Neurophysiology of Communication
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Cerebral Localization
CEREBRAL LOCALIZATION PRESENTED BY: HARSHIT MISHRA Definition 1. The diagnosis of the location in the cerebrum of a brai n lesi on, made either from the signs and symptoms manifested by the patient or from an investigation modality. 2. The mapping of the cerebral cortex into areas, and the correlation of these areas with cerebral function. Functional Localization of Cerebral Cortex ‐‐‐ HISTORY Phrenology of Gall ((17811781))andand Spurzheim Phrenology: Analysis of the shapes and lumps of the skull would reveal a person’s personality and intellect. Identified 27 basic faculties like imitation, spirituality Paul Broca (1861): Convincing evidence of speech laterality “Tan” : Aphasic patient Carl Wernicke (1874): TTemporal lesion disturbs comprehension. Connectionism model of language Predicated conduction aphasia Experimental evidences Fritsch and Hitzig (1870 (1870)) ‐‐‐ motor cortex von Gudden (1870 (1870)) ‐‐‐‐ visual cortex Ferrier (1873 (1873)) ‐‐‐‐ auditory cortex BASED ON CYTOARCHITECTONIC STUDIES Korbinian Brodmann (1868-1918): ¾ Established the basis for comparative cytoarchitectonics of the mammalian cortex. ¾ 47 areas ¾ most popular Vogt and Vogt (1919) - over 200 areas von Economo (1929) -- 109 areas HARVEY CUSHING:-CUSHING:- Mapped the human cerebral cortex with faradic electrical stimulation in the conscious patient. PENFIELD & RASMUSSEN:- Outlined the motor & sensory Homunculus. Brodmann’s Classification Cerebral Dominance (Lateralization, Asymmetry) Dominant Hemisphere (LEFT) Language – speech, writing Analytical and -
Prospect for a Social Neuroscience
Levels of Analysis in the Behavioral Sciences Prospect for a • Psychological Social Neuroscience – Mental structures and processes • Sociocultural – Social, cultural structures and processes Berkeley Social Ontology Group • Biophysical Spring 2014 – Biological, physical structures and processes 1 2 Levels of Analysis On Terminology in the Behavioral Sciences • Physiological Psychology (1870s) Sociocultural – Animal Research Social Psychology • Neuropsychology (1955, 1963) Social Cognition – Behavioral Analysis – Brain Insult, Injury, or Disease Psychological • Neuroscience (1963) – Interdisciplinary Cognitive Psychology • Molecular/Cellular Cognitive Neuroscience Social Neuroscience •Systems • Behavioral Biophysical 3 4 Towards a Social Neuropsychology The Evolution of Klein & Kihlstrom (1998) Social Neuroscience Neurology NEUROSCIENCE • Beginnings with Phineas Gage (1848) Neuroanatomy Molecular – Phrenology, Frontal Lobe, and Personality Integrative and • Neuropsychological Methods, Concepts Neurophysiology Cellular Cognitive – Neurological Cases – Brain-Imaging Methods Systems Affective • But Neurology Doesn’t Solve Our Problems Behavioral Conative(?) – Requires Psychological Theory Social – Adequate Task Analysis at Behavioral Level 5 6 1 The Rhetoric of Constraint “Rethinking Social Intelligence” Goleman (2006), p. 324 “Knowledge of the body and brain can The new neuroscientific findings on social life have usefully constrain and inspire concepts the potential to reinvigorate the social and behavioral sciences. The basic assumptions -
Conduction Aphasia, Sensory-Motor Integration, and Phonological Short-Term Memory – an Aggregate Analysis of Lesion and Fmri Data ⇑ Bradley R
Brain & Language 119 (2011) 119–128 Contents lists available at ScienceDirect Brain & Language journal homepage: www.elsevier.com/locate/b&l Conduction aphasia, sensory-motor integration, and phonological short-term memory – An aggregate analysis of lesion and fMRI data ⇑ Bradley R. Buchsbaum a, , Juliana Baldo b, Kayoko Okada d, Karen F. Berman e, Nina Dronkers b, ⇑ Mark D’Esposito c, Gregory Hickok d, a Rotman Research Institute, Toronto, Ontario, Canada b VA Northern California Health Care System, Center for Aphasia and Related Disorders, Martinez, CA, USA c Department of Psychology, University of California, Berkeley, CA, USA d Department of Cognitive Sciences, University of California, Irvine, CA, USA e Section on Integrative Neuroimaging, National Institute of Mental Health, Bethesda, MD, USA article info abstract Article history: Conduction aphasia is a language disorder characterized by frequent speech errors, impaired verbatim Accepted 11 December 2010 repetition, a deficit in phonological short-term memory, and naming difficulties in the presence