Introduction Cognitive Neuropsychology Of
IntroductionCognitive Neuropsychology ofLanguagennnnStructure of the courseHistorical background to aphasiaTwo modern approachesBasic forms of aphasiaMichael ThomasBirkbeck CollegeCourseReading ListMichaelThomasDisorders of Language, Spring 2005Lectures 11.30am to 1.00pm, ThursdaysRoom 534, Birkbeck College Main BuildingWk1 Thursday 13t h JanIntroduction to aphasia and its basic formsWk2 Thursday 20t h JanAcquired Comprehension DeficitsWk3 Thursday 27t h JanGuest Lecture: Dr. Andrea Mechelli: Functionalimaging of semantic retrieval(Seminar)Wk4 Thursday 3rd FebGuest Lecture: Dr. David Green: Aphasia inbilingualsWk5 Thursday 10t h FebGuest Lecture: Dr. Sophie Scott: Neurobiology ofspeech perceptionWk6 Thursday 17t h FebAcquired Production DeficitsWk7 Thursday 24t h FebDevelopmental disorders of the language systemWk8 Thursday 3rd MarGuest Lecture: Dr. Jennifer Aydelott: Speechperception, psycholinguistics and aphasia(Seminar)Wk9 Thursday 10t h MarConnectionist models of language deficitsthWk10 Thursday 17 MarThe right hemisphere. Specialisation, plasticity, andrecoveryWk11 Thursday 24t h MarNO LECTURESeminar 1Seminar 24- 5pm on Thursday27t h January4- 5pm on Thursday3rd MarchCategory-specific deficits or Treatment of aphasia(students choice)Specific Language ImpairmentDisorders of Language: Reading ListRapp, B. (2001). The handbook of cognitive neuropsychology. Sussex, Hove:Psychology Press. [Chapters 8, 9, 12, 13, 17]Ellis, A. W., & Young, A. W. (1996).Human cognitive neuropsychology: A textbookwith readings. Sussex, Hove: Psychology Press. [Chapters 5, 6, 9]Hillis, A. E. (2002).The handbook of adult language disorders. Sussex, Hove:PsychologyPress.Andrews, D. (2001). Neuropsychology: From theory to practice. Psychology Press:Hove, Sussex. [Chapters 1, 7, 10, 11]Kolb, B. & Whishaw, I. Q. (2003).Fundamentals of human neuropsychology 5Edition. New York: Worth Publishers. [Chapter 19]Sources for specific top ics Psycholinguistics and aphasia:Dick, F., Bates, E., Wulfeck, B., Aydelott Utman, J., Dronkers, N., & Gernsbac her,M. A. (2001). Language deficits, localization, and grammar: Evidence for adistributive model of language breakdown in aphasic patients and neurologicallyintactindividuals. PsychologicalReview, 108(4), 759-788. nnnnSame incidence as MS or Parkinson’s200,000 in UK; 1M in US90% caused by stroke, mostly in elderlyLoss of (aspects of) languageCan be accompanied by paralysis /weakness of right arm and legDevelopmental disorders:Thomas, M. S. C. (2005). Constraints on language development: Insights fromdevelopmental disorders. In: P. Fletcher & J . Miller (Eds.), Language Disordersand Developmental Theory(pp.11 -34). John Benjamins.Temple, C. M. (1997). Cognitive neuropsychology and its application to children.Journal of Child Psychology and Psychiatry , 38, 27-5 2 .Anderson, V., Northam, E., Hendy, J., & Wrennall, J. (2001). Developmentalneuropsychology: A clinical approach. Sussex, Hove: Psychology Press. [Chapter 4]Bates, E., & Roe, K. (2001). Language development in children with unilateral braininjury. In Nelson, C. A. & Luciana, M. (Eds.), Handbook of developmentalcognitive neuroscience (p. 281-318). Cambridge, Mass.: MIT Press.Fowler, A. E. (1998). Language in mental retardation: Associations with anddissociations from general cognition. In J. A. Burack, R. M. Hodapp, & E. Zigler,Handbook of mental retardation and development(p. 290-333). Cambridge:Cambridge University Press. Semanticretrieval:Price, C. J., & Friston, K. J. (2002). Degeneracy and cognitive anatomy. TrendsinCognitive Sciences, 6(10),416-421.Category-specific deficits:Forde,E. M. E., & Humphreys, G. W. (2002). Category specificity in brain and mind.Hove, Sussex: Psychology Press.Pulvermuller, F. (2001). Brain reflections of words and their meaning. Trends inCognitive Sciences, 5(12), 517-524.Shelton, J. R., & Caramazza, A. (2001). The organization of semantic memory. In. B.Rapp (ed.), The handbook of cognitive neuropsychology (p. 423-443). Sussex,Hove: Psychology Press.AphasianhtHale, S. (2002). The man who lost his language. London: Allen Lane. Thomas, M. S. C. & Karmiloff-Smith, A. (2002). Are developmental disorders likecases of adult brain damage? Implications from connectionist modelling.Behavioral and Brain Sciences, Vol. 25 No.6 , 727-788.General sourcesBilingualaphasia:Seminar Readings Seminar 1: Option (a) Category-specificdeficitsSartori, G., Job, R., & Zago, S. (2002). A case of domain -specific semantic deficits. InE. M. E. Forde & G. W. Humphreys (Eds.), Category specificity in brain andm i n d(p. 25-49). Hove, Sussex: Psychology Press.Whatmough, C., & Chertkow, H. (2002). Category -specific recognition impairmentsin Alzheimer’s disease. In E. M. E. Forde & G. W. Humphreys (Eds.),Categoryspecificity in brain and mind (p. 181-210). Hove, Sussex: Psychology Press.Gainotti, G. (2002).The relationships between anatomical and cognitive locus oflesion in category-specific disorders. In E. M. E. Forde & G. W. Humphreys(Eds.), Category specificity in brain and mind (p. 403-426). Hove, Sussex:Psychology Press. Seminar 1: Option (b) TreatmentMitchum, C. C., Haendiges, A. N., & Berndt, R. S. (1995). Treatment of thematicmapping in sentence comprehension: implications for normal processing.Cognitive Neuropsychology, 12, 503-547. [Reprinted in Ellis & Young, 1996,p. 5 9 2-6 3 9 ]Horton,S., & Byng, S. (2002). “Semantic therapy” in day-t o-day clinical practice:Perspectives on diagnosis and therapy related to semantic impairments in aphasia.In. A. E. Hillis (Ed.),The handbook of adult language disorders(p. 229-249).Sussex, Hove: Psychology Press.Gollan, T. H., & Kroll, J. F. (2001). Bilingual lexical access. In. B. Rapp (ed.),Thehandbook of cognitive neuropsychology (p. 321-345). Sussex, Hove: PsychologyPress.Semel, E. & Rosner, S. R. (2003).Understanding Williams syndrome: Behavioralpatterns and interventions. Mahwah, New Jersey: Lawrence Erlbaum Associates.Chapter 3 (p. 64-107).Green, D. W. & Price, C. J. (2001). Functional imaging in the study of recoverypatterns in bilingual aphasia. Bilingualism: Language and Cognition, 4, 191-201.Small, S. L. (2002). Biological approaches to the treatment of apha sia. In. A. E. Hillis(Ed.), The handbook of adult language disorders (p. 397-411). Sussex, Hove:Psychology Press. Language in the right hemisphereTomkins, C. A., Fassbinder, W., Lehman-Blake, M. T., & Baumgaertner, A., (2002).The nature and implications of right hemisphere language disorders. In. A. E.Hillis(Ed.) The handbook of adult language disorders (p. 429-448). Sussex,Hove: Psychology Press.Andrews, D. (2001).Neuropsychology: From theory to practice. Psychology Press:Hove, Sussex. [Chapter 7]. Recovery and rehabilitationAndrews, D. (2001). Neuropsychology: From theory to practice. Psychology Press:Hove, Sussex. [Chapters 10, 11] Seminar 2: Specific Language ImpairmentJoanisse, M. F., & Seidenberg, M. S. (1998). Specific Language Impairment: A deficitin grammar or processing? Trends in Cognitive Sciences, 2(7), 240-247.van der Lely, H. K. J. (2004). Evidence for and implications of a domain-specificgrammatical deficit. In Lyle Jenkins (Ed.),The genetics of language. LinguisticVariations series, (pp117-145). El sevier, Oxford.Ullman, M. T., & Pierpont, E. I. (in press). Specific language impairment in notspecific to language: The Procedural Deficit hypothesis. Cortex.Thomas, M. S. C. (in press). Characterising compensation. Cortex.HistorynEgyptians, Greeks, Romansnnnnn2800 BC: loss of language treatment in Egyptian papyrusHippocrates 400 BC: loss of speech ‘aphonia’Valerius Maximus, AD 30: selective problems with readingConfused with paralysis of tongue, deafness,mutism, stutteringRelation to brain?nnheart seen as engine of thought (Aristotle)mind seen as controlled by non- physical spirit (Descartes)1
