can be advanced. Secondly,
it removes the widespread confusion about the legitimacy of mental illness: all
disorders should have a footprint in the brain-mind system.
In sum, one reason for the division between psychiatry and neurology was the
difference between mind or first-person experience and brain. That this difference
is artificial is taken as good support for a merge between these specialties.
Causal pluralism
Another broad reason for the divide is that neurology traditionally looks at the
causes of disorders from an ‘inside-the-skin’ perspective (neuropathology,
genetics) whereas psychiatry looks at ‘outside-the-skin’ causation (personal,
interpersonal, cultural). This dichotomy is argued not to be instructive and authors
have argued that it is better conceptualised as two ends of a causal continuum.
NEUROPSYCHOLOGY
Comparative neuropsychology refers to an approach used for understanding
human brain functions. It involves the direct evaluation of clinical neurological
populations by employing experimental methods originally developed for use
with nonhuman animals.
Over many decades of animal research, methods were perfected to study the
effects of well-defined brain lesions on specific behaviours, and later the tasks
were modified for human use. Generally the modifications involve changing the
reward from food to money, but standard administration of the tasks in humans
still involves minimal instructions, thus necessitating a degree of procedural
learning in human and nonhuman animals alike.
Within the past decade, comparative neuropsychology has had prevalent use as a
framework for comparing and contrasting the performances of disparate
neurobehavioural populations on similar tasks.
The task of neural science is to explain behaviour in terms of the activities of the
brain. It is indeed a marvel to find that the brain controls and manipulates millions
of individual nerve cells to bring about a behaviour. These cells are also influenced
by the environment and it is important to know how this happens. It is important
to understand the biological basis of consciousness and the mental processes by
which we perceive, act, learn and remember Neuroscience can be studied at
different levels from molecular to cellular level to systems level to cognitive
level.
Neurons form functional circuits, each responsible for specific tasks to the
behaviours at the organism level.
At this level, tools from molecular biology and genetics are used to understand
how neurons develop and die, and how genetic changes affect biological functions.
Given the ever increasing number of neuroscientists that study the nervous system,
several prominent neuroscience organisations have been formed to provide a
forum to all neuroscientists and educators. For example, the International Brain
Research Organisation was founded in 1960, the European Brain and Behaviour
Society in 1968, and the Society for Neuroscience in 1969.
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Psychology, as the scientific study of mental processes, is closely related to Neuropsychology and other
Disciplines
neuroscience, although the two disciplines are distinct, with such subjects as
behaviourism and traditional cognitive psychology studied independently of the
underlying neural processes.
Neurology deals with diseases of the central and peripheral nervous systems
such as amyotrophic lateral sclerosis (ALS) and stroke, while psychiatry focuses
on behavioural, cognitive, and emotional disorders.
Behavioural neurology is that speciality which deals with the study of neurological
basis of behaviour, memory, and cognition, and their impact of damage and disease
and treatment.
Disabling or decreasing neural function. These include the following, viz., lesions,
electrolytic lesions, chemical lesions, temporary lesions, transcranial magnetic
stimulation, psychopharmacological manipulations, etc.
Although animal models for all mental illnesses do not exist, the field has
contributed important therapeutic data on a variety of conditions, including the
following:
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Neuropsychology • Alzheimer’s Disease, a neurodegenerative disease that, in its most common
form, is found in people over the age of 65 and is characterised by progressive
cognitive deterioration, together with declining activities of daily living and
by neuropsychiatric symptoms or behavioural changes.
• Clinical depression, a common psychiatric disorder, characterised by a
persistent lowering of mood, loss of interest in usual activities and diminished
ability to experience pleasure.
• Schizophrenia, a psychiatric diagnosis that describes a mental illness
characterised by impairments in the perception or expression of reality, most
commonly manifesting as auditory hallucinations, paranoid or bizarre
delusions or disorganised speech and thinking in the context of significant
social or occupational dysfunction.
• Autism, a brain development disorder that impairs social interaction and
communication, and causes restricted and repetitive behaviour, all starting
before a child is three years old.
• Anxiety, a physiological state characterised by cognitive, somatic, emotional,
and behavioural components. These components combine to create the
feelings that are typically recognised as fear, apprehension, or worry.
Clues about the role of the occipital lobes in the visual system were provided by
soldiers returning from World War I. The small bore ammunition often used in
this conflict occasionally caused focal brain injuries. Studies of soldiers with
such wounds to the back of their head showed that areas of blindness in the
visual field were dependent on which part of the occipital lobe had been damaged,
suggesting that specific areas of the brain were responsible for sensation in specific
visual areas, known as retinotopy.
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Studies on Patient HM are commonly cited as some of the precursors, if not the Neuropsychology and other
Disciplines
beginning of modern cognitive neuropsychology. Henry Gustav Molaison
(February 26, 1926 – December 2, 2008), famously known as HM or H.M., was
an American memory disorder patient who was widely studied from late 1957
until his death. His case played a very important role in the development of
theories that explain the link between brain function and memory, and in the
development of cognitive neuropsychology, a branch of psychology that aims to
understand how the structure and function of the brain relates to specific
psychological processes. Before his death, he resided in a care institute located
in Windsor Locks, Connecticut, where he was the subject of ongoing investigation.
His brain now resides at UC San Diego where it was sliced into histological
sections on December 4, 2009. HM had parts of his medial temporal lobes
surgically removed to treat intractable epilepsy in 1953. The treatment proved
successful in reducing his dangerous seizures, but left him with a profound but
selective amnesia.
Because HM’s impairment was caused by surgery, the damaged parts of his brain
were precisely known, information which was usually not possible to know in a
time before accurate neuroimaging became widespread. This allowed detailed
connections to be made between theories of memory formation and the brain
structures removed in HM.
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Neuropsychology
2) Discuss the relationship of behavioural neuroscience with the field of
psychology and biology.
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3) Enumerate the areas of behaviour neuroscience.
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4) What do you understand by Broca’s and Wernicke’s area?
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While neurophysiology is the study of the chemical and physical changes which
take place in the nervous system, Neuroscience is the study of all aspects of
nerves and the nervous system, in health and in disease. It includes the anatomy,
physiology, chemistry, pharmacology, and pathology of nerve cells; the
40
behavioural and psychological features that depend on the function of the nervous Neuropsychology and other
Disciplines
system; and the clinical disciplines that deal with them, such as neurology,
neurosurgery, and psychiatry. Neuroscience is the scientific study of the nervous
system. Traditionally, neuroscience has been seen as a branch of biology.
Neurology deals with diseases of the central and peripheral nervous systems
such as amyotrophic lateral sclerosis (ALS) and stroke, while psychiatry focuses
on behavioural, cognitive, and emotional disorders.
42
Neuropsychology and other
UNIT 3 HISTORICAL PERSPECTIVE OF Disciplines
NEUROPSYCHOLOGY
Structure
3.0 Introduction
3.1 Objectives
3.2 History of Neuropsychology
3.2.1 Trephanation
3.2.2 Ancient Egyptian
3.2.3 Ancient Greek
3.2.4 The Cell Doctrine
3.2.5 Phrenology
3.2.6 Localisation
3.3 Brain and Behaviour
3.4 Let Us Sum Up
3.5 Unit End Questions
3.6 Suggested Readings
3.0 INTRODUCTION
In this unit we will be discussing the historical perspective of neuropsychology.
We start with history of neuropsychology within which we will be presenting
trephanation, ancient Egyptian methods, Ancient Greek methods and then follow
it up with cell doctrine. We then discuss phrenology and how this helped in
understanding the functions of the brain. Then we take up localisation in which
we present some of the disorders arising due to pathology in certain localised
areas. Then we have a discussion about the relationship between brain and
behaviour.
3.1 OBJECTIVES
After going through this unit, you will be able to:
• understand the evidence of neuropsychology;
• know various studies which got neuropsychology into existence;
• discuss the relation between the brain and behaviour; and
• understand the current developments in neuropsychology.
3.2.1 Trephanation
Trephanation is the ancient surgical procedure of operating on the human skull
by scraping, chiseling, or cutting bone from the skull. This method was discovered
by archaeologists. It is reported that at that time when this method was used
many who underwent trephanations survived which showed that this method
was very effective in healing some of the brain disorders. Those disorders for
which trephanation was used included Traumatic Brain disorders, psychiatric
disorders etc. This method was rather a crude method and many also died and
never got alright. Some even underwent multiple trephanations. Many had their
skulls damaged due to trephanation. Trephanation was also carried out for
religious purposes that is to release and drive away the evil spirits etc. perhaps a
religious rite - to release evil spirits.
In a study conducted by Verona & Williams (1992), they examined 750 skulls
from Peru and measured trephinated skulls for technique, location, size, healing,
and presence of fractures. Results suggest that most trephinations were performed
in the frontal and upper parietal regions following injury to the skull from clubs
and other weapons of the pre-Columbian era. Scraping and circular grooving
had the highest success rates as opposed to straight cutting and drilling. Techniques
used were similar to modern day methods of drilling burr holes to relieve pressure
and release trapped blood.
In one process, the practitioner had even produced ring of small holes. The next
step in the procedure is to cut the bone between each hole and pry off the bone
piece in the center. The patient probably would die before the trephination is
completed. There is no evidence of healing. There is also a large linear skull
fracture besides the trephination opening. It is clear that this trephination was
used to treat the associated skull fracture. Perhaps the practitioner believed that
a blood clot was underneath the skull, near the fracture. Such blood clots are a
frequent result of this type of traumatic skull injury.
This skull on the right shows evidence of multiple head injuries and trephinations.
There is a well-healed trephination and a fresh one. The patient probably died
soon after receiving this recent head injury and fresh trephination. This one
demonstrates the great survival rate associated with the procedure. This person
44
lived for many years after the first trephination. There is considerable healing. Historical Perspective of
Neuropsychology
This trephination was done with the scraping method.
In another process, the practitioner begins with cuts that surround the central
area. They began cutting the outer perimeter in order to create a larger opening.
This trephination shows no signs of healing because the patient dies.
Why? After death, the heart was weighed to see if one would enter into eternal
afterlife, but the brain was usually discarded. Aristotle believed in “dualism”
which divides the world into two spheres: mind and matter. The mind (or soul)
is a nonphysical entity, which somehow interacts with the material body. In
particular, mind-body dualism claims that neither the mind nor matter can be
reduced to each other in any way, and is sometimes referred to as “mind and
body” and stands in contrast to philosophical monism, which views mind and
matter as being ultimately the same kind of thing. According to Aristotle, the
mind and body interacted through a “point of interaction” which he identified as
the heart. To this day, we continue to perpetuate this belief by giving cards with
hearts on Valentine’s day, and by using terms such as “heartbroken” or “cold-
blooded.”
Pythagoras (circa 550 BC, best known for the Pythagorean theorem) was one of
the first to propose that the thought processes and the soul were located in the
brain and not the heart. This belief is the “brain or cephalocentric hypothesis”,
stating that the brain is the source of reasoning and all human behaviour.
Pytharoras also claimed to have lived four lives that he could remember in detail,
and heard the cry of his dead friend in the bark of a dog.
Hippocrates (circa 400 BC, influenced by Socrates) was considered one of the
most outstanding figures in the history of medicine, is referred to as the “father
of medicine”, and was the founder of the Hippocratic school of medicine. The
Hippocratic school held that all illness was the result of an imbalance in the
body of the four humours, fluids which in health were naturally equal in proportion
(pepsis). When the four humours, blood, black bile, yellow bile and phlegm,
were not in balance (dyscrasia, meaning “bad mixture”), a person would become
sick and remain that way until the balance was somehow restored. Hippocratic
therapy was directed towards restoring this balance.
However, Hippocrates also believed the brain to be the seat of intelligence, and
the controller of the senses, emotions, and movement, and was the first to
45
Neuropsychology recognise that paralysis occurred on the side of the body opposite the side of a
head injury.
The 1960s saw two such seminal collaborative papers, which marked the rebirth
of cognitive neuropsychology: Marshall and Newcombe (1966) on reading and
Warrington & Shallice (1969) on memory. A decade later, cognitive
neuropsychology had been fully reestablished, according to Selnes (2001), who
notes that in 1977 “a meeting to discuss deep dyslexia was convened in Oxford,
and this is often considered by many to be a convenient marker for the early
beginnings of cognitive neuropsychology (E. Saffran, personal communication,
2000). The book Deep Dyslexia (Coltheart, Patterson & Marshall, 1980) which
resulted from the conference is considered by many to be the first major book
that deals with the cognitive approach to neuropsychology. The journal Cognitive
Neuropsychology was first published in 1984.” (Selnes, 2001, p. 38). Not long
afterwards, in 1988, the field’s first textbook, Human Cognitive Neuropsychology,
was published (Ellis & Young, 1988), and so was the first book critically reviewing
the field (Shallice, 1988).
The volume by Coltheart and Caramazza (2006) is a recent review of the field
which contains state-of-the-art accounts of contributions of cognitive
neuropsychology to our understanding of a variety of domains of cognition,
showcasing in particular what we have learned so far from cognitive
neuropsychology about conceptual representation, speech production, sentence
comprehension, reading and spelling, short-term memory, visual object
recognition, spatial attention and skilled action.
From this period, many important discoveries and theories were noted. Dissections
of condemned criminals (who, at that time, were at the disposal of scientists and
physicians) led to the knowledge that specific parts of the brain control specific
behaviours (discussed later as localisation). As well, the discovery of ascending
(sensory) and descending (motor) nerves occurred.
Galen (circa 200 BC) was a prominent ancient Greek physician, who also served
as a physician in a gladiator school. During this time he gained much experience
with treating trauma and especially wounds, which he later called “windows
into the body”. He performed many operations, including brain and eye surgeries,
and also “vivisections” of numerous animals to study the function of the kidneys
and the spinal cord. From these studies, Galen hypothesised that the mind
controlled fluids known as pneuma (animal spirits): the brain was the reservoir
of pneuma, which were stored in the ventricles.
Pneuma traveled through nerves, which Galen believed were tubes, throughout
the body - sent out from the brain to the muscles (i.e., controlled by the mind,
causing the body to move) and sent back to the brain due to sensory stimulation.
Physical functioning was dictated by the balance of four bodily fluids or humors:
Blood, Mucus, Yellow bile, Black bile, which were related to the four elements
- air, water, fire, and earth. Galen also showed that pressing on the heart in human
subjects did not lead to loss of consciousness or loss of sensation but severing
the spinal cord in animals abolished sensory responses after brain stimulation.
The First Anatomical Studies: Vesalius (1514-1564) was the first to conduct
careful observations of brain anatomy and qualify the teachings of the cell doctrine
in which he was trained. He represents the beginning of a period in which careful
observations and empirical science began to triumph over the ideas that had
been handed down since the time of Aristotle and Galen. Vesalius introduced the
anatomical theater in which students and doctors could watch dissections from
above. Vesalius made careful diagrams of human anatomy.
Descartes did subscribe to some of Galen’s theories (that the brain was a reservoir
of fluid), as demonstrated by one of his illustrations, in which the fire displaces
49
Neuropsychology the skin, which pulls a tiny thread, which opens a pore in the ventricle (F) allowing
the “animal spirit” to flow through a hollow tube, which inflates the muscle of
the leg, causing the foot to withdraw. This would now be described as a reflex,
for which Descartes is credited. Popular culture has many references to dualism.
3.2.5 Phrenology
Phrenology is a hypothesis stating that the personality traits of a person can be
derived from the shape of the skull. It is now considered a pseudoscience.
Developed by German physician Franz Joseph Gall in 1796, the discipline was
very popular in the 19th century.
Phrenology is based on the concept that the brain is the organ of the mind, and
that certain brain areas have localised, specific functions or modules.
Phrenologists believed that the mind has a set of different mental faculties, with
each particular faculty represented in a different area of the brain.
These areas were said to be proportional to a person’s propensities, and the
importance of the given mental faculty. It was believed that the cranial bone
conformed in order to accommodate the different sizes of these particular areas
of the brain in different individuals, so that a person’s capacity for a given
personality trait could be determined simply by measuring the area of the skull
that overlies the corresponding area of the brain.
Gall (1758-1828) introduced the idea that the brain was comprised of separate
organs, each localised and responsible for a basic psychological trait. These traits
controlled complex mental faculties, such as Cautiousness, Combativeness and
Agreeableness, and simpler functions, such as Memory, Calculation Ability and
Color Perception. Phrenology correlated the mental faculties described by
philosophers with the development of specific brain areas. The development of
these brain areas, called cerebral organs, resulted in skull prominences. These
bumps could be analysed and a Phrenology practitioner could determine the
subject’s personality and intelligence from analysis of the skull, called
cranioscopy.
Followers of phrenology categorised individuals on the basis of skull, and thus,
brain size. Men were believed to have larger “social regions” with more “pride,
energy, and self-reliance”, as compared to female skulls which were thought to
possess more “inhabitivness (love of home), a lack of firmness and self esteem.”
Many studies have refuted the notion that skulls of different races reflect
superiority, and it is impossible to distinguish between murders and geniuses on
the basis of skull size or shape.
Phrenology was a complex process that involved feeling the bumps in the skull
to determine an individual’s psychological attributes. Franz Joseph Gall first
believed that the brain was made up of 27 individual ‘organs’ that created one’s
personality, with the first 19 of these ‘organs’ believed to exist in other animal
species.
Phrenologists would run their fingertips and palms over the skulls of their patients
to feel for enlargements or indentations. The phrenologist would usually take
measurements of the overall head size using a caliper. With this information, the
phrenologist would assess the character and temperament of the patient and
address each of the 27 “brain organs”.
50
Gall’s list of the “brain organs” was lengthy and specific, as he believed that Historical Perspective of
Neuropsychology
each bump or indentation in a patient’s skull corresponded to his “brain map”.
An enlarged bump meant that the patient utilised that particular organ extensively.
The 27 areas were varied in function, from sense of colour, to the likelihood of
religiosity, to the potential to commit murder.
Each of the 27 “brain organs” was located in a specific area of the skull. As a
phrenologist felt the skull, he could refer to a numbered diagram showing where
each functional area was believed to be located.
There is no relationship between the bumps on the skull and the underlying
brain tissue, nor is there a relationship between the size of an area of brain and
the size of the function that it supports (skulls are hard, brains are not). Although
he was almost completely incorrect, Gall’s Phrenology represents the beginning
of the strong modern day localisationist doctrine.
3.2.6 Localisation
Broca (1824-1880) described most famous case, “Tan”, and a patient who suffered
a stroke of the left hemisphere who could only utter the phrase “Tan”. The patient
could accurately comprehend language. Broca then used this case and a number
of others to show that the expression of language was localised to the left frontal
lobe. If you look carefully at the brain, you can detect a soft, fluid-filled area in
the frontal lobe. This represents the empty space, or infarction that is caused by
the drop in blood supply to that brain area (stroke). The third convolution of the
inferior posterior frontal lobe has since become known as “Broca’s area”, and
patients with damage to Broca’s area are referred to as having “Broca’s aphasia”.
Several years after Broca presented his cases of frontal lobe lesions, Wernicke
(1848-1904) presented cases in which patients had lesions of the superior posterior
part of the left hemisphere and had trouble comprehending language. This resulted
in the idea that component processes of language were localised. On the basis of
Wernicke’s observations, the modern doctrine of component process localisation
and disconnection syndromes was begun. This doctrine states that complex mental
functions, such as language, represent the combined processing of a number of
subcomponent processes represented in widely different areas of the brain. A
mental faculty like “Combativeness” described by the Phrenologists was not
discreetly localised in the brain. Such faculties, if they have validity at all, are
the result of a number of primary cognitive operations.
Responses to Localisation: Freud described several types of language disorders
wich could not be explained by lesions to Broca’s or Wernike’s areas. He
postulated that lesions in the subcortical areas would produce similar behavioural
disorders. Similar anti-localisation concepts were presented by Flourens (1794-
1867). He asserted that while sensory input was localised, to an extent, at an
elementary level, the more compels process of perception was dependent on the
entire brain (Luria later explained this in terms of primary, secondary and tertiary
zones). Based on ablation studies of hens and pigeons, he concluded that loss of
function is more a product of the amount of damage rather than the location of
that damage. Flourens also offered the notion of equipotentiality of brain tissue,
or that if there is enough intact tissue following brain damage, the remaining
tissue will compensate and take over the function of the missing area. By utilising
dependent measures such as wing-flapping and eating behaviours in pigeons,
Flourens erroneously suggested that only 10 percent of brain tissue of used.
51
Neuropsychology Munk (1839-1912) produced temporary “mind-blindness” in dogs following
lesions in their association cortex. This notion that an animal will recognise an
object (i.e., see the object) but fail to recall the conditioned significance is similar
to the concept of “anosognosia.” Following lesions to the association cortex of
the right hemisphere, Babinski (1857-1932) described a similar unawareness of
deficit.
Structure
4.0 Introduction
4.1 Objectives
4.2 Areas of Neuropsychology
4.2.1 Clinical Neuropsychology
4.2.2 Expérimental Neuropsychology
4.3 Cognitive Functions
4.3.1 Attention
4.3.2 Motor Function
4.3.3 Language
4.3.4 Learning and Memory
4.3.5 Visual Perception and Constructional Ability
4.3.6 Executive Functions
4.4 Neuropsychological Assessment
4.5 Approaches of Neuropsychological Assessment
4.5.1 Fixed Battery Approach
4.5.2 Flexible Battery Approach
4.6 Goals of Neuropsychological Assessment
4.7 Assessment Process
4.8 Other Assessments
4.9 Let Us Sum Up
4.10 Unit End Questions
4.11 Suggested Readings
4.0 INTRODUCTION
The brain is a fascinating and enigmatic machine. It has the ability to monitor
and control our basic life support systems, to maintain our posture and direct our
movements, to receive and interpret information about the world around us, and
to store information in a readily accessible form throughout our lives. It allows
us to solve problems which range from the strictly practical to the highly abstract,
to communicate with our fellows through language, to create new ideas and
imagine things that have never existed, to feel love and happiness and
disappointment and to experience an awareness of ourselves as individuals.
Neuropsychology as one of the neurosciences has grown to be a separate field of
specialisation within psychology. Neuropsychology seeks to understand the
relationship between the brain and behaviour i.e. it attempts to explain the way
in which the activity of the brain is expressed in observable behaviour.
4.1 OBJECTIVES
After completing this unit, you will be able to:
• Define neuropsychology;
55
Neuropsychology • Describe neuropsychological functions;
• Explain the different neuropsychological functions;
• Explain the different approaches to neuropsychological assessment;
• Elucidate the goals of neuropsychological assessment; and
• Describe the various tests used for assessment.
4.3.1 Attention
Attention can be defined as “the concentration of mental effort on sensory or
mental events. Attentional processes facilitate, enhance, or inhibit other cognitive
processes. Attentional problems may manifest as either distractibility or difficulty
remaining focused on a task. Individuals with attentional dysfunction are usually
unable to allocate cognitive resources effectively to the task at hand and fails to
perform at optimal levels even though primary cognitive resources, such as
sensory registration, perception, memory, and associative functions, are intact.
Sustained attention
This requires ‘holding’ attention over relatively long periods of time and has
features of vigilance. Right fronto parietal network mediates sustained attention.
Imaging studies have depicted that vigilance tasks that require sustained attention
activate a network of structures in the right frontal and parietal cortices.
Divided attention
This refers to the ability to perform two or more tasks simultaneously and may
be considered as requiring the opposite operations to selective attention. For
example a subject may be presented with stimuli which vary with respect to
colour, motion and shape and monitor changes in all three dimensions.
Dorsolateral prefrontal cortex is implicated in divided attention. Overall it can
be said that frontal lobe plays an important role in all aspects of attention.
4.3.3 Language
Language functions include expressive language (e.g. naming, vocabulary,
storytelling), verbal fluency (fluency of speech, writing, reading), and receptive
language (following directions, attending to spoken language, comprehension
of information). Disorder of language occurs as aphasia.
Aphasia is a primary disturbance in the comprehension or production of speech
caused by brain damage. Mainly there are two types of aphasia:
Expressive aphasia characterised by difficulty in producing words. Patients has
difficulty using grammatical constructions, a nomia (word finding difficulty)
and articulation difficulty (mispronounce words).It is caused by lesion in the left
frontal lobe.
Receptive Aphasia is characterised by poor speech comprehension and production
of meaningless speech.
Explicit memory
This is the conscious recollection of information such as specific facts or events
and at least in humans that can be verbally communicated. There are two subtypes
of explicit memory. 57
Neuropsychology Episodic memory
It is the retention of information about the where and when of life’s happening.
Semantic Memory
Semantic means meanings. It is a person’s knowledge about the world. It includes
general knowledge, knowledge about meanings of words famous individuals,
important places etc.
Procedural memory
It is related to unconsciously remembering skills and perceptions rather than
consciously remembering facts. Examples include skills of driving a car or typing.
Once learnt the individuals do not have to remember consciously how to drive a
car or type. The subsystems of implicit memory are:
The left prefrontal cortex is involved in encoding episodic memory and retrieval
for semantic memory.
The right prefrontal lobe is implicated in retrieval from episodic memory. Left
temporal lobe mediates verbal memory and of the right temporal lobe mediates
visuo- spatial memory.
Memory deficits may take the form of amnesia in which there is a partial or total
loss of memory. Amnesic patients are unable to encode and consolidate verbal
and nonverbal information regardless of the modality of presentation (auditory
or visual) or the nature of the material (verbal or nonverbal). In contrast, attention
span, language functions, and reasoning are relatively preserved. Amnesic patients
show the greatest deficits on tasks of declarative memory in that they are unable
to demonstrate awareness of prior learning experiences, whereas procedural
memory (skills, habits, and classically conditioned responses) remains intact.
Amnesia may be of two types.
Visual perception
It is the process through which sensory information derived from light is
interpreted for object recognition or spatial orientation. Visual perception consists
of visuoperceptual and visuospatial ability, two functionally independent
processes that have separate neuroanatomical substrates.This functional
58
distinction is commonly referred to as “what” (visuoperceptual) verses “where” Domains of
Neuropsychology
(visuospatial).
Visuoperceptual ability
This subsumes form or pattern discrimination. Colour, shape, and other intrinsic
features are processed by the visuoperceptual system, regardless of the spatial
dimensions of an object or environment. Visuo-perceptual deficit may manifest
in the form of
a) Visual agnosia I
It is a deficit in recognition of common objects or familiar faces. Bilateral temporo-
occipital lesions damaging the visual association cortices of both hemispheres
usually leads to the manifestation of visual agnosia.
Visuospatial ability
It is the processing of visual orientation or location in space, regardless of the
intrinsic features of that object or environment. Depth and motion are subsumed
by this system. Visuospatial deficit may appear as
Constructional ability
Constructional ability is the capacity to draw or assemble an object from
component parts, either on command or to copy a model. The concept measures
the integrative aspect of construction. Visuo constructive ability requires attention,
59
Neuropsychology visuo spatial perception, visuomotor coordination, planning and error correction
abilities. It is mediated by bilateral parietal structures predominantly right parietal
structure. The prefrontal structures mediate the planning and error correction
capacity.
Planning
It is the ability to set goals, to monitor performance so as to reach the goals and
to make corrections in the steps adopted, in order to ensure that the goal is attained.
Goal setting involves identification of both final goals and intermediate goals
that needs to be achieved in order to attain the final goal. Left frontal lobe is
associated with planning ability.
Response inhibition
The concept refers to the suppression of actions that are inappropriate in a given
context and that interfere with goal-driven behaviour. Prefrontal areas are essential
for response inhibition.
Problems with executive function may present in many ways, such as impulsivity,
disorganisation, poor judgment, dysregulated behaviour, and amotivation.
Finally serial assessments over time helps to monitor treatment effects and provide
information regarding the rate of recovery and the potential for resuming previous
lifestyle.
Intelligence Tests
Usually Wechsler Tests of Intelligence is administered.WAIS-IV, (current version)
is composed of 10 core subtests and five supplemental subtests, with the 10 core
subtests comprising the Full Scale IQ. It provides four index scores representing
major components of intelligence:
Verbal Comprehension Index (VCI)
Perceptual Reasoning Index (PRI)
Working Memory Index (WMI)
Processing Speed Index (PSI)
Subtests
The Verbal Comprehension Index includes four tests:
i) Similarities: Abstract verbal reasoning (e.g., “In what way are an apple and
a pear alike?”)
ii) Vocabulary: The degree to which one has learned, been able to comprehend
and verbally express vocabulary (e.g., “What is a guitar?”)
iii) Information : Degree of general information acquired from culture (e.g.,
“Who is the president of Russia?”)
iv) Comprehension [Supplemental]: Ability to deal with abstract social
conventions, rules and expressions (e.g., “What does Kill 2 birds with 1
stone metaphorically mean?”)
The Perceptual Reasoning Index comprises five tests:
i) Block Design: Spatial perception, visual abstract processing and problem
solving.
ii) Matrix Reasoning: Nonverbal abstract problem solving, inductive reasoning,
spatial reasoning.
iii) Visual Puzzles: non-verbal reasoning.
iv) Picture Completion [Supplemental]: Ability to quickly perceive visual details.
v) Figure Weights [Supplemental]: quantitative and analogical reasoning.
62
The Working Memory Index is obtained from three tests: Domains of
Neuropsychology
i) Digit span: attention, concentration, mental control (e.g., Repeat the numbers
1-2-3 in reverse sequence)
ii) Arithmetic: Concentration while manipulating mental mathematical
problems (e.g., “How many 45-cent stamps can you buy for a dollar?”)
iii) Letter-Number Sequencing [Supplemental]: attention and working memory
(e.g., Repeat the sequence Q-1-B-3-J-2, but place the numbers in numerical
order and then the letters in alphabetical order)
The Processing Speed Index includes three tests:
i) Symbol Search: Visual perception, speed
ii) Coding: Visual-motor coordination, motor and mental speed
iii) Cancellation [Supplemental]: visual-perceptual speed
Two broad scores are also generated, which can be used to summarise general
intellectual abilities:
Full Scale IQ (FSIQ), is obtained from the combined performance of the VCI,
PRI, WMI, and PSI
General Ability Index (GAI), based only on the six subtests that comprise the
VCI and PRI
The WAIS-IV measure is appropriate for use with individuals aged 16–90 years.
For individuals under 16 years, the Wechsler Intelligence Scale for Children
(WISC, 6-16 years) and the Wechsler Preschool and Primary Scale of Intelligence
(WPPSI, 2½–7 years, 3 months) are used.
Scores for three summary scales can also be calculated: pathognomonic, right
hemisphere, and left hemisphere.
Reaction Times: This measures the amount of time between the presentation of
the stimulus and the client’s response.
Omission errors: This indicates the number of times the target was presented,
but the subject did not respond/click the mouse. High omission rates indicate
that the subject is either not paying attention (distractibility) to stimuli or has a
sluggish response.
Commission errors: This score indicates the number of times the client responded
but no target was presented. A fast reaction time and high commission error rate
points to difficulties with impulsivity.
• •
•
They are then asked to select the previously viewed words that are presented -in
a forced-choice list (one foil paired with each target). In the second subtest, 50
black-and-white photographs of male faces are presented. The patient is then
shown two faces (one previously seen and one distractor) and asked to point
tothe target stimulus. The Warrington Recognition Memory Test provides useful
information regarding material-specific aspects of memory.
Visuoperceptual discrimination
Benton Test of Facial Recognition (BFRT)is a clinically useful test of
visuoperceptual discrimination. In BFRT subjects are presented with a target
face and several test faces, and they are asked to indicate which of the images
match the target face. Male and female faces are used, and the faces are
closelycropped so that no clothing and little hair are visible.
Visuospatial Judgment
Benton et al.’s (1994) Judgment of Line Orientation task is a clinically useful
test of visuospatial judgment. It consists 30 stimuli with one page with two lines
and a second page with 11 lines. Participants are asked to compare the two pages
and report which two lines on the second page point in the same direction and
are in the same location as the two lines on the first page. This measure has high
split-half reliability for adults.
Constructional Ability
The Benton Visual Retention Test (or simply Benton Test) is an individually
administered test for ages 8-adult The individual is shown 10 designs, one at a
time, and asked to reproduce each one as exactly as possible on plain paper from
memory. The test is untimed, and the results are professionally scored by form,
shape, pattern, and arrangement on the paper.
Executive functions
Planning is assessed using
Tower of London. This test evaluates the subjects’ ability to plan and anticipate
the results of their actions to achieve a predetermined goal. The test consists of
two identical wooden boards with three round pegs of different sizes and two
sets of three balls painted red, green, and blue respectively. The examiner arranges
the balls in a predetermined manner (goal state) on one of the wooden boards
and instructs the subjects to move the balls on the wooden board placed before
him so that he/she achieves that goal state. Tower of London comprises of
problems with 2 moves, 3 moves 4 moves and 5 moves. Scoring yields standard
scores for the total number of moves, total initiation time, total problem-solving
time, total execution time, and the number of correct solutions (i.e., items solved
in minimum number of moves), total time violations, and total rule violations.
The Porteus Maze Test is a graded set of paper forms on which the subject traces
the way from a starting point to an exit; the subject must avoid blind alleys along
the way. There are no time limits. The mazes vary in complexity from simple
diamond shape for the average three-year-old to intricate labyrinths for adults.