of other- Available online 21 January 2011 wise fluent and grammatical speech output. While traditional models of conduction aphasia have typi- cally implicated white matter pathways, recent advances in lesions reconstruction methodology Keywords: applied to groups of patients have implicated left temporoparietal zones. Parallel work using functional Conduction aphasia magnetic resonance imaging (fMRI) has pinpointed a region in the posterior most portion of the left pla- Working memory num temporale, area Spt, which is critical for phonological working memory. Here we show that the Speech production region of maximal lesion overlap in a sample of 14 patients with conduction aphasia perfectly circum- Planum temporale Brain lesion scribes area Spt, as defined in an aggregate fMRI analysis of 105 subjects performing a phonological work- Sensorimotor integration ing memory task. -
Correlation of CT Cerebral Vascular Territories with Function: 3. Middle Cerebral Artery
161 Correlation of CT Cerebral Vascular Territories with Function: 3. Middle Cerebral Artery Stephen A. Berman 1 Schematic displays are presented of the cerebral territories supplied by branches of L. Anne Hayman2 the middle cerebral artery as they would appear on axial and coronal computed Vincent C. Hinck 1 tomographic (CT) scan sections. Companion diagrams of regional cortical function and a discussion of the fiber tracts are provided to simplify correlation of clinical deficits with coronal and axial CT abnormalities. This report is the third in a series designed to correlate cerebral vascular territories and functional anatomy in a form directly applicable to computed tomog raphy (CT). The illustrations are intended to simplify analysis of CT images in terms of clinical signs and symptoms and vascular territories in everyday practice. The anterior and posterior cerebral arteries have been described [1 , 2] . This report deals with the middle cerebral arterial territory. Knowledge of cerebral vascular territories can help in differentiating between infarction and other pathologic processes. For example, if the position and extent of a lesion and the usual position and extent of a vascular territory are incongruous, infarction should receive relatively low diagnostic priority and vice versa. Knowledge of vascular territories can also facilitate correct interpretation of cerebral angio grams by pinpointing specific vessels for particularly close attention. Knowledge of functional neuroanatomy applied to a patient's clinical findings can improve detection of subtle lesions by pinpointing specific areas for special attention on CT and specific vessels for attention on angiograms. Discussion The largest area of the brain that is normally supplied by the vessel(s) of the middle cerebral territory is indicated in figures 1 and 2. -
Speech-Oct-2011.Pdf
10/11/2011 1 10/11/2011 PHYSIOLOGY OF SPEECH Dr Syed Shahid Habib MBBS DSDM FCPS Associate Professor Dept. of Physiology King Saud University 2 10/11/2011 OBJECTIVES At the end of this lecture the student should be able to: • Describe brain speech areas as Broca’s Area, Wernicke’s Area and Angular Gyrus • Explain sequence of events in speech production • Explain speech disorders like aphasia with its types and dysarthria 3 10/11/2011 Function of the Brain in Communication- Language Input and Language Output 1.1.1.Sensory1. Sensory Aspects of Communication. 2.2.2.Integration2. Integration 3.3.3.Motor3. Motor Aspects of Communication. 4.4.4.Articulation4. Articulation 4 10/11/2011 5 10/11/2011 BRAIN AREAS AND SPEECH 6 10/11/2011 PRIMARY, SECONDARY AND ASSOCIATION AREAS 7 10/11/2011 ASSOCIATION AREAS These areas receive and analyze signals simultaneously from multiple regions of both the motor and sensory cortices as well as from subcortical structures. The most important association areas are (1) Parieto-occipitotemporal association area (2) prefrontal association area (3) limbic association area. 8 10/11/2011 Broca's Area. A special region in the frontal cortex, called Broca's area, provides the neural circuitry for word formation. This area, is located partly in the posterior lateral prefrontal cortex and partly in the premotor area. It is here that plans and motor patterns for expressing individual words or even short phrases are initiated and executed. 9 10/11/2011 PARIETO-OCCIPITOTEMPORAL ASSOCIATION AREAS • 1. Analysis of the Spatial Coordinates of the Body. -
Diseases of the Digestive System (KOO-K93)