History19 th centurynnnnHistorynGall well-developed mental facultiescorrespond to large areas of cortex;language in frontal lobes1825 French physician Jean -BaptisteBouillaud delivers scientific paper withsame conclusion1830 Marc Dax, language in lefthemispherennnnnHistorynnnConclusion impaired language productionassociated with left anterior damage to thirdfrontal gyrusSuggestion of second type: posterior damage,impaired associations between language andthoughtDid not offer specific localisation1884 Carl Wernickennnpost-mortem reports of two patients withimpaired language functionTan (named after one of few utterances)1863, 8 more patientsAll cases, damage left anterior lesionAdditional patient, right anterior lesion nolanguage impairmentOrienting our brain areasHistoryn1861 Paul BrocaAphasia predominant difficulty withcomprehension lesions to left superiortemporal lobeFurther type predicted, due to disconnectionbetween anterior and posterior areas(conduction aphasia)Historyn1965: Geschwind extends theory to produce“Wernicke-Geschwind” model1885: Lichtheim proposes diagrammaticform of model2
HistoryThe Wernicke-Geschwind modelnn1885-1965: Why the 80-year delay?Early writings of Broca and Wernickecontroversialne.g. Pierre Marie (1906) proposed that:nnnnAll aphasia has some comprehension deficitBroca’s aphasics interference with more posterior zoneBroca’s area purely for motor aspects of speechCritical lesions in Broca’s aphasia are sub-corticalThe brain of Paul Broca’s patient, TannNote the gross subcortical extent ofthe lesion in the coronal section –Tan case study supports Marie?Two modern approachesWhy the 80-year delay? (cont.)nnn1860s John Hughlings Jackson - rejection oflocalisationist approachHead (1926) - more psychologicaldescription of aphasia, irrespective ofneural correlates1940s - Behaviourist approach rejectsmentalistic analysisnExternal S-R schedules of reinforcementnCognitive neuropsychologynnnSyndrome approachnnSingle case studies looking for dissociations betweenpsychological components of language systemLess concerned with relation to underlying substrateGroups patients according to symptoms, looks for commonpatterns of underlying damageApproaches interact; imaging may bring themtogethernnFunctional module may be realised by distributed network ofbrain areasImaging may help us link network with module via regionsof brain damage3
Cognitive neuropsychologySemanticSystemInput(e.g., picture ofobject)JCU has deficitEST okJJ has deficitPhonologicalOutput LexiconJCU has deficitEST has deficitJJ has deficitOrthographicOutput LexiconJJ okSyndrome approachnnLet’s identify the broad types of languagebreakdownFirst, what are the language ‘areas’ of thebrain?nTry poking itPatient JCU: naming problem with semantic errors (Howard & Orchard-Lisle, 1984)Patient EST: could give precise semantic info about objects unab le to name (Kay & Ellis, 1987)Patient JJ: naming problems, unable to give meanings, but could write word forms(Hillis & Caramazza, 1991)The language areasnElectrical mapping: Penfield and Roberts (1959)The language areasnElectrical mapping: Ojemann et al. (1989)nos. in circles consistent failure in naming following lity?Cross-species comparisonLanguage areas(cousins)4
