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Subcortical Structures and Cognition (eBook)

Implications for Neuropsychological Assessment
eBook Download: PDF
2009 | 2009
XIII, 405 Seiten
Springer New York (Verlag)
978-0-387-84868-6 (ISBN)

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Subcortical Structures and Cognition -  Deborah Ely Budding,  Leonard F. Koziol
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Clinical psychologists and neuropsychologists are traditionally taught that cognition is mediated by the cortex and that subcortical brain regions mediate the coordination of movement. However, this argument can easily be challenged based upon the anatomic organization of the brain. The relationship between the prefrontal cortex/frontal lobes and basal ganglia is characterized by loops from these anterior brain regions to the striatum, the globus pallidus, and the thalamus, and then back to the frontal cortex. There is also a cerebrocerebellar system defined by projections from the cerebral cortex to the pontine nuclei, to the cerebellar cortex and deep cerebellar nuclei, to the red nucleus and then back to thalamus and cerebral cortex, including all regions of the frontal lobes. Therefore, both the cortical-striatal and cortical-cerebellar projections are anatomically defined as re-entrant systems that are obviously in a position to influence not only motor behavior, but also cognition and affect. This represents overwhelming evidence based upon neuroanatomy alone that subcortical regions play a role in cognition. The first half of this book defines the functional neuroanatomy of cortical-subcortical circuitries and establishes that since structure is related to function, what the basal ganglia and cerebellum do for movement they also do for cognition and emotion.

The second half of the book examines neuropsychological assessment. Patients with lesions restricted to the cerebellum and/or basal ganglia have been described as exhibiting a variety of cognitive deficits on neuropsychological tests. Numerous investigations have demonstrated that higher-level cognitive functions such as attention, executive functioning, language, visuospatial processing, and learning and memory are affected by subcortical pathologies. There is also considerable evidence that the basal ganglia and cerebellum play a critical role in the regulation of affect and emotion. These brain regions are an integral part of the brain's executive system. The ability to apply new methodologies clinically is essential in the evaluation of disorders with subcortical pathology, including various developmental disorders (broadly defined to include learning disorders and certain psychiatric conditions), for the purpose of gaining greater understanding of these conditions and developing appropriate methodologies for treatment.

 

The book is organized around three sources of evidence:

  1. neuroanatomical connections;
  2. patients with various disease processes;
  3. experimental studies, including various imaging techniques.

These three sources of data present compelling evidence that the basal ganglia and cerebellum are involved in cognition, affect, and emotion. The question is no longer if these subcortical regions are involved in these processes, but instead, how they are involved. The book is also organized around two basic concepts: (1) the functional neuroanatomy of the basal ganglia and the cerebellum; and (2) how this relates to behavior and neuropsychological testing.

Cognitive neuroscience is entering a new era as we recognize the roles of subcortical structures in the modulation of cognition. The fields of neuropsychology, cognitive psychology, neuropsychiatry, and neurology are all developing in the direction of understanding the roles of subcortical structures in behavior. This book is informative while defining the need and direction for new paradigms and methodologies for neuropsychological assessment.



Dr. Leonard F. Koziol is a clinical psychologist with specialty board certifications in Neuropsychology and Pediatric Neuropsychology. He works with children, adolescents, and adults with attention or concentration problems, memory loss, or learning disabilities. Dr. Koziol has served as a forensic psychologist expert in legal proceedings. Dr. Koziol is currently part of the Clinical Faculty at Chicago Medical School, Finch University Hospital Clinic, North Chicago, IL; the Consulting Neuropsychology Faculty at Fielding Institute, Santa Barbara, CA; and the Adult Faculty at Illinois School of Professional Psychology, IL, from where he is also a Professional Psychology graduate. His awards include: Fellow, National Academy of Neuropsychology - 2004; and Fellow, American College of Professional Neuropsychology - 1995.

Deborah Ely Budding is a clinical neuropsychologist practicing in Southern California. She worked as a writer and editor prior to training as a psychologist and neuropsychologist. She specializes in evaluating children, adolescents and adults with neurodevelopmental disorders and has a particular interest in integrating emotional and cognitive, as well as conscious and unconscious aspects of function. She holds specialty board certifications in Neuropsychologyand Pediatric Neuropsychology.


