AIPS

Basics of Neuropsychology

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MODULE 2
 NEUROPLASTICITY
• Neuroplasticity – or brain plasticity – is the ability of the brain to modify its
connections or re-wire itself. Without this ability, any brain, not just the
human brain, would be unable to develop from infancy through to adulthood
or recover from brain injury.
• "Brain plasticity refers to the capacity of the nervous system to change its
structure and its function over a lifetime, in reaction to environmental
diversity.”
• Neuroplasticity allows neurons to regenerate both anatomically as well as
functionally, and to form new synaptic connections. It is the ability for the
brain to recover and restructure itself.
CEREBRAL CORTEX
 What is it?
• The cerebral cortex is the largest region of the cerebrum in the
mammalian brain

• The cerebral cortex is the most anterior brain region and consists of an
outer zone of neural tissue called gray matter, which
contains neuronal cell bodies.

• Plays a key role in memory, attention, perception, cognition,

awareness, thought, language and consciousness.
 STRUCTURE
• Cerebral cortex is formed of one pair, larged sized lobes called Cerebral
Hemisphere, which covers almost all the parts of the brain.

• These form 80% of the weight of the brain.

• Cerebral cortex is demarcated by a median or cerebral fissure.

• The roof of each cerebral hemisphere is called Pallium and is highly folded to
form ridges and depression respectively called gyri (singular-gyrus) and Sulci
(singular-sulcus)
• The gyri increases the surface area of cerebral cortex (about 3 times) formed of grey matter. The
ventro-lateral walls are thick and are called corpora striata.

• White deeper part is called cerebral medulla. It forms the bulk of cerebrum and represents fibre tracts.

• Inside the cerebral medulla, there are different groups of neurons, called nuclei, each of which is
specialized for a specific function.

• The cortex comprises of two hemispheres:- Left and Right.

• The two hemispheres are interconnected by a thick band of transverse nerve fibres called Corpus
Callosum. These are myelinated fibres carrying the messages between the hemispheres.
• The peripheral portion of each cerebral hemisphere is formed of grey matter and is called cerebral
cortex, while the deeper white part is called cerebral medulla.

• Cerebral cortex comprises of fissures and gyri. Most of the information processing happens over
here.

• A few sulci are well developed and form three deep and wide fissures which divide each cerebral
hemisphere into 4 lobes
⮚Lateral fissure(also called fissure of Sylvian)
⮚Central fissure
⮚Parieto-Occipital fissure

• Additionally, the cortical constitutes of the limbic system which is also considered to be a region of
the cerebral hemisphere.
• The cerebral cortex is the highest centre for many sensations and activities and is within the sensory
area. For example:-

1. Motor area- controls the voluntary movements

1. Premotor area- controls the involuntary movements

1. Associated area- controls association between various sensation and movements and is also seat of
learning, memory and communication

