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112 Cards in this Set
- Front
- Back
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On drawing tests, patients have a tendency to draw on the ….. side of page as lesion |
same
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Compared to copying, which tasks are even better at detecting unilateral inattention? |
Free drawing and bilaterally symmetrical figures such as cross or star
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Drawing of right hemisphere patients usually … ?... than left hemisphere patients |
larger
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This test involves copying 24 geometric figures of increasing difficulty
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Beery Developmental Test of Visual-Motor Integration
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On Beery Developmental Test of VMI, scores are expressed in terms of
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developmental level of ability
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What is Beery Developmental Test of VMI good for? |
assessment of developmental cognitive deficits
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On the clock test, patients with right-hemisphere damage |
have a tendency to leave out numbers of left-side or bunch them on right.
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On the clock test, including all numbers but having difficulties with spacing may be suggestive of
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right hemisphere damage
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On the clock test, patients with left-hemisphere damage
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may be inattentive to right-side or have difficulty with sequencing
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On the clock test, perseverative errors may be suggestive of
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left hemisphere damage
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On the clock test, trouble with hand placement may indicate
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executive dysfunction
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Does the ability to draw a clock change a lot over life span?
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no
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Is the clock test a good screening measure for brain dysfunction? |
yes
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On the House Drawing test, struggling with roof line or flattening corner between front and side of house more likely to reflect |
right than left hemisphere dysfunction
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On RCFT, what do healthy adults typically draw first?
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large central rectangle
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On RCFT, patients with brain dysfunction |
take a more fragmented approach (lose overall configuration of design)
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On RCFT, patients with right hemisphere damage
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may omit elements altogether
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On RCFT, patients with frontal lesions
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show problems with repetition/perseveration of elements and disorganization
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On Wechsler scales, which subtest is the best measure of visuospatial organization?
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Block design
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On the Block design, patients with left hemisphere lesions
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approach in orderly manner, proceed from left to right, top to bottom, show simplification and concrete handling of design.
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On Block Design, patients with left hemisphere lesions may be able to achieve normal scores
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with additional time
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On Block Design, in addition to problems with design orientation, distortion, misperception, and loss of overall configuration, patients with right hemisphere lesions
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May work from right to left; fail to respect squared format of design; leave out left half or quadrant using less than full number of blocks.
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On Block Design, if you observe stimulus boundedness, impulsivity and carelessness, concrete perspective, random approach to solution, failure to detect or correct errors, you may suspect
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frontal lesions
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Which visuocontruction test has the lowest correlation of all Wechsler subtests with general mental ability? |
Object Assembly
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On Object Assembly, L hemisphere patients |
more likely to join pieces according to edge contours and to disregard internal details and relative sizes of pieces (such as the fingers on the hand)
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On Object Assembly, R hemisphere patients
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have more difficulty visualizing what puzzle pieces make and may not recognize until almost finished or may regard grossly inaccurate constructions as correct
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This test is useful for differentiating between visuoperceptual and more motor-constructive problems
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Hooper VOT
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On HVOT, normal individuals generally fail no more than
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6 items.
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Examples of mild extrapyramidal findings in dementia with Lewy bodies
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bradykinesia, rigidity, masked facies
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Recurrent visual hallucination that are typically well-formed and detailed are common in (diagnosis) |
Dementia with Lewy bodies.
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In dementia with Lewy bodies, in addition to fluctuating cognition with variations in attention/ alertness/ arousal, you may see
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Prominent visuoperceptual /constructional deficits on testing with frontal subcortical profile and reduced attention
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Symptom triad of memory loss, anomia and visuospatial deficits has been suggested as hallmark of |
Alzheimer’s disease
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In Alzheimer’s disease, 1) getting lost in familiar surroundings or when driving, 2) becoming disoriented in their own home, 3) difficulty recognizing familiar faces can be seen as
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functional evidence of visuospatial impairment
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Hallmark deficit in classic limbic amnesia syndrome
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anterograde amnesia
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Anterograde amnesia |
inability to establish new, permanent memories of an “explicit” nature from time of illness onset as evident in deficits in delayed recall and recognition
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Retrograde amnesia
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defect in ability to recall events that occurred prior to illness onset
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In classic limbic amnesia syndrome, retrograde amnesia is
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temporally graded (amnesia for unconsolidated info)
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In addition to previously learned skills and preferences, which other abilities are intact in classic limbic amnesia syndrome?