68
Set Shifting Domains of
Neuropsychology
Wisconsin Card Sorting Test (WCST)
The test uses stimulus and response cards that show different forms in various
colours and numbers. Individually administered, it requires the client to sort the
cards according to different principles (i.e., by colour, form, or number). As the
test progresses, there are unannounced shifts in the sorting principle which require
the client to alter his or her approach: however, the subject is given the feedback
whether a particular match is right or wrong. Time taken for the participant to
learn the new rules, and the mistakes made during this learning process are
analysed to arrive at a score.
Response inhibition
Stroop Test-
It comprises of three cards (D,W & C).Card D consists of 24 dots printed in
blue, green, red and yellow. Each color is used six times and arranged in a order
so that each color appear once in a row. Subjects are instructed to read the color
of the dots. Card W is similar to card D except dots are replaced by the words
and subjects are instructed to name the colour of the word in which it is printed.
In Card stimuli is the name of the colours and the instruction is to read the colour
in which the word is printed. Scoring is done in the form of the time taken and
the number of errors committed.
Language
Measure of Aphasia
Boston Diagnostic Aphasia Examination:
The tests are organised into five major sections as given below:
i) Conservational and Expossitory Speech
ii) Auditiory Comprehension
iii) Oral Expression
iv) Understanding Written Language
v) Writing
Token Test
Token Test: This test is designed to assess verbal comprehension of commands
of increasing complexity. The test employs a set of 20 plastic tokens consisting
of 5 colours, two shapes and two sizes. The test sees if an individual can follow
orally presented instructions. For example, the examiner may say, “Touch the
69
Neuropsychology red square” and then the behaviour or lack of behaviour in the individual is
observed and noted.
Motor Function
Motor Speed
Finger Tapping Test In Finger Tapping Test (FTT) also referred as the Finger
Oscillation Test the client is asked to initially tap his or her dominant index
finger as fast as possible for five consecutive 10- second trials. The procedure is
then repeated for the nondominant index finger. Performances are measured on
a recording device . The score is simply the average number of taps in a 10-
second interval. The two average scores (for dominant and nondominant fingers/
hands) are compared with each other to see if there are wide discrepancies.
Dexterity
It is measured by Purdue Pegboard Test. The test board consists of two parallel
rows of 25 holes each. Pins, collars and washers are located at the extreme right
hand and left hand cups at the top of the board. The procedure for administration
and scoring is as follows. Performance of the RH and LH subtests require
participants to first use their right hand (dominant) then left hand (nondominant)
to place as many pins as possible down the respective row within 30 sec. The
score for each of these subtests is the total number of pins placed by each hand in
the time allowed. The BH subtest is a bimanual test where the participants use
their right and left hand simultaneously to place as many pins as possible down
both rows in 30 sec. The score for this subtest is the total number of pairs of pins
placed in 30 sec. The assembly subtest requires that both hands work
simultaneously while performing different tasks for 60 sec. The score for this
subtest is the total number of pins, washers, and collars placed in 60 sec. It can
be administered to individuals or groups.
Strength
In order to assess the strength of the voluntary movements of the hands Hand
Dynamometer is used. The subject is required to hold the upper part of the
dynamometer in the palm of the hand and squeeze the stirrup with the fingers as
hard as possible. It is conducted on each hand respectively.
Measure of Personality
Minnesota Multiphasic Personality Inventory (MMPI) It is a self administered
measure of personality. The revised version MMPI-2 contains 567 test items and
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Neuropsychology takes approximately 60 to 90 minutes to complete. It comprises of following
clinical scales that are used to indicate different conditions.
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Neuropsychology Methods
UNIT 1 NEUROPSYCHOLOGY METHODS
Structure
1.0 Introduction
1.1 Objectives
1.2 Techniques for Measuring Brain Structure and Functions
1.2.1 Examining Tissue
1.2.2 Lesions and Ablation
1.2.3 Electrical Stimulation
1.2.4 Neurochemical Manipulations
1.2.5 Electrical Recording
1.2.6 In-Vivo Imaging
1.3 Neuropsychological Assessment
1.4 Dissociation and Double Dissociations
1.5 In Vivo Imaging in Psychiatry
1.6 Let Us Sum Up
1.7 Unit End Questions
1.8 Suggested Readings
1.0 INTRODUCTION
In this unit, you will be introduced to some of the methods that researchers use
to explore the relationships between brain structure and function.
Neuropsychology is a bridging discipline that draws on material from neurology,
experimental psychology and even psychiatry; and the area is served by a diverse
collection of investigative measures ranging from neuroanatomical procedures
at one end of the spectrum to assessments from experimental psychology at the
other.
A particularly exciting development over the last 30 years has been the
introduction of invivo imaging techniques. The rapid spread in availability of
scanning and imaging hardware (particularly during ’the decade of the brain’ in
1990s) has provided neuroscientists with research opportunities that were, until
recently, unthinkable. In vivo imaging has provided independent confirmation
of the suspected role(s) of particular brain regions in psychological processing
(for example, the role of the anterior cingulate in attention). In other instances,
in-vivo techniques have revealed the true complexity of processes that other
procedures had tended to oversimplify.
The application of imaging techniques to language to find out the different areas
involved in different processing of language is an example of the same.
Informative though the various procedures can be, it is also important to realise
that most neuropsychological techniques (including in vivo scanning) have their
limitations. So, although the demise of older procedures has frequently been
predicted as imminent, many still have important role to play. In fact, the
combination of imaging with traditional techniques can turn out to be a particularly
fruitful and informative collaboration. In simple terms using a combination of
5
Brain Behaviour methods is the best way to follow when studying a phenomenon in
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neuropsychology.
The unit starts with a brief review of classical techniques that are, for the most
part, neuroanatomical in origin. Next, the use of electrical stimulation and
electrical recording of the brain is discussed and elaborated. Then some of the
in-vivo techniques are identified that allows researchers to visualise the structure
and/or function of the ‘living’ brain. Neuropsychological procedures are
elaborated towards the end, some of which can be used in conjunction with in-
vivo imaging to provide better insight and understanding of the functioning of
the brain. It is tried to keep the information simple and brief, but at the same
time pertinent information is not omitted. The unit concludes with an illustration
of an exciting application of in-vivo imaging in psychiatry.
1.1 OBJECTIVES
After completing this unit, you will be able to:
• Define and describe neuropsychological assessment;
• Describe the techniques for measuring brain structures and functions;
• Describe the tests and subtests underlying neuropsychological assessment
battery;
• Differentiate between dissociation and double dissociation; and
• Elucidate the in vivo imaging in psychiatry.
Obstructions such as tumors can interrupt normal brain activity, leading to deficits
of normal reasoning, motor control, or consciousness. Many of the signs of neural
damage are easily recognisable by an outside observer, but since the actual cause
of these problems are internal, the symptoms can be vague. The real deficits can
affect the brain’s anatomy, or the way signals are processed. A physician can
only determine the real cause by examining the brain internally to find
irregularities, either in structure or in functioning. Since the brain is extremely
fragile and difficult to access without risking further damage, imaging techniques
are used frequently as a noninvasive method of visualising the brain’s structure
and activity.
Today’s technology provides many useful tools for studying the brain, and this
website will try to briefly describe the most important ones. Some have their
most important applications in medical diagnosis, and some are used more for
research. The latter are often too expensive or limited for cost-efficient medical
use, but can prove valuable and necessary in the future through development
and further advances.
6
There are two main groups of procedures. Structural analysis is used to analyse Neuropsychology Methods
the anatomy of the brain, in order to find structural deviations. These could be
tumors, hemorrhages, blood clots and lesions, or even deficits present at birth.
Functional analysis tries to measure and locate brain activity. This is useful for
investigating the functioning of special structures, and to diagnose epileptic
seizures or diseases affecting brain activity. Functional imaging is also used to
aid surgical treatment of brain lesions when it becomes necessary to determine
the locality of essential functional cortex to help guide the best surgical approach.
Many times a structural and functional method will be used in conjunction to
better assess how the activity and region are related.
Brain tissue looks solid to the naked eye (it has a consistency of stiff jelly), so
‘finger-grain’ investigations had to await two technological developments. The
first was the gradual refinement over many years of the light microscope, and
second was the discovery of tissue staining techniques that had the effect of
‘highlighting’ particular component structures of tissue. The combinations of
these developments enable researchers to identify small groups of neurons, or
even individual neurons, using a microscope. Thanks to technological
improvements in lens manufacture, microscopy has developed considerably since
its first reported use to examine biological tissues (of a cow) by Van Leeuwenhoek
in1674. Light microscope can now reliably magnify by a factor of several hundred,
but electron microscope can magnify by a factor of several thousands. They can
produce images of images of individual synapses (junctions between neurons),
or even of receptor sites for neurotransmitters on the surface of neurons.
New staining techniques have also been developed since the pioneering work of
Golgi in the late 19th century, although his silver-staining method (which makes
7
Brain Behaviour stained material appear dark) is still used to produce images of neurons. Other,
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staining techniques, such as horseradish peroxidise (HRP), have been developed
to enable the tracing of connections between neurons. This stain gets absorbed
by distal (remote) regions of neuron, but is carried back to the cell body (by
retrograde transport within the neuron) to reveal the pathway that the neuron’s
axon takes. A combination of silver and HRP techniques can be used to establish
functional connectivity between the brain regions, such as the innervations of
the striatum by the substantia nigra.
For obvious reasons these procedures are not used experimentally on humans,
but sometimes brain tissue is ablated for medical reasons such as the excision of
tumour. Occasionally, surgical lesioning is also undertaken. Taylor’s (1969) study
of the effects of lesions to the left and right sides of the cortex in two patients is
an example of the former. The surgical procedure of lesioning the corpus callosum
as a treatment for epilepsy is an example of the latter. Sometimes, accidents
cause lesions (or ablations). The case of Phineas Gage is one celebrated case in
point. The case of NA, who developed amnesia following an accident with a
fencing foil, is less well known but equally interesting.
8
Neuropsychology Methods
Self Assessment Questions
1) Discuss the techniques for measuring brain structures and functions.
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2) What is meant by lesions and ablations? Discuss their role in measuring
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3) Discuss Taylor’s study of the effects of lesions to the left and right sides
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In order to record ERPs a series of stimuli such as tones or light flashes are
presented to the participant, and the raw EEG for a precise one or two second
period following each stimulus is recorded and fed into a computer where it is
summed and averaged. This will be a response (or ‘event-related potential’) in
the brain to each separate stimulus but this will be small (millionths of a volt) in
comparison with the background EEG (thousandths of a volt). By summing all
EEGs together and averaging them, the more-or-less random EEG averages to
zero, to leave an ERP that has a characteristic waveform when shown on the
computer screen. Various abnormalities in this waveform have been linked to
predisposition to alcoholism and schizophrenia. The ERP technique has also
been useful as a tool to explore the mechanism of attention.
10
Neuropsychology Methods
Self Assessment Questions
1) What is the contribution/discovery of Penfield?
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2) How will you correlate the behavioural effects of pharmacological agents
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3) Discuss the ERP.
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Source: www.mirium-english.org
12
Other in vivo imaging procedures that you may read about include regional Neuropsychology Methods
cerebral flow (rCBF) and single photon emission computerised tomography
(SPECT). Both are variants of PET technology.
SPECT differs from PET in certain technical respects, the upshot of which is
that the clarity of the scans is less precise because they take longer to generate.
The MRI scanner can be ‘tuned’ to detect the very subtle disturbances to the
magnetic field induced by the different proportions of oxygenated and
deoxygenated blood in active and inactive regions. The so-called BOLD (blood
oxygenated level dependent) signal can be further improved by the use of more
powerful magnets in the scanner, and the spatial resolution (which generates the
structural scans) is barely compromised.
Although fMRI has only been available for a few years, it has been adopted
enthusiastically by researchers because, like MRI, fMRI scanning does not expose
participants to radiation. Among many of its applications, it has recently been
used to identify functional changes in frontal brain regions as participants
undertake tests of working memory.
13
Brain Behaviour
Inter-relationship 3) What is MRI? Describe
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4) What is the function of PET scan?
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5) Differentiate between SPECT and PET.
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Usually, a series of tests (called a test battery) will be given. One widely used
battery is Halstead Reitan, which includes measures of verbal and nonverbal
intelligence, language, tactile and manipulative skills, auditory sensitivity, and
so on (Reitan & Wolfson, 1993). Some of the tests are very straightforward: The
tapping test, which assesses motor function, requires nothing more than for the
respondent to tap as quickly as possible with each of his\her fingers for a fixed
time period on a touch sensitive pad. The Corsi block-tapping test measures
14 spatial memory using a series of strategically placed wooden blocks on a tray. A
third test measures memory span for sets of digits. The Luria Nebraska test battery Neuropsychology Methods
(Luria, 1966) is even more exhaustive procedure taking about two to three hours
to administer, including over 250 test items.
Source: portal.wpspublish.com
The lengthy administration of test battery may be unsuitable for some individuals
(such as demented or psychiatric patients) who simply do not have the requisite
attention span. In such instances a customised battery may be more appropriate.
Such assessments typically still include some overall index of intelligence: the
comprehensively norm-referenced WAIS-R (the revised Wechsler Adult
Intelligence Scale; Wechsler, 1981) is commonly used. In addition, specific
measures may be adopted to test particular hypotheses about an individual.
For example, if the person has received brain damage to the frontal lobes, tests
might be selected that are known to be especially sensitive to frontal damage.
The Wisconsin card sort test, the trails test (in which respondents have to join
numbered doted on a page according to particular rules) and verbal fluency
(generating words starting with particular letter on belonging to a specific
category) are cases in point.
Poor performance on one particular test may signal possible localised damage or
dysfunction, while poor across the board performance may indicate generalised
damage. For example, inability to recognise objects by touch (astereognosis)
may be a sign of damage to the parietal lobes.
A poor verbal test score (compared with normal non-verbal test score) may
indicate generalised left hemisphere damage.
The WAIS-R is particularly useful in this respect because the eleven components
tests segregate into six verbal and five performance sub tests, from which it is
possible to derive separate verbal and non verbal estimates of IQ.
15
Brain Behaviour The National Adult Reading Test (NART; Nelson, 1982) allows the researcher
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to obtain an estimate of an individual’s IQ prior to damage or disease onset. This
may be useful if a neuropsychologist is making an initial assessment of a person
who has been brain damaged or ill for some time. The NART comprises 50
words that sound different to their spelling (such as yacht, ache and thought).
The respondent reads through the list until they begin to make pronunciation
errors. Such words were almost certainly learned before the onset of illness or
brain damage, and because this test has been referenced against the WAIS, the
cut off point can be used to estimate IQ prior to illness, disease or accident.
Self Assessment Questions
1) Discuss in detail the neuropsychological assessment.
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2) Describe the tests and subtests.
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3) What is the implication of applying these tests.
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Table 1.1: Groups and tasks % correct Neuropsychology Methods
Hypothetical results from this study are shown in the above table. At first glance
they seem to support the hypothesis because the right frontal subjects appear to
be selectively impaired on the MemD condition. Many neuropsychological
investigations employ this sort of design, and use the evidence of dissociation
between groups in the MemD but not the MemW as support for the hypothesis.
There is, however design problem with single dissociation studies stemming
from the assumption that the two conditions are equally ‘sensitive’ to differences
between the two groups of participants (which may or may not be the case). For
example, it could be that right frontal subjects have poor attention, which happens
to affect the memD task more than the MemW task.
A much ‘stronger’ design is one with the potential to show a double dissociation.
For example, if we also thought that left frontal damage impaired MemW but
not MemD, we could recruit two groups of patients that is (i) one group with left
and (ii) the other with right frontal damage, plus (iii) a control group. Then test
all participants on both measures. Hypothetical results from this design are shown
in the table. They indicate that one group of patients is good at one test but not
the other, and the reverse pattern is true for the second group of patients. In other
words, we have evidence of a double dissociation, which suggests to
neuropsychologists that the two tasks involve non overlapping component
operations that may be anatomically separable too.
A recent update of Woodruff’s study has been reported by Shergill et al. (2000).
The researchers recorded fMRI activity in six regularly hallucinating
schizophrenic patients. Approximately every 60 seconds respondents had to
indicate whether (or not) they had ‘experienced’ an auditory hallucination during
the last time epoch.
19
Brain Behaviour
Inter-relationship UNIT 2 NEUROPSYCHOLOGICAL
ASSESSMENT AND SCREENING
Structure
2.0 Introduction
2.1 Objectives
2.2 Neuropsychological Assessment of Infants and Young Children
2.2.1 Localisation of Functions in the Brain
2.2.2 Categorisation of Neuropsychological Assessment
2.2.3 Categorisation of Major Brain Functions
2.2.4 Approaches to Neuropsychological Assessment
2.2.5 Functional Domains in Children
2.2.6 Developmental Concepts Unique to Infants and Young Children
2.2.7 Nonhuman Experimental Studies
2.3 Advances in Neurodiagnostic Techniques
2.3.1 Clinical Studies
2.3.2 Nature and Degree of Abnormality
2.3.3 Social Attention and Environmental Influences
2.3.4 Clinical Evaluation of Infants and Young Children
2.4 Neuropsychological Assessment of Older Children
2.4.1 General Principles
2.4.2 Methods of Assessment
2.5 Neuropsychological Assessment of Adults
2.6 Validity and Reliability
2.7 Neuropsychological Screening of Adults
2.8 Let Us Sum Up
2.9 Unit End Questions
2.10 Suggested Readings
2.0 INTRODUCTION
The clinical practice of neuropsychology involves an integration of knowledge
bases from the disciplines of psychology, psychometrics, neuroscience, clinical
neuropsychology and psychiatry. In this unit you will be presented with an
introduction to how neuropsychologists assess brain function. First we will look
at the area from a developmental perspective illustrating how neuropsychologists
evaluate young preschool children, older children, youngster adults, and elderly
adults. The brain is an evolving organ and functions very differently at different
stages of life span. Assessment issue are different during these stages, as are the
prevalence and characteristics of the various brain disorders. Obviously, the
behavioural evaluation of a 3-years-old child cannot use the same materials and
methods as the evaluation of a 40-year-old adult. It has therefore has been
necessary to develop different tests and methods for neuropsychological
evaluations across the life span, and consequently we have now tests and test
batteries specifically designed for infants and young children, older children,
adults, and the elderly.
20
Neuropsychological assessment provides information concerning the status of Neuropsychological
Assessment and Screening
brain function across the life span. It does so primarily by testing those functions
and abilities may be evaluated in a comprehensive, specialised, or combined
manner. The areas typically assessed in a neuropsychological evaluation include
the ability to reason and conceptualise; to remember; to speak and understand
spoken and written language; to attend to and perceive the environment accurately
through the senses of vision, hearing, touch, and smell; to construct objects in
two- or three-dimensional space; and to perform skilled, purposive movements.
Clinical neuropsychology in particular has the task of identifying in individual
patients the level and pattern of disruption of these abilities as a result of brain
dysfunction.
The present unit starts with Neuropsychological Assessment of Infants and Young
Children followed by the developmental Concepts Unique to Infants and Young
Children. Then we deal with the various experimental studies especially the non
human ones. We then discuss the advances that have taken place in the
neurodiagnostic techniques and how one could accurately measure and assess
the neurological damages in the brain. These are substantiated by clinical studies.
This is followed by social attention and environmental influences. We then take
up the clinical evaluation of infants and young children. This is followed by
neuropsychological assessment of older children, the general principles associated
with the same, the methods of assessment etc. Finally we take up
neuropsychological assessment of adults and discuss the validity and reliability
associated with these assessments. Then we describe the neuropsychological
screening.
2.1 OBJECTIVES
After completing this unit, you will be able to:
• Define and describe neuropsychological assessment;
• Elucidate the neuropsychological methodology for assessing infants and
young children;
• Explain the developmental concepts unique to infants and young children;
• Describe the advances in the neurodiagnostic techniques;
• Delineate the methods for neuropsychological assessment of older children;
• Describe the neuropsychological assessment with adults;
• Analyse the validity and reliability of these tests; and
• Explain Neuropsychological Screening.
Domain Syndrome
Abstraction\intellectual function Dementia
Memory Amnesia
Language Aphasia, Alexia, Acalculia
Spatial abilities Constructional apraxia, visuospatial defects
Motor skills Apraxia
The aim of specialised assessment is often to identify a syndrome and specify its
probable basis in abnormal brain function. The basic purpose for identifying a
syndrome is to characterise the deficit and make a formulation concerning possible
neurological correlates. For example, in the case of memory, the diagnostic
question often involves whether the patient has amnesia, and if so, what type.
Thus, there is an association between the domain and a class of abnormal
syndromes, illustrated in the table above. This table is gross oversimplification,
but is only meant to suggest the association of certain cognitive domains to
different non behavioural syndromes.
23
Brain Behaviour A comprehensive assessment ideally uses all four approaches. Some forms of
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specialised assessment rely heavily on pathognomic signs, behaviours that are
almost exclusively seen in brain damaged patient and that have some specific,
often localising significance. Other forms of specialised evaluations rarely use
the general level of performance approach, which is generally reflected in some
kind of summary index of impairment based on tests of varying domains and
modalities. While all these approaches are important, relative emphases on any
of them may relate to setting in which one practises and the clinical characteristics
of the clientele in that practice. In the light of contemporary patterns of health
care provision, the distinction between being in a primary care, “first-line” setting
and a specialised tertiary care practise is very important.
• How does one reliably assess and evaluate brain behaviour relationships in
the newborn, neonate or very young child?
• If this is even possible, how practical would such evaluation be?
• Is the methodology used by paediatric neuropsychologists applicable to the
youngest ages? and
• If so, with what degree of reliability or validity?
• Which variables are traceable to the very youngest ages?
• Which will result in long lasting (i.e., adult) cognitive compromise?
• What interventions can be applied in these very early years to lessen the
impact of early insults?
Since these and other related questions remain largely unanswered, many
practitioners are naturally reluctant to endorse terminology that may be misleading
or inappropriate.
What is not controversial is the fact that paediatric and psychological specialists
frequently encounter infants and young children whose developmental delays or
cognitive deficiencies are attributable to underlying neurodevelopmental
24
abnormality or to documented neurological disease or disorder that occurred in Neuropsychological
Assessment and Screening
the earliest stages of growth and development. The increased recognition that
these etiological factors exist and have an important influence on the child’s
later cognitive outcome is a result of a number of converging developments.
These include:
1) a better definition of the unique developmental concepts that are applicable
to infants and young children,
2) finely detailed analyses of normal and abnormal brain development from
experimental studies of nonhumans,
3) major advances in neurodiagnostic techniques,
4) an expanding clinical and research literature on human developmental
studies, and
5) an increase in societal attention to the needs of infants and young children,
in part emphasised by preschool screening and intervention programs.
Although the social learning theory has long posited that behaviour is an important
element in learning, imitation behaviours etc., they are significantly more
pronounced and overt in infants and young children. From a neuropsychological
perspective, imitation can be an adaptive form of stimulus bound behaviour,
which can be considered pathological at older ages.
25
Brain Behaviour 2.2.7 Nonhuman Experimental Studies
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How normal brain development proceeds is essential knowledge for professionals
concerned with understanding infant and young child development. Laboratory
studies of nonhumans have contributed substantially to our knowledge about
normal and abnormal human brain function. Our understanding of the
abnormalities that can occur and that may explain and individual’s
neurobehavioural dysfunctioning has broadened considerably as a result of these
studies.
TECHNIQUES
Major scientific and technology advances have made it easier to correlate
behaviours suspected as having a neurological basis with actual neuroanatomical
(structural) and neurophysiological abnormalities. Many of these advances have
been applied to the study of infants and young children, such as techniques to
examine the foetus in utero and to monitor development in the perinatal period.
For example, real time ultrasonography is useful for determining the presence,
timing, and course of intraventicular behaviour in a preterm infant.
The paediatric clinical literature has expanded greatly in its coverage of the wide
variety of medical circumstances that can negatively affect the developing human
brain. As a consequence, populations of children who are at risk for cognitive
impairment have been identified, and formal investigations have provided insight
into the influence of the many factors that influence the success or failure of
cognitive development. That infants at risk are more likely to have learning
difficulties than infants not at risk is well established.
The link between structural abnormality and unique behavioural aberration has
become clearer as technological advances have allowed for even more finely
tuned discrimination than that obtained from study of gross structural anatomy.
This was made dramatically apparent by several early neuropathological studies
of dyslexia. The classic diagnosis of dyslexia was based on psychoeducational
features until advances in neurological diagnosis enabled identification of
associated neuropathological mechanisms and anatomic abnormalities.
Plasticity: The notion of brain plasticity has been of interest to researchers and
clinicians alike for decades. The outcome of injury is the result of the underlying
plastic potential of the brain and varies with the neurodevelopmental stage at the
time of insult, the type of lesion, the severity of the lesion, the behaviour being
measured, the range of the scores of the individual at assessment, and other
factors. It has been proposed that the brain modifies itself through change at the
synapse, that is, by alterations in the axon terminal, spine density, dendritic
behavioural, or structure of the existing synapse. The neural process occurring
in the recovery from brain injury are thought to be similar to the processes involved
in learning from experience, which result in the production of new synapse, the
loss of old synapses (pruning), and the modification of existing synapses.
Adaptation in response to insult is also an impressive finding.
In the evaluation of infants and young children, all sources of reliable and valid
data available to the paediatric neuropsychologist must be used, including the
history, direct and indirect observations of behaviour, and performance on selected
tests. Although the evaluation of an individual at any age should never rest solely
upon test performance, work with infants and young children demands an even
greater degree the use of multiple sources of data. Some of the sources of data
are given below.
• Motor development
• Age at first accomplishment (e.g., sat alone, crawled, walked alone)
• Was child slow to develop motor skills or awkward compared to sibling/
friends (e.g., running skipping, climbing, biking, playing ball)?
• Handedness (right, left, both); history of left – handedness
• Need for physical therapy or occupational therapy
Language
• Age at first accomplishment (e.g., first word, put two or three words
together)
• Speech/language delays/problems (e.g., stutters, difficult to understand,
poor comprehension)
• Oral motor problems (e.g., the alphabet, name colours, count)
• Language spoken in home
• Provision of speech/language therapy
Toileting
• Age when toilet trained
• Associated problems (e.g., bedwetting, urine accidents, soiling)
Social behaviour
• Relationships with other children; with adults
• Ability to begin and maintain friendships
• Understanding of gestures, nonverbal stimuli, social cues
• Appropriateness of sense of humour
Medical history
• Results of vision check
• Results of hearing check
• Serious illness/injuries/hospitalisations/surgeries
• Head injuries (e.g., date, type, loss of consciousness?, changes in
behaviour)
• Current medications and reasons
Personal history
• Febrile seizures
• Epilepsy
31
Brain Behaviour
Inter-relationship • Lead poisoning/toxic ingestion
• Asthma or allergies
• Loss of consciousness
• Abdominal pains/vomiting, and when they occur
• Headaches, and when they occur
• Frequent ear infections
• Sleep difficulties
• Eating difficulties
• Tics/twitching
• Repetitive/stereotyped movements
• Impulsivity
• Temper tantrums
• Nail biting
• Clumsiness
• Head banging
• Self-injuries behaviour
Family history
Learning difficulty
Neurological illness
Seizures
Psychiatric disorder
Instances of similar problem in any family member
Education history
Current school and address
Grade and type of placement (e.g., regular, resource, special education,
emotionally disturbed)
Grades skipped or repeated
Teachers reported problems areas (e.g., reading, spelling, arithmetic, writing,
attention/concentration
Problems with hyperactivity or inattention in the classroom
Although it was once thought that the capacities of the very young child were
quite limited, it is now well understood that the infant has cognitive abilities that
can be demonstrated with appropriate techniques. An examination of the literature
on three domains, namely attention, memory, and executive function, provides
data that support this idea.
b) Psychological tests
Attention
32
The construct of attention has been found to comprise several interrelated elements Neuropsychological
Assessment and Screening
that the paediatric neuropsychologist can consider in the clinical evaluation. For
example, attention may be conceptualised as involving more specific components,
such as the ability to initiate, sustain, inhabit, and shift, or the ability to focus /
execute (scan the stimulus field and respond), sustain (be vigilant, attend for a
time interval), encode (sequential registration, recall and mental manipulation
of information), and shift. The ability to focus and sustain attention is especially
relevant to the study of attention in the infant and the preschool child. The shift
dimension of attention is related to executive function.
Begin
3) Principle of Context
A third principle guiding the neuropsychological assessment of children is
that environment contexts help to constraint and determine behaviour. Thus,
the ability of neuropsychological assessment to determine whether brain
impairment contributes to failures of adaptation or of adaption rests on a
careful examination of the influences of environmental or contextual
variables that also influence behaviour. The reasons for examining these
influences are to rule out alternative explanations for a child’s adaptive
difficulties and to assess the nature of the child’s environment and as the
situational demands being placed on the child. In this regard,
neuropsychological assessment is designed not so much to measure a child’s
specific cognitive skills, but to determine how a child applies thesse skills
in the environment.
4) Principle of Development
The final guiding principle is that assessment involves the measure of change,
or development, across multiple levels of analysis. Developmental
neuroscience has highlighted the multiple processes that characterise brain
development. For example the cell differentiation and migration, the dendritic
behavioural and pruning as well as the timing of these processes. Although
less research has been conducted concerning developmental changes in
37
Brain Behaviour children’s environment, there is nevertheless a natural history of environment
Inter-relationship
that is characteristic of most children in a culture. Behavioural development
in turn can be conceptualised as the result of the joint interplay of these
biological and environmental time tables and is characterised by the
emergence, stabilisation and maintenance of new scales as well as the loss
of earlier ones. The neuropsychological assessment therefore requires
appreciation for the developmental changes that occur in brain, behaviour
and context because the interplay between these levels of analysis determines
adaptation outcomes.
1) History taking
The careful collection of historical information is accomplished by a combination
of questionnaires and parent interviews which are essential in neuropsychological
assessments. Thorough history not only clarifies the nature of a child’s presenting
problems but also assists in determination of its source. A careful history can
help to determine a child’s present problems have a neuropsychological basis or
may be related primarily to psychological or environmental factors.
38
a) Birth and Developmental History: Collection of information regarding a Neuropsychological
Assessment and Screening
child’s early development usually begins with the mother’s pregnancy, labour
and delivery, and extends to the acquisitions of developmental milestones.
Information about such issues and events is useful in identifying early risk
factors, as well as these are early indicators of anomalous development.
The presence of early risk factors or developmental anomalies makes a
stronger case for a constitutional or neuropsychological basis for a child’s
failures in adaptation.
The early development of the child also warrants study, including interactions
with parents, socialisation with peers, gross and motor skills, receptive and
expressive language skills, constructional skills (i.e., block/puzzle/picture
play), attention disabilities, feeding and sleeping patterns and development
of hand preference/ delays or anomalies in these domains are often early
precursors of later learning problems.
c) Family and Social History: Recent studies suggest that genetic variation
plays an important role in etiology of learning problems. Hence, the collection
of information regarding a family’s history of academic difficulties is often
relevant in establishing a possible familial basis for learning problems.
Family History should also be collected regarding psychiatric disturbances,
language disorders, and neurological illnesses, each of which can also signal
a biological foundation for later neuropsychological deficits.
2) Behavioural Observations
Behavioural observations of the child are the second critical source of
information available to the neuropsychologist. Qualitative observations
are extremely important, not only in interpreting the results of
neuropsychological testing, but also in judging the adequacy of social,
communicative, problem solving, and sensorimotor skills that may not be
amenable to standardised testing.
Behavioural observations are often noteworthy to the extent that they involve
alterations in the examiner’s usual responses to a child. That is, changes in
39
Brain Behaviour the examiner’s usual style of interaction may signal anomalies in a child’s
Inter-relationship
functioning. For instance, the need for the clinician to modify his or her
utterances may signal a language disorder.
Similarly, if the clinician must use verbal prompts more frequently than
usual in order to keep the child on task, then the child may be considered to
have attention problems. Rigorous observation, though, must be referenced
to certain basic domains of functioning to which neuropsychologists routinely
attend.
A typical list of domains would include the following:
• Mood and affect
• Motivation and cooperation
• Social interaction
• Attention and activity level
• Response style
• Speech, language and communication
• Sensory and motor skills
• Physical appearance
3) Psychological Testing
Psychological testing is the third source of information about the child, and
the source most often equated with neuropsychological assessment. The
findings obtained from formal testing allow for normative comparisons.
The findings obtained from formal testing allow for normative comparisons.
Formal testing also provides a context for making qualitative observations
of response styles and problem-solving strategies under standardised test
batteries, such as Halstead-Reitan Neuropsychological Test Battery, as
opposed to more flexible approaches to assessment. In general, however,
most child neuropsychologists administer a variety of tests that sample from
a broad range of behavioural domains. The administration of a comprehensive
battery provides converging evidence for specific deficits or problems and
ensures an accurate portrayal of a child’s overall profile of functioning.
Test batteries typically assess the following domains:
• General cognitive ability
• Language ability
• Visuoperceptual and constructional abilities
• Attention
• Learning and memory
• Executive functions
• Corticosensory and motor capacities
• Academic skills
• Emotional status, behavioural adjustment and adaptive behaviours
Let us deal with each of them above domains
40
a) General Cognitive Ability: General cognitive ability is usually assessed Neuropsychological
Assessment and Screening
using standardised intelligence tests, such as Wechsler Intelligence Scale
for Children Third Edition (WISC-III), the Stanford Binet Intelligence Scale
Fourth Edition, and the Kauffman Assessment Battery for Children.
f) Academic skills: These are tested for reading, writing and mathematics by
giving achievement tests etc. appropriate to the age and class levels of the
students.
g) Emotional status etc. These are tested with personality tests such as the
personality trait questionnaires, sentence completion tests etc.
