Introduction to Physiological Psychology Review
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Case Study 1 & 2
CASE Courtesy of: STUDY Mitchell S.V. Elkind, MD, Columbia University 1 & 2 and Shadi Yaghi, MD. Brown University CASE 1 CASE 1 A 20 year old man with no past medical history presented to a primary stroke center with sudden left sided weakness and imbalance followed by decreased level of consciousness. Head CT showed no hemorrhage, no acute ischemic changes, and a hyper-dense basilar artery. CT angiography showed a mid-basilar occlusion. CASE 1 CONTINUED Head CT showed no hemorrhage, no acute ischemic changes, and a hyper-dense basilar artery (Figure 1, arrow). CT angiography showed a mid-basilar occlusion (Figure 2, arrow). INFORMATION FOR PATIENTS Fig. 1 AND FAMILIESFig. 2 CASE 1 CONTINUED He received Alteplase intravenous tPA and was transferred to a comprehensive stroke center where angiography confirmed mid-basilar occlusion (Figure 3, arrow ). He underwent mechanical thrombectomy (Figure 4) with recanalization of the basilar artery. His neurological exam improved and he was discharged to home after 2 days. At his 3 month follow up, he was back to normal and returned to college. Fig. 3 Fig. 4 CASE 2 CASE 2 A 62 year old woman with a history of hypertension and hyperlipidemia presented to a primary stroke center with sudden onset of weakness of the right side. On examination, she had a global aphasia, left gaze preference, right homonymous hemianopsia (field cut), right facial droop, dysarthria, and right hemiplegia (NIH Stroke Scale = 22). Head CT showed only equivocal hypodensity in the left middle cerebral artery territory (Figure 1 on next slide). CT angiography showed a left middle cerebral artery occlusion (Figure 2 on next slide, arrow). -
Classification of Aphasic Phenomena
LE JOURNAL CANAD1EN DES SCIENCES NEUROLOG1QUES Classification of Aphasic Phenomena ANDREW KERTESZ SUMMARY: A brief but comprehensive Most clinicians will agree that al tions cover the same phenomenon. survey of classifying aphasia reveals though aphasic disability is complex, In Table I the various terms are that most investigators describe at least many patients are clinically similar shown to overlap and those describ four major groups, conveniently labelled and may be classified into identifi ing the same disturbance appear un Broca's, Wernicke's, anomic and global. able groups. There are many classi derneath each other. Four columns Conduction and transcortical aphasias fications indicating that none is al appear to represent the entities that are less generally described and mod ality specific syndromes rarely, if ever, together satisfactory. Nevertheless, almost everybody identifies: exist purely. The controversy between this effort is useful and even neces 1. What Broca (1861) described as unifiers and splitters continues but ob sary to diagnose and treat aphasics aphemia, Wernicke (1874) called jective numerical taxonomy may solve and to understand the phenomena. motor aphasia. Marie (1906) did not some of the problems of classification. The opponents of classification consider Broca's aphemia true point out the numerous disagree aphasia. Pick (1913) labelled it ex ments among observers, the many pressive aphasia with agrammatism RESUME: Line etude breve, mais com exceptions that cannot be fitted into and Weisenburg & McBride (1935) prehensive, de la classification de categories and the frequent evolu popularized "expressive aphasia" I'aphasic revile que la plupart des cher- cheurs decrivent au moins 4 groupes tion of certain types into others. -
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. -
A Young Woman with Sudden Hemiparesis
f Clin al o ica rn l & ISSN : 2376-0249 u o M J e l d a i c n International Journal of a o l i Vol 5 • Iss 3• 1000601 Mar, 2018 t I m a n a r g e t i n n I g DOI: 10.4172/2376-0249.1000601 ISSN: 2376-0249 Clinical & Medical Images Case Report A Young Woman with Sudden Hemiparesis Monique Boukobza* and Jean-Pierre Laissy Department of Radiology, Assistance Publique-Hôpitaux de Paris, Bichat Hospital, Paris, France (1) (2) (3) (4) (5) (6) Figure 1: Diffusion weighted imaging (DWI) shows hyperintensity indicative of core infarction on MRI within less than 3 h after onset. Figure 2: Fluid-attenuated inversion recuperation imaging-Hyperintense vessels proximal to the sylvian fissure. Figure 3: Fluid-attenuated inversion recuperation imaging-Hyperintense vessels distal to the sylvian fissure. Figure 4: Magnetic resonance angiography-Severe vasospasm of the left internal carotid artery (short arrow) and middle cerebral artery (M1 segment) (long arrow). Figure 5: Digital subtraction angiography-Severe vasospasm (long arrow) and small aneurysm of the left anterior choroidal artery of 10 mm of diameter (short arrow). Figure 6: Magnetic resonance angiography follow-up-Exclusion of the aneurysm and normal caliber of the cerebral arteries. Abstract Stroke related to cerebral vasospasm may have the same appearance that ischemic stroke of other causes. The correct diagnosis is critical to avoid inappropriate treatments as thombolysis and anticoaglant therapy. In this case, a previous young healthy woman presented with acute onset of right-sided hemiplegia and expressive aphasia. Interpretation of Magnetic Resonance Images was challenging: acute ischemia, severe vasospasm, no signs of subarachnoid hemorrhage or intra-arterial thrombi, no evidence of cervical artery dissection. -
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. -