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Immediate or “working” memory; Remote memory; Semantic (factual) knowledge and other
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Abilities such as “implicit”, unconscious learning (e.g., new motor, perceptual, & cognitive skills), and intellectual function remain intact in |
limbic amnesia syndrome.
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Name temporal parameters of memory
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echoic, short-term, long-term, remote
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Memory process: registration. Description:
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information perceived via sensory channels.
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Memory process: registration. Anatomy:
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Primary sensory processing pathways.
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Memory process: Encoding. Description:
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Process by which info (auditory, visual, motor) is initially organized for immediate repetition or later recall
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Memory process: Encoding. Anatomy:
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(Left) prefrontal-->temporal.
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Processes by which memories converted from temporary to more permanent storage; bind elements together in a memory trace with a marker
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consolidation memory process.
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Memory process: Consolidation. Description:
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Involves changes in cellular structure; usually not effortful, but active processing can improve later recall (e.g., spaced rehearsal)
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The following anatomic structures -- medial temporal lobe, hippocampal formation, limbic structures – are particularly important for which memory process?
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storage/ consolidation.
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process by which previously learned information/skills are recalled, brought back to awareness (name the “memory process”) |
retrieval (“remembering”)
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Memory process: Retrieval. Anatomy:
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Prefrontal regions (R > L for episodic; L > R for semantic).
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a hypothetical permanent change in the brain accounting for the existence of memory; a memory trace |
engram
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Iconic or echoic memory
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ultra STM, residual of sensory-perceptual processing, msecs
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STM/WM
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active, online maintenance and manipulation of information; interface between attention and memory; limited duration and storage capacity
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LTM |
information stored off-line for indefinite periods of time; capacity virtually infinite
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Remote memory
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well-consolidated information that no longer depends on hippocampus for reconstitution
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limbic amnesia primarily
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involves LTM
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frontal lobe damage primarily |
affects WM |
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In 1974, Baddeley and Fitch proposed
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a concept of working (short-term) memory.
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working (short-term) memory, definition |
Temporary storage of a limited amount of information in mind for execution of a goal or intention (learning, problem-solving, preparation for action)
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this is primarily an attentional function mediated by dorsolateral prefrontal (and posterior parietal) cortex |
working (short-term) memory
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Dependent on medial temporal lobe system involving the hippocampus and adjacent entorhinal, perirhinal, and parahippocampal cortices |
declarative memory
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What is amygdala’s role in memory? |
emotionally arousing events (which activate it) remembered better than emotionally neutral events (depends, in turn, on release of cortisone and adrenaline) --> strengthens neural connections
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Acquisition of motor skills with practice e.g., driving a car, riding a bike, mirror tracing
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procedural learning
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Which anatomical structures are important in procedural learning? |
cerebellum and striatum
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CS à US à UR; CS à CR; e.g., eyeblink
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classical conditioning
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Different types of nondeclarative (implicit) memory include: |
procedural learning, classical conditioning, evaluative learning, and priming.
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Which anatomical structures are important in classical conditioning? |
interpositus nucleus and overlying cerebellar cortex.
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Whether a stimulus or event has positive or negative valence (e.g., fear conditioning and extinction/ desensitization)
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evaluative learning
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Which anatomical structure is important in evaluative learning?
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amygdala
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Facilitation in processing a stimulus (faster response time, greater accuracy, less cuing required) as a result of a recent encounter with the same stimulus (in absence of conscious recollection) |
priming
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Which anatomical structure is important in priming? |
neocortical regions engaged by the task.