1. Somaesthetic area- controls general sensations like pain, touch and temperature

1. Visual area- controls visual sensation

1. Auditory area- controls hearing

 FUNCTIONS
• The cerebral cortex consists of folded bulges called gyri that create deep
furrows or fissures called sulci.
• The folds in the brain add to its surface area and therefore increase the
amount of gray matter and the quantity of information that can be
processed.
• Most information processing occurs in the cerebral cortex. The cerebral
cortex is divided into four lobes that each have a specific function. These
lobes include the frontal lobes, parietal lobes, temporal lobes,
and occipital lobes.
The cerebral cortex is involved in several functions of the body including:
• Determining Intelligence
• Determining Personality
• Motor Function
• Planning and Organization
• Touch Sensation
• Processing Sensory Information
• Language Processing
• The cerebral cortex contains sensory areas and motor areas. Sensory areas receive input from
the thalamus and process information related to the senses.
• They include the visual cortex of the occipital lobe, auditory cortex of the temporal lobe,
gustatory cortex and somatosensory cortex of the parietal lobe. Within the sensory areas are
association areas which give meaning to sensations and associate sensations with specific stimuli.
• Motor areas, including the primary motor cortex and the premotor cortex, regulate voluntary
movement.
 DYSFUNCTIONS
• Apraxia
It is a group of disorders that are characterized by the inability to perform certain motor
tasks, although there is no damage to motor or sensory nerve function. Individuals may
have difficulty walking, be unable to dress themselves or unable to use common objects
appropriately. Apraxia is often observed in those with Alzheimer’s disease, Parkinson's
disorders, and frontal lobe disorders.
• Agraphia
Damage to the cerebral cortex parietal lobe can cause a condition known
as agraphia. These individuals have difficulty writing or are unable to write.
• Ataxia
These types of disorders are characterized by a lack of coordination and balance.
Individuals are unable to perform voluntary muscle movements smoothly. Injury to the
cerebral cortex has also been linked to depressive disorders, difficulty in decision
making, lack of impulse control, memory issues, and attention problems.
 CASE STUDY
• NAME : Peter (The Split-Brain Patient Troubled By Conflict

• Location of Damage: Corpus Callosum

• Peter began to suffer from complex partial seizures at the age of 8. His seizures were severe,
despite taking antiepileptic medication; so, at the age of 20, after struggling with his condition
for over 12 years, he and his doctors agreed to have him undergo a commissurotomy.
• The commissurotomy involved a surgical incision of Peter’s corpus callosum.
• On one hand, Peter’s surgery was a success, as it did end up attenuating the magnitude of his
seizures. On the other hand, however, Peter was left much different than before. For example,
he was not able to respond with the left side of his body to verbal input. If asked to “Stand like
a Boxer,” his left side would sag and appear lackluster, while his right side would behave
appropriately. Because his brain had, literally, been split into two separate pieces, his left and
right sides were often behaving like two separate people. He complained that his left hand
would turn off television shows that he was enjoying, that his left leg would not always walk in
the intended direction, and that his left arm would occasionally begin to fight with the right
side of his body. It is clear from Peter’s case that the brain works best when it is capable of
functioning as a single, cohesive unit, as opposed to multiple ones
 LOCALIZATION OF BRAIN

• The theory of localization refers to the idea that different parts of the brain are
responsible for specific behaviors, or that certain functions are localized to certain
areas in the brain.
• For example: Damage to the Broca's area, or that part of the brain that is involved
in language expression, will render a person unable to communicate even when he
is perfectly capable of understanding language.
 FUNCTIONS OF VARIOUS PARTS
• Frontal lobe: thinking, problem-solving, emotions, personality
• Motor Cortex: movement
• Sensory Cortex: sensations
• Wernicke's Area: interprets auditory code
• Parietal Lobe: perception, making sense of the world
• Angular Gyrus: converting visual into auditory code
• Occipital Lobe: vision
• Visual Cortex: receives written words as visual simulation
• Cerebellum: processing sensory info., coordination/balance
• Temporal Lobe: memory, understanding language
But how do we find out?
• Accidental damage – Phineas Gage (frontal cortex)
• Deliberate damage/lesion (ablation)
• Stimulation of the brain – electrodes inside the brain
 EVALUATION
Accidental damage
▪ Lack of precision – we cannot control the damage
▪ Hard to compare before and after damage (no concrete records of
„before‟)
▪ Confounding variables – could Gage‟s behavior be caused by social
relations?
▪ Ethically good, as the damage occurs naturally in these natural
experiments
 Ablation (the surgical removal of body tissue)

▪ Ethical problems – not just in humans!