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. -
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. -
High-Yield Neuroanatomy, FOURTH EDITION
LWBK110-3895G-FM[i-xviii].qxd 8/14/08 5:57 AM Page i Aptara Inc. High-Yield TM Neuroanatomy FOURTH EDITION LWBK110-3895G-FM[i-xviii].qxd 8/14/08 5:57 AM Page ii Aptara Inc. LWBK110-3895G-FM[i-xviii].qxd 8/14/08 5:57 AM Page iii Aptara Inc. High-Yield TM Neuroanatomy FOURTH EDITION James D. Fix, PhD Professor Emeritus of Anatomy Marshall University School of Medicine Huntington, West Virginia With Contributions by Jennifer K. Brueckner, PhD Associate Professor Assistant Dean for Student Affairs Department of Anatomy and Neurobiology University of Kentucky College of Medicine Lexington, Kentucky LWBK110-3895G-FM[i-xviii].qxd 8/14/08 5:57 AM Page iv Aptara Inc. Acquisitions Editor: Crystal Taylor Managing Editor: Kelley Squazzo Marketing Manager: Emilie Moyer Designer: Terry Mallon Compositor: Aptara Fourth Edition Copyright © 2009, 2005, 2000, 1995 Lippincott Williams & Wilkins, a Wolters Kluwer business. 351 West Camden Street 530 Walnut Street Baltimore, MD 21201 Philadelphia, PA 19106 Printed in the United States of America. All rights reserved. This book is protected by copyright. No part of this book may be reproduced or transmitted in any form or by any means, including as photocopies or scanned-in or other electronic copies, or utilized by any information storage and retrieval system without written permission from the copyright owner, except for brief quotations embodied in critical articles and reviews. Materials appearing in this book prepared by individuals as part of their official duties as U.S. government employees are not covered by the above-mentioned copyright. To request permission, please contact Lippincott Williams & Wilkins at 530 Walnut Street, Philadelphia, PA 19106, via email at [email protected], or via website at http://www.lww.com (products and services). -
Neurophysiology of Communication
Neurophysiology of Communication Presented by: Neha Sharma MD Date: October 11, 2019 What is Communication? Ø The imparting or exchange of information Ø Auditory, Language, Speech, and Comprehension Ø Focus of presentation – how language and speech are perceived and comprehended by the brain Neurophysiology of Hearing Neurophysiology of Hearing Ø Frequency of sound as speech (sound waves) Ø Frequency of speech is 60-500 Hz Ø Males – 85-180 Hz; Female – 165-255 Hz Ø Ear picks up 20-20,000 Hz Animal Frequencies Animal Vocal Frequency (Hearing Frequency) Elephants 14-24 Hz (14-12,000 Hz) Dogs 1,000-2,000 Hz (67-45,000 Hz) Birds 1,000-8,000 Hz (200-8,500 Hz) Ants 1,000 Hz (500-1500 Hz) Mice/Rats 20,000-100,000 Hz (1,000-100,000 Hz) Cow 70-7,000 Hz (16-40,000 Hz) Bats 50,000-160,000 Hz (2,000-110,000 Hz) Torrent Frog 128,000 Hz (38,000 Hz) Katydid 138,000 Hz-150,000 Hz (15,000-50,000 Hz) Dolphins 175,000 Hz (75-150,000 Hz) Wax Moth 300,000 Hz (300,000 Hz) Auditory Anatomy https://endoplasmiccurriculum.wordpress.com/2012/03/09/internal-ear-anatomy/ Neurophysiology of Hearing Ø Sound waves transmit through the air to the ear Ø Travels through external acoustic meatus to auditory canal to tympanic membrane Ø Oscillate against the ossicles which causes vibration of the oval window Ø Stimulating the cochlea which converts the vibration into electrical signals Ø Hair cells move upwards and forwards causing depolarization of the basilar membrane Ø Due to perturbation of basilar membrane against tectorial membrane Ø Inner hair cells – discriminate -
Isolated Traumatic Expressive Aphasia
UC Irvine Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health Title Isolated Traumatic Expressive Aphasia Permalink https://escholarship.org/uc/item/1691788n Journal Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health, 12(1) ISSN 1936-900X Authors Paulsen, Jeremy Testa, Nicholas Publication Date 2011 License https://creativecommons.org/licenses/by-nc/4.0/ 4.0 Peer reviewed eScholarship.org Powered by the California Digital Library University of California Images In emergency medIcIne Isolated Traumatic Expressive Aphasia Jeremy Paulsen, MD University of Southern California, Los Angeles, CA Nicholas Testa, MD Supervising Section Editor: Sean Henderson, MD Submission history: Submitted April 3, 2010; Revision Received July 23, 2010; Accepted September 27, 2010 Reprints available through open access at http://escholarship.org/uc/uciem_westjem [West J Emerg Med. 2011;12(1):141.] operating room for definitive care. The neurosurgical services followed this patient for two weeks. During that time he was persistently aphasic. He was transferred to a rehabilitation hospital with persistent posttraumatic expressive aphasia. The importance of this case is to remind the clinician that isolated expressive aphasia can be associated with significant head trauma. A Medline1 search for traumatic aphasia reveals prior case reports of aphasia being the presenting sign of subdural hematomas, but only in the subacute presentation. Other studies have reported the presence of aphasia in major brain trauma to be as high as 19%, although all cases were associated with other significant deficits.2 Most literature focuses instead on the rehabilitation potential in traumatic aphasias, which has been consistently reported to have a much higher success when compared to other causes of aphasia.3,4 Address for Correspondence: Nicholas Testa, MD, 1200 North State St, Room 1011, Los Angeles, California 90033.