Self Assessment Questions
1) Discuss the methods of assessment.
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41
Brain Behaviour
Inter-relationship 2) What are all the aspects to be covered in history taking?
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3) What is meant by behavioural observations? What aspects need to be
covered here?
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4) What are the various psychological tests to be used in assessment?
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Perhaps the best definition of a neuropsychological test has been offered by Ralph
Reitan, who described it as a test that is sensitive to the condition of the brain. If
performance on a test changes with a change in brain function, then the test is a
neuropsychological test. However, neuropsychological assessment is not restricted
to the use of only neuropsychological tests. It should also contain some tests that
are often useful for providing a baseline against which the extent of impairment
associated with acquired brain damage can be measured.
The linear approach is best exemplified in the work of A.R. Luria and various
collaborators, while the configurational approach is seen in the work of Ward
43
Brain Behaviour Halstead and collaborators. In either case, however, the aim of the assessment is
Inter-relationship
to determine the pattern of the patient’s preserved and impaired functions and
infer from this pattern the nature of the disturbed brain function. Individual tests
and test batteries are really only of neuropsychological value if they can be
analysed by one of these two methods.
Autopsy data are not always entirely usable for validation purposes, in that
numerous changes may have taken place in the patient’s brain between the time
of testing and time of examination of the brain. Currently, the new neuroimaging
procedures and the very extensive research associated with them have made
substantial progress towards resolution of this problem. Of the various imaging
techniques, magnetic resonance imaging (MRI) is currently the most widely used.
The cognitive and social emotional development of infants and very young
children has unique features. This age range is associated with less differentiation
of some functional areas, the presence of early developmental constructs that are
less dominant than in older children, and an increased variability of performance
compared to older children. While the approach to the neuropsychological
examination of infants and young children is similar in its general form to that
used in the evolution of older individuals, there are differences in terms of the
existence of a body of knowledge regarding the cognitive and social emotional
development process in this age group and brain behaviour relationships in normal
and abnormal developmental condition; and there is relatively less reliance on
standardised test measures to assess all desired functional areas.
46
Neuropsychological
2.10 SUGGESTED READINGS Assessment and Screening
References
Christensen, A.L. (1975a). Luria’s neuropsychological investigation. New York
spectrum.
Christensen, A.L. (1975b). Luria’s neuropsychological investigation: manual.
New York spectrum.
Davis, K.(1983,october). Potential neurochemical and neuroendocrine validators
of assessment instruments. paper presented at conference on clinical memory
Assessment of older adults, Wakefield, M.A.
Golden, C. J(1981). A standardised version of Luria’s neuropsychological tests;a
quantitative and qualitative approach to neuropsychological evaluation. In Filskov,
S. B., & Bold, T. J (Eds.),handbook of clinical neuropsychology(pp.608 to 642).
New York: Wiley-Interscience.
Golden, C. J., Hemmeke, T. & Purisch, A. (1980). The Luria-Nebraska battery
manual, Los Angeles: Western psychological services.
Golden, C. J., Hemmeke, T. & Purisch, A(1985) Luria-Nebraska
neuropsychological battery manual form I & II. Los Angeles: Western
psychological services.
Goldstein, G. (1982). Overview: clinical application of Halstead-Reitan and Luria-
nebraska batteries. Paper presented at NE-RMEC conference, Northport, NY.
Goldstein, G., & Watson, J. R (1989). Test-retest reliability of the Halstead-Reitan
battery and the WAIS in a neuropsychiatric population. The clinical
neuropsychologist,3,265-273.
Heaton, R. K, Grant, I., & Matthews, C. G.(1991).comprehensive norms for an
expanded Halstead-Reitan battery. Odessa, FL: psychological assessment
resources.
Heaton, R. K, Pendleton, M. G. (1981). Use of neuropsychological test to predict
adult patients everyday functioning. Journal of consulting and clinical
psychology,49, 807-821.
Jastak, S.,& Wilkinson, G. S (1984).wide range achievement test-revised.
Wilmington, DE: Jastak Associates, Inc.
Levin, H. S., Benton, A. L., & Grossman, R. G. (1982).neurobehavioural
consequences of closed head injury. New York Oxford university press.
Sherrill, R. E. jr. (1987). options for shortening Halstead’s category test for adults.
I Archives of clinical neuropsychology,2,343-352.
48
Neuropsychological
UNIT 3 NEUROPSYCHOLOGY TEST Assessment and Screening
BATTERIES
Structure
3.0 Introduction
3.1 Objectives
3.2 Neuropsychological Assessment
3.2.1 The Nervous System and Behaviour
3.2.2 Neuropsychological Examination
3.3 Neuropsychological Understanding of Behavioural Deficits
3.4 Goals of Neuropsychological Assessment
3.5 Nature of Neuropsychological Tests
3.6 Identifications of a Deficit by Neuropsychological Tests
3.7 The Luria-Nebraska Neuropsychological Battery
3.7.1 History
3.7.2 Structure and Content
3.7.3 Theoretical Foundations
3.7.4 Standardisation Research
3.8 The Halstead-Reitan Neuropsychological Battery
3.8.1 History
3.8.2 Structure and Content
3.8.3 Theoretical Foundations of Component Tests
3.8.4 Standardisation Research
3.8.5 The NIMHANS Neuropsychological Battery
3.9 Let Us Sum Up
3.10 Unit End Questions
3.11 Suggested Readings
3.0 INTRODUCTION
In this unit we are dealing with neuropsychological batteries and tests. We start
with the definition of neuropsychological assessment and present the various
aspects related to the same. Then we discuss how Neuropsychological Assessment
would also lead to obtaining information regarding the neurological deficits
resulting in behavioural deficiencies. Then we take up Goals of
Neuropsychological Assessment and discuss the various factors and clues that
may be obtained in regard to the neurological problems within the individual.
This is followed by a discussion on the nature of neuropsychological tests and
how to identify a deficit with the help of neuropsychological test battery. Two
major batteries, the Luria Nebraska and the Halstead Reitan Neuropsychological
batteries are presented with their history, structure and content within the tests,
the theoretical foundations underlying these tests and the validity and reliability
of these tests. Then we deal with the NIMHANS Neuropsychological battery
and give a description of the various tests within the same.
49
Brain Behaviour
Inter-relationship 3.1 OBJECTIVES
After completing this unit, you will be able to:
• Define and describe Neuropsychological;
• Explain how neuropsychological tests can be used for understanding of
behavioural deficits;
• Elucidate the goals of neuropsychological assessment;
• Describe the nature of neuropsychological tests;
• Explain how to identify a deficit through neuropsychological tests;
• Describe the various aspects of the Luria-Nebraska Neuropsychological
Battery;
• Delineate how the test was evolved and devised;
• Describe the Halstead-Reitan battery and its contents, tests and subtests;
and
• Explain the NIMHANS Neuropsychological Battery.
The typical neuropsychological exam begins with a careful history taking. Areas
of interest include:
• Medical history of patient.
• Medical history of patient’s family.
• Presence of absence of developmental milestones.
• Psychosocial history.
• Character, severity, and progress of any history of complaints.
The MSE deals with questions concerning the addressee’s Consciousness,
Emotional State, Thought Content and Clarity, Memory, Sensory Perception,
Performance of Action, Language, Speech, Handwriting, Handedness.Tests and
assessment procedures assess various aspects of functioning including aspects
of:
• Perceptual functioning
• Motor functioning
• Verbal functioning
• Memory Functioning
• Cognitive Functioning
These tests are also used in screening for deficits and in adjunct to medical
examinations.
The tests can be helpful in the assessment of:
• Change in mental status
• Abnormalities in function before abnormalities in structure can be detected.
• Strengths and weaknesses of patient.
• Ability of individual to stand trial.
• Changes in disease process over time.
The Wechsler Scales are often used as a diagnostic tool for intellectual ability
testing.
Formal testing for memory may involve the use of instruments such as the
Wechsler Memory Scale-Revised:
• The task is to recall stories and other verbal stimuli.
• The test is appropriate for people within the ages of 16-74.
Verbal memory, non verbal memory etc. are tested through the presentation of
stimuli such as verbal learning test, selective reminding test Benton test of visual
retention etc. As for tests of cognitive functioning, difficulty in thinking abstractly
is a relatively common consequence of brain injury. One popular measure of
verbal abstraction ability is the Wechsler Similarities Subtest in which the task is
to identify how two objects are alike. Proverb interpretation is another way to
assess ability to think abstractly. Nonverbal tests of abstraction include sorting
tests such as the Wisconsin Card Sorting Test. 51
Brain Behaviour A neuropsychological assessment is a clinical examination of both the working
Inter-relationship
brain and dysfunctional brain. Neuropsychological tests are an aid in this
examination. The objective of neuropsychological assessment is to chart the
deficits and adequacies in the behaviour of patients. The behavioural deficits are
explained by underlying cognitive, emotional, and volitional deficits as well as
changes in the patient’s behaviour. The outcome of a neuropsychological
assessment is a profile of the patient’s deficits and adequacies.
52
Neuropsychological assessment therefore has twin goals. Neuropsychology Test
Batteries
i) The first goal is to identify the disrupted psychological components/
processes/domains in an individual patient and arrive at a profile of
adequacies and deficits of psychological functions.
ii) The second goal is to identify the brain structures/ functional networks, which
are dysfunctional or damaged using the neuropsychological profile that has
previously been derived. Finally, this information is used to lateralise and
localise the bran lesion.
On the other hand, the psychometric approach takes a ‘here and now’ view. It
interprets objective scores with reference to normative data, without taking into
account previous history or current functioning in other areas.
At the same time, it is essential to have objective scores, in order to identify and
classify deficits in psychological components and processes. The need for
objective scores becomes greater when the deficits are mild or when minimal
levels of temporal improvement or deterioration are being tracked. Objective
scores can be obtained if the tests are constructed according to the psychometric
approach.
54
Neuropsychology Test
3) In what way neuropsychology helps in understanding the behvarioural Batteries
deficits?
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4) What are the goals of neuropsychological assessment?
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5) Discuss the nature of neuropsychological tests.
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6) How would neuropsychological test identify a deficit?
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The raw score for each scale is the sum of the 0, 1 and 2 item scores. Thus, the
higher the score, the poorer the performance. The scores for the individual items
may be based on speed, accuracy, or quality of response. In some cases, two
scores may be assigned to the same task, one for speed and the other for accuracy.
These two scores are counted as individual items. For example, one of the items
is a block counting task, with separate scores assigned for number of errors and
time to completion of the task. In case of time scores, blocks of seconds are
associated with the 0, 1 and 2 scores. When quality of response is scored, the
manual provides both rules for scoring and, in the case of copying tasks,
illustrations of figures representing 0, 1 and 2 scores.
The 269 items are divided into 11 content scales, each of which may be
administered individually. Since these scales contain varying number of items,
raw scale scores are converted to T score with a mean of 50 and a standard
deviation of 10. These T scores are displayed as a profile on a form prepared for
that purpose. In the alternate form of the battery, the names of the content scales
have been replaced by abbreviations. Thus, we have Motor, Rhythm, Tactile,
Visual, Receptive Speech, Expressive Speech, Writing, Reading, Arithmetic,
Memory, and Intellectual Processes scales, which are referred to as the C1 through
C11 scales in the alternate form.
In addition to these 11 content scales, there are three derived scales that appear
on the standard profile form: the Pathognomonic, Left Hemisphere scales. The
Pathognomonic scale contains from throughout the battery found to be particularly
sensitive to the presence or absence of brain damage. The left and right hemisphere
scales are derived from the Motor and Tactile scale items that involve comparisons
56
between the left and right sides of the body. They therefore reflect sensorimotor Neuropsychology Test
Batteries
asymmetries in the two sides of the body.
Several other scales have been developed by Golden and various collaborators,
all of which are based on different ways of scoring the same 269 items. These
special scales include new (empirically derived) right and left hemisphere scales,
a series of localisation scales a series of factor scales and double discrimination
scales. The new right and left hemisphere scales contain items from throughout
the battery and are based on actual comparisons among patients with right
hemisphere, left hemisphere, and diffuse brain damage.
The localisation scales are also empirically derived, being based on studies of
patients with localised brain lesions. There are frontal, sensorimotor, temporal,
and parieto-occipital scales for each hemisphere. The factor scales are based on
extensive factor analytical studies of the major content scales. The new right and
left hemisphere scales contain items from throughout the battery and are based
on actual comparisons among patients with right hemisphere, left hemisphere
and diffuse brain damage. The new right and left hemisphere, localisation factor
scales may all be expressed in T scores with a mean of 50. There are also two
scales that provide global indices of dysfunctions, and are meant as equivalents
to the Halstead impairment index. They are called the Profile Elevation and
Impairment Scales.
Therefore, our discussion of the theory underlying the Luria Nebraska battery
will be based on the assumption that the only connecting link between Luria and
that procedure is the set of Christensen items. In doing so, it becomes clear that
the basic theory underlying the development of Luria- Nebraska is based on a
philosophy of science that stresses empirical validity, quantification and
application of established psychometric procedures. Indeed, as pointed out
elsewhere, it is essentially the same epistemology that characterises the work of
the Reitan group.
Thus, research done with the Luria Nebraska battery determined
1) whether it discriminates between brain damaged patients in general and
normal controls;
2) whether it discriminates between patients with structural brain damage and
those with schizophrenia;
3) whether the procedure has the capacity to lateralise and regionally localise
brain damage; and
4) whether there are performance patterns specific to particular neurological
disorders, such as alcoholic dementia or multiple sclerosis.
Since this research was accomplished in recent years, it was able to benefit from
the new brain imaging technology, notably the CT scan, and the application of
high speed computer technologies, allowing for extensive use of powerful
multivariate statistical methods. With regard to methods of clinical inference,
the same method suggested by Reitan that is level of performance, pattern of
performance, pathognomonic signs, and right left comparisons etc., are used
with the Luria Nebraska battery.
Adhering to our assumption that the Luria Nebraska bears little resemblance to
Luria’s methods and theories, there seems little point in examining the theoretical
basis for the substance of the Luria Nebraska battery. For example, there is little
point in examining the theory of language that underlies the Receptive Speech
and Expressive Speech scales or the theory of memory that provides the basis
for the Memory scale. We believe that the Luria Nebraska battery is not a means
of using Luria’s theory and methods in English speaking countries, but rather a
standardised psychometric instrument with established validity for certain
purposes and reliability.
The test manual reports reliability data. Test-retest reliabilities for the 13 major
scales range from .78 to .96. The problem of interjudge reliability is generally
not a major one for neuropsychological assessment, since most of the test used is
quite objective and have quantitative scoring systems. However, there could be
a problem with the Luria-Nebraska, since the assignment of 0, 1, and 2 scores
sometimes requires a judgement by the examiner.
During the preliminary screening stage in the development of the battery, items
in the original pool that did not attain satisfactory interjudge reliability were
dropped. A 95% inter-rater agreement level was reported by the test constructors
for the 282 items used in an early version of the battery developed after dropping
those items. The manual contains means and standard deviations for each item
based on samples of control, neurologically impaired, and schizophrenic subjects.
An alternate form of the battery is available. To the best of our knowledge, there
have been no predictive validity studies. It is unclear whether or not there have
been studies that address the issue of construct validity.
60
Reitan adopted Halstead’s methods and various test procedures and with them Neuropsychology Test
Batteries
established a laboratory at the University of Indiana. He supplemented these
tests with a number of additional procedures in order to obtain greater
comprehensiveness and initiated a clinical research program that is ongoing.
The program began with cross validation of the battery and expanded into
numerous areas, including validation of new tests added to the battery (e.g. the
Trail Marking Test), lateralisation and localisation of function, aging, and
neuropsychological aspects of a wide variety of disorders such as alcoholism,
hypertension, disorders of children, and mental retardation.
The Halsted Reitan battery, as the procedure came to be known over the years,
also has a history. It has been described as a fixed battery, but the sets of tests are
grown by accretion and revision and continues to be revised. The tests that
survived a long research history include the Category Test, The Tactual
Performance Test, The Speech Perception Test, The Seashore Rhythm Test, and
Finger Tapping.
There have been numerous additions, including the various Wechsler Intelligence
scales, the Trail Making test, a sub-battery of perceptual tests the Reitan aphasia
Screening Test, the Klove Grooved Pegboard, and other tests that are used in
some laboratories but not in others.
The Halstead Reitan battery continues to be widely used as a clinical and research
procedure. Numerous investigators use it in their research, and there have been
several successful cross validations done in settings other than Reitan’s laboratory.
In addition to the continuation of factor analytic work with the battery, several
investigators have applied other forms of multivariate analysis to it in various
research applications.
Some of this research has been conducted relative to objectifying and even
computerising interpretation of the battery; the most well-known efforts are the
Selz Reitan rules for classification of brain function in older children and the
Russel, Neuringer, and Goldstein “neurological keys”.
The issue of reliability of the battery has been addressed, with reasonably
successful results. Clinical interpretation of the battery continues to be taught at
workshops and in numerous programs engaged in the training of professional
psychologists.
61
Brain Behaviour 3.8.2 Structure and Content
Inter-relationship
Although there are several versions of the Halsted Reitan battery, the differences
tend to be minor, and there appears to be a core set procedures that essentially all
versions of the battery must be administered in a laboratory containing specific
equipment. It is probably best to plan on about 6 to 8 hours of patient time. Each
test of the battery is independent and may be administered separately from the
other tests. However, it is generally assumed that a certain number of the tests
must be administered in order to compute an impairment index.
Scoring for the Halsted Reitan varies with the particular test, such that individual
scores may be expressed in time to completion, errors, number correct, or some
form of derived score. These scores are often converted to standard scores or
ratings so that they may be profiled. All of the tests contributing to the impairment
index on a 6-point scale, the data being displayed as a profile of the ratings. They
have also provided quantitative scoring systems for the Reitan Aphasia Test and
for the drawing of a Greek cross that is part of that test. However, some clinicians
do not quantify those procedures, except in the form of counting the number of
Aphasic symptoms elicited.
Theoretical Foundation: There are really two theoretical bases for the Halsted
Reitan battery, one contained in brain and intelligence and related writings of
Halstead. The other are found in numerous papers and chapters written by Reitan
and various collaborators. Halstead was really the first to establish a human
neuropsychology laboratory in which patients were administered objective tests,
some of which are semi automated, utilising standard procedures and sets of
instructions. His Chicago laboratory may have been the stimulus for the now
common practice of administration of neuropsychological tests by trained
technicians. Halstead was also the first to use sophisticated, multivariate statistics
in the analysis of neuropsychological test data.
One could say that Reitan’s great concern has always been with the empirical
validity of test procedures. Such validity can only be established through the
collection of large amounts of data obtained from patients with reasonably
complete documentation of their medical\neurological conditions. Both presence
and absence of brain damage had to be well documented, and if present, findings
related to site and type of lesion had to be established. He described his work
62
informally as one large experiment, necessitating maximal consistency in the Neuropsychology Test
Batteries
procedures used, and to some extent, in the methods of analysing the data. Reitan
and his various collaborators represent the group that was primarily responsible
for the introduction of standard battery approach to clinical neuropsychology. It
is clear from reviewing the Reitan group’s work that there is substantial emphasis
on performing controlled studies with samples sufficiently large to allow for the
application of conventional statistical procedures.
It would probably be fair to say that the major thrust of Reitan’s research and
writings has not been espousal of some particular theory of brain function, but
rather an extended examination of the inferences that can be made from
behavioural indices relative to the condition of the brain. There is a great emphasis
on methods of drawing such inferences in case of the individual patient. Thus,
this group’s work has always involved empirical research and clinical
interpretation, with one feeding into the other. In this regard, there has been a
formulation of inferential methods used in neuropsychology that provides a
framework for clinical interpretation. Four methods are outlined: level of
performance, pattern of performance, specific behavioural deficits
(pathognomonic signs), and right-left comparisons. In other words, one examines
whether the patient’s general level of adaptive function is comparable to that of
normal individuals, whether there is some characteristics performance profile
that suggests impairment even though the average score may be within normal
limits, whether there are unequivocal individual signs of deficits, and whether
there is a marked discrepancy in functioning between the two sides of the body.
Halstead’s Biological Intelligence Tests: There are five subtests in this section
of Halsted-Reitan battery developed by Halstead.
The point of the test is to see how well the subject can learn the concept, idea, or
principle that connects the pictures. If the correct switch is pressed, the subject
will hear a pleasant chime, while wrong answers are associated with a rasping
buzzer. The conventionally used score is the total number of errors for the seven
groups of stimuli that forms the test. Booklet forms (Adams & Trenton, 1981;
DeFillippis, McCampbell & Rogers, 1979) and abbreviated forms (Calsyn,
O’Leary, & Chaney, 1980; Russel & Levy, 1987; Sherril, 1987) of this test have
been developed.
The Halstead Tactual Performance Test: This procedure used a version of the
Seguin-Goddard Form board, but it is done blindfold. The subject’s task is to
place all the 10 blocks into the board, using only the sense of touch. The task is
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Brain Behaviour repeated three times, once with the preferred hand, once with the non preferred
Inter-relationship
hand, and once with both hands, after which the board is removed. After removing
the blindfold, the subject is asked to draw a picture of the board, filling in all of
the blocks he or she remembers in their proper locations on the board. Scores
from this test include time to complete the task for each of the three trials, total
time, number of blocks correctly drawn, and number of blocks correctly drawn
in their proper locations on the board.
The Seashore Rhythm Test: This test consists of 30 pairs of rhythmic patterns.
The task is to judge whether the two members of each pair are the same or
different and to record the response by writing an S or a D on an answer sheet.
The score is either the number correct or the number of errors.
Finger Tapping: The subject is asked to tap his or her extended index finger on
a typewriter key attached to a mechanical counter. Several series of 10-second
trials are run, with both the right and the left hand. The scores are the average
number of taps, generally over five trials, for the right and left hand.
Tests added to the battery by Reitan. Reitan added four components to the battery
and these are given below:
The Trail Making Test: In part A of this procedure the subject must connect in
order a series of circled numbers randomly scattered over a sheet of 81\2 X 11
paper. In part B, there are circled numbers and letters and the subject’s task
involves alternating between numbers and letters in serial order. The score is
time to completion expressed in seconds for each part.
The Reitan Aphasia Screening Test: This test serves two purposes in that it
contains both copying and language-related tasks. As an Aphasia screening
procedure, it provides a brief survey of the major language functions: naming,
repetition, spelling, reading, writing, calculation, narrative speech, and right-left
orientation. The copying task involves having the subject copy a square, Greek
cross, triangle, and key. The first three items must each be drawn in one continuous
line. The language section may be scored by listing the number of aphasic
symptoms or by using the quantitative system developed by Russel and co-
workers. The drawings are either not formally scored are rated through a matching
to model system also provided by Russel and Colleagues.
Perceptual Disorders: The procedure actually constitute a sub-battery and
include tests of the subject’s ability to recognise shapes by touch and identifies
numbers written on the fingertips, as well as tests of finger discrimination and
visual, auditory, and tactile neglect. The number of errors is the score for all
64 these procedures.
Other Tests: The Halsted Reitan battery was expanded further by other Neuropsychology Test
Batteries
researchers to include more tests.
The Klove Grooved Pegboard Test: The subject must place pegs shaped like
keys into a board containing recesses that are oriented in randomly varying
directions. The test is administered twice, once with the right and once with the
left hand. Sores are the time to completion in seconds in each hand and errors for
each hand, defined as the number of pegs dropped during performance of the
task.
The Klove roughness Discrimination Test: The subject must order four blocks
covered with varying grades of sandpaper presented behind a blind with regards
to degree of roughness. Time and error scores are recorded for each hand.
Visual Field Examination: Russel et. al include a formal visual field examination
using a parameter as part of their assessment procedure.
Tests in the expanded version include the Wisconnin card Sorting, Thurstone
word Fluency, Story Memory, Figural Memory, Seashore Tonal Memory, Digit
Vigilance, Peabody Individual Achievement, and Boston naming Tests, plus a
part of Boston Diagnostic Aphasia Examination.
It would appear from one impressive study that valid inferences concerning
prediction at this level must be clinically, and one cannot call upon the standard
univariate statistical procedures to make the necessary discriminations. The study
65
Brain Behaviour provides the major impetus for Russel and co-workers’ neuropsychological key
Inter-relationship
approach, which was an essence an attempt to objectify higher-order inferences.
With regard to the first aspect, Heaton and Pendleton (1981) document lack of
predictive validity studies using extensive batteries of the Halsted Reitan type.
However they do not report one study in which Halsted Reitan successfully
predicted employment status on 6-month follow-up. With regard to prediction
of course of illness, there appears to be a good deal of clinical expertise, but no
major formal studies in which the battery’s capacity to predict whether the patient
will get better, worse, or stay the same is evaluated. This matter is of particular
significance in such conditions as head injury and stroke, since outcome tends to
be quite variable in these conditions. The changes that occur during the early
stages of these disorders are often the most significant ones related to prognosis.
In general, there has not been a great deal of emphasis on studies involving the
reliability of the Halsted Reitan battery, probably because of nature of the tests
themselves, particularly with regard to the practice effect problem, and because
of the changing nature of those patients from whom the battery was developed.
Golstein and Watson (1989) provided a review of Halsted Reitan battery reliability
studies, as well as a test-retest study of their own, concluding that reliability
levels were satisfactory in a number of different clinical groups.
The category test can have its reliability assessed through the split-half method.
Self Assessment Questions
1) Discuss in detail the Halstead-Reitan Neuropsychological battery.
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Neuropsychology Test
2) Trace the history of how the Halstead-Reitan battery was devised. Batteries
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Neuropsychological battery?
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4) Discuss the theoretical foundation on which Halstead Reitan battery is
devised.
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Tests of Attention:
3) Focused attention-Colour trails test
4) Sustained attention- digit vigilance test
5) Divided attention- the triads test
Working memory:
9) N back test (Verbal working memory and Visual working memory)
10) Self ordered pointing test
Planning
11) Tower of London test
Set shifting
12) Wisconsin card sorting test (WCST)
Response inhibition
13. Stroop test-NIMHANS version
Verbal comprehension
14) Token test
Tests of verbal Learning and memory:
15) Rey’s Auditory verbal learning test
16) Logical memory test
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Neuropsychology Test
Batteries
References
Sherrill, R. E. jr. (1987). options for shortening Halstead’s category test for adults.
I Archives of clinical neuropsychology,2,343-352.
73
Brain Behaviour
Inter-relationship UNIT 4 BEHAVIOURAL
NEUROPSYCHOLOGY, BRAIN
FITNESS AND ACTIVITIES THAT
PROMOTE BRAIN FITNESS
Structure
4.0 Introduction
4.1 Objectives
4.2 Neuropsychology
4.2.1 Definition of Neuropsychology
4.2.2 Brief History of Neuropsychology
4.2.3 Neuropsychology and Related Fields
4.3 Behavioural Neuropsychology
4.3.1 Introduction
4.3.2 Techniques Used in the Cognitive Retraining
4.4 Brain and Behaviour
4.5 Brain Fitness
4.6 Brain Training
4.6.1 General Activities that Promote Brain Fitness
4.6.2 Activities for Improving Specific Cognitive Domains
4.7 Let Us Sum Up
4.8 Unit End Questions
4.9 Suggested Readings
4.0 INTRODUCTION
This unit is about neuro bio behavioural psychology. It starts with the definition
of Neuropsychology and continues on to discuss the evolution of
neuropsychology. The historical aspects are covered in detail in tis section. This
is followed by a detailed discussion of the relationship of neuropsychology to
other scientific and related fields such as experimental neuropsychology, cognitive
neuropsychology etc. Then a definition of behavioural neuropsychology will be
presented followed by the various techniques used in cognitive training. The
next section deals with brain behaviour relationship and the various aspects related
to the same. This is followed by a section on brain fitness and how to retain such
fitness and the exercises needed for the same. Then the section presents measures
to be used to improve specific cognitive domains.
4.1 OBJECTIVES
After completing this unit, you will be able to:
• Define Neuropsychology;
• Trace historically the development of neuropsychology;
• Describe the relationship of neuropsychology to other related fields;
74
• Define behavioural neuropsychology; Behavioural
Neuropsychology, Brain
• Elucidate the technbiques used in cognitive retraining; Fitness and Activities that
Promote Brain Fitness
• Delineate the relationship between brain and behaviour;
• Explain what is brain fitness;
• Explain the various methods used to retain the fitness of the brain; and
• Analyse the various activities related to mental stimulation.
4.2 NEUROPSYCHOLOGY
4.2.1 Definition of Neuropsychology
According to Bruce, the term neuropsychology was first used by Williams Osler.
It was then used by D.O. Hebb, in a subtitle in his 1949 book The Organisation
of behaviour: A Neuropsychological Theory. Although neither defined nor used
in the text itself, the term was probably intended to represent a study that combined
the neurologist’s and physiological psychologist’s common interest in brain
function. Traditionally defined, neuropsychology is the study of (and the
assessment, understanding, and modification of) brain-behaviour relationships.
The contemporary definition is strongly influenced by two traditional foci for
experimental and theoretical investigations in brain research: the brain hypothesis,
the idea that the brain is the source of behaviour; and the neuron hypothesis, the
idea that the unit of brain structure and function is the neuron.
Neuropsychology seeks to understand how the brain, through structure and neural
networks, produces and controls behaviour and mental processes, including
emotions, personality, thinking, learning and remembering, problem solving,
and consciousness. The field is also concerned with how behaviour may influence
the brain and related physiological processes, as in the emerging field of
psychoneuroimmunology (the study that seeks to understand the complex
interactions between brain and immune systems, and the implications for physical
health). Neuropsychology seeks to gain knowledge about brain and behaviour
relationships through the study of both healthy and damaged brain systems. It
seeks to identify the underlying biological causes of behaviours, from creative
genius to mental illness, that account for intellectual processes and personality
One important question is debated: What structure in the body is the “seat of
intellect”?
Descartes thought of the body as an automaton. The nerves and brain control the
reflexive actions of the automaton. Also believed that at the pineal gland in the
brain. And concluded that there is a spiritual soul and the physical brain, and the
soul and brain interact to generate human behaviour.
Gall theorised (correctly) that different parts of the brain carried out different
cognitive and behavioural functions.
Fritsch and Hitzig supported the theory of functional localisation via their
discovery of the motor cortex. Unlike Broca’s work, which depended on the use
of clinical patients (hence, it’s imprecision), Fritsch and Hitzig did electrical
stimulation and lesion work with dogs. These tools and methods allowed more
precise replication.
• Neuron doctrine: By arguing that neurons are individual units or cells that
are physically isolated from each other, this theory was preferred for most
in the functional localisation school.
• Nerve nets theory: This theory proposed that neurons grow together to
form interconnected nets that are physiologically inseparable in adult animals,
more consistent with the theory of holism.
This debate was eventually resolved because of research carried out by Camillo
Golgi; she developed an important staining technique that allowed scientists to
see the neuron cell structure much more clearly. Using Golgi’s new staining
technique, Santiago Ramon y Cajal was able to show that neurons were in fact
separate individual cells. These findings also provided additional support for the
more general theory of localisation of function.
77
Brain Behaviour 4.2.3 Neuropsychology and Related Fields
Inter-relationship
1) Clinical Neuropsychology: Clinical neuropsychology is the application of
neuropsychological knowledge to the assessment, management and
rehabilitation of people who have suffered illness or injury (particularly to
the brain) which has caused neurocognitive problems. In particular they
bring a psychological viewpoint to treatment, to understand how such illness
and injury may affect and be affected by psychological factors. They also
can offer an opinion as to whether a person is demonstrating difficulties due
to brain pathology or as a consequence of emotional or other (potentially)
reversible cause.
78
However, there may be reason to believe that the link between mental Behavioural
Neuropsychology, Brain
functions and neural regions is not so simple. An alternative model of the Fitness and Activities that
link between mind and brain, such as parallel processing, may have more Promote Brain Fitness
explanatory power for the workings and dysfunction of the human brain.
Yet another approach investigates how the pattern of errors produced by
brain-damaged individuals can constrain our understanding of mental
representations and processes without reference to the underlying neural
structure. A more recent but related approach is cognitive neuropsychiatry
which seeks to understand the normal function of mind and brain by studying
psychiatric or mental illness.
4) Neuroscience generally refers to the study of neurons and the way they
work in either animals or humans.
Visuoperceptive disorders
It relates to the way in which brain damage impairs people’s ability to adapt to
the visual world and the methods used to treat these disabilities which consist of
• Restoration of memory
• Cognitive retraining of attention and concentration
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• Cognitive retraining of Language and communication Behavioural
Neuropsychology, Brain
• Management of effects of brain damage on affect and mood Fitness and Activities that
Promote Brain Fitness
• Restoration of Executive functioning
• Management of impairments in the Activities of daily living
Environmental control
Restructuring and adaptations are set up to cue appropriate behaviours.
Response cost
This is a type of punishment in which the subject has to return back the token
(positive reinforcement) earned earlier if the subject displays undesirable or
maladaptive behaviour like anger, distraction etc.
Chaining
Chaining involves reinforcing individual responses occurring in a sequence to
form a complex behaviour. It is frequently used for training behavioural sequences
(or “chains”) that are beyond the current repertoire of the learner. The chain of
responses is broken down into small steps using task analysis. Parts of a chain
are referred to as links. The learner’s skill level is assessed by an appropriate
professional and is then either taught one step at a time while being assisted
through the other steps forward or backwards or if the learner already can complete
a certain percentage of the steps independently, the remaining steps are all worked
on during each trial total task. A verbal stimulus or prompt is used at the beginning
of the teaching trial. The stimulus change that occurs between each response
becomes the reinforcer for that response as well as the prompt/stimulus for the
next response without requiring assistance from the teacher.