CHAPTER XI Diseases of the digestive system (KOO-K93) Diseases of oral cavity, salivary glands and jaws (KOO-K14) lijell Diseases of pulp and periapical tissues 1m Dentofacial anomalies [including malocclusion] Excludes: hemifacial atrophy or hypertrophy (Q67.4) K07 .0 Major anomalies of jaw size Hyperplasia, hypoplasia: • mandibular • maxillary Macrognathism (mandibular)(maxillary) Micrognathism (mandibular)( maxillary) Excludes: acromegaly (E22.0) Robin's syndrome (087.07) K07 .1 Anomalies of jaw-cranial base relationship Asymmetry of jaw Prognathism (mandibular)( maxillary) Retrognathism (mandibular)(maxillary) K07.2 Anomalies of dental arch relationship Cross bite (anterior)(posterior) Dis to-occlusion Mesio-occlusion Midline deviation of dental arch Openbite (anterior )(posterior) Overbite (excessive): • deep • horizontal • vertical Overjet Posterior lingual occlusion of mandibular teeth 289 ICO-N A K07.3 Anomalies of tooth position Crowding Diastema Displacement of tooth or teeth Rotation Spacing, abnormal Transposition Impacted or embedded teeth with abnormal position of such teeth or adjacent teeth K07.4 Malocclusion, unspecified K07.5 Dentofacial functional abnormalities Abnormal jaw closure Malocclusion due to: • abnormal swallowing • mouth breathing • tongue, lip or finger habits K07.6 Temporomandibular joint disorders Costen's complex or syndrome Derangement of temporomandibular joint Snapping jaw Temporomandibular joint-pain-dysfunction syndrome Excludes: current temporomandibular joint: • dislocation (S03.0) • strain (S03.4) K07.8 Other dentofacial anomalies K07.9 Dentofacial anomaly, unspecified 1m Stomatitis and related lesions K12.0 Recurrent oral aphthae Aphthous stomatitis (major)(minor) Bednar's aphthae Periadenitis mucosa necrotica recurrens Recurrent aphthous ulcer Stomatitis herpetiformis 290 DISEASES OF THE DIGESTIVE SYSTEM Diseases of oesophagus, stomach and duodenum (K20-K31) Ill Oesophagitis Abscess of oesophagus Oesophagitis: • NOS • chemical • peptic Use additional external cause code (Chapter XX), if desired, to identify cause. -
Neurological Examination
Neurology Examination Dr. Bandar Al Jafen, MD Head of Neurology Assistant Professor Consultant Neurologist and Epileptologist King Saud University, Riyadh Objectives • Understand neurological examination • Perform a neurological examination • Higher function • Cranial nerves • Motor system • Sensory system • Interpret neurological examination Examination of higher mental functions and sensory examination Examination of higher mental functions Mental Status • Handedness • Alertness • Attention • Orientation – Person, Place, Time • Cognitive function • Perception – Illusions = misinterpretations of real external stimuli – Hallucinations = subjective sensory perceptions in the absence of stimuli • Judgment • Memory – Short-term & long-term • Speech – Rate & rhythm – Spontaneity – Fluency – Simple vs. complex Testing Cognitive Function • Information & vocabulary – Common • Calculating – Simple math – Word problems • Abstract thinking – Proverbs – Similarities/differences • Construction – Copy figures of increasing difficulty (i.e. circle, clock) Bedside memory testing is limited! Testing requires alertness and is not possible in a confused or dysphasic patient! • Short-term memory – DIGIT SPAN TEST – ask the patient to repeat a sequence of 5, 6, or 7 random numbers. • Long-term memory – ask the patient to describe present illness, duration of hospital stay or recent events in the news (RECENT MEMORY), ask about events and circumstances occuring more than five years previously (REMOTE MEMORY). • Verbal memory – ask the patient to remember a sentence or a short story and test after 15 minutes. • Visual memory – ask the patient to remember objects on a tray and test after 15 minutes Memory episodic m. (autobiographic data) (mesiotemporal regions – hipp,entorh, perirh, GP) long-term m. (> 1 min) Explicite memory semantic m. (declarative) (encyclopedic knowledge) (more extensive reg. – MT+LT,P,O) (visual x verbal, recallF x recognition) short-term (working) m. -
Abadie's Sign Abadie's Sign Is the Absence Or Diminution of Pain Sensation When Exerting Deep Pressure on the Achilles Tendo
