Transcript Neuropsychology

Neuropsychology
Prepared by:
Cicilia Evi GradDiplSc., M. Psi
The Development
• “Psychology has a long past but a short
history” (Ebbinghaus)
• The same thing can be said for
Neuropsychology
Historical Roots - Egyptians
• Ancient Egyptians believed that heart and
diaphragm were the seats of mental life
(Feinberg & Farah, 1997)
• Heart, liver, spleen and other organs were
carefully removed from dead body and stored
in separate jars  while the brain was simply
discarded  considered unimportant (Rains,
2002)
• The first recorded evidence on brain –
behavior relationship: The Edwin Smith
Surgical Papyrus (2000 B.C.)  was misleading
• The impairments were ipsilateral to the lesion
(same side) rather than contralateral (opposite
side)
• Egyptian observers didn’t take theoretical leap
despite their findings
Historical Roots – Greeks
• Alcmaeon of Croton (500 BC)  the first
neurologist or neuropsychologist  proposed
that the brain is ‘the seat of the soul’
• Plato (400 BC)  similar proposal: the head is
part of the body closest to heaven and
therefore most likely to contain the most
divine organ
• On the other hand  pitfalls of rationalism
• Empedocles (500BC)  heart was ‘the seat of
the soul’
• Aristotle (400BC) agreed:
– Brain with its elaborate network of blood vessels
and its position near the surface of the body 
served to cool the blood
– Heart, being an active and central structure was
more suitable as the organ of feeling and thinking
• Hippocrates (400 BC) had his brain hypothesis 
brain was responsible for the intellect, senses,
knowledge, emotions and even mental illness
(Adams, 1932)
• In ‘On The Sacred Disease’  epilepsy is a
medical condition, not demonic possession
• Found contralateral relationship
– Head injury on the left side  seizure on the right
side
– Head injury on the left side  speech impairments
Historical Roots
• Romans accepted the brain hypothesis
• Localization of function  where in the brain
various psychological functions (perception,
memory and thinking) take place?
• Galen of Pergamus  cerebral ventricles,
fluid-filled cavities deep within the brain, were
the structures in which thinking and other
psychological processes were localized
• Nemesius (4th century)  ventricular
hypothesis  assigning different psychological
processes to locations within different
ventricles
– Cellula phantastica  seat of perception
– Cellula logistica  seat of reasoning and cognition
– Cellula memoralis  seat of memory
• This theory was lack of empirical support …
until 19th century
Mind – Body Problem
• Monism  hold to one belief, either physical
(materialism) or spiritual (idealism)
• Dualism  Rene Descartes  there is brain and
there is mind, independent of each other but
they interact.
– Pineal gland  organ that mediate the interaction
– No localization of function  because the mind was
not localized, wasn’t in space at all
• Holism  whole brain mediates all functioning
Modern Neuropsychology
• Franz Joseph Gall and Johann Casper
Spurzheim  phrenology  relating specific
brain regions to particular faculties or
functions  no precise definition or empirical
basis
• Jean Baptiste Bouillaud  left-hemisphere
specialize for motor dexterity, underlying
right-handedness, also specialized movements
involved in speech
Modern Neuropsychology (2)
• Paul Broca
• A patient, Leborgne called ‘Tan’  epileptic, right
hemiplegia and loss of speech for over 20 years
 understood language, not demented,
responded accurately to questions asked through
gestures, such as his age  after his dead, found
a lesion on his left hemisphere
• In 1865  Broca concluded that left hemisphere
is dominant for language
• Marc Dax’s view
Definition
• Meier (1974)  Neuropsychology is the
scientific study of brain – behavior
relationships
• Subfields: clinical neuropsychology,
experimental neuropsychology, behavioral
neurology, and behavioral neuropsychology
Clinical Neuropsychology
• The application of our understanding of human
brain – behavior relationships to clinical problems
(Horton, Wedding & Phay, 1981)
• Clinical Neuropsychologist is a professional
psychologist with diagnostic skills and
psychometric expertise applicable to behavioral
dysfunction associated with CNS dysfunction
• Halstead – Reitan Neuropsychology Battery and
Luria – Nebraska Neuropsychology Battery
Experimental Neuropsychology
• Elucidation of basic brain – behavior
relationship (Horton, Wedding & Phay, 1981)
• Focus on theoretical questions rather than
practical ones  nonhuman subjects
• Degree of generality depends on the species
and area of psychology under study
Behavioral Neurology
• Concerned with clinical application of
scientific knowledge  using qualitative,
intuitive approach
• Contrast with clinical neuropsychology which
used psychometric and quantitative approach
• Traditional medical case study approach 
assumes the practitioner has considerable
clinical expertise and thorough understanding
of neural structure and function
Behavioral Neuropsychology
• Horton (1979)  the application of behavior
therapy techniques to problems of organically
impaired individuals while using a
neuropsychological assessment and
intervention perspective
• Emphasis on the problems of management,
retraining, and rehabilitation
Psychometric Approach to
Neuropsychology
• Case study approach  revealed in-depth
study of single individual case  but we need
more …
• Group Studies  started at 40-50s  allowed
the formation of control groups to reveal the
nature of impairments associated with a
particular lesion  result: quantitative
definitions of impairments and sensitivity of
specific tests to the presence of impairments
• Statistical analyses  used to quantify the
probability that a group with a particular lesion is
performing at a lower level than a control group
on a particular task  help us to understand
cerebral organization of psychological processes
• Also provide a basis for making inferences
regarding the presence of cognitive impairments
and associated cerebral abnormality in that
individual (Reitan & Davidson, 1974)  provide a
set of procedures in diagnosis and rehabilitation
(Lezak, 1995)
Case Study?
• Still effective in very rare disorders (agnosia or
aphasia)  provide a vivid and detailed
description of the impairment that is often lost in
the analysis of group data
• Individual differences and avoid overgeneralized
appraisal of the effects of particular lesions
• Group study defined on the basis of lesion sites
 may comprise subjects with widely varying
lesion sites  erroneous interpretation
Summary
• Erroneous idea of mind-body relationship can
remain widely accepted for long periods
• Establishment of localization of function within
cerebral cortex and the specialization of left
hemisphere for language  mid 19th century
• An awareness of historical antecedents of current
controversies helps place them in perspective and
provides a framework for possible resolutions