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What kind of patients show impaired procedural learning? |
Those with Huntington’s disease and Parkinson’s disease
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Patients with prefrontal damage not amnesic but have deficits in
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executive processes involved in monitoring, organizing, and using memory effectively
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In addition to deficits in free recall involving strategic search, patients with prefrontal damage have deficits in
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memory for temporal order of events and source memory
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Meta-memory and “feeling of knowing”
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knowledge about one’s own memory capabilities, memory demands of particular tasks or situations, and potentially useful strategies relevant to given tasks or situations
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memory for temporal order of events
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recency judgments
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source memory
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recollection of context in which information was acquired.
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Prospective memory
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memory for future events, “remembering to remember” (time-based; event-based).
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Deficits in source memory and meta-memory are also characteristic in
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patients with prefrontal damage.
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Deficits observed in patients with prefrontal damage can also be observed in
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Diencephalic amnesics (e.g., Korsakoff disease patients), which differentiate them from bitemporal amnesics.
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Capgras Syndrome
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Pts have delusional belief that family members of friends are imposters. Confabulate to rationalize this belief.
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Capgras Syndrome is usually a result of
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partial or recovering limbic lesion superimposed on FL damage, especially in right hemisphere.
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Name paramnesic phenomena in frontal patients:
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confabulation; reduplicative paramnesia; Capgras syndrome.
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Reduplicative Paramnesia, definition:
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Pt convinced that a person, place, or object exists in duplicate.
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Reduplicative Paramnesia, cause:
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may be due to disturbed sense of familiarity rendering pt unable to associate/fuse present situation/stimulus with existing engram and so 2 parallel memories created.
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a condition or phenomenon involving distorted memory or confusions of fact and fantasy, such as confabulation or déjà vu
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paramneisa
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confabulation
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a memory disturbance, defined as the production of fabricated, distorted or misinterpreted memories about oneself or the world, without the conscious intention to deceive
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What does FTLD stand for?
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frontotemporal lobar degeneration
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What does FTD stand for?
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frontotemporal dementia
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Name several FTLD clinical syndromes
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FTD, Progressive Aphasia, Semantic Dementia.
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Neuropathological topography of FTD:
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prefrontal/ anterior temporal
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Neuropathological topography of Progressive Aphasia:
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Left fronto-temporal
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Neuropathological topography of semantic dementia:
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temporal.
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What does FTD/MND stand for?
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frontotemporal dementia with motor neuron disease.
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What does PNFA stand for?
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progressive non-fluent aphasia
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What does PAX stand for?
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progressive apraxia.
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Main symptoms of semantic dementia:
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word finding difficulties; impaired knowledge of word meaning.
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Patients with anomia
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know the meaning of the word, but cannot retrieve the word.
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Patients with semantic dementia
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do not know the meaning of the word, even if it is familiar.
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If you notice a gradual reduction of vocabulary; use high frequency terms (thing, boy); speech is fluent and well articulated; no phonological or syntactic errors, you may suspect
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semantic dementia.
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How do you assess dissociation between two abilities: repetition and meaning knowledge?
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Ask to repeat the word, then ask what it means.
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What are the oral subtests of WAB-R?
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Spontaneous speech, auditory comprehension, repetition, naming.
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What does WAB-R stand for?
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Western Aphasia Battery Revised.
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Nonfluent type of progressive aphasia is characterized by:
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impaired fluency and apraxia of speech.
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Primary progressive aphasia is characterized by:
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: impairment in fluency and naming.
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A measure of discrepancy from normal language performance
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Aphasia Quotient (AQ) on WAB.
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Name different types of aphasia:
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isolation, conduction, anomic, transcortical motor, transcortical sensory, global, Wernicke’s, Broca’s.
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On WAB-R, reading and writing scores are used to calculate
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Language Quotient (LQ).
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Tests of apraxia, drawing, block design construction, calculation, and Raven’s Progressive Matrices are included in
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Cortical Quotient (CQ)
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On motor examination, deficient performance can indicate
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dysfunction in the hemisphere contralateral to the affected limb.
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Different types of apraxia include:
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melokinetic, ideomotor, ideational
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Melokinetic apraxia =
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limb-kinetic apraxia.
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Astereognosia
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inability to recognize objects by touch in context of intact sensation |