Types of Aphasia:The Wernicke-Geschwind modelBasic forms of aphasiaPredicts three types of aphasia nBroca’s aphasianWernicke’s aphasiannnnnnnnnBroca’s aphasicnJargon aphasiaConduction aphasiaWord deafnessGlobal aphasiaThe Transcortical vianaphasiasTranscortical motor aphasiaTranscortical sensory aphasiaSubcortical aphasiaRight hemisphere damageBroca’s aphasiaCinderella’s story (from Saffran, Berndt, and Schwartz, 1989)“a mother/ three kids/ bad mother/one kid beautiful/ rich/Italian/ mother/ stepmother/ talk about Cinderella/Cinderella/clean myhouse/ you Cinderella/close the door/ Cinderella like jail/ mother three kids/ I love mother/ Cinderella walk ball/ people ball/ rich people/ man and Cinderella dance dance dance party/ one/ dance dance dance/ dance every time/ ball beautiful people/ people watched Cinderella/ Cinderella beautiful clothes andgarments/ twelve o’clock night/ Cinderella/ oh no/ oh no/ I’m sorry/I’m sorry people/ I love you baby/ walk walk/ tumble/ one shoebye-bye/ Cinderella pumpkin cab/ oh shoe/ oh please/ oh well/walk pumpkin car/.”Broca’s aphasianSymptoms:nnnnInitial speech assessment (Andrewes, 2001, p.309)Difficulties in production (lack of function words and inflections),some problems in comprehension of syntax (e.g., reversiblesentences)Non-fluent / AgrammatismRepetition difficultiesnIn excess of Broca’s area. Arterial system means motor areastypically also damagedDA:HH:Type of damage:nnPatient with small Broca’s aphasiaHH:Problems with simple model:nn1. Lesion location – need to damage more than original Broca’sarea; Broca’s alone articulation difficulties2. Term too broad, individual variability of agrammatism: small vs.large Broca’s patients; function word/inflection deficit dissoci atefrom word order deficit; (syntactic) comprehension deficitsDA:HH:Sometimes I say “yes” [halts in mid sentence] when I mean“no”. I realise immediately afterwards that I have said thewrong thing and correct myself.Does this happen often? [Appears to be thinking about what to say and lunges forwardas if forcing out the word] “No” (we both saw the humour in thesituation, but he refrains from elaborating).How does this affect your everyday life?It’s a problem when converse with the mates.5
Wernicke’s aphasic(Subtler) comprehension deficitsnProblems with syntactic aspects of comprehensionn“Point to the picture that goes with The brown dog is chased bythe white horse”SP:Frank:SP:Frank:Could you tell me where you are? Yes, er, I just don’t feel too good.Are you in hospital at the present time? That is really one thing, really I feel bad you know. Mm I’m not reallyfeeling too good.What’s wrong with you, Frank?Well I don’t know, to be honest you just er, there will be a few days I feel shy.Saturday was bad, I get bad, Sunday and today.Where do you live? I don’t know, to be honest, we’ve got a lot of things my dad.Do you live in East Keilor? Sorry? Yeh well fair outside things, you can’t do warn. I can talk but I can’tshow up myself. I can’t put the voice. It would be one thing if I could talk. ButI can’t talk so people can see it.Are you married, Frank? I was news to due to be.(Note: Production data on deficit)Wernicke’s aphasiaWernicke’s aphasianSymptoms:nnnnnType of damage:nnIn excess of original Wernicke’s area. Posterior superior temporal gyrusstill appears crucialProblems with simple model:nnPatient with Wernicke’s (jargon) aphasiaComprehension difficultiesFluent (sometimes excessive), word finding difficulties, paraphasias,excess of grammatical words but paucity of meaning; some syntacticdifficultiesSevere: ‘jargon’ aphasia: neologisms (new words) lack of awarenessRepetition difficultiesPatients appear to be aware of meaning they are trying to produce: Notsemantic deficit but communication with phonological output system?Lack of awareness of jargon implies ‘unconscious’ route to productionComparisonInterviewer: