Impaired Cognition Flashcards Preview

PY2CN > Impaired Cognition > Flashcards

Flashcards in Impaired Cognition Deck (43):

Define retrograde amnesia

Loss of memory from before damaging incident

Assoc diecephallic regions


Define anterograde amnesia

Inability to create new memories

Associate with hippocampal damage


What causes amnesia

Stroke, ABI, TBI, alcohol


What is korsakoff syndrome

Amnesia due to long term excessive alcohol consumption - thiamine deficiency due to malnutrition and alcohol cause impairment in regions that require thiamine ie lesions in limbic system/thalamus/diecephallic structures
leads to confabulation, disordered eye and limb movement, retrograde/anterograde amnesia and enlarged ventricles


What is the limbic system

Interconnecting structures in the brain
ie thalamus, cc, fornix, hyp, hipp, amygdala, olfactory bulb


Biomaterial of korsakoff S

Vitamin b1 deficiency

Thalamus impairment - acts as relay centre for forming and maintaining episodic memory

Enlarged ventricles that fill with CSF


Define hemispatial neglect

Attentional deficit where failt to respond or orient to stimuli in contralesional side of space
More common in left hemispace as right hemisphere modulate attention
thought to be due to impairment in gradient of attention between two hemispheres - right more dominant across visual field and left specific to right spatial attention


Define contralesional

Opposite side of lesion


Define ipsilesional

Same side of brain lesion


Define hemianopia

Visual deficit that means cannot see/process info on one side of space


Braine regions assoc with hemispatial neglect

Tempo paretial junction

Intraparetial sulcus

Supramarginal gyrus


Symptoms of neglect

Deficit in body representation

Don't incorporate what don't perceive & ignore

Anosognosia - unaware of disorder

Representational neglect - have info but ignore it (piazzo del duomo)

Extinction - when there is two competing stimuli, one extinguished

allesthia - see stimulus on left but report seeing on right


Tests for hemispatial neglect

visual search task
line bisection
drawing tasks (visual or representational)


Treatment of hemispatial neglect

Cognitive training
Scan training
Neck muscle vibrations
Mental imagery training
Video feedback training


Problems with hemispatial treatments

Improvement is transient and short lived


Describe prism adaptation treatment

Wear prism goggles that shift visual field 10 degrees

Ask to reach for targets whilst wearing - realligns the visual and proprioceptive frame 'peas magic shift'

causes after effect - neglect slower to realign to vision so show reduction in neglect symptoms for longer - limited feedback/attention


Prism adaptation improvements rosette 1998

subjective shift to midline
Improvement on : line bisection, line cancellation, copying drawings, memory drawing and reading as well as wheel chair navigation
last for at least 2 hours


Prism adaptation lasting effects pisella et al

Found to last up to 5 weeks

But limit of 10 weeks


What other problems can arise from pre frontal lobe damage

impaired executive function
Deficient self awareness


Define intertia

Problems starting
Apathetic and unresponsive - superior medial damage

Ie only eat when food in front of them


Define perseveration

Prolongation or continuation of act/action sequence - can't break sequence

Dorsolateral lesions


Define disinhibition

Impulsivity - don't inhibit behaviours

Aggressive outbursts, promiscuity, poor decisions

Orbital frontal cortex


Define deficient self awareness

Inability to perceive performance errors and failure to appreciate impact on others

Don't respond normally to emotional or social reinforcers

Orbital cortex and related limbic systems


Define inflexibility

Concrete attitude
Can't plan or sustain goal directed behaviours


Define amnesia

Impairment to encoding or storage processes in memory due to disease or accident

Retrograde or anterograde


patient HM

anterograde amnesia following procedure to remove bilateral medial temporal lobe in epilepsy procedure
also remove hippocampus and amygdala


minler 1962 Patient HM

gave repeated procedural tasks
ie draw line between two outlines or draw a 5 point star in mirror
not recall doing procedures but show sig improvement in speed and accuracy
- dissoc between motor and knowledge base learning


kopelman 2014 temp lobe amnesia vs korsakoff

Both syndromes show ‘core’ features of an anterograde amnesic syndrome; but retrograde amnesia more extensive (going back many years or decades) in the Korsakoff syndrome.
spontaneous confabulation occurs more commonly in the Korsakoff syndrome
amnesia forget more rapidly but korsakoff more influenced by proactive interference
These differences are attributed to the greater prevalence of frontal atrophy and frontal damage in Korsakoff cases.


proactive interference

previously learned material hinders subsequent learning.


retroactive interference

new material interferes with old memory/learning


Thelma (parkin 1996)

neglect patient fail to notice stimuli to the left side of space unless important


behtman et al 1997 hemispatial neglext

each hemisphere accounts for contralateral attention of space
hemispatial show similar eye saccased across left and right hemispace as controls - take into account both sides just don't attend to one


baylis driver and rafal 1993 hemispatial neglect and extinction

extinction paradigm - two pens or 1 pen and 1 comb
extinction of 2nd pen in first condition but recognise comb in second - ignore unnecessary/irrelevant info


Bisiach and Luzzatti 1978 hemispatial and representational neglect

two neglect patients describe imagined perspective of piazza del duomo
omit descriptions on left but report when from a diff perspective - have the info but ignore


visual search task for neglect

cancel or identify target numbers or letters in a display of similar stimuli or distractors
neglect fail to identify targets to the left


line bisection task for neglect

bisect centre of the line
fail to account for left to bisect to the right of the centre


drawing tasks for neglect

visual - copy
representational - from memory
omit details to the left/squeeze to the right


marshall and halligan 1988 neglect

burning house
which would you prefer to live
neglect say one with non burning window


laduras paladine and cubelin 1998 priming and neglect

present patients with word/non word on neglect side then letter dring
letter string is word/non word linked or not to word seen on neglect side
faster to respond to word linking to that prev see but fail to explicitly report seeing the word


luaute et al 2006 neural basis of prism adaptation

improvement correlated with neural activity in right cerebellum (assoc with control of visuospatial output), left thalamus, left temporal occ cortex, right posterior parietal crtex and left medial temp lobe
increased efficiency in visual stimuli recognition and greater implications of ventral "what" region


what is executive function

set of cognitive processes – including attentional control, inhibitory control, working memory, and cognitive flexibility, as well as reasoning, problem solving, and planning – that are necessary for the cognitive control of behavior: selecting and successfully monitoring behaviors

assoc with frontal lobes


Phineas gage

explosion during ork
tamping iron in skull
heat courterise wound
"not gage anymore" - change in personality, become unreliable, unpredictable disrespectful and lacked social skills


damasio graborski and trank et al 1994 Phineas gage

estimate trajectory of rod using neuroimaging on skull
impaired orbitofrontal cortex and anterior medial areas
all assoc with exec functioning