BEHAVIORAL NEUROLOGY

Question 1

Initial cortical processing of afferent sensory input or
source of primary motor efferents.

Directly connected with association cortices and subcortical modulating nuclei

Answer 1

Idiotypic primary cortex (sensory or motor, e.g., primary

visual cortex)

Question 2

Usually anatomically close to respective primary cortex;

modulates the function of primary cortex

Answer 2

Homotypic unimodal association cortex

Question 3

Directly connected with each other and unimodal association cortices (including the limbic and paralimbic
regions)

Answer 3

Homotypic heteromodal (multimodal) association cortex

Question 4

Two major areas OF Homotypic heteromodal (multimodal) association cortex

1) _________concerned with planning of movements and
executive functions
2) ________________: visuospatial perception and language

Answer 4

Anterior heteromodal association area (prefrontal cortex):

Posterior heteromodal association area

Question 5

What cell type

“Projection neurons” involved in transmitting signals
to other cortical, subcortical, or spinal areas

Located mainly in layers III, V, and VI

The neurotransmitter is glutamate (excitatory

Answer 5

Pyramidal cells

Question 6

What cell type

Star-shaped neurons with dendritic extensions in all
directions

Found in all layers, but most common in layer IV

Are local inhibitory interneurons; use γ-aminobutyric
acid (GABA)

Answer 6

Stellate cells

Question 7

Neocortex (primary, unimodal, and heteromodal areas)
is organized in six layers
1) Layers_______ receive afferents
2) Layer __________projects to spinal cord, brainstem, and basal
ganglia
3) Layer _____ projects to thalamus

Answer 7

I to IV

V

VI

Question 8

Layer I—molecular (plexiform) layer: consists mainly of
local _____ and ______ of pyramidal cells
in deeper layer

Answer 8

interneurons and apical dendrites

Question 9

Layer II—external granular layer
1) _________: axons project to deeper cortical layers
2) ___________: axons project to contralateral cortex
as commissural fibers

Answer 9

Stellate cells

Pyramidal cells

Question 10

Layer III—_________layer: pyramidal cells
with projections to ipsilateral cortices (association fibers)
or contralateral hemisphere (commissural fibers

Answer 10

external pyramidal

Question 11

Layer IV—internal granular layer

1) Consists mainly of ______ cells
2) Receives afferent glutaminergic input from ____
3) Prominent layer in _____

Answer 11

stellate

thalamus

primary sensory cortices

Question 12

__________ layer
1) Pyramidal cells: axons project to basal ganglia, brainstem,
spinal cord, and contralateral cortex (commissural
fibers)
2) Prominent layer in primary motor cortex, which contains
giant pyramidal cells of Betz

Answer 12

Layer V—internal pyramidal layer

Question 13

Layer VI—multiform layer: pyramidal cells with projections

to ____ and _____

Answer 13

thalamus and layer IV

Question 14

Each column is a functional unit of cortex

Answer 14

Vertical (columnar) cortical organization

Question 15

__________connection between different cortices

in same hemisphere

Answer 15

Association fibers:

Question 16

Examples of Association fibers

Answer 16

1) U-fibers (short association fibers)
2) Superior longitudinal fasciculus
3) Cingulum (part of the Papez circuit)
4) Inferior longitudinal fasciculus
5) Uncinate fasciculus

Question 17

__________ connection between the two

cerebral hemispheres

Answer 17

Commissural fibers:

Question 18

Examples of Commisural fibers

Answer 18

1) Corpus callosum
2) Anterior commissure
3) Posterior commissure
4) Hippocampal commissure

Question 19

_______ corticosubcortical fibers

Answer 19

Projection fibers:

Question 20

Premotor areas. What type of cortex?

Answer 20

homotypic unimodal cortex

Question 21

parietopremotor pathways are important in ______

Answer 21

goal-directed

movements (reaching and grasping)

Question 22

Responsible for initiating motor plans in response
to sensory stimuli (e.g., stopping at a red light)

Involved in learning to associate a particular
sensory stimulus with a particular motor movement
(associative learning)

Answer 22

Ventral and dorsolateral premotor cortex

Question 23

Input from ipsilateral parietal lobe and prefrontal
“presupplementary area

Blood flow increases when one is thinking about or planning a movement

Answer 23

SMA

Question 24

Projects to premotor areas involved in motor programs

required for speech production

Answer 24

Broca’s area

Question 25

Important for executive functions, planning, judgment, | problem-solving

Answer 25

Dorsolateral prefrontal cortex

Question 26

Responsible for emotional and visceral activities, social behavior, and inhibition of inappropriate behavior in a particular social context as well as judgment

