Neuropsychology Lecture Notes PDF

Quiz! Please come down and get a notecard. Name Student ID Write your NAME on the top left of the card and your STUDENT ID on the top right of the card.  Quiz! Which of the following is a means by which neurot...

Quiz! Please come down and get a notecard. Name Student ID Write your NAME on the top left of the card and your STUDENT ID on the top right of the card.  Quiz! Which of the following is a means by which neurotransmitter action in the synapse can be terminated? a. Enzymatic degradation b. Reuptake c. Diffusion d. All of the above  Quiz! Which of the following is a means by which neurotransmitter action in the synapse can be terminated? a. Enzymatic degradation b. Reuptake c. Diffusion d. All of the above Human Neuropsychology Lecture 4 BIO N173 / PSY 163/ PSYCH 162 Neuropsychological Assessment  What is neuropsychology? Study of the structure and function of the brain as they relate to specific psychological processes and behaviors. Clinical evaluations or scientific research. Goals: Diagnosis: What damage happened to the brain? Description: What are the cognitive, behavioral or emotional consequences of this damage? Tracking: Observing patient performance over time to track improvement or deterioration and effect of treatment.  Different avenues of testing History Taking – gathering medical history of a patient and his/her family. Is there a historical determinant of the behavior? Interviewing the patient and family or friends. Neuropsychological testing – to supplement anecdotal evidence, performance on standardized tests can be compared to “normal” group averages.  Advantages of Neuropsych Testing Standardized: repeatable instructions and tasks Norms: comparison to find out how “abnormal” test results are for someone with a given age, sex and IQ. Intensive: multiple measures for each domain allow for rich characterization of cognitive or behavioral deficits Sensitivity: Tests can be designed to be sensitive to subtle deficits as well as subtle enhanced abilities Specificity: Tests can be designed to be very domain-specific e.g. language, visuospatial skill, etc  Measuring the quality of a test Receiver Operating Characteristic (ROC) Curve Higher Area Under the Curve (AUC) = better test 100% sensitivity 100% specificity  Issues: Reliability of Measurement Does the measurement procedure give the same accurate measurement EACH AND EVERY time? Can be thought of as measurement consistency  Issues: Validity of Measurement Does your test assess what you actually intend it to assess? Validity is essentially the truthfulness of measurement.  Reliability and Validity Reliable but not valid Valid but not reliable Neither valid nor reliable Both valid and reliable  Example: Learning and memory Rey Auditory Verbal Learning Test (RAVLT) – developed in the 1940s. DRUM PARENT NOSE CURTAIN MOON TURKEY BELL GARDEN COLOR COFFEE HAT HOUSE SCHOOL FARMER RIVER Now write down as many as you can remember in any order!  Example: Learning and memory Now compare your answers! DRUM PARENT NOSE CURTAIN MOON TURKEY BELL GARDEN COLOR COFFEE HAT HOUSE SCHOOL FARMER RIVER What parts of your brain do you think are involved?  Example: Language assessment Boston Naming Test – Kaplan, Goodglass, and Weintraub 1983. 60 line drawings. Simple goal: name the object. Objects range in difficulty. A score below 45 in an adult is considered a deficit (possible anomic aphasia). What parts of the brain do you think are involved?  Clock Drawing Test Instructions: Draw a clock as a circle with all of the numbers on it. Place the arms at 10 past 11. Another example - moderate AD Another example - severe AD  Example: Executive functioning Stroop Task – developed by John Stroop 1935. Goal: name the color, DO NOT READ the word! Normally challenging, but near impossible if you have damage to what parts of the brain?  Example: Visuospatial abilities Rey-Osterrieth Complex Figure – Rey and Osterrieth 1941. Take out a piece of paper and copy this figure: What parts of the brain do you think are involved? Example: Visuospatial Recall Alzheimer’s Patient - Immediate Recall Alzheimer’s Patient - Delayed Recall  Back to Rey-O Get another sheet of paper and reproduce the complex figure you saw previously (the one with the bowling ball), to the best of your abilities. Are the same brain areas involved as before? What happens with no hippocampus?  Matrix Reasoning Test - Easy Can you pick which one of the choices at the bottom is the correct missing item?  Matrix Reasoning Test - Moderate What brain areas may be involved?  Wisconsin Card Sorting Test Rules: Shape Color Number Sort according to unspoken rule; Examiner changes the rule often. Patient only receives correct/incorrect feedback. Can patient adapt to new rule? How many words do you remember? DRUM PARENT NOSE CURTAIN MOON TURKEY BELL GARDEN COLOR COFFEE HAT HOUSE SCHOOL FARMER RIVER  Malingering - Faking mental disorders Faking a disorder or a deficit For legal and financial reasons - sometimes people fake a deficit to collect insurance payments or to fraudulently obtain narcotics. There are specific tests designed to catch malingering and they’re based on the fact that malingerers don’t know what real deficits look like - Often they show too much loss of function. E.g. hallucinations are external (not “in the head”) “I hear voices in my head” is usually a telltale sign of malingering.  Example: Test of Memory Malingering (ToMM) Examinee shown 50 line drawings (3 seconds each). Test is two-alternative forced-choice recognition. Normal adults will score ~100% Brain damaged patients may score anywhere between 50 and 100% Anyone scoring BELOW chance (