A.qxd 9/29/05 04:02 PM Page 1 A Abadie’s Sign Abadie’s sign is the absence or diminution of pain sensation when exerting deep pressure on the Achilles tendon by squeezing. This is a frequent finding in the tabes dorsalis variant of neurosyphilis (i.e., with dorsal column disease). Cross References Argyll Robertson pupil Abdominal Paradox - see PARADOXICAL BREATHING Abdominal Reflexes Both superficial and deep abdominal reflexes are described, of which the superficial (cutaneous) reflexes are the more commonly tested in clinical practice. A wooden stick or pin is used to scratch the abdomi- nal wall, from the flank to the midline, parallel to the line of the der- matomal strips, in upper (supraumbilical), middle (umbilical), and lower (infraumbilical) areas. The maneuver is best performed at the end of expiration when the abdominal muscles are relaxed, since the reflexes may be lost with muscle tensing; to avoid this, patients should lie supine with their arms by their sides. Superficial abdominal reflexes are lost in a number of circum- stances: normal old age obesity after abdominal surgery after multiple pregnancies in acute abdominal disorders (Rosenbach’s sign). However, absence of all superficial abdominal reflexes may be of localizing value for corticospinal pathway damage (upper motor neu- rone lesions) above T6. Lesions at or below T10 lead to selective loss of the lower reflexes with the upper and middle reflexes intact, in which case Beevor’s sign may also be present. All abdominal reflexes are preserved with lesions below T12. Abdominal reflexes are said to be lost early in multiple sclerosis, but late in motor neurone disease, an observation of possible clinical use, particularly when differentiating the primary lateral sclerosis vari- ant of motor neurone disease from multiple sclerosis. -
Eyes and Stroke: the Visual Aspects of Cerebrovascular Disease
Open Access Review Stroke Vasc Neurol: first published as 10.1136/svn-2017-000079 on 6 July 2017. Downloaded from Eyes and stroke: the visual aspects of cerebrovascular disease John H Pula,1 Carlen A Yuen2 To cite: Pula JH, Yuen CA. Eyes ABSTRACT to the LGBs,1 5 6 the terminal anastomosis is and stroke: the visual aspects of A large portion of the central nervous system is dedicated vulnerable to ischaemia.7 Optic radiations cerebrovascular disease. Stroke to vision and therefore strokes have a high likelihood 2017; : originate from the lateral geniculate nucleus and Vascular Neurology 2 of involving vision in some way. Vision loss can be the e000079. doi:10.1136/svn- (LGN) and are divided into superior, inferior, 2017-000079 most disabling residual effect after a cerebral infarction. and central nerve fibres. The optic radiations Transient vision problems can likewise be a harbinger of are predominantly supplied by the posterior stroke and prompt evaluation after recognition of visual and middle cerebral arteries1 and the AChA.6 Received 12 March 2017 symptoms can prevent future vascular injury. In this review, Inferior fibres, known as Meyer’s Loop,6 travel Revised 30 May 2017 we discuss the visual aspects of stroke. First, anatomy and Accepted 2 June 2017 the vascular supply of the visual system are considered. to the temporal lobe, while the superior and Published Online First Then, the different stroke syndromes which involve vision central nerve fibre bundles travel to the pari- 6 July 2017 1 are discussed. Finally, topics involving the assessment, etal lobes. The termination of optic radia- prognosis, treatment and therapeutic intervention of vision- tions is located in the visual striate cortex (V1) specific stroke topics are reviewed. -
A Dictionary of Neurological Signs
FM.qxd 9/28/05 11:10 PM Page i A DICTIONARY OF NEUROLOGICAL SIGNS SECOND EDITION FM.qxd 9/28/05 11:10 PM Page iii A DICTIONARY OF NEUROLOGICAL SIGNS SECOND EDITION A.J. LARNER MA, MD, MRCP(UK), DHMSA Consultant Neurologist Walton Centre for Neurology and Neurosurgery, Liverpool Honorary Lecturer in Neuroscience, University of Liverpool Society of Apothecaries’ Honorary Lecturer in the History of Medicine, University of Liverpool Liverpool, U.K. FM.qxd 9/28/05 11:10 PM Page iv A.J. Larner, MA, MD, MRCP(UK), DHMSA Walton Centre for Neurology and Neurosurgery Liverpool, UK Library of Congress Control Number: 2005927413 ISBN-10: 0-387-26214-8 ISBN-13: 978-0387-26214-7 Printed on acid-free paper. © 2006, 2001 Springer Science+Business Media, Inc. All rights reserved. This work may not be translated or copied in whole or in part without the written permission of the publisher (Springer Science+Business Media, Inc., 233 Spring Street, New York, NY 10013, USA), except for brief excerpts