Can you tell me your address, Tom?Tom:Four and pleasant, Plain Sodars. [There is no such district]Interviewer: How long have you lived there?Tom:I think that was only five, no eight prentices. Small plut b e in there.Interviewer: How old are you?Tom:80, 85 no 83 cheldren. [His age is 83 years old]Interviewer: What month is it?nBroca’s vs. Wernicke’s aphasicsTom:Today? Well that would be ten. If I say, it used to be called Naym Prentice.Interviewer: If I said it was May, what would you say?Tom:That’s correct, Naym Prentice.Interviewer: Could you count up to ten?Tom:A, B, C, D, E, F, M, P, M.Interviewer: No, say after me: 1, 2.[Tom then proceeds to count fluently with only a few errors]6
Wernicke’s vs. Broca’s aphasiaCookie theft (from Boston aphasia exam)nDescription of cookie theft storynWernicke’s patient (Goodglass, 1983)“Well this mother is away here working her work out o’here to get herbetter, but when she’s looking, the two boys looking in the other part.One their small tile into her time here. She’s working another timebecause she is getting, too.”nBroca’s patient (Helm-Estabrooks et al., 1981)“Well see girl eating no cookie no ah school no stool ah tip over and ah cookie jar ah kid no see wa terall over spilled over yuck Mother daydreaming.”Basic forms of aphasianBroca’s aphasiannWernicke’s aphasiannnnnnnJargon aphasiaConduction aphasiaWord deafnessGlobal aphasiaThe Transcortical aphasiasnnAgrammatismConduction ianaphasiasComprehension and production relatively intactRepetition is predominant impairmentnType of damage:nProblems with simple model:nnTranscortical motor aphasiaTranscortical sensory aphasianSupramarginal gyrus and insula (close to arcuate fasciculus)W-G model suggests disconnection but why is expression okay?Shouldn’t concepts be disconnected from syntax and articulation,impairing production?Possibly problem with working or short-term memorySubcortical aphasiaRight hemisphere damageConduction aphasiaOther perisylvian aphasiasnGlobal aphasiannnType of damage:nnDamage of all language areasPure word deafnessnnnComplete loss of languageIf recovery, comprehension before production, to state likeBroca’sPatients unable to hear phonological form of wordsProduction may be faultlessType of damage:nBilateral lesions to posterior temporal plane (Heschl's gyrus)7
Global aphasiaPause for breath . .nnTypes of Aphasia:The Wernicke-Geschwind modelTwo modern approachesnCognitive neuropsychologynnSyndrome approachGroups patients according to symptoms, looks for commonpatterns of underlying damagennPredicts three types of aphasia Single case studies looking for dissociations betweenpsychological components of language systemLess concerned with relation to underlying substratenApproaches interact; imaging may bring themtogetherFunctional module may be realised by distributed network ofbrain areasImaging may help us link network with module via regionsof brain damagennBasic forms of aphasianBroca’s aphasiannWernicke’s aphasiannnnnnnJargon aphasiaConduction aphasiaWord deafnessGlobal aphasiaThe Transcortical aphasiasnnAgrammatismTranscortical motor aphasiaTranscortical sensory aphasiaSubcortical aphasiaRight hemisphere damageTranscortical nnnKnown since Wernicke’s time that aspects of Broca’sand Wernicke’s aphasia could appear in patients whohad a preserved ability to repeat back .Due to damage outside perisylvian area – watershedinfarctionPosition of damage (anterior / posterior) determinestype of deficitnnnTranscortical motor aphasia (Broca-like)Transcortical sensory aphasia (Wernicke-like)(or both)8