As small chains become mastered, i.e. are performed consistently following the
initial discriminative stimulus prompt, they may be used as links in larger chains.
(Ex. teach hand washing, tooth brushing, and showering until mastered and then
teach morning hygiene routine which includes the mastered skills). Chaining
requires that the teachers present the training skill in the same order each time
and is most effective when teachers are delivering the same prompts to the learner.
The most common forms of chaining are backward chaining, forward chaining,
and total task presentation.
Shaping
The differential reinforcement of successive approximations, or more commonly,
shaping is a conditioning procedure used primarily in the experimental analysis
of behaviour. In shaping, the form of an existing response is gradually changed
across successive trials towards a desired target behaviour by rewarding exact
segments of behaviour.
Relaxation exercises
A relaxation technique (also known as relaxation training) is any method, process,
procedure, or activity that helps a person to relax, to attain a state of increased
calmness, or otherwise reduce levels of anxiety, stress or anger. Relaxation
techniques are often employed as one element of a wider stress management
program and can decrease muscle tension, lower the blood pressure and slow
heart and breath rates, among other health benefits. Examples are- Jacobson’s
Progressive muscular relaxation technique, deep breathing exercise and pranayam.
Neurobiofeedback
Neurofeedback (NFB), also called neurotherapy, or EEG biofeedback, is a type
of biofeedback that uses real time displays of electroencephalography to illustrate
brain activity, often with a goal of controlling central nervous system activity.
Sensors are placed on the scalp to measure activity, with measurements displayed
using video displays or sound.
Observational learning
This is also known as vicarious learning, social learning, or modelling. This is a
type of learning that occurs as a function of observing, retaining and replicating
novel behaviour executed by others. It is argued that reinforcement has the effect
of influencing which responses one will partake in, more than it influences the
actual acquisition of the new response.
Prompting
A prompt is a cue or assistance to encourage the desired response from an
individual. Types of prompts:
Verbal prompts: Utilising a vocalisation to indicate the desired response.
Visual Prompts: a visual cue or picture.
Gestural prompts: Utilising a physical gesture to indicate the desired response.
Positional prompt: The target item is placed closer to the individual.
Modeling: Modeling the desired response for the student. This type of prompt is
best suited for individuals who learn through imitation and can attend to a model.
Physical prompts: Physically manipulating the individual to produce the desired
response. There are many degrees of physical prompts. The most intrusive being
hand-over-hand, and the least intrusive being a slight tap to initiate movement.
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Brain Behaviour 2) Describe visuoperceptual disorders.
Inter-relationship
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3) What are the techniques used in cognitive retraining?
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4) Discuss chaining and shaping and neurobiofeedback.
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Four pounds and several thousand miles of interconnected nerve cells (about Behavioural
Neuropsychology, Brain
100 billion) control every movement, thought, sensation, and emotion that Fitness and Activities that
comprises the human experience. Within the brain and spinal cord there are ten Promote Brain Fitness
thousand distinct varieties of neurons, trillions of supportive cells, a few more
trillion synaptic connections, a hundred known chemical regulating agents, miles
of minuscule blood vessels, axons ranging from a few microns to well over a
foot and a half in length, and untold mysteries of how almost flawlessly all these
components work together. This is the amazing brain.
The brain behaviour relationships, namely the functional system, were developed
in the many works of Luria. A preferred term might be the ‘distributed anatomical
system’. The term emphasise that every complex psychological process has as
its underpinning collections of nerve cells, both in the cerebral cortex and sub
cortex, linked together through fibre pathways usually of greater complexity.
Each of these anatomical systems has extensive connections with numerous other
systems. Mesulam (1981) has expressed the major features clearly as follows:
• Components of a single complex function are represented within distinct
but interconnected sites which collectively constitute an integrated network
for that function.
• Individual cortical areas contain the neural substrate for components of
several complex functions and may therefore belong to several partially
overlapping networks.
• Lesions confined to a single cortical region are likely to result in multiple
deficits.
• Severe and lasting impairments of an individual complex function usually
involve the simultaneous involvement of several components in the relevant
network and
• The same complex function may be impaired as a consequence of a lesion
in one of several cortical areas, each of which is a component of an integrated
network for that function.
Brain fitness is the capacity of a person to meet the various cognitive demands
of life. It is evident in an ability to assimilate information, comprehend
relationships, and develop reasonable conclusions and plans. Brain fitness can
be developed by formal education, being actively mentally engaged in life,
continuing to learn, and exercises designed to challenge cognitive skills. Healthy
lifestyle habits including mental stimulation, physical exercise, good nutrition,
stress management, and sleep can improve brain fitness. On the other hand,
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Brain Behaviour chronic stress, anxiety, depression, aging, decreasing estrogen, excess oxytocin,
Inter-relationship
and prolonged cortisol can decrease brain fitness as well as general health.
Joe Verghese, M.D. found that people with higher activity score had lower risks
of Alzheimer’s and dementia. An open question in the field is whether people
who will later develop Alzheimer’s are naturally less active, or whether
intervening to raise an activity score will delay or prevent Alzheimer’s. If the
latter hypothesis were true, people could lower their dementia risk by 7% simply
by adding one activity per week (such as doing a crossword puzzle or playing a
board game) to their schedule. According to the findings of that same study,
subjects who did crossword puzzles four days a week had a 47% lower risk of
dementia than subjects who did a crossword puzzle just once a week.
Brain fitness is a national health priority, as positive adaptation and healthy living
clearly improves brain function. The good news is that the brain is adaptable and
able to grow new brain cells with our experiences and new learning. We should
examine the relationship between our lifestyle and our brain fitness. From before
birth, through childhood, adolescence, and through adulthood and beyond we
can optimize brain fitness. Continuing education about brain fitness is needed to
maximize our potential.
Brain health is a national priority. What is good for the heart is good for the
brain. Lifestyle and brain fitness go hand-in-and Brain fitness programs should
begin early in life and continue across the life span that involve positive adaptation
86 and brain health.
Neuroplasticity and neurogenesis have fuelled the imagination toward increasing Behavioural
Neuropsychology, Brain
the brain’s connectivity and improve speed of transmission which are based on Fitness and Activities that
your experiences and health. Promote Brain Fitness
MOTIVATION
PERCEPTION
Accuracy METACOGNITION
Noticing
& spted
Utilising
Strategies Self reflection
REASONING
MEMORY
Logical
Thinking Systomatic
Thought Retriewal
MENTAL FITNESS Information
Processing
USING NUMBERS
FLEXIBLE
Mathmatical Practical
THINKING
Reasoning Arithmatic
Divergent
Opening New Thinking SPATIAL RELATIONSHIPS
Pathways
Dancing regularly
practicing yoga
Aerobic exercise 3 hours per week for 3 months helped healthy seniors grow
new brain cells in their frontal lobes (increased attention and memory) and corpus
callosum (speed of processing)
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Brain Behaviour Stretching exercises and supervised weight-bearing exercises are recommended.
Inter-relationship
The best single exercise done without equipment is standing on one foot for as
long as possible and then switching to the other foot and doing the same thing.
This combines muscle strengthening, balance, and coordination;
Mental Health: Positive mental health is very necessary for happiness and good
functioning of the body and the brain. It can be attained through the following
measures:
• Work as long as possible in a career
• Retain consistent level of physical activity
• Find opportunities to converse
• Avoid excessive use of alcohol and other drugs
• Active group activities – tennis, dancing
• Passive group activities – volunteering, art class
• Active individual activities – walking, swimming
• Passive individual activities – cooking, word puzzle
Try to retain a sense of humor and do everything you can to keep up your present
friendships and strike up new ones.
Try cultivating a few with the younger generation, loneliness is the greatest
challenge to overcome as you advance toward the mature years.
Build up your tolerance for being alone; find pleasure in your own company;
consider a pet.
When facing mental challenges, go slowly, check your work, draw on your years
of experience, and rely less on your speed of response. Reaction time lengthens
with age. Compensate by using your wisdom and accumulated life experience.
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Mental stimulation: Activities of mental stimulation directly contributes for Behavioural
Neuropsychology, Brain
improving the brain fitness. Some research shows that brain stimulation can Fitness and Activities that
help prevent age-related cognitive decline, reverse behavioural assessment Promote Brain Fitness
declines in dementia and Alzheimer’s and can also improve normally functioning
minds. Brain fitness can be improved by various challenging activities such as
playing chess or bridge.
Structured computer based workouts: This is not a substitute for a social life,
but a place to be stimulated with new information, find others who share common
interests, and engage in activities (internet bridge groups) that you may not be
able to attend outside the home; games like bingo, bridge, and chess help maintain
sharpness in different mental domains.
2) Paraphrase and repeat back what you have said as a way to focus on the
conversation and recall the important details.
5) When shopping, group items into categories that can later act as reminders.
Group grocery store items into fruits, meats and canned goods to assist in
recalling the items as you go through the store.
7) Connect new information with old information. When meeting a new person
named “Brenda”, compare and contrast her characteristics with those of
another person named “Brenda”.
9) Practice a new task in shorter, more frequent intervals rather than longer
and less frequent sessions.
10) To reduce the anxiety of retrieving information, try deep breathing or other
relaxation techniques.
11) Caregivers can help out a forgetful loved one by cuing them with the first
letter of the word they are looking for or by saying the category of the lost
word, like hardware, clothing or food.
2) Timers: To provide an auditory cue for tasks in the future, set a watch alarm,
alarm clock or cooking timer to go off when a task needs to be performed.
4) Electronic Organiser: Besides personal information, you can enter the task
you need to perform and the time you need to begin.
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Brain Behaviour
Inter-relationship Self Assessment Questions
1) What are the activities to improve the cognitive domains?
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2) How do we help a person to improve reasoning, planning etc abilitieis?
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3) How do we help improve memory in a person?
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Step I
Error analysis: This involves identification and analysis of the types of errors
the patient does. It involves knowledge of basic sight words, configuration cues
(like word lengths, capital letters, double letters and letter height), context cues
(like pictures and words), phonetic analysis of consonents, phonetic analysis of
vowels, prefixes, suffixes and dictionary skills etc. Once the error analysis is
done following techniques can be used to develop reading and writing skills.
a) For improving basic sight words: Flash cards can be used and making the
patient familiar with 4 to 5 words
b) Multisensory method or Fernald method: In it a written word on flash
card is presented in front of the patient. Then the patient has to trace the
word with finger and saying it aloud while tracing. Then the patient writes 93
Brain Behaviour the word without tracing, patient recognise the word with memory and then
Inter-relationship
each word is filed in alphabetic order and used in stories.
c) Gillingham method or Phonetic method: A small card with one letter
printed on it is exposed to the patient and the name spoken by therapist. The
name is then repeated by patient.
As soon as the name is mastered, its sound is made by the therapist and
repeated by patient. The original card is then exposed and the therapist asks
what this letter says. The patient is expected to give the sound.
Without the card exposed, the therapist makes the sound represented by
letter and says, “tell me the name of the letter that has this sound. The Patient
is expected to give the name of the letter. The letter then written by the
therapist and its form is explained to the patient. Then letter is traced, copied,
written from memory and then written again by looking at it.
Finally, the therapist makes the sound and instructs the patient to write the
letter that has this sound.
d) For writing: For improving writing skills, regular practise of writing is
required. After each practise session adequate feedback should be given
with reinforcements.
Visuospatial Functions
1) Computerised tasks involving visual scanning and reaction time: The
program uses a light board with 20 coloured lights and a target can be moved
around the board at different speeds. With this device the patient can be
systematically trained to attend to the neglected visual field. This procedure
with addition of other tasks e.g. size estimation and body awareness task
improves visual perceptual functioning. In left unilateral neglect syndrome,
patients may be made to actively scan left hemisphere by implanting left
visual field anchor like bright red light stimulus, response pacing, immediate
feedback etc.
brainfitnessresources.com
References
Cullum.C.M (1998). Neuropsychological assessment of adults. In Bellack A.S,
Herson M, Reynolds. C.R (eds) Comprehensive clinical psychology: 4 328-333.
en.wikipedia.org/wiki/Brain_fitness
en.wikipedia.org/wiki/Behaviour_modification
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Brain Size and Devaluation,
UNIT 1 BRAIN SIZE AND DEVALUATION, Genes, Brain and
Behaviour
GENES, BRAIN AND BEHAVIOUR
Structure
1.0 Introduction
1.1 Objectives
1.2 Brain Size
1.2.1 Male Female Brain Differences
1.3 Indicators of Biological Basis of Behaviour
1.3.1 Behaviour often is Species Specific
1.3.2 Behaviour often Breed True
1.3.3 Behaviours Change in Response to Alterations in Biological Structures
1.3.4 Behaviour has an Evolutionary History
1.4 Human Brain and Human Behaviour
1.5 Genes, Brain and Behaviour
1.5.1 Definition of Behavioural Genetics
1.5.2 Definition of a Gene
1.5.3 Description of DNA
1.5.4 Definition of Chromosome
1.6 Genes Influence Behaviour and Attitudes
1.7 Let Us Sum Up
1.8 Unit End Questions
1.9 Suggested Readings
1.0 INTRODUCTION
The brain is the organ that sets us apart from any other species. It is not the
strength of our muscles or of our bones that makes us different, it is our brain.—
Pasko T. Rakic
Brain is an important part of our various organs. Without brain humans do not
exist. In this unit we will be dealing with brain, brain size and how this varies in
humans and especially between males and females. Then we discuss the biological
indicators of behaviour of humans within which we will show how behaviour is
species specific, and how behaviour keeps occurring and how behaviours change
in response to alternations in biological structures and processes. Then we trace
the evolutionary history of behaviour. This is followed by brain and behaviour
and how they are interrelated. What all aspects of behaviours are produced by
the activities within the brain etc. Then we deal with genes, brain and behaviour
within we will be discussing the definition of behavioural genetics and then we
give the definition of gene, DNA and chromosomes. Then we delineate how
behaviour and attitudes are influenced by genes.
1.1 OBJECTIVES
After completing this unit, you will be able to:
• Elucidate brain and brain size;
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Basics of the Central • Differentiate between male and female brain size;
Nervous System
• Elucidate the indicators of biological basis of behaviour;
• Explain how behaviour change in response to alternations in biological
structures;
• Describe the relationship between brain and behaviour;
• Define genes, behavioural genetics;
• Describe DNA and Chromosomes; and
• Explain how genes influence behaviour and attitudes.
• The cerebrum is divided into two hemispheres that is the left and the right
hemispheres. It controls the interpretation of impulses from sense receptors,
memory, learning, and emotions.
The midbrain
• The midbrain carries messages between the forebrain and hindbrain.
The hindbrain
The hindbrain is composed of the cerebellum and the medulla oblongata.
• The cerebellum controls all voluntary and some involuntary movements.
• It maintains balance and coordination.
The medulla oblongata
• This controls many involuntary functions such as breathing and heartbeat.
• If the medulla is destroyed, a person will die.
• The medulla is connected to the spinal cord, which connects the peripheral
nervous system with the brain and controls reflexes (automatic responses).
Early humans are known as hominids. Australopithecus was the first human like
creature, that lived in Africa about 5 million years ago. Their brains were 350 to
450 cubic centimeters, the size of a gorilla. Homo habilis, which was more human
like, lived two million years ago and was the first to use stone tools. Their brain
volume was about 700 cubic centimeter. The Neanderthals, which are more
modern humans, are classified in the same species (Homo sapiens) as today’s
humans. However, living humans belong to a different subspecies, Homo sapiens.
Although the Neanderthal brain was larger than that of humans today, it does not
mean that the Neanderthals were more intelligent, because brain size is related
to body size and the temperature of the environment.
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Basics of the Central About 6,000 of our genes seem to be active only in the brain; gene-produced
Nervous System
proteins, which induce neurons to grow in specific directions inside the skull,
and others that allow them to recognise friendly neurons and cling to them and
make a synapse, and then allow signals to be transmitted across those synapses
together.
Once neurons have made their specific connections together in the course of
their development, those same synapses can be used to send signals from one
neuron to other.
Synapses are not truly connections but gaps between neurons into which signaling
chemicals are injected. Usually, those chemicals are neurotransmitters, like
serotonin, which are used to send signals from one neuron to the next across the
synaptic gap. But hormones and other compounds, like anti-depressants, in the
bloodstream are also able to influence the signal of many synapses and other
receptors at a global level.
The adult human brain weighs on average about 3 lb (1.5 kg) with a size (volume)
of around 1130 cubic centimeters (cm3) in women and 1260 cm3 in men, although
there is substantial individual variation. Men with the same body height and
body surface area as women have on average 100g heavier brains, although these
differences do not correlate in any simple way with gray matter neuron counts or
with overall measures of cognitive performance. The volume is usually measured
in cubic centimeters (cm3 or cc). Modern humans have cranial capacities from
950 cm3 to 1800 cm3, but the average volume of a modern human brain is
1300 cm3 to 1500 cm3.
vi) Language: Two areas in the frontal and temporal lobes related to language
(the areas of Broca and Wernicke) were significantly larger in women, thus
providing a biological reason for women’s notorious superiority in language
associated thoughts. For men, language is most often just in the dominant
hemisphere (usually the left side), but a larger number of women seem to be
able to use both sides for language. This gives them a distinct advantage. If
a woman has a stroke in the left front side of the brain, she may still retain
some language from the right front side. Men who have the same left sided
damage are less likely to recover as fully.
vii) Inferior parietal lobule (IPL) It is a brain region in the cortex, which is
significantly larger in men than in women. This area is bilateral and is located
just above the level of the ears (parietal cortex). Furthermore, the left side
IPL is larger in men than the right side. In women, this asymmetry is reversed,
although the difference between left and right sides is not so large as in
men. This is the same area which was shown to be larger in the brain of
Albert Einstein, as well as in other physicists and mathematicians. So, it
seems that IPL’s size correlates highly with mental mathematical abilities.
Studies have linked the right IPL with the memory involved in understanding
and manipulating spatial relationships and the ability to sense relationships
between body parts. It is also related to the perception of our own affects or
feelings. The left IPL is involved with perception of time and speed, and the
ability to mentally rotate 3-D figures .
ix) Limbic size: Females, on average, have a larger deep limbic system than
males. This gives females several advantages and disadvantages. Due to the
larger deep limbic brain women are more in touch with their feelings, they
are generally better able to express their feelings than men. They have an
increased ability to bond and be connected to others. Females have a more
acute sense of smell, which is likely to have developed from an evolutionary
need for the mother to recognise her young. Having a larger deep limbic
system leaves a female somewhat more susceptible to depression, especially
at times of significant hormonal changes such as the onset of puberty, before
menses, after the birth of a child and at menopause. Women attempt suicide
three times more than men. Yet, men kill themselves three times more than
women, in part, because they use more violent means of killing themselves.
Men are generally less connected to others than are women. Disconnection
from others increases the risk of completed suicides.
The average human brain weighs three pounds (1.36 kilograms). The average
female brain capacity is 79.3 cubic inches, slightly smaller than the male brain
of 88.5 cubic inches. The largest human brains may be twice those of average
size, but size has no relevance to brain performance.
Man has been a tribal animal since he first walked erect, more than four million
years ago. With the impediment of being bipedal, he could not out climb or
outrun his predators. Only through tribal cooperation could he hold his predators
at bay.
For two million years, the early hominid was a herd/tribal animal, primarily a
herd herbivore. During the next two million years the human was a tribal hunter/
warrior. He still is. All of the human’s social drives developed long before he
developed intellectually. They are, therefore, instinctive. Such instincts as mother-
love, compassion, cooperation, curiosity, inventiveness and competitiveness are
ancient and embedded in the human. They were all necessary for the survival of
the human and pre human. Since human social drives are instinctive (not
intellectual), they can not be modified through education. As with all other higher
order animals, however, proper behaviour may be obtained through training.
The intellect, the magnitude of which separates the human from all other animals,
developed slowly over the entire four million years or more of the human
development. The intellect is not unique to the human, it is quite well developed
in a number of the other higher animals. The intellect developed as a control
over instincts to provide adaptable behaviour. The human is designed by nature
(evolution) to modify any behaviour that would normally be instinctive to one
that would provide optimum benefit (survivability). This process is called self-
control or self-discipline, and is the major difference between the human and the
lower order animals, those that apply only instinct to their behavioural decisions.
Self-discipline, therefore, is the measuring stick of the human. The more
disciplined behaviour (behaviour determined by intellect) displayed by the
individual, the more human he becomes. The less disciplined behaviour
(behaviour in response to instinct) displayed by an individual, the more he
becomes like the lower order animals that are lacking in intellect and are driven
10 by their instincts.
Brain Size and Devaluation,
Self Assessment Questions Genes, Brain and
Behaviour
1) Describe different parts of the brain.
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2) Differentiate between the brain size of male and female humans.
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3) In what way corpus callosum differs in females?
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4) Discuss inferior parietal lobe and its significance.
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5) What is meant by OAR?
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6) How does limbic size vary between males and females?
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Basics of the Central
Nervous System 1.3 INDICATORS OF BIOLOGICAL BASIS OF
BEHAVIOUR
1.3.1 Behaviour often is Species Specific
A chickadee, for example, carries one sunflower seed at a time from a feeder to
a nearby branch, secures the seed to the branch between its feet, pecks it open,
eats the contents, and repeats the process. Finches, in contrast, stay at the feeder
for long periods, opening large numbers of seeds with their thick beaks. Some
mating behaviours also are species specific. Prairie chickens, native to the upper
Midwest, conduct an elaborate mating ritual, a sort of line dance for birds, with
spread wings and synchronised group movements. Some behaviours are so
characteristic that biologists use them to help differentiate between closely related
species.
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Basics of the Central Consider these facts. Julian Huxley was satisfied that the evidence demonstrates
Nervous System
that a larger brain is a better learning organ than a smaller one, though the learning
process may take longer. In a nutshell, his argument is that an absolutely larger
brain (i.e., not larger relative to the body itself) will have a relatively as well as
an absolutely larger number of cells in its cortex. A larger number of cortical
cells make more elaborate learning possible. The experiments upon which Huxley
based this were conducted by the German biologist, Rensch.
About 6,000 of our genes seem to be active only in the brain. Genes (or gene-
produced proteins) like Robo which induce neurons to grow in specific directions
inside the skull, and others that allow them to recognise friendly neurons and
cling to them (making a synapse), and then allow signals to be transmitted across
those synapses. Many specialised proteins, such as Reelin, help in the formation
of synapses once two neurons find each other and “dock” together. Reelin also
helps the brain develop its characteristic six layer structure.
Cadherins are sticky molecules that guide neurons as they migrate inside the
skull, to find their permanent position. Think of them like Spiderman climbing
a building, using a sticky substance to cling and move against gravity and friction,
propelling against other neurons until the right one is found with which to form
a more permanent synaptic connection.
The Emx family of genes is involved in establishing the identity of certain regions
in the brain. The brain is full of specialised areas such as vision, speech, planning,
etc., which are set up in the course of development.
The Eph family of genes helps in lay out of the basic topography map of the
brain, by setting up a chemical gradient, which allows migrating neurons to find
their homes.
The Hox genes also help to establish basic layouts of the brain and body.
Other examples of “brain genes” include Pax6, important for the formation of
the eye, and NMDA receptors which seem to play an important role in establishing
memories when the activity of two neurons coincides closely in time.
Since genes largely function to create proteins, genes and proteins can be used
interchangeably. However, some genes can code for multiple proteins depending
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on the context, so it is not as simple as one gene = one protein. Brain Size and Devaluation,
Genes, Brain and
Behaviour
The FGF8 gene (fibroblast growth factor 8), for example, can be sliced and
diced in different ways, leading to the production of different proteins , depending
on the context. Those proteins are also responsible for laying out some of the
gross anatomy of the brain.
Once neurons have made their specific connections together in the course of
their development, those same synapses can be used to send signals from one
neuron to another. Synapses are not truly connections that is, gaps between
neurons into which signaling chemicals are injected. Usually, those chemicals
are neurotransmitters such as the serotonin which are used to send signals from
one neuron to the next across the synaptic gap. But hormones and other
compounds such as the anti depressants in the bloodstream are also able to
influence the signal of many synapses at a global level.
15
Basics of the Central Having established a definition for research purposes, the investigator still must
Nervous System
measure the behaviour with acceptable degrees of validity and reliability. That is
especially difficult for basic personality traits such as shyness or assertiveness,
which are the subject of much current research. Sometimes there is an interesting
conflation of definition and measurement, as in the case of IQ tests, where the
test scores itself has come to define the trait it measures. This is a bit like using
batting averages to define hitting prowess in cricket. A high average may indicate
ability, but it does not define the essence of the trait. Behaviours, like all complex
traits, involve multiple genes, a reality that complicates the search for genetic
contributions.
As with much other research in genetics, studies of genes and behaviour require
analysis of families and populations for comparison of those who have the trait
in question with those who do not. The result often is a statement of “heritability,”
a statistical construct that estimates the amount of variation in a population that
is attributable to genetic factors. The explanatory power of heritability figures is
limited, however, applying only to the population studied and only to the
environment in place at the time the study was conducted. If the population or
the environment changes, the heritability most likely will change as well. Most
important, heritability statements provide no basis for predictions about the
expression of the trait in question in any given individual.
The traits which make us each unique are also inherited from our ancestors.
Physical characteristics such as curly hair, blue eyes, and a tendency for acne are
all determined by our genes. Scientists also believe that many emotional and
behavioural traits, at least in part, are influenced by an individual’s genetic
makeup. Eating habits, intelligence, a penchant for aggressiveness, and even
sleeping patterns all have their roots in our DNA.
Because genes are carried on the chromosomes, humans have two copies of each
gene, one inherited from the mother and one from the father. The two copies are
not necessarily the same, however. Just like snowflakes, genes come in variant
forms. These variations are known as alleles. Different alleles are what produce
variations in inherited traits. This is why your individual traits such as hair colour
or blood type may not match those traits in either of your parents.
DNA is a chemical polymer and is found in the nucleus of the cell. The specific
ordering of the chemical bases (mentioned earlier) found within DNA allow it to
store and maintain the biological characteristics of all living things. The Laws
by which the DNA sequences govern our biological traits are known as the laws
of genetics.
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Basics of the Central
Nervous System 2) Define behavioural genetics and bring out the characteristic features.
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3) Define gene. What are their importances?
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4) Describe DNA. How is it important for growth and development of
behaviour.
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5) Define chromosome and state its importance.
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Brain Size and Devaluation,
1.6 GENES INFLUENCE BEHAVIOUR AND Genes, Brain and
Behaviour
ATTITUDES
Studies of families and twins strongly suggest genetic influences on the
development and expression of specific behaviours, but there is no conclusive
research demonstrating that genes determine behaviours. In “The Interplay of
Nature, Nurture, and Developmental Influences: The Challenge Ahead for Mental
Health” (Archives of General Psychiatry, vol. 59, no. 11, November 2002),
psychiatrist Michael Rutter observed that a range of mental health disorders from
autism and schizophrenia to attention deficit hyperactivity disorder (ADHD)
involve at least indirect genetic effects, with heritability ranging from 20 to 50%.
He further asserted that genetically influenced behaviours also bring about gene-
environment correlations.
Traditional psychological theory holds that attitudes are learned and most strongly
influenced by environment. In “The Heritability of Attitudes: A Study of Twins”
(Journal of Personality and Social Psychology, vol. 80, no. 6, June 2001), James
Olson et al. examined whether there is a genetic basis for attitudes by reviewing
earlier studies and conducting original research on monozygotic and dizygotic
twins. Olson and his colleagues argued that the premise that attitudes are learned
is not incompatible with the idea that biological and genetic factors also influence
attitudes. They hypothesized that genes probably influence predispositions or
natural inclinations, which then shape environmental experiences in ways that
increase the likelihood of the individual developing specific traits and attitudes.
For example, children who are small for their age might be teased or taunted by
other children more than their larger peers. As a result, these children might
develop anxieties about social interaction, with consequences for their
personalities such as shyness or low self-esteem discomfort with large groups.
It has been shown in research as mentioned above, that behavioural traits such as
intelligence, personality including anxiety, novelty seeking and shyness, antisocial
behaviour including aggression and violent behaviour and sexual orientation are
all determined to a great extent by genes. It has been also shown that some
diseases are caused by changes to a single gene, such as cystic fibrosis and
Huntington’s disease. In the case of heart disease and diabetes it has been stated
that they are likely to be affected by many genes, and the environment may also
play a role. The relationship between genes and behaviour is even more complex.
It is widely agreed that genes do have some influence on behaviour but it is
likely that many genes are involved in influencing behaviours. Environmental
factors will also have an effect.
There are several reasons as to why it is so difficult to find which genes have an
effect on behavioural traits. The following section gives the details.
• More than one gene may contribute to a trait, with many genes each having
a small effect;
• A gene may affect more than one trait.
• The action of a gene depends on the presence of other genes.
• Environmental factors may contribute to a trait.
• Genes and the environment interact together in different ways and
• Genes do not have a continuous effect throughout our bodies or for all of
our lives.
• The effects of genes are not inevitable.
• Genes, like environmental factors, probably just make a behaviour more or
less likely to occur. They are part of the cause, but not the only cause.
One single gene has major consequences for behaviour
A single gene usually makes a single protein or sometimes only a part of a protein
as for example, it takes the products of 4 different genes to produce a single
acetylcholine receptor/channel. A typical cell expresses 10,000 different gene
products. Therefore, if the product of a single gene differs from the prototype
for that gene because of a heritable change in the gene, we would expect the
following:
• Many cells will be affected, sometimes all the cells in the body.
• Some cells will be affected more than others.
• Consequences for the organism can range from lethality to slightly altered
performance.
• Altered performance may at times include an improvement in performance
Morgan, C.T. and King, R.A. (2010). (11th edition). Introduction to Psychology.
McGraw Hill Book Company, New Delhi.
21
Basics of the Central
Nervous System UNIT 2 THE BRAIN
Structure
2.0 Introduction
2.1 Objectives
2.2 The Brain
2.2.1 The Cerebrum
2.2.2 The Cerebellum
2.2.3 The Pituitary Gland
2.2.4 The Hypothalamus
2.2.5 The Brain Stem
2.3 The Forebrain
2.3.1 The Cerebral Cortex
2.3.2 The Lobes
2.3.3 The Limbic System
2.3.4 Basal Ganglia
2.3.5 Thalamus
2.4 The Midbrain
2.4.1 The Brain Stem
2.4.2 Colliculi
2.5 The Hindbrain
2.5.1 Cerebellum
2.5.2 The Pons
2.5.3 Medulla
2.6 The Neurons or the Brain Cells
2.6.1 Different Types of Neurons
2.6.2 The Lifespan of Neurons
2.6.3 Protection of the Brain
2.7 Functions of the Brain
2.8 Let Us Sum Up
2.9 Unit End Questions
2.10 Suggested Readings
2.0 INTRODUCTION
In this unit we give a very elaborate description of the brain and its various parts.
We start with the brain itself and its parts briefly with the cerebrum, cerebellum,
pituitary gland, the hypothalamus and the brain stem. Then we move on to the
forebrain and the cerebral cortex followed by the four lobes, that is the frontal,
temporal, occipital and the parietal lobe and their functions. This is followed by
the description of the limbic system, the basal gangliaand the thalamus. Then we
discuss the parts of the midbrain in which we discuss in detail the brain stem and
the colliculi. The hindbrain is the last part which we discuss in which we describe
the cerebellum, the pons and the medulla. Then we take on the very important
brain nerve cells called the neurons and discuss their different types, the lifespan
of the neurons and how the brain as a whole is protected. Then we present the
22 functions of the brain.
The Brain
2.1 OBJECTIVES
After completing this unit, you will be able to:
• Define and describe brain and its five different parts;
• Describe the forebrain and the cerebral cortex and their functions;
• Explain the four different lobes and their functions;
• Describe the limbic system and the basal ganglia;
• Explain the parts of the midbrain;
• Describe the brain stem and its functions;
• Explain the hindbrain and its parts;
• Define neurons and their functions;
• Analyse the different types of neurons; and
• Elucidate the functions of the brain.
In humans, the brain weighs about 3 pounds. Differences in weight and size do
not correlate with differences in mental ability. The brain is the control center for
movement, sleep, hunger, thirst, and virtually every other vital activity necessary
to survive. It is a pinkish gray mass that is composed of about 10 billion nerve
cells. The nerve cells, called neurons, are linked to each other and together are
responsible for the control of all mental functions.
The nervous system consists of the brain, the spinal cord and the network of
nerves that extend to every part of the body. The brain weighs about three pounds;
there are about 45 miles of nerves in the human body. It has right and left
hemispheres. (See figure below)
The cerebrum has right and left halves, called hemispheres, which are connected
in the middle by a band of nerve fibers (the corpus collosum) that enables the
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two sides to communicate. Though these halves may look like mirror images of The Brain
each other, many scientists believe they have different functions. The left side is
considered the logical, analytical, objective side. The right side is thought to be
more intuitive, creative, and subjective. So when you’re balancing the checkbook,
you’re using the left side; when you’re listening to music, you’re using the right
side. It’s believed that some people are more “right-brained” or “left-brained”
while others are more “whole-brained,” meaning they use both halves of their
brain to the same degree.