in connection with reviews or scholarly analysis. Use in connection with any form of information storage and retrieval, electronic adaptation, computer software, or by similar or dis- similar methodology now known or hereafter developed is forbidden. The use in this publication of trade names, trademarks, service marks, and similar terms, even if they are not identified as such, is not to be taken as an expression of opinion as to whether or not they are subject to propri- etary rights. While the advice and information in this book are believed to be true and accurate at the date of going to press, neither the authors nor the editors nor the publisher can accept any legal responsibility for any errors or omis- sions that may be made. -
26 Aphasia, Memory Loss, Hemispatial Neglect, Frontal Syndromes and Other Cerebral Disorders - - 8/4/17 12:21 PM )
1 Aphasia, Memory Loss, 26 Hemispatial Neglect, Frontal Syndromes and Other Cerebral Disorders M.-Marsel Mesulam CHAPTER The cerebral cortex of the human brain contains ~20 billion neurons spread over an area of 2.5 m2. The primary sensory and motor areas constitute 10% of the cerebral cortex. The rest is subsumed by modality- 26 selective, heteromodal, paralimbic, and limbic areas collectively known as the association cortex (Fig. 26-1). The association cortex mediates the Aphasia, Memory Hemispatial Neglect, Frontal Syndromes and Other Cerebral Disorders Loss, integrative processes that subserve cognition, emotion, and comport- ment. A systematic testing of these mental functions is necessary for the effective clinical assessment of the association cortex and its dis- eases. According to current thinking, there are no centers for “hearing words,” “perceiving space,” or “storing memories.” Cognitive and behavioral functions (domains) are coordinated by intersecting large-s- cale neural networks that contain interconnected cortical and subcortical components. Five anatomically defined large-scale networks are most relevant to clinical practice: (1) a perisylvian network for language, (2) a parietofrontal network for spatial orientation, (3) an occipitotemporal network for face and object recognition, (4) a limbic network for explicit episodic memory, and (5) a prefrontal network for the executive con- trol of cognition and comportment. Investigations based on functional imaging have also identified a default mode network, which becomes activated when the person is not engaged in a specific task requiring attention to external events. The clinical consequences of damage to this network are not yet fully defined. THE LEFT PERISYLVIAN NETWORK FOR LANGUAGE AND APHASIAS The production and comprehension of words and sentences is depen- FIGURE 26-1 Lateral (top) and medial (bottom) views of the cerebral dent on the integrity of a distributed network located along the peri- hemispheres. -
Clinical Neuroanatomy Brain & Eyes
Clinical Neuroanatomy Part I: Brain & Eyes Introduction Aliza Ben-Zacharia, DNP, ANP, MSCN The Corinne Goldsmith Dickinson Center for Multiple Sclerosis The Icahn School of Medicine Mount Sinai Medical Center Clinical Neuroanatomy Brain & Eyes Objectives •Identify the anatomical structures of the central nervous system in the Cerebral Hemispheres and structures involved in CNS function •Develop a rational, systematic approach to localization in clinical neurology •Recognize those areas of the Brain and Eyes involved in the development of common symptoms of multiple sclerosis Localization of Symptoms Cognitive loss Emotional disinhibition Tremor Ataxia Diplopia Vertigo Dysarthria Sensory symptoms L’Hermitte’s phenomenon Bladder Proprioception dysfunction Adapted from Miller AE. In: Cook SD, ed. Handbook of Multiple Sclerosis. New York, NY: Taylor & Francis Group: 2001:213-232. Localization Tips • The neurological approach to localization within the nervous system is: – Take note of all symptoms and signs – For each, consider what system(s) or pathway(s) is(are) implicated – For each, decide on the potential location a lesion could be & the side of the lesion; focal vs. multifocal – Adding up this analysis for each S/S, we then ask "Where in the nervous system can each of these localizations overlap?" The answer is the location of the current problem! One lesion vs. 2 or more lesions! Localization in Neurology • The principal of "garbage in-garbage out" does apply: if you fail to identify the clinical signs correctly, then you will be unable