▪ Animal studies – we cannot necessarily generalize
▪ Neuroplasticity – the brain can compensate, so the
missing part may not be showing
▪ Good because there is greater control – precision of
damage and therefore easier to compare
 Stimulation

▪ Less harmful than ablation

▪ More valid – a better way of investigation
▪ However, it is invasive – surgery is risky
▪ The brain’s interconnectedness makes it hard to know
if the stimulated areas affect other areas.
 Case of Phineas Gage
• Phineas Gage (1823–1860) was the victim of a terrible accident in
1848
• His injuries helped scientists understand more about the brain
and human behaviour.
• In 1848, when he was just 25 years old, Gage sustained a terrible
injury to his brain. His miraculous survival, and the effects of the
injury upon his character, made Gage a curiosity to the public and
an important case study for scientists hoping to understand more
about the brain.
• In 1848 Gage was working as a foreman on the construction of the Rutland and Burlington Railroad in
Vermont, USA. Workers often used dynamite to blast away rock and clear a path for the railway. On
13 September, Gage was using a tamping iron (a long hollow cylinder of iron weighing more than
6 kilos) to compact explosive powder into the rock ready for a blast. The iron rod hit the rock, creating
a spark that ignited the explosives. The rod was propelled through Gage’s skull, entering through
his left cheekbone and exiting through the top of his head.
• Despite his horrific injury, within minutes Gage was sitting up in a cart, conscious and
recounting what had happened. He was taken back to his lodgings, where he was attended by Dr
John Harlow.
• His family did not expect him to survive, but Gage revived.
• His friends and acquaintances said he was ‘no longer Gage’.
• The damage to Gage’s frontal cortex caused by the iron rod
seems to have resulted in a loss of social inhibitions. The role of
the frontal cortex in social cognition and decision making is now
well-recognised; in the 19th century, however, neurologists were
only just beginning to realise these connections. Gage’s injuries
provided some of the first evidence that the frontal cortex was
involved in personality and behaviour.
 RESEARCHES ON LOCALIZATION
• One study which focused on localization of function in the brain was conducted by French
physician Paul Broca in the 19th Century. Broca set out to test his theory that damage to a
specific part of the brain (the frontal lobe) was responsible for problems with speech.
• Initially, Broca tested his theory through the use of case studies, one of which was on a patient named
“Tan” (the only word Tan was able to say). During these case studies, Broca gathered a substantial
amount of evidence including the problems each individual faced and details of any medical issues.
• Broca found that his patients all had two main factors in common – they understood language but
had distinct problems with speech, and each patient had suffered some element of damage to the
left side of their brains in earlier life.
• This led Broca to hypothesize that there must be a link between specific head trauma and the
development of speech-based problems.
• After Tan’s death, Broca carried out a postmortem study, and found that Tan had
lesions on the frontal lobe of his left hemisphere where damage had occurred earlier
on in his life. Subsequent postmortem research of several of his other patients identified
that they too had specific damage to the left frontal lobe – an area now known as
Broca’s area.
• The research that Broca carried out led him to the conclusion that different parts of the
brain must be responsible for specific functions. In this case, speech can be said to be
localized to the frontal cortex of the left hemisphere, a finding which has been
supported by recent empirical research.
• In 1874, Carl Wernicke identified the part of the brain responsible for receptive
speech (the upper rear part of the left temporal lobe, known as Wernicke's area),
and in 1870 Gustav Fritsch and J. L. Hitzig found that stimulating different parts of
the cerebral cortex produced movement in different areas of the body.
 CASE OF H.M.