The cerebellum is smaller than the cerebrum and located below it at the back of
the brain. It controls balance, movement and coordination. We could not move
around without it.
The spinal cord is about 18 inches long and three-quarters of an inch wide and
acts as a conduit for all impulses to and from every body part and the brain. It is
protected from harm by the bones of the spinal column.
Our nerves are intimately linked with our senses and our emotions, which are
also seated in the brain. They relay information to and from the brain so that it
can function as “executive”, controlling responses to stimuli and keeping things
going.
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Basics of the Central Damage to the brain can result in altered functioning. Because the brain is so
Nervous System
complex, it is sometimes impossible to determine cause and effect accurately.
Human traits like mood, preferences, and character are somewhat of a mystery,
probably due to the relationship of our spiritual selves with the physical, social
and emotional.
The brain is wrapped in 3 layers of tissue and floats in a special shock proof fluid
to stop it from getting bumped on the inside of your skull as your body moves
around.
The brain is made of three main parts: the forebrain, midbrain, and hindbrain.
The forebrain consists of the cerebrum, thalamus, and hypothalamus (part of the
limbic system). The midbrain consists of the tectum and tegmentum. The
hindbrain is made of the cerebellum, pons and medulla. Often the midbrain,
pons, and medulla are referred to together as the brainstem.
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The Brain
4) What is the role of hypothalamus?
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5) Describe the brain stem and its functions.
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The cerebral cortex is divided into four sections, called “lobes”: the frontal lobe,
parietal lobe, occipital lobe, and temporal lobe. Each has a specific function. For
example, there are specific areas involved in vision, hearing, touch, movement,
and smell. Other areas are critical for thinking and reasoning. Although many
functions, such as touch, are found in both the right and left cerebral hemispheres,
some functions are found in only one cerebral hemisphere. For example, in most
people, language abilities are found in the left hemisphere. 27
Basics of the Central 2.3.2 The Lobes: (see picture below)
Nervous System
i) Frontal Lobe: This Lobe is located deep to the Frontal Bone of the skull. It
plays an integral role in the following functions/actions such as reasoning,
planning, parts of speech, movement, emotions, and problem solving.
ii) Parietal Lobe: This Lobe is located deep to the Parietal Bone of the skull. It
is associated with movement, orientation, recognition, perception of stimuli.
iii) Occipital Lobe: The Occipital Lobe is located deep to the Occipital Bone
of the Skull. Its primary function is the processing, integration, interpretation,
etc. of vision and visual stimuli.
iv) Temporal Lobe: These Lobes are located on the sides of the brain, deep to
the temporal Bones of the skull and associated with perception and
recognition of auditory stimuli, memory, and speech.
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2.3.4 Basal Ganglia The Brain
The basal ganglia are a collection of subcortical nuclei in the forebrain that lie
beneath the anterior portion of the lateral ventrical. Nuclei are group of neurons
of the same shape.
Diencephalon: The diencephalon, the inner part of the forebrain, consists of the
thalamus, hypothalamus, and pituitary gland.
2.3.5 Thalamus
A large mass of gray matter deeply situated in the forebrain at the topmost portion
of the diencephalon. The structure has sensory and motor functions. Almost all
sensory information enters this structure where neurons send that information to
the overlying cortex. Axons from every sensory system (except olfaction) synapse
here as the last relay site before the information reaches the cerebral cortex. The
thalamus carries messages from the sensory organs like the eyes, ears, nose, and
fingers to the cortex.
It consists of two major parts: (i) Tectum and (ii) Tegmentum. Tectum is the
dorsal part of the midbrain and includes the inferior colliculi and the superior
colliculi. Tegmentum is the ventral part of the midbrain which includes the
periacquductal grey matter, reticular formation, red nuclei and substantia nigra.
Most of the cranial nerves come from the brainstem. The brainstem is the pathway
for all fiber tracts passing up and down from peripheral nerves and spinal cord to
the highest parts of the brain.
This region of the brain is involved in auditory and visual responses as well as
motor function. The reticular formation influences motor functions. The
tegmentum is a general area within the brainstem. It is located between the
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ventricular system and distinctive basal or ventral structures at each level. It The Brain
forms the floor of the midbrain whereas the tectum forms the ceiling. It is a
multisynaptic network of neurons that is involved in many unconscious
homeostatic and reflective pathways. The tectum (Latin: roof) is a region of the
brain, specifically the dorsal part of the mesencephalon (midbrain). This is
contrasted with the tegmentum, which refers to the region ventral to the ventricular
system. It is responsible for auditory and visual reflexes.
The midbrain also contains the crus cerebri, which is made up of nerve fibres
connecting the cerebral hemispheres to the cerebellum, and a large pigmented
nucleus called the substantia nigra. The substantia nigra consists of two parts,
the pars reticulata and the pars compacta. Cells of the pars compacta contain the
dark pigment melanin; these cells synthesize dopamine and project to either the
caudate nucleus or the putamen, both of which are structures of the basal ganglia
and are involved in mediating movement and coordination. The roof plate of the
midbrain is formed by two paired rounded swellings, the superior and inferior
colliculi.
2.4.2 Colliculi
In adult humans it is present only in the mesencephalon as the inferior and the
superior colliculi.
Both colliculi also have descending projections to the paramedian pontine reticular
formation and spinal cord, and thus can be involved in responses to stimuli faster
than cortical processing would allow. Collectively the colliculi are referred to as
the corpora quadrigemina.
At the caudal (rear) midbrain, crossed fibres of the superior cerebellar peduncle
(the major output system of the cerebellum) surround and partially terminate in
a large centrally located structure known as the red nucleus. Most crossed
ascending fibres of this bundle project to thalamic nuclei, which have access to
the primary motor cortex. A smaller number of fibres synapse on large cells in
caudal regions of the red nucleus; these give rise to the crossed fibres of the
rubrospinal tract, which runs to the spinal cord and is influenced by the motor
cortex.
The second segment appears as a slight swelling in lower vertebrates and enlarges
in the higher primates and ourselves into the midbrain. The structures contained
here link the lower brain stem to the thalamus (for information relay) and to the
hypothalamus (which is instrumental in regulating drives and actions). The latter
is part of the limbic system.
31
Basics of the Central
Nervous System 2. 5 THE HINDBRAIN
The hindbrain sits underneath the back end of the cerebrum, and it consists of
the cerebellum, pons, and medulla. (Picture of cerebellum. The small portion
indicated is cerebellum)
2.5.1 Cerebellum
It is also called the “little brain” because it looks like a small version of the
cerebrum — is responsible for balance, movement, and coordination. The
cerebellum, or “little brain”, is similar to the cerebrum in that it has two
hemispheres and has a highly folded surface or cortex. This structure is associated
with regulation and coordination of movement, posture, and balance. The
cerebellum is assumed to be much older than the cerebrum, evolutionarily. The
pons and the medulla, along with the midbrain, are often called the brainstem.
32
The pons measures about 2.5 cm in length. It contains nuclei that relay signals The Brain
from the cerebrum to the cerebellum, along with nuclei that deal primarily with
sleep, respiration, swallowing, bladder control, hearing, equilibrium, taste, eye
movement, facial expressions, facial sensation, and posture. It is a part of the
metencephalon in the hindbrain. It is involved in motor control and sensory
analysis, for example, information from the ear first enters the brain in the pons.
It has parts that are important for the level of consciousness and for sleep. Some
structures within the pons are linked to the cerebellum, thus are involved in
movement and posture.
2.5.3 Medulla
This structure is the caudal-most part of the brain stem, between the pons and
spinal cord. It is responsible for maintaining vital body functions, such as breathing
and heart rate. The brainstem takes in, sends out, and coordinates all of the brain’s
messages. It also controls many of the body’s automatic functions, like breathing,
heart rate, blood pressure, swallowing, digestion, and blinking.
34
The Brain
Thalamus The thalamus is part The thalamus The thalamus recieves
of the limbic system controls your sensory information
so it is located in the s e n s o r y and relays it to the
internal portion of integration and cerebral cortex. The
the brain or the motor integration. cerebral cortex also
center of the brain. sends information to
the thalamus which
then transmits this
information to other
parts of the brain and
the brain stem.
Neurons are nerve cells that transmit nerve signals to and from the brain at up to
200 miles per hour. A typical neuron has about 1,000 to 10,000 synapses
i) a cell body (or soma) . The cell body (soma) contains the neuron’s nucleus
(with DNA and typical nuclear organelles). Dendrites branch from the cell
body and receive messages.
ii) Dendrites branch from the cell body. They are the signal receivers. Dendrites
bring information to the cell body.
iii) A projection called an axon, which conduct the nerve signal. Axon is a long
extension of a nerve cell which take information away from the cell body.
Bundles of axons are known as nerves. Within the Central Nervous System
these are known as nerve tracts or pathways.
At the other end of the axon, the axon terminals transmit the electro-chemical
signal across a synapse (the gap between the axon terminal and the receiving
cell).
The axons are protected by myelin coats and insulates the axon, increasing
transmission speed along the axon. Myelin is manufactured by Schwann’s cells,
and consists of 70-80% lipids (fat) and 20-30% protein.
36
2.6.1 Different Types of Neurons The Brain
There are different types of neurons. They all carry electro chemical nerve signals,
but differ in structure (the number of processes, or axons, emanating from the
cell body) and are found in different parts of the body.
Sensory neurons or Bipolar neurons carry messages from the body’s sense
receptors (eyes, ears, etc.) to the CNS. These neurons have two processes. Sensory
neuron account for 0.9% of all neurons. (Examples are retinal cells, olfactory
epithelium cells.). are sensitive to various non-neural stimuli. There are sensory
neurons in the skin, muscles, joints, and organs that indicate pressure, temperature,
and pain. There are more specialised neurons in the nose and tongue that are
sensitive to the molecular shapes we perceive as tastes and smells. Neurons in
the inner ear are sensitive to vibration, and provide us with information about
sound. And the rods and cones of the retina are sensitive to light, and allow us to
see.
Motor neurons or Multipolar neurons carry signals from the CNS to the
muscles and glands. These neurons have many processes originating from the
cell body. Motoneurons account for 9% of all neurons. (Examples are spinal
motor neurons, pyramidal neurons, Purkinje cells.). are able to stimulate muscle
cells throughout the body, including the muscles of the heart, diaphragm,
intestines, bladder, and glands.
Inter neurons or Pseudopolare (Spelling) cells form all the neural wiring within
the CNS. These have two axons (instead of an axon and a dendrite). One axon
communicates with the spinal cord; one with either the skin or muscle. These
neurons have two processes (Examples are dorsal root ganglia cells.) are the
neurons that provide connections between sensory and motor neurons, as well
as between themselves. The neurons of the central nervous system, including
the brain, are all inter-neurons.
The outside layer of the cerebrum has special areas which receive messages
about sight, touch, hearing and taste. Other areas control movement, speech,
learning, intelligence and personality.
The brain stem is in charge of keeping the automatic systems of the body working,
such as breathing,
The human brain has 100 billion nerve cells. It also has 1000 billion other cells,
which cover the nerve cells and the parts of the nerve cells which form the links
between one cell and another, feed them and keep them healthy.
The left side of the brain is better at problem solving, maths and writing.
The right side of the brain is creative and helps the person to be good at art and
music.
39
Basics of the Central The brain stores in memory facts and figures and all the smells, tastes and things
Nervous System
the person has seen, heard or touched.
The brain can also find things that one has remembered such as how to spell a
word etc.
Each area of the brain has an associated function, although many functions may
involve a number of different areas.
The cerebellum is the hind part of the brain. It is made up of gray, unmyelinated
cells on the exterior and white, myelinated cells in the interior. The cerebellum
coordinates muscular movements and, along with the midbrain, monitors posture.
It is essential to the control of movement of the human body in space. The brain
stem, which incorporates the medulla and the pons, monitors involuntary activities
such as breathing and vomiting.
The thalamus, which forms the major part of the diencephalon, receives incoming
sensory impulses and routes them to the appropriate higher centers. The
hypothalamus, occupying the rest of the diencephalon, regulates heartbeat, body
temperature, and fluid balance. Above the thalamus extends the corpus callosum,
a neuron-rich membrane connecting the two hemispheres of the cerebrum.
The cerebrum occupies the topmost portion of the skull. It is by far the largest
part of the brain. It makes up about 85% of the brain’s weight. The cerebrum is
split vertically into left and right hemispheres. it appears deeply fissured and
grooved. Its upper surface, the cerebral cortex, contains most of the master controls
of the body. In the cerebral cortex ultimate analysis of sensory data occurs, and
motor impulses originate that initiate, reinforce, or inhibit the entire spectrum of
muscle and gland activity. The left half of the cerebrum controls the right side of
the body; the right half controls the left side.
Other important parts of the brain are the pituitary gland, the basal ganglia, and
the reticular activating system (RAS). The pituitary participates in growth
regulation. The basal ganglia, located just above the diencephalon in each cerebral
hemisphere, handle coordination and habitual but acquired skills like chewing
and playing the piano. The RAS forms a special system of nerve cells linking the
medulla, pons, midbrain, and cerebral cortex. The RAS functions as a sentry. In
a noisy crowd, for example, the RAS alerts a person when a friend speaks and
enables that person to ignore other sounds.
The two hemispheres of the brain are somewhat specialised for different activities,
with language depending upon areas on the left, spatial processing upon areas
on the right. Emotional processing is also lateralised. However, expert
neuroscientists feel that the idea of “right brain thinking” and “left brain thinking”
has been overdone, and most complex mental activity involves a mix of areas on
the two sides.
Pearce, Evelyn (2008)(16th edition). Anatomy and Physiology for Nurses. Faber
Publications, London.
41
Basics of the Central
Nervous System UNIT 3 THE CEREBRUM AND THE
CEREBRAL HEMISPHERES AND
THEIR FUNCTIONS
Structure
3.0 Introduction
3.1 Objectives
3.2 The Cerebrum and the Cerebellum
3.3 The Brain Stem
3.4 The Diencephalon
3.5 The Cerebrum
3.5.1 The Cerebral Cortex
3.5.2 Functional Areas of the Cerebral Cortex
3.6 The Cerebellum
3.6.1 Difference between Cerebrum and Cerebellum
3.7 Study of the Brain
3.8 Cerebral Hemisphreres
3.8.1 Left Brain and Right Brain
3.8.2 The Hands and the Two Hemispheres
3.8.3 Cerebral Dominance
3.8.4 Functions of the Left Hemisphere
3.8.5 Functions of the Right Hemisphere
3.8.6 Hemispheric Lobe Functions
3.8.7 Lateralisation or Plasticity of Hemispheric Function
3.9 The Limbic System
3.10 The Forebrain
3.11 Lobes of the Brain
3.11.1 Frontal Lobe
3.11.2 Parietal Lobe
3.11.3 Temporal Lobe
3.11.4 Occipital Lobe
3.12 Let Us Sum Up
3.13 Unit End Questions
3.14 Suggested Readings
3.0 INTRODUCTION
This unit discusses the two main aspects of the brain namely the cerebrum and
the cerebral hemispheres and their functions. The first section starts with the
cerebrum and the cerebellum followed by a discussion on the brain stem and its
various functions. This is followed by a description of the diencephalon and its
functions. The next topic to be taken up is the cerebrum within which we discuss
the cerebral cortex and the functional areas of the cerebral cortex. We then take
up the description of the cerebellum and bring out the differences between the
42
cerebrum and the cerebellum. How to learn about the brain and what are the The Cerebrum and the
Cerebral Hemispheres and
various methods available to us to learn about the brain is discussed next which their Functions
includes the MRI, PET and other such equipments which help to understand
what goes on within the brain. Then the two hemispheres are discussed of the
brain and we take up the description of the left and the right brain followed by
the how the two hands are controlled and managed by the two hemispheres.
Then we discuss about the cerebral dominance and the functions of the right and
left hemispheres. Then we discuss the limbic system, the forebrain and the four
lobes of the brain.
3.1 OBJECTIVES
After completing this unit, you will be able to:
• Define and describe cerebrum and the cerebellum;
• Differentiate between the cerebrum and the cerebellum;
• Describe the diencephalon, and the brain stem;
• Explain the cerebral cortex and its functions;
• Describe the two hemispheres of the brain;
• Explain how the right and left hands are controlled by the two sides of the
brain;
• Define the limbic system and its functions;
• Eklucidate the role of the forebrain; and
• Analyse the functions of the four lobes of the brain.
The human brain is a soft, shiny, grayish white, mushroom shaped structure.
Encased within the skull, the brain of an average adult weighs about 3 lb
(1.4 kg).
At birth, the average human infant’s brain weighs 13.7 oz (390 g); by age 15, the
brain has nearly reached full adult size. The brain is protected by the skull and by
a three layer membrane called the meninges.
Many bright red arteries and bluish veins on the surface of the brain penetrate
inward. Glucose, oxygen, and certain ions pass easily from the blood into the
brain, whereas other substances, such as antibiotics, do not.
The four principal sections of the human brain are:
• the brain stem,
• the diencephalon,
• the cerebrum, and
• the cerebellum.
43
Basics of the Central
Nervous System 3.3 THE BRAIN STEM
Underneath the limbic system is the brain stem. This structure is responsible for
basic vital life functions such as breathing, heartbeat, and blood pressure.
Scientists say that this is the “simplest” part of human brains because animals’
entire brains, such as reptiles (who appear early on the evolutionary scale)
resemble our brain stem.
The brain stem connects the brain with the spinal cord. All the messages that are
transmitted between the brain and spinal cord pass through the medulla, which
is a part of the brain stem. This it does through fibers. The fibers on the right side
of the medulla cross to the left and those on the left cross to the right.
As a result, each side of the brain controls the opposite side of the body. The
medulla also controls the heartbeat, the rate of breathing, and the diameter of the
blood vessels and helps to coordinate swallowing, vomiting, hiccupping,
coughing, and sneezing.
Another component of the brain stem is the pons (meaning bridge). The pons
conducts messages between the spinal cord and the rest of the brain, and between
the different parts of the brain. They convey impulses between the cerebral cortex.
The pons, and the spinal cord is a section of the brain stem known as the midbrain,
which also contains visual and audio reflex centers involving the movement of
the eyeballs and head.
The brain stem is made of the midbrain, pons, and medulla. Let us see what
these structures do:
i) Midbrain: The midbrain is the smallest region of the brain that acts as a
sort of relay station for auditory and visual information.
The midbrain controls many important functions such as the visual and
auditory systems as well as eye movement. Portions of the midbrain called
the red nucleus and the substantia nigra are involved in the control of body
movement. The darkly pigmented substantia nigra contains a large number
of dopamine-producing neurons are located. The degeneration of neurons
in the substantia nigra is associated with Parkinson’s disease.
ii) Pons: In Latin, the word pons literally means bridge. The pons is a portion
of the hindbrain that connects the cerebral cortex with the medulla oblongata.
It also serves as a communications and coordination center between the two
hemispheres of the brain. As a part of the brainstem, the pons helps in the
transferring of messages between various parts of the brain and the spinal
cord.
iii) Medulla: This structure is the caudal most part of the brain stem, between
the pons and spinal cord. It is responsible for maintaining vital body
functions, such as breathing and heartrate
iv) Cranial nerves: Twelve pairs of cranial nerves originate in the underside of
the brain, mostly from the brain stem. They leave the skull through openings
and extend as peripheral nerves to their destinations. Among these cranial
nerves are the olfactory nerves that bring messages about smell and the
optic nerves that conduct visual information.
44
The Cerebrum and the
3.4 THE DIENCEPHALON Cerebral Hemispheres and
their Functions
The diencephalon lies above the brain stem and embodies the thalamus and
hypothalamus. The thalamus is an important relay station for sensory information,
interpreting sensations of sound, smell, taste, pain, pressure, temperature, and
touch.
The thalamus also regulates some emotions and memory.
The hypothalamus controls a number of body functions, such as heartbeat rate
and digestion, and helps regulate the endocrine system and normal body
temperature. The hypothalamus interprets hunger and thirst, and it helps regulate
sleep, anger, and aggression.
Broca studied patients with language deficits. Later after their death when he
autopsied, he found a sizable lesion in the left inferior frontal cortex. Subsequently,
Broca studied eight other patients, all of whom had similar language deficits
along with lesions in their left frontal hemisphere. This led him to make his
famous statement that “we speak with the left hemisphere” and to identify, for
the first time, the existence of a “language centre” in the posterior portion of the
frontal lobe of this hemisphere. Now known as Broca’s area, this was in fact the
first area of the brain to be associated with a specific function that is in this case
language.
Ten years later, Carl Wernicke, a German neurologist, discovered another part of
the brain, this one involved in understanding language, in the posterior portion
45
Basics of the Central of the left temporal lobe. People who had a lesion at this location, could speak,
Nervous System
but their speech was often incoherent and made no sense.
Broca’s area translates thoughts into speech, and coordinates the muscles needed
for speaking. Impulses from other motor areas direct hand muscles for writing
and eye muscles for physical movement necessary for reading.
The cerebrum is divided into two hemispheres, that is, left and right.
In general, the left half of the brain controls the right side of the body, and vice
versa.
For most right-handed people (and many left-handed people as well), the left
half of the brain is dominant.
By studying patients whose corpus callosum had been destroyed, scientists
realised that differences existed between the left and right sides of the cerebral
cortex.
The left side of the brain functions mainly in speech, logic, writing, and arithmetic.
The right side of the brain, on the other hand, is more concerned with imagination,
art, symbols, and spatial relations.
Motor Areas: Four motor areas collectively occupy almost half of the frontal
lobe. One of these, the primary motor cortex, is the precentral gyrus just anterior
to the central sulcus. The motor areas are extensively connected to the basal
ganglia and cerebellum. Working together in complex feedback loops, these areas
are essential for motor coordination, postural stability and balance, learned
movements, and the planning and execution of voluntary movement.
Primary sensory areas are organised into precise sensory maps of the body. The
primary somatosensory cortex, for example, has a point-for-point correspondence
with the opposite (contralateral) side of the body, so that, for instance, the first
and second fingers of the left hand send sensory information to adjacent areas of
the right primary somatosensory cortex. Similarly, the primary visual cortex has
a point-for-point map of the contralateral visual field. The primary auditory cortex
has a tonotopic map of the cochlea of the inner ear, with different points in the
cortex representing different sound frequencies.
The human brain differs from that of other primates in its large amount of
association cortex. Association areas not only integrate immediate sensory data
with other information, but are also responsible for human ingenuity, personality,
judgment, and decision making.
47
Basics of the Central
Nervous System 2) Define brain stem and states its functions.
...............................................................................................................
...............................................................................................................
...............................................................................................................
...............................................................................................................
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3) What is Diencephalon and what role does it play?
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...............................................................................................................
4) Describe the cerebral cortex and indicate the functional areas of the
cerebral cortex.
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...............................................................................................................
...............................................................................................................
...............................................................................................................
Fifty different neurotransmitters have been discovered since the first one was
identified in 1920. By studying the chemical effects of neurotransmitters in the
brain, scientists are developing treatments for mental disorders and are learning
more about how drugs affect the brain.
Scientists once believed that brain cells do not regenerate, thereby making brain
injuries and brain diseases untreatable. Since the late 1990s, researchers have
been testing treatment for such patients with neuron transplants, introducing
nerve tissue into the brain. They have also been studying substances, such as
nerve growth factor (NGF), that someday could be used to help regrow nerve
tissue.
Technology provides useful tools for researching the brain and helping patients
with brain disorders. An electroencephalogram (EEG) is a record of brain waves,
electrical activity generated in the brain. An EEG is obtained by positioning
electrodes on the head and amplifying the waves with an electroencephalograph
and is valuable in diagnosing brain diseases such as epilepsy and tumors.
Scientists use three other techniques to study and understand the brain and
diagnose disorders:
49
Basics of the Central Using an MRI along with MEG, physicians and scientists can look into the brain
Nervous System
without using surgery. They foresee that these techniques could help paralysis
victims move by supplying information on how to stimulate their muscles or
indicating the signals needed to control an artificial limb.
Although the right and left hemispheres seem to be a mirror image of one another,
there are important functional distinctions. In most people, for example, the areas
that control speech are located in the left hemisphere, while areas that govern
spatial perceptions reside in the right hemisphere.
51
Basics of the Central Left and Right Hemispheres
Nervous System
Left Hemisphere Functions Right Hemisphere Functions
Damage or disease in the left hemisphere shows up in the right side of the body
and visa versa. The left hemisphere tends to be dominant in terms of hand use
and language storage in about 92% of humans. You determine dominance by
watching which hand holds a pen and does more of the fine motor skills. The
dominant side of the body also tends to be larger than the non-dominant side.
About 4% of humans have right hemisphere dominance and another 4% are in
the middle with more or less symmetrical hemispheric function.
The human hand is remarkably adaptable and the brain systems that control
hand movements are more remarkable. Human hands hold tools, gesture, express
feelings and meanings. Two hands work together in most tasks. This means that
the two hemispheres work together by sending signals back and forth through a
massive bundle of wires, the corpus callosum. In normal people, the left and
right hemispheres form integrated operating systems that are often tightly
coordinated as in walking, running, and tool use. Clumsy people are less
coordinated and some have distinct difficulty achieving left and right cooperation.
A popular notion, that the dominant left hemisphere is “analytic” and the right
hemisphere is “synthetic or artistic,” makes little sense and is not a good way to
try to understand how the human brain works. Roger Sperry and other surgeons
launched the right-left theories by cutting the corpus callosum in patients with
epilepsy. Studies of cognitive function revealed some interesting features of these
“split-brain” patients who could not send signals back and forth between their
hemispheres. These were distinctly abnormal people and their peculiarities did
not reveal how normal people work.
52
As one would expect, the split-brain patients had disconnected cognitive functions The Cerebrum and the
Cerebral Hemispheres and
because their hemispheres could not share information. In contrived experiments, their Functions
information could be supplied to only one hemisphere and would not be available
to the other. Each hemisphere revealed a separate consciousness in terms of
responses to stimuli and reportable contents. Usually, only the left hemisphere
could speak and could only report on information received on the left. The right
hemisphere could not speak, but communicated with nonverbal vocalisations
and in other ways.
The coordination of left and right hand and arm movements is critically important
to human survival. Both hands are needed to perform most tasks and although
the hands may do different tasks, both hands cooperate and work toward the
same goal. The right-left linkage shows up clearly whenever you try to perform
distinctly different tasks with each hand. Even with sustained practice, the hands
want to do similar things or perform linked movements as you do when you play
the bongo drums or knit sweaters.
The central sulcus and the lateral sulcus, divide each cerebral hemisphere into
four sections, called lobes (see Division of the Cortex Into Lobes). The central
sulcus, also called fissure of Rolando, also separates the cortical motor area (which
is anterior to the fissure).
Starting from the top of the hemisphere, the upper regions of the motor and
sensory areas control the lower parts of the body.
The advantage of the popular right and left-brain speculations is that most people
know they have two cerebral hemispheres. The left hemisphere controls the right
half of the body and visa versa. The crossed innervation of the body is one of
those curious facts that has no particular explanation. It just happens to be the
case.
Damage or disease in the left hemisphere shows up in the right side of the body
and visa versa. The left hemisphere tends to be dominant in terms of hand use
and language storage in about 92% of humans. You determine dominance by
watching which hand holds a pen and does more of the fine motor skills. The
dominant side of the body also tends to be larger than the non-dominant side.
About 4% of humans have right hemisphere dominance and another 4% are in
the middle with more or less symmetrical hemispheric function.
53
Basics of the Central The human hand is remarkably adaptable and the brain systems that control
Nervous System
hand movements are more remarkable. Human hands hold tools, gesture, express
feelings and meanings. Two hands work together in most tasks. This means that
the two hemispheres work together by sending signals back and forth through a
massive bundle of wires, the corpus callosum. In normal people, the left and
right hemispheres form integrated operating systems that are often tightly
coordinated as in walking, running, and tool use. Clumsy people are less
coordinated and some have distinct difficulty achieving left and right cooperation.
The dominant hand leads the non dominant hand by 15 to 30 milli-seconds when
coordinated movements are performed. This suggests that the left hemisphere
initiates the movement and sends signals to the right. This asymmetric activation
of the hemispheres may come from below the cerebral cortex (from the thalamus,
for example) and may have implications about how all volitional activity is
organised.
A popular notion, that the dominant left hemisphere is “analytic” and the right
hemisphere is “synthetic or artistic,” makes little sense and is not a good way to
try to understand how the human brain works. Roger Sperry and other surgeons
launched the right-left theories by cutting the corpus callosum in patients with
epilepsy. Studies of cognitive function revealed some interesting features of these
“split-brain” patients who could not send signals back and forth between their
hemispheres. These were distinctly abnormal people and their peculiarities did
not reveal how normal people work.
As one would expect, the split-brain patients had disconnected cognitive functions
because their hemispheres could not share information. In contrived experiments,
information could be supplied to only one hemisphere and would not be available
to the other. Each hemisphere revealed a separate consciousness in terms of
responses to stimuli and reportable contents. Usually, only the left hemisphere
could speak and could only report on information received on the left. The right
hemisphere could not speak, but communicated with nonverbal vocalisations
and in other ways.
The coordination of left and right hand and arm movements is critically important
to human survival. Both hands are needed to perform most tasks and although
the hands may do different tasks, both hands cooperate and work toward the
same goal. The right-left linkage shows up clearly whenever you try to perform
distinctly different tasks with each hand. Even with sustained practice, the hands
want to do similar things or perform linked movements as you do when you play
the bongo drums or knit sweaters.
This term refers to the fact that one of the cerebral hemispheres is “leading” the
other one in certain functions. The difference is most realised in language and
manual skills. Although there is an individual and cultural variability, language
is mostly represented on the left hemisphere, while non-verbal skills tend to be
represented on the right hemisphere.
Broca’s area and Wernick’s area refer to language function and lie on the left
hemisphere.
54
3.8.4 Functions of the Left Hemisphere The Cerebrum and the
Cerebral Hemispheres and
Considered the “dominant half of the brain” in most people due to the verbal and their Functions
analytical skills contained, the left hemisphere is the logical, rational hemisphere
of the brain, as Enspire Press states. It controls all communication such as talking,
reading and verbal awareness. The processing of information in logic and spatial
perceptions—such as multiplying, using reason, typing and analysing situations
is made possible within the left hemisphere. The left hemisphere also controls
the right half of the body.
55
Basics of the Central
Nervous System Self Assessment Questions
1) With the help of a diagram show the two hemispheres of the brain and
discuss their functions.
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2) Discuss the role of right and left hemispheres in regard to hand
dominance.
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3) What is meant by cerebral dominance?
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4) What are the functions of left and right hemispheres?
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5) What do you understand by lateralisation or plasticity of hemispheric
function?
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56
The Cerebrum and the
3.9 THE LIMBIC SYSTEM Cerebral Hemispheres and
their Functions
The limbic system is a ring of tissue on the medial surface of each hemisphere,
surrounding the corpus callosum and diencephalon and incorporating parts of
the frontal, parietal, and temporal lobes. Corpus callosum is the main “bridge”
between the left and right cerebral hemispheres; a broad bundle of myelinated
fibers (white matter) carrying information from regions in one lobe to similarly
placed regions in the opposing lobe. There are some 300 million fibers in the
average corpus callosum. Cutting the corpus callosum prevents communication
between the hemispheres (creating the well-known “split-brain” cases), and is
used in severe cases of epilepsy. A major component of this system is the
hippocampal formation, deep in the temporal lobe.
This is often referred to as the “emotional brain”, and is found buried within the
cerebrum. Like the cerebellum, evolutionarily the structure is rather old.
1) Thalamus
2) Hypothalamus
3) Amygdala
4) Hippocampus
Let us see what these structures do.
1) The thalamus: The thalamus is part of the limbic system so it is located in
the internal portion of the brain or the center of the brain. The thalamus
controls your sensory integration and motor integration. The thalamus
recieves sensory information and relays it to the cerebral cortex. The cerebral
cortex also sends information to the thalamus which then transmits this
information to other parts of the brain and the brain stem.
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Basics of the Central 2) The Hypothalamus: The hypothalamus is part of the limbic system. It is
Nervous System
located in the internal portion of the brain under the thalamus. The
hypothalamus controls your body temperature, emotions, hunger, thirst,
appetite, digestion and sleep. The hypothalamus is composed of several
different areas and is located at the base of the brain. It is only the size of a
pea (about 1/300 of the total brain weight), but is responsible for some very
important behaviours.
The frontal, parietal, temporal, and occipital lobes are visible on the surface of
the brain. The frontal lobe extends from the region of the forehead to a groove
called the central sulcus at the top of the head.
The parietal lobe begins there and progresses posteriorly as far as the parieto-
occipital sulcus, which is visible only on the medial surface of the brain.
The occipital lobe extends from there to the rear of the head.
59
Basics of the Central A conspicuous lateral fissure separates the temporal lobe, in the region of the
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ear, from the frontal and parietal lobes above it.
The insula is a fifth lobe of the cerebrum not visible from the surface. It lies deep
to the lateral fissure between portions of the frontal, parietal, and temporal lobes.
The primary motor cortex is the most posterior part of the precentral gyrus. The
primary motor cortex on one side controls all moving parts on the contralateral
side of the body. 90% of motor fibers from each hemisphere cross the midline in
the brain stem. Thus, damage to the motor cortex of one hemisphere causes
weakness or paralysis mainly on the contralateral side of the body.
