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Second Edition PRINCIPLES OF NEUROPSYCHOLOGY Eric A. Zillmer Drexel University Mary V. Spiers Drexel University William C. Culbertson Drexel University Australia | Brazil | Canada | Mexico | Singapore | Spain | United Kingdom | United States Principles of Neuropsychology, Second Edition Eric A. Zillmer, Mary V. Spiers, William C. Culbertson Acquisitions Editor: Erik Evans Permissions Editor: Robert Kauser Assistant Editor: Gina Kessler Production Service: Graphic World Inc. Editorial Assistant: Christina D. Ganim Photo Researcher: Terri Wright Technology Project Manager: Lauren Keyes Copy Editor: Graphic World Inc. Marketing Manager: Sara Swangard Illustrator: International Typesetting and Composition Marketing Assistant: Melanie Cregger Cover Designer: Denise Davidson Senior Marketing Communications Manager: Linda Yip Cover Image: © UHB Trust/Getty Images Content Project Manager: Christy Krueger Cover Printer: Thomson West Creative Director: Rob Hugel Compositor: International Typesetting and Composition Senior Art Director: Vernon Boes Printer: Thomson West Senior Print Buyer: Rebecca Cross © 2008, 2001 Thomson Wadsworth, a part of The Thomson Thomson Higher Education Corporation. Thomson, the Star logo, and Wadsworth are 10 Davis Drive trademarks used herein under license. Belmont, CA 94002-3098 USA ALL RIGHTS RESERVED. No part of this work covered by the copyright hereon may be reproduced or used in any form or by any means—graphic, electronic, or mechanical, including For more information about our products, contact us at: photocopying, recording, taping, Web distribution, informa- Thomson Learning Academic Resource Center tion storage and retrieval systems, or in any other manner— 1-800-423-0563 without the written permission of the publisher. For permission to use material from this text or product, Printed in the United States of America submit a request online at 12345671110090807 http://www.thomsonrights.com. Any additional questions about permissions can be submit- Library of Congress Control Number: 2007920598 ted by e-mail to [email protected]. ISBN-13: 978-0-495-00376-2 ISBN-10: 0-495-00376-X This book is dedicated to the memory of Carl R. Pacifico Drexel Alumnus, Class of ’44 Friend, Mentor, Benefactor E.A.Z. This book is dedicated to my father. His guidance as a psychologist and his personal struggle with Parkinson’s disease have brought some of my greatest lessons. M.V.S. This book is dedicated to my wife and daughter, my greatest gifts. W.C.C. This page intentionally left blank BRIEF CONTENTS Part One Introduction 1 Chapter 1 A History of Neuropsychology 3 Chapter 2 Methods of Investigating the Brain 32 Chapter 3 Neuropsychological Assessment and Diagnosis 62 Part Two The Functioning Brain 91 Chapter 4 Cells of Thought 93 Chapter 5 Functional Neuroanatomy 114 Chapter 6 Cerebral Specialization 154 Chapter 7 Somatosensory, Chemical, and Motor Systems 176 Chapter 8 Vision and Language 199 Chapter 9 Memory, Attention, Emotion, and Executive Functioning 224 Part Three Disorders of the Brain 267 Chapter 10 Developmental Disorders of Childhood 269 Chapter 11 Learning and Neuropsychiatric Disorders of Childhood 297 Chapter 12 Cerebrovascular Disorders and Tumors 339 Chapter 13 Traumatic Head Injury and Rehabilitation 369 Chapter 14 Normal Aging and Dementia: Alzheimer’s Disease 399 Chapter 15 Subcortical Dementias 423 Chapter 16 Alterations of Consciousness 443 v This page intentionally left blank CONTENTS Part One INTRODUCTION 1 Chapter 1 A History of Neuropsychology 3 Keep in Mind 4 Overview 4 The Brain in Antiquity: Early Hypotheses 5 Ancient Greek Perspectives 6 The Cell Doctrine 7 Anatomic Discoveries and the Role of the Spiritual Soul 8 Non-Western Attitudes 12 Localization Theory 13 Phrenology and Faculty Psychology 13 The Era of Cortical Localization 16 Critics of Cortical Localization 18 Localization versus Equipotentiality 20 Integrated Theories of Brain Function 20 Jackson’s Alternative Model 20 Luria’s Functional Model 21 Modern Neuropsychology 24 Emerging Research Areas in Neuropsychology 27 Forensic Neuropsychology 28 Sports Neuropsychology 28 Terrorism, Law Enforcement, and the Military 28 Summary 30 Critical Thinking Questions 30 Key Terms 30 Web Connections 30 Neuropsychology in Action 1.1 The Brain of a Nazi 15 1.2 Paul Broca: A Manner of Not Speaking 17 1.3 Sigmund Freud: The Neurologist 19 1.4 The Walter Freeman Lobotomies: Mind over Matter? 