• One important research study related to localization of function in the brain is the longitudinal case
study by Milner on HM.
• HM’s study demonstrates the role of the hippocampus in turning short term memory into long
term memory.
• After the operation HM suffered from anterograde amnesia, which means he could remember most
things from before the operation but he was unable to make new memories afterwards. For example, his
parents moved house and while he could remember the old address, he could not remember the new
one.
• He also could never remember Milner, because she met him after his operation so while she studied
him for 50 years, he never remembered her. If he focused on something he could remember it, but if
he was distracted the information was lost. Milner concluded from these findings that one function of
the hippocampus is to convert short term memories in to long term ones.
• Interestingly, no other part of HM’s behaviour was affected. For instance, his IQ test scores actually increased from
104 to 112. He could still carry conversations with people he met, but he was unable to remember ever meeting them
shortly afterwards. This suggests that personality and IQ must be localized in other areas of the brain and are not a
function of the hippocampus.
• Another test that shows procedural memory must be localized in a different part of the brain than the
hippocampus was the star tracing task. Milner asked HM to fill in a star with a pencil by looking at a mirror reflection
of his hands and the paper star. This is a difficult task and HM struggled the first time. He completed this task every day
for one week and by the seventh day he was very adept at filling in the star. He was impressed with his ability to do this,
because he had no recollection of ever trying to do it before.
• The researchers were able to conclude that while his episodic memory was damaged, he was able to acquire and
develop new skills. This further supports localization of brain function because it demonstrates how motor skill learning
(procedural memory) must require a different part of the brain to other types of memory.
• In conclusion, the longitudinal case study of HM provided valuable information regarding localization of function, in
particular the role of the hippocampus on memory. The findings from the case study can also show that memory
storage, procedural memory and IQ must be localized in other areas of the brain, not the hippocampus.
 CONFLICTING VIEWPOINTS
• An influential conflicting view is the equipotential theory, which asserts
that all areas of the brain are equally active in overall mental functioning.
• According to this theory, the effects of damage to the brain are
determined by the extent rather than the location of the damage.
• Early exponents of this view—including Goldstein and Lashley—
believed that basic motor and sensory functions are localized, but that
higher mental functions are not.
• Some experts also advocate a combination of the two theories, while
others search for new alternatives, such as that proposed by J. Hughlings
Jackson in 1973.
• Jackson claimed that the most basic skills were localized but that most
complex mental functions combined these so extensively that the whole
brain was actually involved in most types of behavior.
 Discussion – can we localize
function?
• The brain is a highly complex, heavily interconnected system that
displays non-linear properties, and this is clearly a short fall of
localization of function. (This means that we can argue that is is hard
to localize a function to a specific structure of the brain, since the
structures are interconnected)
 Lateralization
The brain controls motor and sensory activities as well as thought process. It is divided into
two parts called cerebral hemisphere: the right and the left. Such separation of function is
called lateralization.

The brain undergoes a gradual process of lateralization during which the left brain
hemisphere and the right hemisphere develops their specialized function.

The medial longitudinal fissure separates the human brain into two distinct cerebral
hemispheres, connected by the corpus callosum. Although the macrostructure of the two
hemispheres appears to be almost identical, different composition of neuronal networks
allows for specialized function that is different in each hemisphere.
FUNCTIONS OF LATERALIZATION
LEFT HEMISPHERE :
RIGHT HEMISPHERE:
• Language • Intuition
• Logical • Feeling and sensitivity
• Aanalytical operations • Emotions
• Structure • Daydreaming and visualizing
• Disciplines and rules • Creativity including art and music
• Time sequence • Color
• Categorizing • Spatial awareness
• Logic and rationally • Non-linguistic sounds such as
• Deductive reasoning noises and animal sounds.
• Higher mathematic.
 Sex differences and Lateralization
• Some evidence suggests that the male brain is more lateralized than
female brain.
• Some fMRI studies show that females tend to use both hemispheres
in language-related tasks more so than males.
• No documented gender disparity in overall intelligence :
• Male advantage on spatial tasks

• Female advantage on language and memory tasks.

• Disproportionate male incidence of dyslexia, delayed speech,

attention disorders and mental retardation.
DYSFUNCTION OF
LATERALIZATION
Right Hemisphere Disorders

• The right hemisphere has been considered the dominant hemisphere for the expression and
detection of emotion in language, gestures, and faces. Localization of emotional
comprehension and emotional repetition have been less well characterized than comparable left
hemisphere language functions. The inability to express affect in speech (affective motor
aprosodia) has repeatedly been shown to result from lesions in the right frontal opercular
region.
• This syndrome is characterized by flat, robotic speech with loss of normal melody and
emotional intonation. Affected patients also lack variability in the spacing of words and
syllables to imply meaning. They rely more on semantic information to convey emotions.
• Frequently, this syndrome is interpreted as depression; however, patients deny the feeling or
experience of being depressed. In addition, receptive amusia and other disorders of music
appreciation are related disturbances predominantly associated with right hemisphere lesions.
CONSCIOUSNESS AND LATERALIZATION