The medial frontal cortex (sometimes called the medial prefrontal area) is
important in arousal and motivation. If lesions in this area are large and extend
to the most anterior part of the cortex (frontal pole), patients sometimes become
abulic (apathetic, inattentive, and markedly slow to respond).
The orbital frontal cortex (sometimes called the orbital prefrontal area, helps
modulate social behaviours. Patients with orbital frontal lesions can become
emotionally labile, indifferent to the implications of their actions, or both. They
may be alternately euphoric, facetious, vulgar, and indifferent to social nuances.
Bilateral acute trauma to this area may make patients boisterously talkative,
restless, and socially intrusive. With aging and in many types of dementia,
disinhibition and abnormal behaviours can develop; these changes probably result
from degeneration of the frontal lobe, particularly the orbital frontal cortex.
The left posteroinferior frontal cortex (sometimes called Broca’s area or the
posteroinferior prefrontal area controls expressive language function. Lesions in
this area cause expressive aphasia (impaired expression of words).
The dorsolateral frontal cortex (sometimes called the dorsolateral prefrontal area)
manipulates very recently acquired information—a function called working
memory. Lesions in this area can impair the ability to retain information and
process it in real time (e.g, to spell words backwards or to alternate between
letters and numbers sequentially).
Parts of the midparietal lobe of the dominant hemisphere are involved in abilities
such as calculation, writing, left-right orientation, and finger recognition. Lesions
in the angular gyrus can cause deficits in writing, calculating, left-right
disorientation, and finger-naming (Gerstmann’s syndrome).
The nondominant parietal lobe integrates the contralateral side of the body with
its environment, enabling people to be aware of this environmental space, and is
important for abilities such as drawing. Acute injury to the nondominant parietal
lobe may cause neglect of the contralateral side (usually the left), resulting in
decreased awareness of that part of the body, its environment, and any associated
injury to that side (anosognosia). For example, patients with large right parietal
lesions may deny the existence of left-sided paralysis. Patients with smaller lesions
may lose the ability to do learned motor tasks (e.g, dressing, other well-learned
activities)—a spatial-manual deficit called apraxia.
The cerebral cortex is divided into lobes that each has a specific function. For
example, there are specific areas involved in vision, hearing, touch, movement,
and smell. Other areas are critical for thinking and reasoning. Although many
functions, such as touch, are found in both the right and left cerebral hemispheres,
some functions are found in only one cerebral hemisphere. For example, in most
people, language abilities are found in the left hemisphere. The cerebral cortex
is responsible for sensing and interpreting input from various sources and
maintaining cognitive function. Sensory functions interpreted by the cerebral
cortex include hearing, touch, and vision. Cognitive functions include thinking,
perceiving, and understanding language.
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The Cerebrum and the
UNIT 4 CEREBRAL LOBES AND THE Cerebral Hemispheres and
their Functions
LIMBIC SYSTEM
Structure
4.0 Introduction
4.1 Objectives
4.2 The Lobes of the Brain
4.3 The Frontal Lobe
4.3.1 The Location of the Frontal Lobe
4.3.2 Anatomy of Frontal Lobe
4.3.3 Different Functions of Frontal Lobes
4.3.4 Frontal Lobe Damage
4.4 The Occipital Lobe
4.4.1 Occipital Lobe Anatomy
4.4.2 Location of the Occipital Lobe
4.4.3 Functions of the Occipital Lobe
4.4.4 Occipital Lobe Damage and Its Effects
4.5 The Parietal Lobe
4.5.1 Location of Parietal Lobe
4.5.2 Anatomy of Parietal Lobe
4.5.3 Functions of Parietal Lobe
4.5.4 Damage to Parietal Lobe and Its Effects
4.6 The Temporal Lobe
4.6.1 Location of Temporal Lobe
4.6.2 Anatomy of Temporal Lobe
4.6.3 The Functions of Temporal Lobe
4.6.4 Temporal Lobe Damage and Its Effects
4.7 The Limbic System
4.8 The Amygdala
4.9 Let Us Sum Up
4.10 Unit End Questions
4.11 Suggested Readings
4.0 INTRODUCTION
In this unit we will be dealing with the lobes of the brain. This consists of the
frontal, occipital, parietal and temporal lobes. Then we take up in detail the
frontal lobe and discuss its anatomy, location and functions. Then we deal with
the damage caused to the frontal lobe and what are the effects of the same. This
section is followed by the section on Occipital lobe. We take up the anatomy,
location and functions of occipital lobe, and discuss the consequences of any
damage to any part of the occipital lobe. Then we take up the issue of parietal
lobe and discuss its location, anatomy and functions. We also mention about the
damages caused to the parietal lobe and the consequences of the same. This is
followed by a section on temporal lobe in which we discuss then location, anatomy
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Basics of the Central and functions of the temporal lobe and point out how damage to this lobe ma
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cause myriads of problems. Then we present the limbic system and amygdala
and their effects on behaviour.
4.1 OBJECTIVES
After completing this unit, you will be able to:
• Define lobes of the brain;
• Categorize the structural divisions of the brain;
• Describe the general structure of the frontal lobe;
• Describe the primary functions of the frontal lobe;
• Explain what would happen if the frontal lobe is damaged;
• Describe the location, anatomy and functions of the occipital lobe;
• Analyse the problems that may arise as a result of damage to the occipital
lob;
• Elucidate the functions, location and anatomy of temporal lobe; and
• Explain the behaviours that may be affected as a result of damage to the
lobe.
The human brain is not only one of the most important organs in the human
body but it is also the most complex. In the following sections, We will discuss
the basic structures that make up the brain as well as how the brain works.
The cerebral cortex is a part of the brain that functions to make human beings
unique. Distinctly human traits including higher thought, language, human
consciousness, as well as the ability to think, reason, and imagine all originate in
the cerebral cortex.
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The cerebral cortex is what we see when we look at the brain. It is the outermost Cerebral Lobes and the
Limbic System
portion that can be divided into the four lobes of the brain. Each bump on the
surface of the brain is known as a gyrus, while each groove is known as a sulcus.
The cerebral cortex can be divided into four sections, which are known as lobes
(see figure above). The frontal lobe, parietal lobe, occipital lobe and temporal
lobe. These lobes have been associated with different functions ranging from
reasoning to auditory perception.
The frontal lobe is located at the front of the cerebrum. This section reaches
maturity when a person is about 25 years old. It handles the functions of planning,
emotions, and parts of speech. It is associated with reasoning, motor skills, higher
lever cognition, and expressive language. It is also where most of the personality
is based. This means that it controls a lot of a person’s behaviour and expressions.
Because this lobe is so large and located in the front of the skull, the majority of
injuries to the brain occur to this lobe. At the back of the frontal lobe, near the
central sulcus, lies the motor cortex. This area of the brain receives information
from various lobes of the brain and utilises this information to carry out body
movements.
The parietal lobe above the occipital lobe and behind the frontal lobe. It is
located in the middle section of the brain and is associated with processing tactile
sensory information This part of the cerebellum handles information related to
touch, temperature, pain and pressure. This lobe coordinates sensory information
and enables the person to correctly perceive their environment as one complete
whole. If this area is damaged, a person may have difficulty with coordination,
movement or recognition that his or her body is in pain. A portion of the brain
known as the somatosensory cortex is located in this lobe and is essential to the
processing of the body’s senses.
The temporal lobe is located on the side of the cerebrum and at the bottom
section of the brain. This lobe is also the location of the primary auditory cortex,
which is important for interpreting sounds and the language we hear. The
hippocampus is also located in the temporal lobe, which is why this portion of
the brain is also heavily associated with the formation of memories. The main
purpose of this lobe is to interpret auditory data. This means that it processes
information that a person receives through their sense of hearing. This lobe also
plays a role in both speech and memory. It is believed that the temporal lobe
helps when the brain is transferring memories from short term to long term.
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Basics of the Central The occipital lobe is the part of the brain that manages data received through
Nervous System
the sense of vision. This lobe is located behind and below the parietal and temporal
lobes. It is located at the back portion of the brain and is associated with
interpreting visual stimuli and information. This part of the brain allows us to
distinguish shapes and colours and to process what our eyes see. The primary
visual cortex, which receives and interprets information from the retinas of the
eyes, is located in the occipital lobe.
Let us now take each of the lobes and discuss them in detail. Let us start with
frontal lobe.
The frontal lobes are considered our emotional control center and home to our
personality. There is no other part of the brain where lesions can cause such a
wide variety of symptoms (Kolb & Wishaw, 1990). The frontal lobes are involved
in motor function, problem solving, spontaneity, memory, language, initiation,
judgement, impulse control, and social and sexual behaviour. The frontal lobes
are extremely vulnerable to injury due to their location at the front of the cranium,
proximity to the sphenoid wing and their large size. MRI studies have shown
that the frontal area is the most common region of injury following mild to
moderate traumatic brain injury.
There are important asymmetrical differences in the frontal lobes. The left frontal
lobe is involved in controlling language related movement, whereas the right
frontal lobe plays a role in non verbal abilities. Some researchers emphasise that
this rule is not absolute and that with many people, both lobes are involved in
nearly all behaviour.
Disturbance of motor function is typically characterised by loss of fine movements
and strength of the arms, hands and fingers. Complex chains of motor movement
also seem to be controlled by the frontal lobes.
66
Patients with frontal lobe damage exhibit little spontaneous facial expression, Cerebral Lobes and the
Limbic System
which points to the role of the frontal lobes in facial expression. Broca’s Aphasia,
or difficulty in speaking, has been associated with frontal lobe damage.
It is separated from the parietal lobe by the post-central gyrus primary motor
cortex, which controls voluntary movements of specific body parts associated
with the precentral gyrus posteriorly.
Frontal Lobe: Front part of the brain; involved in planning, organising, problem
solving, selective attention, personality and a variety of “higher cognitive
functions” including behaviour and emotions.
The anterior (front) portion of the frontal lobe is called the prefrontal cortex. It is
very important for the “higher cognitive functions” and the determination of the
personality.
The posterior (back) of the frontal lobe consists of the premotor and motor areas.
Nerve cells that produce movement are located in the motor areas. The premotor
areas serve to modify movements.
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On the lateral surface of the human brain, the central sulcus separates the frontal Cerebral Lobes and the
Limbic System
lobe from the parietal lobe.
The lateral sulcus separates the frontal lobe from the temporal lobe.
The frontal lobe can be divided into the following:
• a lateral part
• a polar (front almost) part
• an orbital (also called basal or ventra) part
• a medial part.
Each of these parts consists of particular gyri:
i) Lateral part: Precentralgyrus, lateral part of the superior frontal gyrus,
middle frontal gyrus, inferior frontal gyrus.
ii) Polar part: Transverse frontopolar gyri, frontomarginal gyrus.
iii) Orbital part: Lateral orbital gyrus, anterior orbital gyrus, posterior orbital
gyrus, medial orbital gyrus, gyrus rectus.
iv) Medial part: Medial part of the superior frontal gyrus, cingulate gyrus.
The gyri are separated by sulci. E.g., the precentral gyrus is in front of the central
sulcus, and behind the precentral sulcus.
The superior and middle frontal gyri are divided by the superior frontal sulcus.
The middle and inferior frontal gyri are divided by the inferior frontal sulcus.
In humans, the frontal lobe reaches full maturity around only after the 20s marking
the cognitive maturity associated with adulthood.
There are important asymmetrical differences in the frontal lobes. The left frontal
lobe is involved in controlling language related movement, whereas the right
frontal lobe plays a role in non verbal abilities. Some researchers emphasise that
this rule is not absolute and that with many people, both lobes are involved in
nearly all behaviour.
The executive functions of the frontal lobes involve the ability to recognise future
consequences resulting from current actions, to choose between good and bad
actions, override and suppress unacceptable social responses, and determine
similarities and differences between things or events. Therefore, it is involved in
higher mental functions.
The frontal lobes also play an important part in retaining longer term memories
which are not task-based. These are often memories associated with emotions
derived from input from the brain’s limbic system.
The frontal lobe modifies those emotions to generally fit socially acceptable
norms.
Psychological tests that measure frontal lobe function include finger tapping,
Wisconsin Card Sorting Task, and measures of verbal and figural fluency.
Dr. Stuss and his research colleagues tested patients who had damage to various
parts of the frontal lobes, and other areas of the brain as well. The selective
impairment in only some patients provided the ability to precisely localise those
regions that are necessary when specific mentalising tasks are performed.
Dr Strauss and his colleagues reported that in their study, the frontal lobes were
the most critical region for visual perspective taking, and the inferior medial
prefrontal region, particularly for the right, for detecting deception. Visual
perspective taking is the ability to empathise or identify with the experience of
another person.
It has long been known that some patients with frontal lobe damage have
significantly changed personalities. What is important about the study is that it
helps families, friends and caregivers of the patient to appreciate and understand
a very important reason why this occurs. This deficit in mentalising can affect
social cognition which is important in everyday human interactions. For example,
patients with damage in the specific frontal area are often less empathetic and
sympathetic, and they miss social cues which lead to inappropriate judgements.
The first test was on visual perspective taking. In this the participants had to
reflect on their own experience to understand and interpret the experience of
others. For example, the participants either saw the ball being hidden under a
particular cup with the curtain open, or were told that the ball was being hidden
when the curtain was closed and they could not see anything.
Then two assistants joined the task. One sat beside the experimenter, and one
beside the participant. The table curtain was drawn this time, concealing which
cup the ball was placed under. When the participant had to guess where the ball
was hidden, the assistants ‘helped’ by moving beside the examiner and each
pointed to a different cup.
Participants needed to realise that one of the assistants had not been in a position
to see where the ball was hidden (because they were sitting beside the participant
who themselves could not see where the ball was hidden).
The results of this experiment showed that the Frontal lesion subjects had a
much higher error rate on the task and it appeared that the ‘right’ frontal lobe
was most critical. While the small number of right frontal subjects (4) makes
this only a suggestion, it is still a striking finding, says Dr. Strauss.
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Basics of the Central In the second test on deception, an assistant sat at the table beside the experimenter
Nervous System
and always pointed to a cup where the ball was NOT hidden. Participants had to
infer that the assistant was trying to deceive them. Those with right inferior
medial prefrontal damage had difficulty catching on to the ruse and were the
most frequently deceived.
The findings are based on functional magnetic resonance imaging (FMRI) scans
showing that brain function associated with language shifted away from the stroke-
damaged area of the adult brain to the corresponding area on the undamaged
side of the brain. The findings show the “healing” that happens after a stroke
occurs at a high level of organisation, demonstrating the plasticity of the human
brain long into adulthood. Such plasticity was routinely credited to the brain in
the first few years of life.
The results also indicate the organisational flexibility of the cortical systems that
underlie higher level thinking processes. The researchers say this knowledge
may be useful in designing future rehabilitation strategies that can exploit the
flexibility.
Using non-invasive FMRI, the team looked at the brains of two stroke patients,
34 and 45 years old, as they read and indicated their comprehension of normal
English sentences. Very soon after stroke, the cortical areas on the right sides of
their brains, the right-hand homologues of Broca’s area or of Wernick’s area,
showed increasing activation during the sentence comprehension, at about the
same time as the patients’ ability to process language was coming back to them.
But if a stroke or some other neurological damage disables one of the network
components on the dominant side, the corresponding left side component rapidly
and spontaneously emerges from its understudy role, and starts to activate to a
normally high level during language processing.
The rapid recovery of the ability to use language after stroke damage to the
language network was previously attributed to tissue healing functions, like
reduction of swelling in the brain.
Researchers say the new results show that part of the recovery is due to the brain
function reorganisation, a re-balancing of the network, like the cast of a play
adjusting to the loss of a key actor. The adjustment can begin within a day or two
after the stroke, and can continue for many months.
Damage to the frontal lobes can lead to a variety of results:
• Mental flexibility and spontaneity will be impaired, but IQ is not reduced.
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• Talking may increase or decrease dramatically. Cerebral Lobes and the
Limbic System
• Perceptions regarding risk-taking and rule abiding are impaired.
• Socialisation can diminish or increase.
• Orbital frontal lobe damage can result in peculiar sexual habits.
• Dorsolateral frontal lobe damage reduces sexual interest.
• Creativity is diminished or increased as well as problem solving skills.
• Distraction occurs more frequently.
• Loss of smell and/or taste.
• One of the most common characteristics of frontal lobe damage is difficulty
in interpreting feedback from the environment.
• Perseverating on a response, risk taking, and non compliance with rules
• Impaired associated learning
• The effects of frontal damage can lead to a dramatic change in social
behaviour.
• A person’s personality can undergo significant changes after an injury to the
frontal lobes, especially when both lobes are involved.
• There are some differences in the left versus right frontal lobes in this area.
Left frontal damage usually manifests as pseudo depression and right frontal
damage as pseudo psychopathic.
• An interesting phenomenon of frontal lobe damage is the insignificant effect
it can have on traditional IQ testing. Researchers believe that this may have
to do with IQ tests typically assessing convergent rather than divergent
thinking.
• Frontal lobe damage seems to have an impact on divergent thinking, or
flexibility and problem solving ability.
• There is also evidence showing lingering interference with attention and
memory even after good recovery from a Traumatic Brain Injury (TBI).
• Disturbance of motor function is typically characterised by loss of fine
movements and strength of the arms, hands and fingers.
• Complex chains of motor movement also seem to be controlled by the frontal
lobes.
• Patients with frontal lobe damage exhibit little spontaneous facial expression,
which points to the role of the frontal lobes in facial expression.
• Broca’s Aphasia, or difficulty in speaking, has been associated with frontal
damage by Brown.
73
Basics of the Central Kolb & Milner (1981) found that individual with frontal damage displayed
Nervous System
fewer spontaneous facial movements, spoke fewer words (left frontal lesions)
or excessively (right frontal lesions).
• The frontal lobes are also thought to play a part in our spatial orientation,
including our body’s orientation in space.
• One of the most common Sexual behaviours can also be affected by frontal
lesions. Orbital frontal damage can introduce abnormal sexual behaviour,
while dorolateral lesions may reduce sexual interest.
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Cerebral Lobes and the
4.4 THE OCCIPITAL LOBES Limbic System
The occipital lobes are the center of our visual perception system.
The Per striate region of the occipital lobe is involved in visuospatial processing,
discrimination of movement and color discrimination.
The primary visual cortex is called the Brodmann area 17, commonly called V1
(visual one). Human V1 is located on the medial side of the occipital lobe within
the calcarine sulcus.
The full extent of V1 often continues onto the posterior pole of the occipital
lobe.
V1 that is Visual one is often also called striate cortex because it can be identified
by a large stripe of myelin, the Stria of Gennari.
There are many extrastriate regions, and these are specialised for different visual
tasks, such as visuospatial processing, color discrimination and motion perception.
The lobes rest on the tentorium cerebelli, a process of dura mater that separates
the cerebrum from the cerebellum. They are structurally isolated in their respective
cerebral hemispheres by the separation of the cerebral fissure.
At the front edge of the occipital are several lateral occipital gyri, which are
separated by lateral occipital sulcus.
The occipital aspects along the inside face of each hemisphere are divided by the
calcarine sulcus.
Above the medial, Y-shaped sulcus lies the cuneus, This cuneus is also called the
Brodman’s area 17 and the area below the sulcus is the lingual gyrus.
Retinal sensors convey stimuli through the optic tracts to the lateral geniculate
bodies, where optic radiations continue to the visual cortex.
Each visual cortex receives raw sensory information from the outside half of the
retina on the same side of the head and from the inside half of the retina on the
other side of the head.
The cuneus (Brodman’s area 17) receives visual information from the contralateral
superior retina representing the inferior visual field.
The lingula receives information from the contralateral inferior retina representing
the superior visual field.
The retinal inputs pass through a “way station” in the lateral geniculate nucleus
of the thalamus before projecting to the cortex.
Cells on the posterior aspect of the occipital lobes’ gray matter are arranged as a
spatial map of the retinal field. Functional neuroimaging reveals similar patterns
of response in cortical tissue of the lobes when the retinal fields are exposed to a
strong pattern.
If one occipital lobe is damaged, the result can be homonomous vision loss from
similarly positioned “field cuts” in each eye.
Damage to one side of the occipital lobe causes homonomous loss of vision with
exactly the same “field cut” in both eyes.
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Disorders of the occipital lobe can cause visual hallucinations and illusions. Cerebral Lobes and the
Limbic System
Lesions in the parietal temporal occipital association area are associated with
color agnosia, movement agnosia, and agraphia.
Visual illusions (distorted perceptions) can take the form of objects appearing
larger or smaller than they actually are, objects lacking color or objects having
abnormal coloring.
Lesions in the parietal temporal occipital association area can cause word
blindness with writing impairments (alexia and agraphia).
Glioma:
Tumor originating in the
brain. It can spread within
the nervous system, but
not outside.
Left Parietal Lobe:
Region of the brain
registering sensory
perception; involved in
understanding written and
spoken words.
Treatment:
Kennedy’s doctors say that
chemotherapy and radiation are
usual in similar cases, but that the best
options for Kennedy have not yet been
determined. The doctors did not mention surgery.
Some tumor locations preclude surgery.
SOURCES: Mayo Clinic; neurskills.com: Massachusetts General Hospital DAVID BUTLER/GLORE STAFF
Damage to the right parietal lobe can result in neglecting part of the body or
space (contralateral neglect), which can impair many self-care skills such as
dressing and washing.
Right side damage can also cause difficulty in making things (constructional
apraxia), denial of deficits (anosagnosia) and drawing ability.
Bi lateral damage (large lesions to both sides) can cause “Balint’s Syndrome,” a
visual attention and motor syndrome.
Special deficits (primarily to memory and personality) can occur if there is damage
to the area between the parietal and temporal lobes.
Left parietal temporal lesions can effect verbal memory and the ability to recall
strings of digits (Warrington & Weiskrantz, 1977).
The temporal lobe is a region of the cerebral cortex that is located beneath the
Sylvian fissure on both cerebral hemispheres of the mammalian brain. 81
Basics of the Central There are two temporal lobes, one on each side of the brain located at about the
Nervous System
level of the ears. These lobes allow a person to tell one smell from another and
one sound from another. They also help in sorting new information and are
believed to be responsible for short-term memory.
Right Lobe - Mainly involved in visual memory (i.e., memory for pictures and
faces).
Left Lobe - Mainly involved in verbal memory (i.e., memory for words and
names).
Blunt trauma to the temporal lobe can result in hair-trigger violent reactions and
increased aggressive responses.
Anterior parts of this ventral stream for visual processing are involved in object
perception and recognition.
The medial temporal lobes (near the Sagittal plane that divides left and right
cerebral hemispheres) are thought to be involved in episodic/declarative memory.
Deep inside the medial temporal lobes lie the hippocampi, which are essential
for memory function that is particularly the transference from short to long term
memory and control of spatial memory and behaviour.
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4.6.4 Temporal Lobe Damage and Its Effects Cerebral Lobes and the
Limbic System
Damage to this area typically results in anterograde amnesia.
Kolb & Wishaw (1990) have identified eight main symptoms of temporal lobe
damage:
1) Disturbance of auditory sensation and perception,
2) Disturbance of selective attention of auditory and visual input,
3) Disorders of visual perception,
4) Impaired organisation and categorisation of verbal material,
5) Disturbance of language comprehension,
6) Impaired long-term memory,
7) Altered personality and affective behaviour,
8) Altered sexual behaviour.
Selective attention to visual or auditory input is common with damage to the
temporal lobes.
Left side lesions result in decreased recall of verbal and visual content, including
speech perception.
Right side lesions result in decreased recognition of tonal sequences and many
musical abilities.
Right side lesions can also effect recognition of visual content (e.g. recall of
faces).
The temporal lobes are involved in the primary organisation of sensory input.
Individuals with temporal lobes lesions have difficulty placing words or pictures
into categories.
Language can be affected by temporal lobe damage. Left temporal lesions disturb
recognition of words.
Right side lesions result in recall of non-verbal material, such as music and
drawings.
Temporal lobe epilepsy can cause perseverative speech, paranoia and aggressive
rages (Blumer and Benson, 1975).
Severe damage to the temporal lobes can also alter sexual behaviour (e.g. increase
in activity) (Blumer and Walker, 1975).
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Basics of the Central
Nervous System Self Assessment Questions
1) Discuss the importance of temporal lobe.
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3) Describe the anatomy of temporal lobe.
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4) What are the functions of temporal lobe?
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5) If damage occurs to the temporal lobe what are the consequences?
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Cerebral Lobes and the
4.7 THE LIMBIC SYSTEM Limbic System
The limbic system, essentially alike in all mammals, lies above the brain stem
and under the cortex and consists of a number of interconnected structures. The
limbic system, often referred to as the “emotional brain”, is found buried within
the cerebrum. Like the cerebellum, evolutionarily the structure is rather old.
This system contains the thalamus, hypothalamus, amygdala, and hippocampus.
1) The Thalamus
A large mass of gray matter deeply situated in the forebrain at the topmost
portion of the diencephalon. The structure has sensory and motor functions.
Almost all sensory information enters this structure where neurons send
that information to the overlying cortex. Axons from every sensory system
(except olfaction) synapse here as the last relay site before the information
reaches the cerebral cortex. The thalamus carries messages from the sensory
organs like the eyes, ears, nose, and fingers to the cortex.
2) Hypothalamus
It is a part of the diencephalon, ventral to the thalamus. The structure is
involved in functions including homeostasis, emotion, thirst, hunger,
circadian rhythms, and control of the autonomic nervous system. The
hypothalamus controls the pulse, thirst, appetite, sleep patterns, and other
processes in our bodies that happen automatically. It also controls the pituitary
gland, which makes the hormones that control our growth, metabolism,
digestion, sexual maturity, and response to stress.
3) Hippocampus
It is the portion of the cerebral hemispheres in basal medial part of the
temporal lobe. This part of the brain is important for learning and memory,
for converting short term memory to more permanent memory, and for
recalling spatial relationships in the world about us.
86
Brain Behaviour
UNIT 1 BRAIN BEHAVIOUR RELATIONSHIP, Relationship, Consiousness
and Mind Brain
CONSCIOUSNESS AND MIND BRAIN Relationship
RELATIONSHIP
Structure
1.0 Introduction
1.1 Objectives
1.2 Brain-Behaviour Relationship
1.2.1 The Brain, Master Organ of the Body
1.2.2 Divisions of the Brain
1.2.3 Brain Structure
1.3 Mind-Brain Relationship
1.3.1 The Relationship between Mind and Brain: The Main Positions
1.3.2 Behaviourism
1.3.3 Identity Theory
1.3.4 Functionalism
1.3.5 Eliminative Instrumentalism
1.3.6 Consciousness and the Brain Process
1.3.7 Selection of Behaviours
1.4 Consciousness
1.4.1 The Neural Basis of Consciousness
1.5 Let Us Sum Up
1.6 Unit End Questions
1.7 Suggested Readings
1.8 Answers to Self Assessment Questions
“From the brain and the brain alone arise our pleasures, joys, laughter and jests,
as well as our sorrows, pains and grief’s” -Hippocrates
1.0 INTRODUCTION
In this unit we will be dealing with the brain behaviour relationship, the
consciousness and the mind brain relationship. Then we present brain behaviour
relationship in which we describe the brain as the master organ of the body.
Provide the divisions of the brain and present the brain structure. Then we discuss
the mind and brain relationship within which we deal with the relationship
between mind and body, behaviourism, identity theory, functionalism and
eliminative instrumentalism. We then deal with consciousness and the brain
processes. The next section deals with consciousness as such and presents the
neural basis of consciousness.
1.1 OBJECTIVES
After completing this unit, you will be able to:
• Explain the relationship between brain and behaviour;
5
Neurobiology and • Describe the different parts of the brain and the divisions of the brain;
Behaviour
• Explain the relationship between brain and behaviour;
• Elucidate the mind brain relationship;
• Analyse the relationship between mind and body;
• Explain how behaviourism is able to deal with mind brain relationship;
• Elucidate the identity theory and functionalism from the mind brain
relationship point of view;
• Describe eliminative instrumentalism; and
• Define consciousness and explain the neural basis of consciousness.
Step back a half-billion years ago, to when the first nerve cells developed. The
original need for a nervous system was to coordinate movement, so an organism
could go find food, instead of waiting for the food to come to it. Jellyfish and sea
anemone, the first animals to create nerve cells, had a tremendous advantage
over the sponges that waited brainlessly for dinner to arrive.
The brain stores information from past experiences. This is why we can learn,
remember, and think. The brain selects and combines messages from the senses
with memories and emotions to form various thoughts and reactions.
The brain is a greatly expanded bulb at the upper end of the spinal cord. It consists
mainly of neurons, or nerve cells; supporting cells, and blood vessels. The nerve
cells carry out the brain’s functions. Each of the billions of tiny neurons consists
of a cell body and a number of fibers. These fibers connect the cell body with
other cell bodies. The brain is not a single organ; it has many parts with special
functions, though they are all connected.
Messages to the brain all pass through the brain stem. From the brain stem, they
go to different parts of the brain for ‘processing.’ Messages go out through the
grain stem to control the muscles and glands of the body.
The brain is vital to our existence. It controls our voluntary movements, and it
regulates involuntary activities such as breathing and heartbeat. The brain serves
as the seat of human consciousness: it stores our memories, enables us to feel
emotions, and gives us our personalities. In short, the brain dictates the behaviours
that allow us to survive and makes us who we are. Scientists have worked for
many years to unravel the complex workings of the brain. Their research efforts
have greatly improved our understanding of brain function.
7
Neurobiology and
Behaviour Central Nervous
System
Amygdala
Hippocampus
Metencephalon Myelencephalon
Forebrain: Found in the area of the forehead, this part of the brain is concerned
with all the emotions, planning, organising, reasoning, memory, movement,
speech, recognition of auditory stimuli, visual processing, etc. It also deals with
our imaginative abilities, creativity, judgments, opinions, etc. The forebrain can
be again divided into three parts called the cerebrum, thalamus, and hypothalamus
(part of the limbic system).
Cerebral Cortex/Cerebrum: The cerebrum or the cortex is the large part of the
brain and is associated with the cognitive functions of the brain, such as thinking
and action. So next time you find people moving into doldrums, ask them to get
their cerebrum moving. This cerebrum can again be divided into four sections or
lobes called:
The parietal lobe is located in the middle section of the brain and is associated
with processing tactile sensory information such as pressure, touch, and pain. A
portion of the brain known as the somatosensory cortex is located in this lobe
and is essential to the processing of the body’s senses.
The temporal lobe is located on the bottom section of the brain. This lobe is
also the location of the primary auditory cortex, which is important for interpreting
sounds and the language we hear. The hippocampus is also located in the temporal
9
Neurobiology and lobe, which is why this portion of the brain is also heavily associated with the
Behaviour
formation of memories.
The occipital lobe is located at the back portion of the brain and is associated
with interpreting visual stimuli and information. The primary visual cortex, which
receives and interprets information from the retinas of the eyes, is located in the
occipital lobe.
These four units together form the cerebrum. Now, a deep furrow is present
which divides the brain into two symmetrical halves, called the left and right
hemispheres or brain. These two hemispheres are connected and their functions
differ slightly. The right hemisphere is seen to be associated with creativity, while
the left brain is seen to deal with logical thinking. We often end up using our
logical thinking side of the brain, however, fail to use the creative part of the
brain as we grow into adults.
Thalamus and Hypothalamus: The thalamus is situated in the forebrain at the
uppermost part of the diencephalon (posterior part of the forebrain). It’s an
important part of the brain as all the sensory information we gather enters into
this part, which is then sent via neurons into the cortex. All sensory inputs to the
brain, except that of the sense of smell, are through the thalamus. The
hypothalamus lies ventral to the thalamus and is a part of the diencephalon. It
deals with the function of homeostasis (metabolic equilibrium), thirst, hunger,
emotions, control of autonomic nervous system and the pituitary gland. The
hypothalamus is involved with the body’s vital drives and activities, such as
eating, drinking, temperature regulation, sleep, emotional behaviour, and sexual
activity. It controls the functions of many internal body organs and helps
coordinate activities of the brain stem.
Midbrain: Also known as the mesencephalon, this part is located behind the
frontal lobes and in the center of the entire brain. It deals with functions such as
hearing, vision, body and eye movements. The midbrain can be divided into
three parts called the tectum, tegmentum and cerebral peduncles. The midbrain
is the smallest region of the brain that acts as a sort of relay station for auditory
and visual information. The midbrain controls many important functions such
as the visual and auditory systems as well as eye movement. Portions of the
midbrain called the red nucleus and the substantia nigra are involved in the
control of body movement. The darkly pigmented substantia nigra contains a
large number of dopamine-producing neurons. The degeneration of neurons in
the substantia nigra is associated with Parkinson’s disease.
Hindbrain: This is the posterior part of the brain, and is composed of cerebellum,
pons and medulla. Often the midbrain, pons and medullas are together referred
to as brain stem. The hindbrain is located toward the rear and lower portion of a
person’s brain. It is responsible for controlling a number of important body
functions and process, including respiration and heart rate. The brain stem is an
important part of the hindbrain, controlling functions that are critical to life,
such as breathing and swallowing. The cerebellum is also part of the hindbrain,
playing a role in physical ability.