Damage depends on position of blockageTranscortical aphasiasTranscortical aphasiasTranscortical aphasiasnTranscortical Motor AphasianType 1nnnnTranscortical Sensory AphasianDysexecutive production problems (echolalia,perseveration)Prefrontal lesion superior to Broca’s areanType 2nnnType 1nMotor initiation symptomsReduced motivation and drive, lower limb paralysisLesions in anterior cingulate and left supplementarymotor areanComprehension problems, extreme difficulty namingobjects / pictures, semantic paraphasias, visual objectagnosiaDamage inferior and posterior to Wernicke’s area (nonoverlapping)Type 2nnWord finding difficulties, few content words, difficultywith complex relational sentences – “semantic” aphasiaSuperior angular gyrus and posterior parietal damageSubcortical aphasiaTSA vs. Conduction vs. Wernicke’s aphasiannnCan aphasia be due to sub-cortical damage (e.g., tothalamus)?Do sub-cortical structures play a processing role or justconnectivity?Nadeau and Crosson (1997): subcortical damageassociated withnnnnAnomia in sponta
Cognitive Neuropsychology of Language Michael Thomas Birkbeck College Introduction nStructure of the course nHistorical background to aphasia nTwo modern approaches nBasic forms of aphasia Course Disorders of Language, Spring 2005 Thomas, M. S. C. & Karmiloff Lectures 11.30am to 1.00pm, Thursdays Room 534, Birkbeck College Main Building mind
Both cognitive and clinical aspects of neuropsychology are addressed to illustrate the advances scientists are making (on many fronts) in . 1 The foundations of neuropsychology 3 Introduction 3 Neuropsychology as a distinct discipline 3 The (re)emergence of neuropsychology 12 Chapter summary 19 2 Methods in neuropsychology 21
Theme 1. Self-reported use and knowledge of child neuropsychology theory and practice 45 Theme 2. Views on inclusion of neuropsychology teaching during the initial EP training 47 Theme 3. Experiences of neuropsychology teaching during the initial EP training course 49 Theme 4. Views on Paediatric
1 Introduction: Philosophy of Science and the Nature of Philosophy 1.1 Three Views on Philosophy and Psychology . Cognitive neuropsychology is the branch of cognitive psychology in which models of, or theories about, normal cognitive processes are developed, evaluated, and refined, in the light of data provided by the empirical .
Introduction While a cognitive neuropsychological approach is widely used in aphasia clinics throughout the UK and other countries to assess and treat people with . Cognitive neuropsychology first emerged as a coherent discipline in the 1970s as a reaction to the then dominant approach in neuropsychology. This earlier
Classes 1-3: Introduction, Methods and Anatomy Jan 11: INTRODUCTION AND HISTORY Class 1 Welcome, Course Syllabus Review Lecture Topics: Neuropsychology and Clinical Neuroscience History of Neuropsychology Readings: Zillmer, Spiers & Culbertson: Chapter 1: A History of Neuropsychology Jan 18: No Class – Martin Luther King, Jr. Day
2 Methods in Cognitive Neuropsychology: A Tool Kit 23 3 Principles and Issues in Cognitive Neuropsychology 43 4 Neglect & Attention 69 5 Apraxia & Motor-Planning 95 6 Visual Agnosia & Object Recognition 113 7 Prosopagnosia & Face Processing 141 8 Amnesia & Memory 173 9 Executive Functions 209 10 Aphasia, Dyslexia & Language
1 Cognitive Neuropsychology of Language Michael Thomas Birkbeck College Introduction Structure of the course Historical background to aphasia Two modern approaches Basic forms of aphasia Course Disorders of Language, Spring 2004 Lectures 10.00am to 11.30am, Thursdays
Andreas Wagner†‡ Historically, one of the most controversial aspects of Darwinian evolution has been the prominent role that randomness and random change play in it. Most biologists agree that mutations in DNA have random effects on fitness. However, fitness is a highly simplified scalar representation of an enormously complex phenotype .