22 Chapter 2 Methods of Investigating the Brain 32 Keep in Mind 33 Overview 33 Neurohistology Techniques 34 Golgi Stain 34 Nissl Stain 34 Other Staining Techniques 35 vii viii Contents Radiologic Procedures 35 Skull X-Ray 36 Air Encephalography (Pneumoencephalography) 36 Computed Transaxial Tomography 36 Angiography 38 Sodium Amytal Injections (Wada Technique) 40 Electrophysiologic Procedures 40 Electroencephalography 40 Evoked Potential 44 Electrical Stimulation 45 Electromyography 47 Imaging of Brain Metabolism 47 Regional Cerebral Blood Flow 47 Single-Photon Emission Computed Tomography 48 Positron Emission Tomography 49 Magnetic Imaging Procedures 51 Magnetic Resonance Imaging 51 Magnetoencephalography 56 Cerebrospinal Fluid Studies: Lumbar Puncture 56 Behavioral Examinations 56 Neurologic Examination 56 Neuropsychological Evaluation 57 New Advances in Imaging Techniques: Mapping the Brain 57 Subtraction Procedures 57 Image Analysis and Quantification (Three-Dimensional) 57 Future Directions 58 Summary 60 Critical Thinking Questions 61 Key Terms 61 Web Connections 61 Neuropsychology in Action 2.1 Case Example of Brainstem Auditory-Evoked Response 46 2.2 Undergoing a Magnetic Resonance Imaging Procedure 52 2.3 New Frontiers in Functional Magnetic Resonance Imaging 54 2.4 Diagnostic Neuroimaging and Neuropsychology 59 Chapter 3 Neuropsychological Assessment and Diagnosis 62 Keep in Mind 63 Overview 63 General Considerations in Neuropsychological Testing 63 Why Testing? 64 Rationale of the Neuropsychological Examination 65 Appropriate Referrals for Neuropsychological Evaluation 66 Psychometric Issues in Neuropsychological Assessment 66 Reliability 67 Validity 67 False Positives and Base Rates 67 Contents ix Neuropsychological Tests 68 Orientation (Arousal) 69 Sensation and Perception 70 Attention/Concentration 71 Motor Skills 72 Verbal Functions/Language 73 Visuospatial Organization 74 Memory 75 Judgment/Problem Solving 76 Neuropsychological Diagnosis 78 Describing Function, Adaptation, and Prognosis 79 Interpreting Neuropsychological Assessment Data 79 Approaches to Neuropsychological Interpretation 80 Assessing Level of Performance 84 Deficit Measurement 86 Lateralizing Signs 88 Pathognomonic Signs (Qualitative Observations) 88 Summary 89 Critical Thinking Questions 89 Key Terms 89 Web Connections 89 Neuropsychology in Action 3.1 Case Example: The Neuropsychology of Lyme Disease 86 Part Two THE FUNCTIONING BRAIN 91 Chapter 4 Cells of Thought 93 Keep in Mind 94 Overview 94 Neurons and Glial Cells 94 Structure and Function of the Neuron 95 Glial Cells 99 Communication within a Neuron: The Neural Impulse 102 Resting Membrane Potential 102 Action Potential 102 Communication among Neurons 105 Structure of Synapses 105 Synaptic Transmission 105 Neurotransmitters 106 Regeneration of Neurons 110 Summary 112 Critical Thinking Questions 112 Key Terms 112 Web Connections 113 Neuropsychology in Action 4.1 Short-Circuiting Neurons: Multiple Sclerosis 98 4.2 Neuronal Firing: Clinical Examples 104 x Contents 4.3 What Can We Learn from Songbirds? 109 4.4 Stem Cell Research: Science and Ethics 110 Chapter 5 Functional Neuroanatomy 114 Keep in Mind 115 Overview 115 Anatomic and Functional Development of the Brain 116 Neurogenesis and Cellular Migration 116 Axon and Dendrite Development 117 Synaptogenesis 117 Myelination 117 Pruning 118 Regional Development 118 Lobular and Convolutional Development 118 Ventricular and Spinal Cord Development 119 Postnatal Development 120 Organization of the Nervous System 121 Peripheral Nervous System 122 Central Nervous System 122 Brain 122 Spinal Cord 123 Gross Anatomy: Protection and Sustenance of the Brain 124 Skull 125 Meninges 125 Ventricular System 127 Vascular System 131 Cerebral Arteries 132 Venous System 133 Principal Divisions of the Brain 133 Brainstem and Cerebellum 134 Lower Brainstem 137 Upper Brainstem: Diencephalon 141 Cerebellum 146 Telencephalon 147 Basal Ganglia 147 Limbic System 149 Corpus Callosum 151 Summary 152 Critical Thinking Questions 152 Key Terms 152 Web Connections 153 Chapter 6 Cerebral Specialization 154 Keep in Mind 155 Overview 155 The Cerebral Hemispheres 155 Structure 155 Contents xi Function 159 Asymmetry, Lateralization, and Dominance 161 Hemispheric Anatomic and Functional Differences 163 Neuropsychological and Behavioral Cerebral Differences 166 Sex Differences and Hemispheric Specialization 167 Sexual Hormones 171 Summary 175 Critical Thinking Questions 175 Key Terms 175 Web Connections 175 Neuropsychology in Action 6.1 The Evolution of the Brain: A Focus on Brain Size 156 6.2 A Land Where Girls Rule in Math 172 Chapter 7 Somatosensory, Chemical, and Motor Systems 176 Keep in Mind 177 Overview 177 Somatosensory Processing 178 Chemical Senses 184 Taste 184 Smell 187 Motor Systems 189 Cortical Motor Processing 189 The Cerebellum and Motor Processing 195 Subcortical Motor Processing 195 Summary 197 Critical Thinking Questions 197 Key Terms 197 Web Connections 198 Neuropsychology in Action 7.1 Synesthesia: Melded Sensory Integration 179 7.2 Phantoms of Feeling 184 7.3 Tourette Syndrome: Too
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