Answer 26

Orbitofrontal cortex

Question 27

Connections of the orbitofrontal cortex

Answer 27

Widespread interconnection with limbic system and | basal ganglia

Question 28

Where is the lesion? poor executive functions, planning, judgment, and problem solving

Answer 28

Dorsolateral:

Question 29

Where is the lesion? disinhibition, impulsive behavior, poor judgment and insight

Answer 29

Orbitofrontal:

Question 30

Interconnections with limbic system (especially amygdala) Important role in initiation, motivation, and goaloriented behavior

Answer 30

Mesial frontal cortex and anterior cingulate cortex

Question 31

severe impairment of the Mesial frontal cortex and anterior cingulate cortex leads to:

Answer 31

``` akinetic mutism (no spontaneous behavior) ```

Question 32

Stimulation/epileptic activity of mesial frontal

Answer 32

complex motor and gestural automatisms

Question 33

Sensitive measure of function of prefrontal cortex The subject is asked to sort the cards according to a certain perceptual attribute of a visual stimulus

Answer 33

Wisconsin Card Sorting Test

Question 34

occipitoparietal visuospatial pathway responsible for visuomotor tasks

Answer 34

Dorsal M pathway:

Question 35

___________ pseudothalamic syndrome Syndrome of delayed pain and paresthesias, as may occur sometimes with thalamic infarcts

Answer 35

Lesion of S II at parietal operculum:

Question 36

anomia, alexia, constructional difficulties, acalculia, dysgraphia, finger anomia, right-left disorientation

Answer 36

Angular gyrus syndrome (lesion of angular gyrus, | heteromodal cortex)

Question 37

___________optic ataxia, ocular apraxia, | simultanagnosia (bilateral lesions)

Answer 37

Balint’s syndrome:

Question 38

amnesia for nonverbal, visuospatial information. Where is the lesion

Answer 38

Nondominant hemisphere

Question 39

amnesia for verbal information. Where is the lesion?

Answer 39

Dominant hemisphere

Question 40

Difficulty with recognition of songs, primarily because of disturbance of recognition of different characteristics of music composition

Answer 40

Amusia

Question 41

Left temporal lobe lesions:

Answer 41

not true amusia, | patient has difficulty understanding lyrics

Question 42

Ageusia (lack of taste): Where is the lesion?

Answer 42

bilateral | lesions of insular cortex

Question 43

lesion for semantic dementia

Answer 43

dominant anterior temporal lobe

Question 44

lesion for Prosopagnosia

Answer 44

Lesion in posteroinferior temporo-occipital region

Question 45

sensation of familiarity with a previously | unfamiliar experience, place, or event

Answer 45

Déjà vu:

Question 46

sensation of familiarity with a previously unfamiliar auditory experience (e.g., sound, music, speech, or narrative)

Answer 46

Déjà entendu

Question 47

sensation of unfamiliarity with a | previously familiar experience, place, or event

Answer 47

Jamais vu:

Question 48

Recurrence of an image no longer present in visual field. May occur with posterior temporo-occipital epileptic focus

Answer 48

Palinopsia

Question 49

What layer of the occipital cortex Receives the majority of input from lateral geniculate nucleus

Answer 49

Layer IV

Question 50

Projections of the occipital cortex to_____ and ______: responsible for production of saccades and rapid shifting of gaze to another point in the visual field in response to a novel stimulus

Answer 50

superficial layer of superior colliculus and pulvinar

Question 51

Anomia, alexia, constructional difficulties, acalculia, dysgraphia, finger anomia, right-left disorientation ± aphasia

Answer 51

Angular gyrus syndrome

Question 52

Bilateral medial occipital lobe lesion Cortical blindness associated with denial of the deficit, for which the patient is unaware, and confabulation

Answer 52

Anton’s syndrome

Question 53

Lesion involves occipitotemporal pathways bilaterally, often seen with Alzheimer’s disease Optic ataxia, ocular apraxia, simultanagnosia

Answer 53

Balint’s syndrome

Question 54

Bilateral anterior temporal lobe lesion Hyperorality and oral exploratory behavior, altered eating habits, weight gain, emotional blunting, blunting of response to fear and aggression, and altered sexual activity (hyposexuality > hypersexuality

Answer 54

Klüver-Bucy syndrome

Question 55

Belief that the strangers are identified by the patient as familiar Usually seen in context of dementia

Answer 55

Fregoli syndrome

Question 56

Belief that a family member is an imposter Usually associated with paranoid delusions in the context of dementia

Answer 56

Capgras’ syndrome

Question 57

“Syndrome of approximate answers”; answers are consistently nearly correct but not correct Usually seen in context of psychiatric disease and malingering but may also be seen in degenerative dementias

Answer 57

Ganser syndrome

Question 58

Impaired ability to produce an internal image of | a named object

Answer 58

Charcot-Wilbrand syndrome

Question 59

Location of the Visual association areas (peristriate cortices)

Answer 59