Cerebellum: The cerebellum forms the posterior part of the brain, just below
the cerebrum. However, as compared to the cerebrum, its far smaller; 1/8 the
size of the cerebellum. Small as it may seem, it performs crucial functions like
balance, movement, co-ordinating muscle movements, etc. It’s the cerebellum
10
that helps us maintain our balance, move around. The very fact that we can enjoy Brain Behaviour
Relationship, Consiousness
all kinds of sport like surfing, skiing, etc. we realise how important this part is. and Mind Brain
Without the cerebellum, we can say goodbye to even walking. Relationship
Pons and Medulla: Pons and medulla along with the midbrain form the brain
stem. This partnering act takes control of involuntary muscle movements in the
body. For example, muscles of the heart and stomach work irrespective of our
desire for them to function. Their movement is not in our control, but is controlled
by the brain stem. While running or performing vigorous exercises, it’s the brain
stem that directs the heart to pump more blood. After a meal, it’s the brain stem
that directs the stomach to digest the food. The pons and medulla also perform
the crucial role of connecting the brain to the spinal cord, thus transform thoughts
into actions.
Self Assessment Questions
1) Fill in the blanks:
Mental stimulation .................. brain function and actually ................
against cognitive decline.
The brain cells that communicate with each other, at the rate of ................
per hour.
Brain is also known as ................................. Pound Universe.
The brain is ............................... to our existence.
The brain has three main divisions: (1) .............., (2) .......................,
and (3) ..........................................
The cerebellum forms the ............................. part of the brain, just below
the cerebrum.
Cerebral Cortex is divided into ............................., ..........................,
........................................ and ............................................
Midbrain is also known as ................................................................
Hindbrain is composed of .................................., ............................, and
........................................................................
Brain stem is responsible for .........................................................
2) “The brain is the master organ of the body” Justify this statement
3) Match the following
i) Frontal lobe a) Pons and cerebellum
ii) Cerebellum b) Connects both hemisphere
iii) Thalamus c) Balance and body control
iv) Hypothalamus d) Reasoning and judgement
v) Temporal lobe e) Controls basic biological functions
vi) Corpus callosum f) Gathers sensory information
vii) Hind brain g) Maintains Homeostasis
viii) Occipital lobe h) Creativity
ix) Metecephalon i) Visual processing
x) Right Brain j) Memory
11
Neurobiology and
Behaviour 1.3 MIND-BRAIN RELATIONSHIP
1.3.1 The Relationship between Mind and Brain: The Main
Positions
In modern times, before the 20th century, the most popular interpretation of the
mind-brain relationship was some version of dualism. It claims that mind is
essentially non-physical. The brain is the place where this nonphysical reality
interacts with physical reality. The reason why you cannot “see” the mind when
you inspect the brain is that the methods of inspection are adapted to the
observation of material phenomena, and not to the observation of immaterial
phenomena like e.g. thoughts. So what you can inspect using the methods of the
natural sciences, is at most the correlates of consciousness, not the conscious
itself.
1.3.2 Behaviourism
According to (philosophical) behaviourism the mind is simply the behaviour, or
dispositions for behaviour, that an organism exhibits. The brain is not the mind,
but the mechanism that enables mind – i.e. the underlying mechanism that enables
the complex behaviour which is the mind. And the reason why you cannot observe
mind by simply observing the brain is not that mind is something immaterial.
The reason is that you are so to speak looking in the wrong place – at the
mechanism that makes mind possible, not at mind (the behaviour) itself.
1.3.4 Functionalism
An objection to the identity theory is that mental phenomena, e.g. pain, can be
realised in the brain in many different ways, depending on what kind of organism
we are talking bout. According to functionalism, mind is not brain states, but
something more abstract – namely the functional states the brain can be in.
Anything (e.g. a complex robot, or an extraterrestrial being) with inner states
that performed the right functions would have a mind, even if it did not have a
biological brain. In functionalism the relationship between brain and mind is
often compared to the relationship between hardware and software. And the
reasons why you cannot observe mind by just observing brain processes, is that
you are not focusing on a sufficiently abstract level – you are like an engineer
who does not understand a computer because he only sees the electronic hardware
12
and not the software (i.e. the set of programmed functions) that runs on this Brain Behaviour
Relationship, Consiousness
hardware. and Mind Brain
Relationship
1.3.5 Eliminative Instrumentalism
What is common to behaviourism, identity-theory and functionalism is a belief
that mental phenomena are real phenomena that can, in the end, be described in
terms taken from the natural sciences (including biology) – either as behaviour,
or neural states, or functional states. Eliminativism maintains that this is not the
case – our common sense conception of mind is a theory of mind (“folk
psychology”) that is basically wrong, so that nothing corresponds to mental
phenomena “in the real world”. A correct theory will only refer to brain states
and behaviour, not mind. Mind is at most a useful fiction (instrumentalism); and
the reasons why you cannot observe the mind by observing the brain, are simply
that the mind does not exist – there is no mind to observe.
None of the theories mentioned above have been generally accepted among
philosophers working on the mind-brain relationship. Many look on themselves
as some kind of materialists (or “physicalists”). Few are fully-fledged dualists,
but elements of such a position can also be found in contemporary philosophy –
notably the following two points:
The answer may also depend on how we conceive the relationship between mind
and brain.
It has also been pointed out that individual mental events (e.g. the pain that I feel
just now) can be identical with individual brain events (e.g. the firing in C-fibres
going on just now) without the properties of mental events necessarily being
identical with neurological properties. The first type of identity is called “token
identity” while the latter is called “type identity”. If this view is accepted one can
for example say that the pain I feel is in fact token-identical with some brain
event, while it has properties (e.g. ‘being a throbbing pain’) which cannot be
identified with neurological properties (though they probably supervene on such
properties). Such a view often called non-reductive physicalism, and may be
considered a kind of compromise between a physicalist and a dualist position. 13
Neurobiology and Donald Hebb and others have argued that the central question in neuropsychology
Behaviour
is the relation between the mind and the brain. The question is easy to ask, yet it
is not so easy to grasp what it is that we need to explain. One needed explanation
is how we select information on which to act.
Thus, as sensory and motor capacities increase, so does the problem of selection
both of information and of behaviour. Furthermore, as the brain expands, memory
increases, providing an internal variable in both stimulus interpretation and
response selection. Finally, as the number of sensory channels increases, the
need to correlate the different inputs to produce a single “reality” arises.
One way to consider these evolutionary changes is to posit that, as the brain
expands to increase sensorimotor capacity, so does some other process (or
processes) having a role in sensory and motor selection. One proposed process
for selective awareness and response to stimuli is attention.
1.4 CONSCIOUSNESS
Conscious experience is probably the most familiar mental process that we know,
yet its workings remain mysterious. Everyone has a vague idea of what is meant
by being conscious, but consciousness is easier to identify than to define.
Definitions of consciousness range from the view that it merely refers to complex
thought processes to the more slippery implication that it is the subjective
experience of awareness or of “inner self.” Nonetheless, there is general agreement
that whatever conscious experience is, it is a process.
14
One of the first modern theories of consciousness was proposed by Descartes. Brain Behaviour
Relationship, Consiousness
He proposed that being able to remember past events and being able to speak and Mind Brain
were the primary abilities that enabled consciousness. But think if we encounter Relationship
people who have lost the ability to remember and have lost the ability to speak.
We may not describe them as no longer being conscious. In fact, consciousness
is probably not a single process but a collection of many processes, such as those
associated with seeing, talking, thinking, emotion, and so on.
Consciousness is also not always the same. A person at different ages of life is
not thought to be equally conscious at each age; young children and demented
adults are usually not considered to experience the same type of consciousness
as healthy adults do. Indeed, part of the process of maturation is becoming fully
conscious. And consciousness varies across the span of a day as we pass through
various states of sleep and waking.
Thus, animals whose behaviour is simply reflexive are not conscious. Similarly,
the isolated spinal cord, although a repository for many reflexes, is not conscious.
Machines that are responsive to sensory events and are capable of complex
movements are not conscious. Many of the functions of normal humans, such as
the beating of the heart, are not conscious processes. Similarly, many processes
of the nervous system, including simple sensory processes and motor actions,
are not conscious. Consciousness requires processes that differ from all of the
aforementioned.
Some people have argued that certain processes are much more important for
consciousness than others. Language is often argued to be essential to
consciousness because language makes a fundamental change in the nature of
human consciousness. Gazzaniga (2004) suggest that language acts as an
interpreter, which he felt led to an important difference between the functions of
the hemispheres. People who are aphasic are not considered to have lost conscious
awareness, however; nor are people who have their right hemispheres removed.
Famous patient H. M., has a dense amnesia, yet he is quite conscious and can
engage in intelligent conversations. In sum, although language may alter the
nature of our conscious experience, it seems unlikely that any one brain structure
can be equated with consciousness. Rather, it makes more sense to view
consciousness as a product of all cortical areas, their connections, and their
cognitive operations.
18
Brain Behaviour
UNIT 2 CONSCIOUSNESS AND NEURO Relationship, Consiousness
and Mind Brain
CHEMICAL PROCESS AND HIGHER Relationship
CEREBRAL FUNCTIONS
Structure
2.0 Introduction
2.1 Objectives
2.2 Consciousness
2.2.1 Definition of Consciousness
2.2.2 Types of Consciousness
2.2.3 Functions of Consciousness
2.2.4 Neurochemistry of Consciousness
2.2.5 Sleep
2.3 Neurochemical Process
2.3.1 Acetylcholine
2.3.2 Noradrenaline
2.3.3 Serotonin
2.3.4 Dopamine
2.3.5 Histamine
2.3.6 Adenosine
2.3.7 Neurotensin
2.4 Neurons
2.4.1 Neurotransmission
2.4.2 Neurotransmitters
2.4.3 Biogenic Amines
2.4.4 Amino Acids
2.4.5 Peptide
2.5 Neurochemical Process and Higher Cerebral Functions
2.5.1 Attention
2.5.2 Neurochemistry of Attention
2.5.3 Memory
2.5.4 Long term Potentiation (LTP)
2.6 Let Us Sum Up
2.7 Unit End Questions
2.8 Suggested Readings
2.9 Answers to Self Assessment Questions
2.0 INTRODUCTION
This unit deals with consciousness, neurochemical process and higher mental
functions. We start with Consciousness, define consciousness, types of consciousness
and functions of consciousness. Then we take up the neurochemistry of
consciousness, followed by sleep and its effect on the consciousness. Then we
deal with the neurochemical processes in which we consider acetylcholine,
noradrenalin, serotonin etc. This is followed by a discussion on neurons and
19
Neurobiology and how these connect to each other through synapse. We then present the
Behaviour
neurotransmitters, biogenic amines, amino acides and peptides. Then we discuss
the neurochemical process and higher cerebral functions which takes into account
attention, neurochemistry of attention, memory and long term potentiation.
2.1 OBJECTIVES
After completing this unit, you will be able to:
• Define Consciousness;
• Elucidate the types of consciousness;
• Explain the functions of consciousness;
• Analyse the Neurochemical processes;
• Explain the structure and functions of neurons;
• Describe the role of neurotransmitters, biogenic amines and peptides;
• Relate neurochemical process with higher cerebral functions; and
• Neurochemical process and higher cerebral functions such as attention,
memory etc.
2.2 CONSCIOUSNESS
The importance of the brain in our everyday lives can never be underestimated.
The brain has physical properties that are in a constant state of flux. The brain
never rests totally but is always teeming with electrochemical activity. All
cognitive functions such as consciousness, attention, memory, thinking, the use
of language and many more are reflection of the modulated pattern of chemical
activity among specialised cells i.e. neuron , that are mostly concentrated in the
brain’s cerebral cortex. We owe our entire cognitive universe to the functioning
of these neurons which transmits information in the form of electrical waves.
Neurochemicals and associated brain processes are simply channel selectors for
various states of consciousness. All states of consciousness exist independent of
the physical body. This relay station works in both directions, that is spiritual,
mental, or emotional states trigger neuro electrochemical events in the brain
(physical consciousness) and neurochemical stimulation, for example through
drugs etc., open access to specific states of emotion, thought, or spiritual
awareness. Contemporary physics has proven very clearly that solid physical
matter is an illusion and that all is energy only. Therefore, to say that the solid
physical brain is the mind, is a mistake. While the brain appears to be solid, it is
not. Actually it is the energy appearing solid, but is not solid. It is energy, only.
The mind is also energy, an energy that interacts with the energy that creates the
appearance of a brain.
21
Neurobiology and The physical body is composed of the energy states of solids, liquids, and gases
Behaviour
and is dependent upon the etheric body for its vitality, life, organisation, and
many processes that result in health.
2.2.5 Sleep
Sleep involves a global alteration of brain functioning, and occupies one third
of our lives, The transition from waking to sleep is one of the most dramatic
natural alterations in consciousness. Sleep is differentiated from waking state by
reduction in neuronal responsiveness, inattention to sensory stimuli, and loss of
consciousness. These two states differ fundamentally in most physiological
parameters including the activity of a variety of key neurotransmitter systems.
Stage 4 sleep: The deepest stage of sleep, shows predominant delta activity with
frequency of 0.5 to 2 cycles per second and highest amplitude. Slow wave sleep
usually lasts for 70–90 minutes and takes place during the first hours of sleep.
2.3.2 Noradrenaline
Increased level of noradrenalin is implicated in wakefulness. Locus coeruleus
noradrenergic neurons decrease their rate of firing at sleep onset. Drugs that
diminish noradrenergic neurotransmission tend to cause sedation, while the
reverse is the case for drugs that potentiate noradrenergic function.
24
2.3.3 Serotonin Consciousness and Neuro
Chemical Process and
Serotonin complements the action of noradrenalin and acetylcholine in promoting Higher Cerebral Functions
wakefulness and cortical responsiveness. Experiments provide evidence that the
level of serotonin during waking is higher in most cortical and subcortical areas
than during sleep.
The seretonergic neurons in the raphe nuclei show the highest firing rate during
waking decrease their firing rate during slow wave sleep.
2.3.4 Dopamine
An increase in dopamine activity produces an increase in wakefulness.
Dopaminergic neurons in the ventral tegmental areas are constantly active
throughout the various stages of sleep, including SWS or non-REM.
D-amphetamine, methylphenidate, high doses of L-dopa and cocaine, which
predominantly enhance dopamine activity, induce arousal and decrease REM
sleep.
2.3.5 Histamine
Histamine is involved in controlling the level of consciousness during waking.
The level of histamine diminishes during sleep and its antagonists induce sleep
and impair daytime vigilance
2.3.6 Adenosine
The adenosine plays a major role in inducing sleep. Injections of adenosine
promote sleep and decrease wakefulness. Conversely, adenosine receptor
antagonists’ caffeine and theophylline are widely used as stimulants to induce
vigilance and promote wakefulness.
2.3.7 Neurotensin
Although little is known about the role of this peptide during the sleep-wake
cycle, it has recently been shown that neurotensin injections in the basal forebrain
decreases slow wave sleep and increases REM sleep.
25
Neurobiology and
Behaviour Self Assessment Questions
Match the Following:
1) Neurotensin a) Beta waves
2) Stage 1sleep b) Promotes wakefulness
3) Altered states of consciousness c) Sensations, perceptions,
memories and feelings you are
aware of at any instance
4) Increased level of acetylcholine d) Theta waves
5) Awake e) Dreaming
6) Consciousness f) Increases REM sleep
7) Decreased Histamine g) Pathological states such as
dementia, psychotic states
8) REM sleep h) Induces sleep
2.4 NEURONS
Information is constantly exchanged between the brain and other parts of the
body through both electrical and chemical impulses. Cells called neurons are
responsible for carrying these impulses. A neuron has three main parts. The cell
body directs all the neuron’s activities. Dendrites, short branches that extend out
from the cell body, receive messages from other neurons and pass them on to the
cell body. An axon is a long fibre that transmits messages from the cell body to
the dendrites of other neurons or to other tissues in the body, such as muscles. A
protective covering, called the myelin sheath, covers the axons of many neurons.
Myelin insulates the axons and helps messages from nerve signals travel faster,
farther, and more efficiently.
2.4.1 Neurotransmission
The exchange of information between the axon of one neuron and the dendrites
of another neuron is called neurotransmission. Neurotransmission takes place
26 through the release of chemicals into the space between the axon of the first
neuron and the dendrites of the second neuron. These chemicals are called Consciousness and Neuro
Chemical Process and
neurotransmitters. The space between the axon and the dendrite is called a Higher Cerebral Functions
synapse.
When neurons communicate, an electrical impulse travels down the axon and
causes neurotransmitters to be released from the end of the axon into the synapse.
The neurotransmitters cross the synapse and bind to special molecules, called
receptors, on the dendrite of the second neuron. Receptors are found on the
dendrites and cell bodies of all neurons. The neurotransmitters bind to receptors
in the same way as a key fits into a lock i.e. a specific neurotransmitter binds
only to its corresponding receptor. The receptors convert the information into
chemical or electrical signals which are then transmitted to the cell body and
eventually to the axon. The axon then carries the signal to another neuron or to
body tissues such as muscles.
2.4.2 Neurotransmitters
There are different types of neurotransmitters found in brain. Each
neurotransmitter has a specific role to play in the functioning of the brain.
Cognitive functions rely on neurotransmitter processes to coordinate what signals
are sent between the different areas of the brain. As already discussed above
neurotransmitters are chemicals manufactured by nerve cells and are released
whenever a nerve cell is stimulated. Neurotransmitter messages can be generalised
as either excitatory or inhibitory messages. An excitatory neurotransmitter is
one that increases the activity of neurons, and an inhibitory neurotransmitter
decreases the activity of neurons.
27
Neurobiology and The three principal neurotransmitters systems found in the brain are:
Behaviour
Biogenic amines
The biogenic amines are the best understood neurotransmitters because they were
the first to be discovered and constitute the neurotransmitter substance in only a
small percentage of neurons. Biogenic amines include dopamine, epinephrine,
norepinephrine, serotonin, acetylcholine, and Histamine
Amino acids
Amino acids were discovered later and are present in 70% of neurons.
Gamaaminobutyric acid (GABA) and Glutamate are examples of aminoacids.
Peptides
The peptide neurotransmitters are intermediate in terms of the percentage of
neurons that contain such neurotransmitter.
Brief description of each neurotransmitter is given below:
Receptors
The two major types of cholinergic receptors are muscarinic and nicotinic.
Dopamine
Dopaminergic neurons occur in two closely connected groups: Ventral tegmental
area (VTA) of the midbrain and Substantia nigra,(in medial region of the
midbrain). While substantia nigra neurons project to the striatum, VTA neurons
serves to most areas of cerebral cortex and limbic system.
Receptors
At least five types of Dopamine receptors, D1 to D5 are known to exist. D1 and
D2 are evenly distributed in the straitum. D2 receptors also occur throughout
the cerebral cortex particularly temporal lobe. D3 receptors are concentrated in
the limbic portion, and in hippocampus.
Receptors
The two broad groups of adrenergic and noradrenergic receptors are á-adrenergic
receptors and â-adrenergic receptors. The á-adrenergic receptors are further
subdivided into two types á1, á 2 and â-adrenergic receptors are subdivided into
â1 â2 and â3 . The â1 subtype predominates in the cerebral cortex and â2 in the
28 cerebellum.
Serotonin Consciousness and Neuro
Chemical Process and
The major site of serotonergic cell bodies is in upper pons and the midbrain, Higher Cerebral Functions
specifically the median and dorsal raphe nuclei and to a lesser extent in caudal
locus ceruleus . These neurons serve to the basal ganglia, limbic system and
cerebral cortex.
Receptors
Seven types of serotonin receptors have been recognised: 5-HT1 through 5-HT7
receptors with numerous subtypes, totaling 14 distinct receptors. 5HT1A receptors
are widely distributed, concentrated in limbic areas (e.g., hippocampus and
amygdala), in the cerebral cortex and also in raphé nuclei. Basal ganglia and
hippocampus have 5HT1B receptors, and the 5HT1D receptor subtype is also
evident in basal ganglia. 5HT2 or 5HT2A receptors are concentrated in cerebral
cortex. 5HT3 receptors are present at low densities in cortex with highest densities
in medulla and spinal cord.
Histamine
A fifth member of the monoamine transmitter group is histamine. That release
histamine as their neurotransmitter is located in the hypothalamus and project
to cerebral cortex, limbic system and thalamus.
Receptors
There are three types of histamine receptors. H1 receptors occur throughout the
CNS with particularly high densities in the thalamus and hippocampus H2
receptors are concentrated in the striatum, hippocampus and thalamus and H3
receptors in cortex, hippocampus and amygdala.
Receptors
There are two types of GABA receptors: GABAA and GABAB.
Glutamate
It is the principal excitatory transmitter in the brain and is found throughout the
central nervous system.
Receptors
Glutamate receptors include NMDA (N-methyl-D-aspartate) and AMPA
(amino3hydroxy-5-methyl-4-isoxazole proprionic acid) subtypes which are
concentrated in cortex and striatum, and the kainate subtype.
29
Neurobiology and 2.4.5 Peptide
Behaviour
There are as many as 300 peptide neurotransmitters found in the brain. Peptide
is a short protein consisting of fewer than 100 amino acids. Examples of peptides
are somatostatin, neuropeptide Y, galanin, substance P, neurotensin, vasopressin
adenosine etc. Peptide implicated in consciousness is discussed below.
Adenosine
Adenosine has four different receptor subtypes (A1, A2A, A2B and A3).
Adenosine A2A receptors are concentrated in striatum. Adenosine receptor
modulation is one of the most important modulatory mechanisms of altering the
level of consciousness.
Neurotensin
Neurons containing neurotensin (NT) are concentrated in the hypothalamus,
striatum, amygdala. Receptors are localised in basal forebrain cholinergic neurons,
dopaminergic nuclei and hypothalamus.
2.5.1 Attention
Attention can be defined as “the concentration of mental effort on sensory or
mental events.
There are three types of attention selective attention, sustained attention and
divided attention.
Divided attention refers to the ability to perform or attend to two or more tasks
simultaneously. The concept of divided attention explains dual tasking, wherein
two tasks require effort and attention. For example a subject may be presented
with stimuli which vary with respect to color and motion and monitor changes
in both the dimensions.
2.5.3 Memory
Memory is the retention of information over time.
Stages or Process of Memory: There are three stages of memory
Encoding process: It is the process of receiving sensory input and transforming
it into a form or code, which can be stored.
Storage: It is the process of actually putting coded information into memory.
There are three systems of memory storage
Sensory memory: It holds information from the external world in its original
sensory form for fraction of a second to few seconds. Information is quickly lost
if not transferred into short term or long term memory.
Short-term memory: It is a limited capacity memory system in which
information is retained for only as long as 30 seconds unless strategies are used
to retain it longer.
Long-term memory: It is a relatively permanent type of memory that stores
huge amount of information for a long time. Long-term memory is further divided
into explicit and implicit memory.
31
Neurobiology and Explicit memory: This is the conscious recollection of information such as
Behaviour
specific facts or events and at least in humans that can be verbally communicated.
There are two subtypes of explicit memory.
Episodic memory: It is the retention of information about the where and when
of life’s happening.
Semantic Memory: Semantic means meanings. It is a person’s knowledge about
the world. It includes general knowledge, knowledge about meanings of words
famous individuals, important places etc.
Implicit memory: It is related to unconsciously remembering skills and
perceptions rather than consciously remembering facts. Examples include skills
of driving a car or typing. Once learnt the individuals do not have to remember
consciously how to drive a car or type. The subsystems of implicit memory are:
Procedural memory involves memory for skills.
Classical conditioning: It implies automatic learning of associations between
stimuli. A small child may develop fear of dogs if the dog approaches the child
and barks on him repeatedly.
Working Memory: It has often been suggested that memory does not always
work in three stage sequence and the model of memory system comprising of
sensory, short-term and long-term memory is too simplistic.
Therefore another concept has been introduced by Alan Baddeley i.e. Working
Memory.
It is a system that temporarily holds information as people perform cognitive
tasks. It is a kind of mental workbench on which information in manipulated and
assembled to help us comprehend language, make decisions and solve problems.
It is an active memory system.
Retrieval: This is the process of gaining access to stored, coded information
when it is needed.
Neurochemistry of Memory: Memory is the result of certain neural mechanism
and biochemical responses in the brain following sensory input. First the neural
mechanism will be discussed followed with the role of various neurotransmitters.
The chemicals involved in LTP are glutamate and its receptors – NMDA and
AMPA. A wide variety of drugs that interfere with LTP also blocks encoding
process whereas drugs that facilitate LTP enhance the process.
32
Acetylcholine Consciousness and Neuro
Chemical Process and
Acetylcholine, a well known neurotransmitter, plays a critical synaptic role in Higher Cerebral Functions
the initial formation of memory. Chemical blockage of the acetylcholine receptors
makes it harder to learn and remember even in healthy young people. Evidence
for it comes from pharmacological studies conducted on human subjects wherein
blockage of muscarinic cholinergic receptors by drugs such as scopolamine
impaired the encoding of new memories. Conversely, drugs which activated
nicotinic receptors enhanced the encoding of new information.
Overall it can be said that decreased acetylcholine in the brain cause problems
with memory function.
Serotonin
Increased level of serotonin is implicated in the enhancement of memory. It plays
a significant role in classical conditioning wherein stimuli are paired repeatedly,
by increasing the efficiency of neural transmission at certain synapses. It has
been also found that a chemical lesion in the raphe nuclei containing large
concentration of serotonin leads to memory problem.
Dopamine
Dopamine is important for working memory and drug that increases the level of
dopamine in the brain or facilities the action of dopamine, enhances working
memory capabilities.Dopamine helps to maintain the ongoing information in
the face of interference by signaling when the information in working memory
should be updated. It is suggested that anatomy of the dopamine system is such
that dopamine-producing cells have a strong connection to the prefrontal cortex–
the brain region that is considered most important for protecting maintained
information from distraction.
33
Neurobiology and
Behaviour 5) Nicotinic receptor improves memory. ( )
6) In long-term potentiation axons bombard dendrite with a
brief but rapid series of stimuli. ( )
7) Implicit memory involves unconscious processing. ( )
8) Glutamate is involved in Long term potentiation of synapses. ( )
9) Selective attention requires holding of attention over relatively
long periods of time. ( )
10) Working memory is a permanent storage of information. ( )
The three principal neurotransmitters systems found in the brain are biogenic
amines, amino acids and peptides.
Since consciousness covers multiple higher cerebral function. The two most
important discussed here are attentional process and memory.
Santrock, J.W. (2006). Psychology Essentials. Tata McGraw Hill, New Delhi
Match the Following: 1f, 2d, 3g, 4b,5a, 6c, 7h, 8e.
True or False
1) F, 2) T, 3) F, 4) F ,5) T, 6) T , 7) T, 8) T, 9) F, 10) F.
35
Neurobiology and
Behaviour UNIT 3 NEUROBIOLOGICAL AND
NEUROPSYCHOLOGICAL
ASPECTS IN THE DEVELOPMENT
OF MEMORY, EMOTION AND
CONSCIOUSNESS
Structure
3.0 Introduction
3.1 Objectives
3.2 Memory
3.3 Neurobiological and Neuropsychological Aspects of Memory
3.3.1 Neurobiology of Short Term Memory
3.3.2 Neurobiology of Long Term Memory
3.3.3 Neural Substrates of Implicit Memory
3.3.4 Neural Substrates of Explicit Memory
3.3.5 Neural Substrates of Emotional Memory
3.4 Anatomy of the Hippocampus
3.4.1 The Perirhinal Cortex
3.4.2 The Temporal Cortex
3.4.3 Parietal and Occipital Cortex
3.4.4 Frontal Cortex
3.5 Emotion
3.5.1 Nature of Emotions
3.5.2 Anatomy of Emotion
3.5.3 Cortical Connections of Emotion
3.5.4 Frontal Lesions and Emotion
3.5.5 Brain Circuits for Emotion
3.6 Neuropsychological Theories of Emotion
3.6.1 Somatic Marker Hypothesis
3.6.2 Cognitive Emotion Interaction
3.6.3 Cognitive Asymmetry and Emotion
3.6.4 Cognitive Control of Emotion
3.7 Consciousness
3.7.1 Neurobiology and Neuropsychology of Consciousness
3.7.2 Involvement of Cerebral Regions in Consciousness
3.8 Let Us Sum Up
3.9 Unit End Questions
3.10 Suggested Readings
3.0 INTRODUCTION
Memory is generally defined as the processes of encoding, storing and retrieving
information. During the 1960’s, a number of models that attempted to explain
the workings and interactions of memory processes and systems were proposed
36 by experts in the field. One model proposed by Atkinson and Shiffrin (1968) has
been nicknamed the “Modal Memory Model” because it was typical of others Neurobiological and
Neuropsychological Aspects
and was probably one of the most influential (Baddeley, 1998). Memory is thought in the Development of
to begin with the encoding or converting of information into a form that can be Memory, Emotion and
stored by the brain. However, the term emotion refers to positive or negative Consciousness
feelings that are produced by particular situations. For example being treated
unfairly makes us unhappy, seeing someone suffer makes us sad, and being closed
to loved one make us feel happy. This further raise the question that does emotion
help us in remembering? How are our emotions connected to our thoughts?
How is our brain connected to our mind, our body, and ultimately, our
consciousness? These are the some question we will be discussing in this section
and will be attempting to explain the neurobiological association of different
parts of the brain in over all functioning of memory, emotion and consciousness.
3.1 OBJECTIVES
After completing this unit, you will be able to:
• Define the concept and meaning of memory, emotion and consciousness;
• Describe nature and associated features of memory, emotion and
consciousness; and
• Differentiate the neurobiological and neuropsychological aspects of memory,
emotion and consciousness.
3.2 MEMORY
Memory is the process by which we encode, store and retrieve the information.
The information is initially recorded in a form usable to memory is known as
encoding. The maintenance of material saved in the memory system is storage,
and the material in memory storage is located, brought in to awareness, and used
is known as retrieval.
The processes of encoding, storing and retrieving the information are necessary
for memory to operate successfully. Many psychologists studying memory suggest
that there are different systems or stages through which information must travel
if it is to be remembered. According to enduring theories, the two major
classification of memory are the short term memory and the long term memory.
Refer to the diagram below.
Memory
Explicit Implicit
(Consicous) (Unconsicous)
ii) Long -term memory systems: Long-term memory refers to the continuing
storage of information. It may last from a minute or so to weeks or even
years. From long term memory you can recall general information about the
world that you learned on previous occasions, memory for specific past
experiences, specific rules previously learned, and the like. In Freudian
psychology, long-term memory would be to recall the preconscious and
unconscious material within the mind. This information is largely outside
of our awareness, but can be called into working memory to be used when
needed. Long term memory has no limit to capacity and can store vast
amounts of information.
Long term memories are of three types:
i) implicit memory
ii) explicit memory and
iii) emotional memory
These are supported by three pathways in the brain. We recall implicit memories
of skills, conditioned reactions and events unconsciously or on prompting.
However, we can spontaneously and consciously recall explicit memories for
events and facts. Emotional memory refers to the affective properties of stimuli
or events and is generally vivid. It has aspects of both conscious and unconscious
long term memory. All these three memories are distinguished by differences in
the way in which the information is processed.
Emotional memory likewise has the intentional, top down element of explicit
memory in that the internal cues that we use in processing emotional events and
it can also be used to initiate their spontaneous recall.
38
Neurobiological and
Self Assessment Questions Neuropsychological Aspects
in the Development of
1) Discuss the neurobiological and neuropsychological aspects of memory. Memory, Emotion and
Consciousness
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2) What are the neurobiological aspects of short term memory?
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3) Elucidate the neurobiology of long term memory.
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4) What are the three types of long term memory? Discuss the three
pathways.
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5) Discuss the neural Substrates of Implicit Memory. Explicit memory
and emotional memory.
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39
Neurobiology and
Behaviour 3.3 NEUROBIOLOGICAL AND
NEUROPSYCHOLOGICAL ASPECTS OF
MEMORY
The first evidence that the temporal lobe might play a role in human memory
came to light by the case of H. M. in 1900, when Vladimir Bekhterev autopsied
the brain of a patient who had shown severe memory impairment. He discovered
the impact of bilateral softening in the region of the medial temporal cortex on
human behaviours. Brenda Milner and her coworkers in the 1950s not only
confirmed the role of the temporal lobe in memory but also indicated the special
contribution of different structures within the temporal lobes to different kinds
of memory.
Temporal Lobe
Brainstem
i) Short Term Memory and Temporal Lobe: Warrington and her colleagues
describe a patient, who received a left posterior temporal lesion. The lesion
resulted in an almost total inability to repeat verbal stimuli such as digits,
letters, words and sentences. In contrast, his long term recall of paired
associates words or short stories was nearly normal. Warrington and her
40
colleagues also found that some patients apparently have defects in short Neurobiological and
Neuropsychological Aspects
term recall of the same stimuli presented auditorily. Short term memory in the Development of
deficits can also result from damage to the polymodal sensory areas of the Memory, Emotion and
posterior parietal cortex and the posterior temporal cortex. Consciousness
ii) Short Term Memory and Frontal Lobe: Damage to the frontal cortex is
the recognised cause of many impairments of short term memory for tasks
in which subjects must remember the temporary location of stimuli. The
tasks themselves may be rather simple given this cue, make that response
after a delay. But as one trial follows another, both animals and people with
frontal lobe lesions start to mix up the previously presented stimuli.
L. Prisko devised a “compound stimulus” task in which two stimuli in the same
sensory modality are presented in succession, separated by a short interval. A
subjects’ task is to report whether the second stimulus of the pair is identical
with the first. In half the trials, the stimuli were the same in the other trials, they
were different. Thus, the task required the subject to remember the first stimulus
of a pair in order to compare it with the second while suppressing the stimuli that
had been presented in previous trials.
Explicit memory provides factual knowledge of the world (semantic) and personal
past (episodic).