• Michael S. Gazzaniga, in Encyclopedia of the Human Brain, 2002

• Apparently the left brain has modules specialized for higher cognitive functions,
while the right has modules specialized for other functions.
• Visuospatial function, for example, is generally more acute in the right hemisphere,
but left hemisphere integration may be needed to perform higher order tasks.
• The use of tactile information to build spatial representations of abstract shapes
appears to be better developed in the right hemisphere, but tasks such as the Block
Design test, which are typically associated with the right parietal lobe, appear to
require integration between the hemispheres in some patients.
• Furthermore, even though the right hemisphere is better able to analyze unfamiliar
facial information than is the left hemisphere, and the left is better able to generate
voluntary facial expressions, both hemispheres can generate facial expression when
spontaneous emotions are expressed.
RESEARCHES
Gotts et al, 2013: Two distinct forms of functional lateralization in
the human brain

This study alters our fundamental understanding of the functional

interactions between the cerebral hemispheres of the human brain by
establishing that the left and right hemispheres have qualitatively
different biases in how they dynamically interact with one another. Left-
hemisphere regions are biased to interact more strongly within the same
hemisphere, whereas right-hemisphere regions interact more strongly
with both hemispheres. These two different patterns of interaction are
associated with left-lateralized functions, such as language and motor
abilities, and right-lateralized functions, such as visuospatial attention.
Importantly, the magnitude of lateralization measured for individual
participants in these regions predicted the level of cognitive ability for
the respective function, demonstrating that lateralization of function is
associated with improved cognitive ability.
Rogers et al, 2010 : Relevance of brain and behavioural
lateralization to animal welfare

The left and right sides of the brain are specialised to process
information in different ways and to control different categories of
behaviour. Research on a range of species has shown that the left
hemisphere controls well-established patterns of behaviour
performed in non-stressful situations, whereas the right hemisphere
responds to unexpected stimuli and controls escape and other
emergency responses. Then it is hypothesised that stressed animals
rely on predominant use of the right hemisphere, and that a bias to
use the right or left hemisphere, respectively, may explain the
behavioural differences between animals with a negative cognitive
bias and those with a positive cognitive bias.
Dawson et al, 1983: Lateralized brain dysfunction in autism: evidence
from the Halstead-Reitan neuropsychological battery.

Selected tests from the Halstead-Reitan neuropsychological battery

were administered to 10 male individuals who had been diagnosed as
autistic in early childhood.
Results from the battery obtained from the autistic group were
compared with a group of retarded persons matched for IQ and with a
group of patients with demonstrable diffuse brain damage. As a group,
the autistic subjects showed a pattern of deficits indicative of a
significantly greater degree of left hemisphere dysfunction than either
comparison group. Furthermore, within-subject comparisons revealed
that the autistic group had a significantly greater left than right
hemisphere dysfunction, while neither comparison group showed this
lateralized pattern.
 REFERENCES:

• Gotts, S. J., Jo, H. J., Wallace, G. L., Saad, Z. S., Cox, R. W., &
Martin, A. (2013). Two distinct forms of functional lateralization
in the human brain. Proceedings of the National Academy of
Sciences, 110(36), E3435-E3444.
• Rogers, L. J. (2010). Relevance of brain and behavioural
lateralization to animal welfare. Applied Animal Behaviour
Science, 127(1), 1-11.
• Dawson, G. (1983). Lateralized brain dysfunction in autism:
Evidence from the Halstead-Reitan Neuropsychological
Battery. Journal of autism and developmental disorders, 13(3),
269-286.