Located in the peristriate occipital areas (areas 18 and 19) and middle and inferior temporal gyri (areas 20, 21, 37)

Question 60

Dorsal M pathway location

Answer 60

Originates in M cells of retina that project to magnocellular portion of lateral geniculate nucleus

Question 61

M pathway carries information on perception of | ____________of a particular visual input

Answer 61

depth, analysis of motion, and spatial orientation | “where”

Question 62

Ventral P pathway location

Answer 62

Originates in P cells in retina that project to parvocellular portion of lateral geniculate nucleus

Question 63

Function of the Ventral P pathway location

Answer 63

Concerned primarily with perception of form and color; important in recognition of faces and objects and pattern identification

Question 64

Results of lesions of the Ventral P pathway

Answer 64

Aperceptive visual agnosia, Achromatopsia, Color agnosia, Prosopagnosia

Question 65

a. Acquisition of new knowledge and experience and alteration of behavior as a result of the experience b. In its simplest form, it represents change in response over time to repeated exposure to the same stimulus

Answer 65

Learning

Question 66

knowledge that requires conscious recall and acquisition; requires fast acquisition and conscious recall Types are: Semantic memory Episodic memory

Answer 66

Explicit (declarative) memory

Question 67

knowledge that does not require conscious recall; acquisition is generally slow Types are Procedural memory Priming

Answer 67

Implicit (nondeclarative) memory

Question 68

Knowledge of facts, objects, and abstract concepts unrelated to events (e.g., geography requires inferotemporal association areas and other regions outside mesial temporal lobe

Answer 68

Semantic

Question 69

Knowledge of past events that have been encoded and stored with certain associations established in particular time and place

Answer 69

Episodic

Question 70

long-lasting or permanent, relatively more resistant to dementing illness and cerebral insult than short-term memory

Answer 70

Long term:

Question 71

Knowledge for performing a motor task is slowly acquired (learned) by repeatedly performing the same task Acquisition is slow and incremental, the knowledge is resistant to forgetfulness by degenerative conditions

Answer 71

Procedural memory

Question 72

Parts of the limbic system Basal forebrain

Answer 72

Septal area Substantia innominata Amygdala complex

Question 73

Connections with hippocampus and hypothalamus has cholinergic projections to hippocampus

Answer 73

Septal area

Question 74

Part of Substantia innominata Cholinergic projections to amygdala and neocortex, Receives projections from subiculum

Answer 74

Nucleus basalis of Meynert

Question 75

connections with hippocampal formation responsible for attachment and association of an emotion with a particular memory

Answer 75

Amygdala complex

Question 76

Parts of Hippocampus

Answer 76

Dentate gyrus Hippocampus proper Subicular complex

Question 77

______ is generally resistant to metabolic, vascular (anoxic), and degenerative insults with few exceptions (argyrophilic grain disease [Braak’s disease] selectively affects CA2)

Answer 77

CA2

Question 78

Focal damage to ____ and ______ is sufficient to | cause anterograde amnesia

Answer 78

CA1 and CA2

Question 79

Parts of the subicular complex

Answer 79

a) Consists of the subiculum proper, presubiculum, | and parasubiculum

Question 80

Mediator of acquisition of emotional memory; important role in emotional responses, particularly ones involving conditioned

Answer 80

Amygdala

Question 81

Responsible for judgment and social behavior and inhibition of inappropriate behavior in a particular social context Part of the pFC

Answer 81

Orbitofrontal cortex

Question 82

involved mainly with motivation Part of the pFC

Answer 82

Medial frontal (anterior cingulate cortex)

Question 83

What is “Temporal lobe personality”

Answer 83

observed in patients with temporal lobe epilepsy: hypergraphia, hyperreligiosity, altered sexual behavior (hyposexuality > hypersexuality), circumstantiality of speech (with excessive detail about minute points), euphoria, sadness, emotionality, and, sometimes, anger and aggressive behavior

Question 84

Acquired impairment of language processes that may include disturbance in comprehension and/or formulation of language symbols (across all modalities, not only verbal

Answer 84

Aphasia

Question 85

amotivational, akinetic state characterized by poor effort to initiate speech, lesion usually localized to mesial frontal lobes

Answer 85

Akinetic mutism:

Question 86

pure anarthria, no speech output Usually due to bilateral lesions of the corticobulbar (upper motor neuron) tract, often from bilateral capsular infarcts limited to corticobulbar fibers (written language and verbal comprehension are preserved)

Answer 86

Aphemia:

Question 87

often considered part of Broca’s area rather than independent language area) Writing is usually abnormal (including copying written material in these lesions

Answer 87

Exner’s area,