Implicit memory stores our skills, tasks, habits and emotional reflexes; however,
their expression does not necessitate immediate transfer into the consciousness
or require the hippocampus for long-term encoding, but is likely to be mediated
through the cerebellum, basal ganglia and amygdala (Squire & Kandel, 1998).
The different parts of cerebral cortex involved in Implicit and explicit memory
have been discussed in detail as below.
41
Neurobiology and
Behaviour
i) The Basal Ganglia: Evidence from other clinical and experimental studies
supports a formative role for the basal ganglia circuitry in implicit memory.
In a study of patients with Huntington’s chorea, a disorder characterised by
the degeneration of cells in the basal ganglia, were impaired in the mirror
drawing task, on which patients with temporal lobe lesions are unimpaired
(Martone et al., 1984). Conversely, the patients with Huntington’s chorea
were unimpaired on a verbal recognition task.
ii) The Motor Cortex: Positron emission tomography was used to record
regional cerebral blood flow as normal subjects learned to perform a motor
task (Grafton et al., 1992). In this Pursuit Rotor Task, a subject attempts to
keep a stylus in particular location on a rotating turntable that is about the
size of a vinyl record album. The task draws on skills that are very much
like the skills needed in mirror drawing. The researchers found that
performance of this motor task is associated with increases in regional
cerebral blood flow in the motor cortex, basal ganglia and cerebellum.
Acquisition of the skill was associated with a subset of these structures,
including the primary motor cortex, the supplementary motor cortex, and
the pulvinar nucleus of the thalamus.
For example, when number 1 appears on the screen, push button 1 with
finger 1 . The measure of learning was the decrease in reaction time between
the appearance of the cue and the pushing of the button on successive trials.
iii) The Cerebellum: The motor regions of the cortex also receive projections
through the thalamus from the cerebellum. Kyu Lee and Richard Thompson
presented evidence that the cerebellum occupies an important position in
the brain circuits taking part in motor learning. They suggested that the
cerebellum plays an important role in a form of learning called classical
conditioning.
42
In their model, a puff of air is administered to the eyelid of a rabbit, paired with Neurobiological and
Neuropsychological Aspects
a stimulus such as a tone. Eventually, the rabbit becomes “conditioned” to blink in the Development of
in expectation of the air puff whenever the tone is sounded. Lesions to pathways Memory, Emotion and
from the cerebellum abolish this conditioned response but do stop the rabbit Consciousness
from blinking in response to an actual air puff, the unconditioned response.
Nuclei in the thalamus also are included, in as much as many connections between
the prefrontal cortex and the temporal cortex are made through the thalamus.
The regions that make up the explicit memory circuit receive input from the
neocortex and from the ascending systems in the brainstem, including the
acetylcholine, serotonin, and noradrenalin systems. Explicit memory function
and contribution of different brain regions are described in the following section:
When the tone is later presented without the sock, the animal will act afraid. It
may become motionless and may urinate in expectation of the shock. The
presentation of a novel stimulus, such as a light in the same environment has
little effect on the animal. Thus, the animal tells us that it has learned the
association between the tone and the shock.
The hippocampus extends in a curve from the lateral neocortex of the medial
temporal lobe toward the midline of the brain and has a tube like appearance. It
consists of two gyri, Ammon’s horn and the Dentate gyrus. If you imagine cutting
a tube length wise and placing one half on top of the other so that their edges
overlapped, the upper half would represent Ammon’s horn and the lower one the
Dentate gyrus. (See the picture below)
The hippocampus is reciprocally concerned with the rest of the brain through
two major pathways.
ii) The fimbria-fornix (arch-fringe, because it arches along the edge of the
hippocampus),
These connect the hippocampus to the thalamus and frontal cortex, the basal
ganglia, and the hypothalamus.
45
Neurobiology and Through its connection to these two pathways, the hippocampus can be envisioned
Behaviour
as a way station between the posterior neocortex on one end of the journey and
the frontal cortex, basal ganglia, and brainstem on the other.
Within the hippocampus, input from the neocortex goes to the dentate gyrus,
and the dentate gyrus projects to Ammon’s horn. (as is seen in the above picture).
Thus, the granule cells are the “sensory” cells of the hippocampus, and the
pyramidal cells are its motor” cells that facilitate this processing and memory
function.
In these studies of memory for objects and contexts, animals with selective
hippocampal removal displayed no impairments on the object recognition test
but were impaired when the test included context. In contrast, animals with rhinal
cortex lesions displayed severe anterograde and retrograde impairments on the
object recognition tests. Thus the conclusion from the results of these studies is
that objects recognition (factual, or semantic, knowledge) depends on the rhinal
cortex, whereas contextual knowledge (autobiographic, or episodic, knowledge)
depends on the hippocampus.
They also show that the temporal neocortex makes a significant contribution to
these functional impairments. After right temporal lobe removal, patients are
impaired on face recognition spatial position and maze learning tests. Left
temporal lobe lesions are followed by functional impairments in the recall of
word lists, the recall of consonant trigrams, and non-spatial associations.
Milner and her colleagues concluded that the lesions of the right temporal lobe
result in impaired memory of nonverbal material. Lesions of the left temporal
46
lobe, on the other hand, have little effect on the nonverbal tests but produce Neurobiological and
Neuropsychological Aspects
deficits on verbal tests such as the recall of previously presented stories and in the Development of
word pairs, as well as the recognition of words or numbers and recurring nonsense Memory, Emotion and
syllables. Consciousness
3.5 EMOTION
Emotion, like memory, entails cognitive processes that may either be conscious
or lie outside our awareness. We begin this topic by exploring the nature of
emotion and how neuroscientists have studied emotion and developed theories
over the past century.
Philip Bard made one of the first major anatomical discoveries about emotion
while working in Walter Cannon’s laboratory in the late 1920s. Working with
cats, Bard showed that emotional response depends on the diencephalon, which
includes the thalamus and hypothalamus.
He found that, if the diencephalon was intact, animals showed strong “emotional”
responses, but if the animals were decerebrate, leaving the diencephalon
disconnected from the midbrain, they were unemotional.
The lesion and stimulation studies on the diencephalon were important, because
they led to the idea that the thalamus and hypothalamus contain the neural circuits
for the overt expression of emotion and for autonomic responses such as changes
in blood pressure heart rate, and respiration.
He spent much time gazing at the television but never learned to turn it on;
when the set was off, he tended to watch reflections of others in the room
on the glass screen. On occasion became facetious, smiling inappropriately
and mimicking the gestures and actions of others. Once initiating an imitative
series, he would perseverate copying all movements made by another for
extended period of time.
ii) Psychsurgery: At about the time of kluver and Bucy’s discovery, a less
dramatic, but in many ways more important discovery was made. Carlyle
Jacobsen studied the behaviour of chimpanzee in a variety of learning tasks
subsequent to frontal lobe removals. In 1935, he reported his findings on
the effects of the lesions at the Second International Neurology Congress in
London. He casually noted that after the surgery similar lesions in people
might relieve various behavioural problems.
Thus was born psychosurgery and the frontal lobotomy. Unbelievably, fontal
lobotomies were performed on humans without an empirical basis. Not until the
late 1960s was any systematic research done on the effects of frontal lobe lesions
on the affective behaviour of nonhuman animals. Experimental findings by several
laboratories clearly confirm the results of frontal lobotomies on humans. Frontal
lobe lesion in rats, cats and monkeys have severe effects on social and affective
behaviour across the board.
50
3.5.4 Frontal Lesions and Emotion Neurobiological and
Neuropsychological Aspects
Spouses or relatives often complain of personality changes in brain damaged in the Development of
Memory, Emotion and
patients, but the parameters of these changes have been poorly specified in human Consciousness
subjects. The results of research on animals, particularly nonhuman primates,
make possible the identification of six behavioural changes associated with
emotional process after frontal lesions.
Reduced social interaction: This was noted especially after orbito-frontal and
anterior cingulate lesions, monkeys become socially withdrawn and even fail to
re establish close preoperative relations with family members. The animals sit
alone; seldom if ever engage in social grooming or contact with other monkeys
and in a free ranging natural environment, become solitary leaving the troop
together.
Altered social preference: Although normal animals prefer to sit beside intact
monkeys of the opposite sex, monkeys with large frontal lesions prefer to sit
with other frontal lesion monkeys of the same sex, presumably because they are
less threatening.
Reduced affect: Monkeys with frontal lesions largely abandon facial expressions,
posturing, and gesturing in social situations. Thus, monkeys with frontal lesions
show a drastic drop in the frequency and variability of facial expression and are
described as poker faced.
Like the prefrontal cortex, the amygdala receives inputs from all sensory systems
to be excited; the cells of the amygdala, like those of the prefrontal cortex require
complex stimuli. Many cells in the amygdala are multimodal, in fact some respond
to visual, auditory, somatic, gustatory and olfactory stimuli just as prefrontal
cells do.
Whereas James was really talking about intense emotions such as fear or anger.
Damasio’s theory encompasses a much broader range of bodily changes. For
example, there may be a change in motor behaviour, facial expression, autonomic
arousal, or endocrine changes as well as neuromodulatory changes in the brain.
Hence, for Damasio, emotions engage those neural structures that represent body
states and those structures that somehow link the perception of external stimuli
to body states. The somatic markers are thus linked to external events and
influence cognitive processing.
In LeDoux’s view, all animals inherently detect and respond to danger, and the
related neural activities eventually evolve to produce a feeling. In this case, it
produced fear. When a mouse detects a cat, fear is obviously related to predation,
and, in most situations, animals such as mice have fear related either to predation
or to danger from other mice who may take exception to their presence in a
52
particular place. For humans, however, fear is a much broader emotion that today Neurobiological and
Neuropsychological Aspects
is only rarely of predation but routinely includes stress-situations in which we in the Development of
must “defend” ourselves on short notice. Memory, Emotion and
Consciousness
The key brain structure in the development of conditioned fear is the amygdala,
which sends outputs to stimulate hormone release and activate the ANS and thus
generates emotion, which we interpret in this case as fear. Physiological measures
of fear conditioning can rank autonomic functioning (for example, heart rate or
respiration), and quantitative measures can rank behaviour (for example, standing
motionless) after the tone is heard.
No such synchronisation should take place among cells that are part of different
neural networks. Recall that the idea of synchrony was proposed earlier as a
mechanism of attention. Taken further, without attention to an input, there is no
awareness of it. But what produces the synchrony? Neuronal groups exhibit a
wide range of synchronous oscillations (6-80 Hz) and can shift from a
desynchronised state to a rhythmic state in milliseconds. Thus, we can predict
that, when we become consciously aware of some event, there should be evidence
of synchronous activity among widely separated brain regions.
A second way to look for cerebral substrates is to look for structures that might
synchronise activity. Crick and Koch introduced the novel idea that a little-studied
brain region may play central role in the processes that bind diverse sensory
attributes. The claustrum, meaning “hidden away,” is a thin sheet of gray matter
that, in the human brain, lies below the general region of the insula. Its connectivity
is unique in that it receives input from virtually all regions of the cortex and
projects back to almost all regions of the cortex.
Virtually nothing is known about the functions of the claustrum in any mammalian
species, in large part because it is almost impossible to damage selectively; Crick
and Koch proposed that this unique anatomy is compatible with a global role in
integrating information to provide the gist of sensory input on a fast time scale.
They provocatively state: “This should be further experimentally investigated,
in particular if this structure plays a key role in consciousness (Crick and Koch,
2005).
57
Neurobiology and In summary, the emerging field of cognitive social neuroscience is radically
Behaviour
changing our understanding of how the brain participates in the complex social
behaviour of humans such as different types of memory function, emotional
behaviours and consciousness. The literature comprising of lesion studies tended
to focus on the perception and production of social behaviour. The new perspective
is allowing insights into the very nature of how the brain allows humans to think
about themselves and one another.
Self Assessment Questions
1) Define consciousness and delineate the nature of consciousness.
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2) Discuss the neurobiological aspects of consciousness.
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3) Discuss the neuropsychological aspects of Consciousness.
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4) Elucidate the involvement of cerebral regions for consciousness.
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58
Neurobiological and
3.8 LET US SUM UP Neuropsychological Aspects
in the Development of
Memory, Emotion and
Memory is generally defined as the processes of encoding, storing and retrieving Consciousness
information. Memory is thought to begin with the encoding or converting of
information into a form that can be stored by the brain. However, the term emotion
refers to positive or negative feelings that are produced by particular situations.
Memory is the process by which we encode, store and retrieve the information.
The information is initially recorded in a form usable to memory is known as
encoding. The maintenance of material saved in the memory system is storage,
and the material in memory storage is located, brought in to awareness, and used
is known as retrieval.
The processes of encoding, storing and retrieving the information are necessary
for memory to operate successfully. Many psychologists studying memory suggest
that there are different systems or stages through which information must travel
if it is to be remembered. According to enduring theories, the two major
classification of memory are the short term memory and the long term memory.
Long term memories are of three types:
i) implicit memory,
ii) explicit memory and
iii) emotional memory
These are supported by three pathways in the brain.
The first evidence that the temporal lobe might play a role in human memory
came to light by the case of H. M. in 1900, when Vladimir Bekhterev autopsied
the brain of a patient who had shown severe memory impairment. In 1890, William
James drew a distinction between memories that endure for a very brief time and
for longer term. Not until 1958, however, there was any separate short term and
long term memories. In 1958, this was specifically postulated by Donald
Broadbent. According to Broadbent, Short term memory, sometimes also called
the working memory or temporal memory refers to a neural record for recent
events and their order. It is the system that we use for holding sensory events,
movements, and cognitive information such as digits, words, names or other
items for a brief period. Short term memory is mediated by different regions in
the cerebral cortex such as temporal lobe, some specific areas of frontal lobe,
and motor cortex. Long term memory is subdivided into explicit (declarative)
and implicit (procedural) memory.
The different parts of cerebral cortex involved in Implicit and explicit memory
include the basal ganglia, the motor cortex and the cerebellum.
Then we discussed the anatomy of the hippocampus. We showed how these are
related to memory. Then we showd how the frontal coretex and occipital cortex
function in regard to memory and related factors. Then we took up temporal
cortex and dealt with it in terms of memory. Then we discussed the neural
substrates of emotional memory. The next section was on emotion. We discussed
the nature of emotion and anatomy of emotions. Then we pointed out how the
frontal lesions affect the emotion. This was followed by brain ciorcuits of emotion.
We then discussed the different theories of emotion. We then took up discussion
on The consciousness and related the same to the neurobiology and
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Neurobiology and neuropsychology of consciousness. Then we discussed about the involvement
Behaviour
of cerebral regions in consciousness.
60
Neurobiological and
UNIT 4 NERVOUS SYSTEM DISEASES Neuropsychological Aspects
in the Development of
Memory, Emotion and
Consciousness
Structure
4.0 Introduction
4.1 Objectives
4.2 Nervous System Diseases
4.3 Causal Factors
4.4 Classification
4.5 Vascular Disorders
4.5.1 Cerebral Ischemia
4.5.2 Migraine Stroke
4.5.3 Cerebral Hemorrhage
4.5.4 Angiomas and Aneurysms
4.6 Traumatic Brain Injuries
4.6.1 Open-Head Injuries
4.6.2 Closed-Head Injuries
4.7 Epilepsy
4.7.1 Focal Seizures
4.7.2 Generalised Seizures
4.7.3 Akinetic and Myoclonic Seizures
4.7.4 Tumor
4.8 Headaches
4.8.1 Migraine
4.8.2 Headache Associated with Neurological Diseases
4.8.3 Muscle Contraction Headache
4.8.4 Non Migrainous Vascular Headaches
4.9 Infections
4.9.1 Viral Infections
4.9.2 Bacterial Infections
4.9.3 Mycotic Infections
4.10 Disorders of Motor Neurons and the Spinal Cord
4.10.1 Myasthenia Gravis
4.10.2 Poliomyelitis
4.10.3 Multiple Sclerosis
4.10.4 Paraplegia
4.10.5 Brown-Sequard Syndrome
4.10.6 Hemiplegia
4.11 Disorders of Sleep
4.11.1 Narcolepsy
4.11.2 Insomnia
4.12 Let Us Sum Up
4.13 Unit End Questions
4.14 Suggested Readings 61
Neurobiology and
Behaviour 4.0 INTRODUCTION
This unit deals with the various nervous system disorders. We start with defining
what is nervous system disorders and then move on to different types of disorders
based on certain standard classification. We start with vascular disorders in which
we discuss cerebral ischemia, migraine stroke, cerebral hemorrhage, and angiomas
and aneurysms. This is followed by another group of nervous system disorders
called the Traumatic brain injuries. Then we take up epilepsy and discuss under
it the focal seizures, generalised seizures, akinetic and myoclonic seizures and
the tumors. In the following section we describe the different types of headaches
such as the migraines, and headaches associated with neurological diseases. Then
we discuss the diseases caused by infections under which we describe the disorders
caused by viral infections, bacterial infections and mycoctic infections. This is
followed by a description of the disorders due to motor neurons and the spinal
cord. This includes myasthenia gravis, poliomyelitis, paraplegia, hemiplegia and
Brown Sequard syndrome. Following this we present sleep disorderssuch as
narcolepsy etc.
4.1 OBJECTIVES
After reading this unit, the students will be able to:
• Define the concept and meaning of nervous system diseases;
• Describe nature and associated features of different nervous system diseases;
• Explain the involvement of different parts of nervous system in the
manifestation of symptoms; and
• Understand and differentiate the neurobiological and neuropsychological
aspects of nervous system diseases.
4.4 CLASSIFICATION
Neurological disorders can be categorised according to the primary location
affected, the primary type of dysfunction involved, or the primary type of cause.
The broadest division is between central nervous system (CNS) disorders and
peripheral nervous system (PNS) disorders. Here in this section we have discussed
various nervous system diseases under the section of Vascular Disorders,
Traumatic Brain Injuries, Epilepsy, Tumors, Headaches, Infections, Disorders
of Motor Neurons and Disorders of Sleep.
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Nervous System Diseases
4.6 TRAUMATIC BRAIN INJURIES
Brain injury is a common result of automobile and industrial accidents and of
war injuries. Brain injury can affect brain function by causing direct damage to
brain by disrupting blood supply; by inducing bleeding, leading to increased
intracranial pressures, by causing swelling, by opening the brain to infections
and by producing the scarring of brain tissue. There are two main types of brain
trauma: open head injury and closed head injury.
• Damage at the site of the blow, a bruise (contusion) called a coup, is incurred
where the rain has been compacted by the bone’s pushing inward, even
when the skull is not fractured.
• The pressure that produces the coup may push the brain against the opposite
side or end of the skull, producing an additional bruise, known as a
countercoup.
• The movement of the brain may cause a twisting or shearing of nerve fibers,
producing microscopic lesions. In addition, twisting and shearing may
damage the major fiber tracts of the brain, especially those crossing the
midline, such as the corpus callosum and anterior commissure. As a result,
connection between the two sides of the brain may be disrupted, leading to
a disconnection syndrome.
• Bruises and strains caused by the impact may produce bleeding (hemorrhage).
Because the blood is trapped within the skull, it acts as a growing mass
(hematoma), exerting pressure on surrounding structures.
• As with blows to other parts of the body, blows to the brain produce edema,
another source of pressure on the brain tissue.
Often, the chronic effects of closed head injuries are not accompanied by any
obvious neurological signs, and the patients may therefore be referred for
psychiatric evaluation. Thorough psychological assessments are especially useful
65
Neurobiology and in these cases for uncovering seriously handicapping cognitive deficits that have
Behaviour
not yet become apparent. Although, the prognosis for significant recovery of
cognitive functions is good, there is less optimism about the recovery of social
skills or normal personality, areas that often change significantly.
66
Nervous System Diseases
6) Discuss traumatic brain injuries. What do you understand by open closed
head injuries?
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4.7 EPILEPSY
In epilepsy, a person suffers from recurrent seizures of various types that register
on an electroencephalogram and are associated with disturbances of
consciousness. Epileptic episodes have been called convulsions, seizures, fits,
and attacks, but none of these terms on its own is entirely satisfactory, because
the character of the episodes can vary greatly.
Epileptic seizures are classified as symptomatic seizures if they can be identified
with a specific cause, such as infection, trauma, tumor, vascular malformation,
toxic chemicals, very high fever, or other neurological disorders.
They are called idiopathic seizures if they appear to arise spontaneously and in
the absence of other diseases of the central nervous system. The most remarkable
clinical feature of epileptic disorders is the widely varying length of intervals
between attacks , that is from minutes to hours to weeks or even years. In fact, it
is almost impossible to describe a basic set of symptoms to be expected in all or
even most people with the disorder. At the same time, three particular symptoms
are found in many types of epilepsy:
1) An aura, or warning, of impending seizure: This aura may take the form
of a sensation-an odor or a noise-or it may simply be a “feeling” that the
seizure is going to take place.
2) Loss of consciousness: Ranging from complete collapse in some people to
simply staring off into space in others, loss of consciousness is often
accompanied by amnesia in which the victim forgets the seizure itself and
the period of lost consciousness.
3) Movement: Seizures commonly have a motor component, although the
characteristics vary considerably. Some people shake during an attack; others
exhibit automatic movements, such as rubbing the hands or chewing.
A diagnosis of epilepsy is usually confirmed by an EEG. In some epileptics,
however, seizures are difficult to demonstrate in this way, except under special
circumstances (for example, in an EEG recorded during sleep). Several schemes
for classifying epilepsy have been published through the years. Four commonly
recognised types of seizures are:
i) focal seizures,
ii) generalised seizures, and
iii) akinetic and
iv) myoclonic seizures.
These are being discussed in the following section. 67
Neurobiology and 4.7.1 Focal Seizures
Behaviour
A focal seizure begins in one place and then spreads. As for example in a
Jacksonian focal seizure, the attack begins with jerking movements in one part
of the body (for example, a finger, a toe, or the mouth) and then spreads to
adjacent parts. John Hughlings-Jackson hypothesized in 1870 that such seizures
probably originate from the point (focus) in the neocortex representing the region
of the body where the movement is first seen.
Myoclonic seizures are massive seizures that basically consist of a sudden flexion
or extension of the body and often begin with a cry.
4.7.4 Tumor
Tumor, or neoplasm, is a mass of new tissue that persists and grows independently
of its surrounding structures and has no physiological use. Brain tumors grow
from glia or other support cells rather than from neurons. Tumors account for a
relatively high proportion of neurological disease compared with other causes.
After the uterus, the brain is the most common site for them.
68
Tumors that are not likely to recur after removal are called benign, and tumors Nervous System Diseases
that are likely to recur after removal, that is often progressing and becoming a
threat to life are called malignant. The brain is affected by many types of tumors,
and no region of the brain is immune to tumor formation.
A tumor may develop as a distinct entity in the brain, a so-called encapsulated
tumor, and put pressure on the other parts of the brain. Some encapsulated tumors
are also cystic, which means that they produce a fluid filled cavity in the brain,
usually lined with the tumor cells.
Because the skull is of fixed size, any increase in its contents compresses the
brain, resulting in dysfunctions.
In contrast with encapsulating tumors, so called infiltrating tumors are not clearly
marked off from the surrounding tissue. They may either destroy normal cells
and occupy their place or surround existing cells (both neurons and glia) and
interfere with their normal functioning.
The general symptoms of brain tumors, which result from increased intracranial
pressure, include headache, vomiting, swelling of the optic disc (papilledema),
slowing of the heart rate (bradycardia), mental dullness, double vision (diplopia),
and, finally, convulsions, as well as functional impairments due to damage to the
brain where the tumor is located.
4.8 HEADACHES
Headache is so common among the general population that rare indeed is the
person who has never suffered one. Headache may constitute a neurological
disorder in itself as in migraine; it may be secondary to neurological diseases
such as tumor or infection; or it may result from psychological factors, especially
stress as in tension headache. There are different kinds of headaches such as
migraine and headache associated with neurological disease etc.
4.8.1 Migraine
Perhaps the most common neurological disorder, migraine afflicts some 5% to
20% of the population at some time in their lives. The World Federation of
Neurology defines migraine as a “Familial disorder characterised by recurrent
attacks of headache widely variable in intensity, frequency and duration. Attacks
are commonly unilateral and are usually associated with anorexia, nausea, and
vomiting. In some cases they are preceded by or associated with neurological
and mood disturbances”. There are several types of migraine, including classic
migraine, common migraine, cluster headache, and hemiplegic and
ophthalmologic migraine.
The results of PET studies have shown that, during the aura, there is a
reduction in blood flow in the posterior cortex, and this reduction spreads at
the rate of about 2 millimeters per minute, without regard to its location.
69
Neurobiology and The headache is experienced as an intense pain localised in one side of the
Behaviour
head, although it often spreads on that side and sometimes extends to the
opposite side as well.
A severe headache can be accompanied by nausea and vomiting, and it may
last for hours or even days.
ii) Common migraine: This is the most frequent type, occurring in more than
80% of migraine sufferers. There is no clear aura as there is in classic
migraine, but there may be a gastrointestinal or other “signal” that an attack
is pending.
iii) Cluster headache: This is a unilateral pain in the head or face that rarely
lasts longer than 2 hours but recurs repeatedly for a period of weeks or even
months before disappearing. Sometimes long periods pass between one series
of cluster headaches and the next.
71
Neurobiology and
Behaviour 4.9 INFECTIONS
Infection is the invasion of the body by disease-producing (pathogenic)
microorganisms and the reaction of the tissues to their presence and to the toxins
generated by them. Because the central nervous system can be invaded by a wide
variety of infectious agents-including viruses, bacteria, fungi, and metazoan
parasites-the diagnosis and treatment of infection are important components of
clinical neurology. Infections of the nervous system are particularly serious
because the affected neurons and glia usually die, leaving permanent lesions.
72
4.10.1 Myasthenia Gravis Nervous System Diseases
Although myasthenia can affect people of any age, it is most likely to begin in
the third decade of life and is more common in women than in men. The muscular
weakness is caused by a failure of normal neuromuscular transmission due to a
paucity of muscle receptors for acetylcholine. These receptors may have been
attacked by antibodies from the patient’s own immune system.
4.10.2 Poliomyelitis
Poliomyelitis is an acute infectious disease caused by a virus that has a special
affinity for the motor neurons of the spinal cord and sometimes for the motor
neurons of the cranial nerves. The loss of these motor neurons causes paralysis
and wasting of the muscles. If the motor neurons of the respiratory centers are
attacked, death can result from asphyxia. The occurrence of the disease was
sporadic and sometimes epidemic until the Salk and Sabin vaccines were
developed in the 1950s and 1960s. Since then, poliomyelitis has been well
controlled.
Often, these early symptoms go into remission, after which they may not appear
again for years. In some forms, however, the disease may progress rapidly in just
a few years until an affected person is limited to bed care. The cause of MS is
still not known. Proposed causes include bacterial infection, a virus,
environmental factors, and an immune response of the central nervous system.
4.10.4 Paraplegia
Paraplegia (from the Greek para, “alongside of,” and plegia, “stroke”) is a
condition in which both lower limbs are paralyzed (quadriplegia is the paralysis
of all four extremities). Paraplegia results when an injury to the spinal cord is
below the first thoracic spinal nerve. This results in the loss of feeling and
movement, to some degree, of the legs. Paraplegics can experience anything
from impairment of leg movement to complete loss of leg movement all the way
up to the chest. Paraplegics are able to move their arms and hands. The degree of
73
Neurobiology and function that a person with paraplegia will experience depends upon the level of
Behaviour
injury, type of injury, and whether the injury was complete or incomplete. The
complications of paraplegia include (i) Skin care issues (ii) Loss of bladder control
(iii) Loss of bowel control (iv) Loss of sensory function (v) Loss of motor
function. Treatment during the acute phase will focus on returning as much
function as possible. Long term treatment will focus on learning to compensate
with disabilities, and keeping complications at bay.
Characteristically, the affected person loses the sense of touch, vibrations and/or
position in three dimensions below the level of the injury (hemiparalysis or
asymmetric paresis). The sensory loss is particularly strong on the same side
(ipsilateral) as the injury to the spine. These sensations are accompanied by a
loss of the sense of pain and of temperature (hypalgesia) on the side of the body
opposite (contralateral) to the side at which the injury was sustained.
Individuals with this syndrome have a good chance of recovering a large measure
of function. More than 90% of affected individuals recover bladder and bowel
control, and the ability to walk. Most affected individuals regain some strength
in their legs and most will regain functional walking ability.
Devices that help an affected individual continue daily activities such as braces,
hand splits, limb supports, or a wheelchair are important. Various other aids may
be necessary if the patient has difficulty breathing or swallowing. Other treatment
is symptomatic and supportive.
74
4.10.6 Hemiplegia Nervous System Diseases
The characteristics of hemiplegia (again, hemi means “half”) are loss of voluntary
movements on one side of the body, changes in postural tone, and changes in the
status of various reflexes. Hemiplegia results from damage to the neocortex and
basal ganglia contralateral to the motor symptoms. In infancy, such damage may
result from birth injury, epilepsy, or fever. In young adults, hemiplegia is usually
caused by rupture of a congenital aneurysm or by an embolism, a tumor, or a
head injury. Most cases of hemiplegia, however, are found in middle-aged to
elderly people and are usually due to hemorrhaging as a consequence of high
blood pressure and degeneration of the blood vessels.
4.11.1 Narcolepsy
This is an inappropriate attack of sleep, the affected person has an overwhelming
impulse to fall asleep or simply collapses into sleep at inconvenient times. Attacks
may be infrequent or may occur many times a day. Narcolepsy disorders are
surprisingly common. The estimates suggest that as much as 0.02% of the
population may suffer from them. Males and females seem equally affected. The
narcolepsies include
1) sleep attacks,
76
2) cataplexy, Nervous System Diseases
i) Sleep attacks: These are brief, often irresistible, episodes of sleep, probably
slow wave, NREM, naplike sleep that last about 15 minutes and can occur
at any time. Their approach is sometimes recognisable, but they can also
occur without warning. Episodes are most apt to occur in times of boredom
or after meals, but they can also occur during such activities as sexual
intercourse, scuba diving, or baseball games. After a brief sleep attack, the
affected person may awaken completely alert and remain attack free for a
number of hours.
ii) Cataplexy: Catalepsy (Greek, ‘cata’ meaning “down,” and ‘plexy’ meaning
“strike”) is a complete loss of muscle tone or a sudden paralysis that results
in “buckling” of the knees or complete collapse. The attack may be so sudden
that the fall results in injury, particularly because the loss of muscle tone
and reflexes prevents an affected person from making any motion that would
break the fall. During the attack, the person remains conscious and, if the
eyelids stay open or are opened, can recall seeing events that took place
during the attack. In contrast with sleep attacks, cataplexic attacks usually
occur at times of emotional excitement, such as when a person is laughing
or angry.
4.11.2 Insomnia
The results from studies of people, who claim that they do not sleep, or wake up
frequently from sleep show that their insomnia can have many causes.
Nevertheless, systematic recordings of EEGs from poor sleepers before and during
sleep show that the sleepers exaggerated the length of time that it took them to
77
Neurobiology and get to sleep. But poor sleepers do have decreased dream sleep, move more during
Behaviour
sleep, and go through more transitions between sleep stages than normal people
do. Moreover, when awakened from slow-wave sleep, they claim that they have
not been sleeping. Insomnia may be associated with nightmares and night terrors,
sleep apnea (arrested breathing during sleep), restless legs syndrome (RLS,
described in the Snapshot below), myoclonus (involuntary muscle contraction),
the use of certain kinds of drugs, and certain kinds of brain damage.
ii) Sleep apnea: Sleep apnea (from the Greek for “not breathing”), a periodic
cessation of respiration in sleep that ranges in length from about 10 seconds
to 3 minutes, is of two types.
i) Obstructive sleep apnea
ii) Central sleep apnea
The obstructive sleep apnea occurs mainly in the course of dream sleep and
seems to be caused by a collapse of the oropharynx during the paralysis of dream
sleep. Patients with this problem invariably have a history of loud snoring sounds
produced as a consequence of the difficulty of breathing through the constricted
air passage. The obstruction can be reduced through surgical intervention.
The Central sleep apnea stems from a central nervous system disorder. It primarily
affects males and is characterised by a failure of the diaphragm and accessory
muscles to move.
Nervous system diseases are the disorders of the body caused by structuctural,
biochemical or electrical abnormalities in the brain or spinal cord, or in the nerves
leading to or from them. The symptoms can be manifested in the form of paralysis,
muscle weakness, poor coordination, loss of sensation, seizures, confusion, pain
and altered levels of consciousness. The identification of symptoms and diagnoses
are done on the basis of neurological examination and neuropsychological
assessments and studied and treated within the specialties of neurology and clinical
neuropsychology. An individual’s neurons, the building blocks of the nervous
system, and the neural networks into which they form, are susceptible to
electrochemical and structural disruption. While neuro-regeneration may occur
in the peripheral nervous system, it is thought to be rare in the brain and spinal
cord and therefore results in different form of neural diseases. 79
Neurobiology and Neurological disorders can be categorised according to the primary location
Behaviour
affected, the primary type of dysfunction involved, or the primary type of cause.
The broadest division is between central nervous system (CNS) disorders and
peripheral nervous system (PNS) disorders. Vascular disorders include Cerebral
Ischemia, Migraine stroke, Cerebral Hemorrhage, Angiomas and Aneurysms.
Merck Veterinary Manual (2008). Nervous System. Merck & Co., Inc. Whitehouse
Station, NJ USA.
80