Clinical psychologists and neuropsychologists are traditionally taught that cognition is mediated by the cortex and that subcortical brain regions mediate the coordination of movement. However, this argument can easily be challenged based upon the anatomic organization of the brain. The relationship between the prefrontal cortex/frontal lobes and basal ganglia is characterized by loops from these anterior brain regions to the striatum, the globus pallidus, and the thalamus, and then back to the frontal cortex. There is also a cerebrocerebellar system defined by projections from the cerebral cortex to the pontine nuclei, to the cerebellar cortex and deep cerebellar nuclei, to the red nucleus and then back to thalamus and cerebral cortex, including all regions of the frontal lobes. Therefore, both the cortical-striatal and cortical-cerebellar projections are anatomically defined as re-entrant systems that are obviously in a position to influence not only motor behavior, but also cognition and affect. This represents overwhelming evidence based upon neuroanatomy alone that subcortical regions play a role in cognition. The first half of this book defines the functional neuroanatomy of cortical-subcortical circuitries and establishes that since structure is related to function, what the basal ganglia and cerebellum do for movement they also do for cognition and emotion.The second half of the book examines neuropsychological assessment. Patients with lesions restricted to the cerebellum and/or basal ganglia have been described as exhibiting a variety of cognitive deficits on neuropsychological tests. Numerous investigations have demonstrated that higher-level cognitive functions such as attention, executive functioning, language, visuospatial processing, and learning and memory are affected by subcortical pathologies. There is also considerable evidence that the basal ganglia and cerebellum play a critical role in the regulation of affect and emotion. These brain regions are an integral part of the brain s executive system. The ability to apply new methodologies clinically is essential in the evaluation of disorders with subcortical pathology, including various developmental disorders (broadly defined to include learning disorders and certain psychiatric conditions), for the purpose of gaining greater understanding of these conditions and developing appropriate methodologies for treatment. The book is organized around three sources of evidence:neuroanatomical connections;patients with various disease processes;experimental studies, including various imaging techniques.These three sources of data present compelling evidence that the basal ganglia and cerebellum are involved in cognition, affect, and emotion. The question is no longer if these subcortical regions are involved in these processes, but instead, how they are involved. The book is also organized around two basic concepts: (1) the functional neuroanatomy of the basal ganglia and the cerebellum; and (2) how this relates to behavior and neuropsychological testing.Cognitive neuroscience is entering a new era as we recognize the roles of subcortical structures in the modulation of cognition. The fields of neuropsychology, cognitive psychology, neuropsychiatry, and neurology are all developing in the direction of understanding the roles of subcortical structures in behavior. This book is informative while defining the need and direction for new paradigms and methodologies for neuropsychological assessment.

Dr. Leonard F. Koziol is a clinical psychologist with specialty board certifications in Neuropsychology and Pediatric Neuropsychology. He works with children, adolescents, and adults with attention or concentration problems, memory loss, or learning disabilities. Dr. Koziol has served as a forensic psychologist expert in legal proceedings. Dr. Koziol is currently part of the Clinical Faculty at Chicago Medical School, Finch University Hospital Clinic, North Chicago, IL; the Consulting Neuropsychology Faculty at Fielding Institute, Santa Barbara, CA; and the Adult Faculty at Illinois School of Professional Psychology, IL, from where he is also a Professional Psychology graduate. His awards include: Fellow, National Academy of Neuropsychology – 2004; and Fellow, American College of Professional Neuropsychology – 1995.Deborah Ely Budding is a clinical neuropsychologist practicing in Southern California. She worked as a writer and editor prior to training as a psychologist and neuropsychologist. She specializes in evaluating children, adolescents and adults with neurodevelopmental disorders and has a particular interest in integrating emotional and cognitive, as well as conscious and unconscious aspects of function. She holds specialty board certifications in Neuropsychologyand Pediatric Neuropsychology.

Subcortical Structures and Cognition 2
Dedication and Acknowledgments 5
Preface 7
Contents 9
Introduction: Movement, Cognition, and the Vertically Organized Brain 14
A Case of Dementia? 16
Why Do We Have a Cortico-centric Bias? 18
Vertically Organized Brain Systems 19
A Theoretical and Historic Context 22
How to Do Things in a Changing Environment 24
When to Do Things-Intention Programs 26
Theories of Types of Behavioral Processing and the Frontostriatal System 27
Analogous Memory Systems 29
The Phylogenetic Perspective 30
Excitation Versus Inhibition 32
Adjustment of Motor ‘‘How’’-The Changing Characteristics of Excitation and Inhibition 33
Summary 35
References 36
The Basal Ganglia: Beyond the Motor System-From Movement to Thought 40
Anatomical Structures and Subdivisions of the Basal Ganglia 41
Basal Ganglia Circuitry 46
Specific Projections into the Striatum 47
Direct and Indirect Pathways 49
The Subthalamic Pathway 50
The Striosomal Pathway 51
Basal Ganglia-Subcortical Loops 51
What Does the Cortico-striatal System Do? 54
Three Selection Pathways-An Interim Summary 55
Application of Motor Behavior to Cognition 55
Examples of the Frontostriatal System in Operation 57
Sensitivity to Context: The Basal Ganglia in Learning 58
Higher-Order Cognition and Working Memory 59
How Does Working Memory Work? 63
Context and Higher-Order Control in Combination 67
The Basal Ganglia and Automatic Processing 68
Alternating Episodes of Automatic Versus Higher-Order Control 70
An Integrated Cortical-Subcortical Model of Behavioral Selection 71
The Striatum Learns and Mobilizes Procedures 71
The Prefrontal Cortex Decides upon Behavior 72
Pathology/Developmental Disorders 74
Summary 75
References 75
Frontal-Subcortical Real Estate: Location, Location, Location 82
Divisions of the Frontal Cortex and the Anterior Circuits 83
The Dorsolateral Prefrontal Circuit (DLPFC) 84
Orbitofrontal Circuit (OFC) 88
The Medial Frontal Circuit (MFC)/Anterior Cingulate Circuit 90
The Motor Circuits 92
Motor, Cognitive, Motivational, and Affective Analogues 93
Frontal System Syndromes 95
Summary 103
References 103
Learning and the Basal Ganglia: Benefiting from Action and Reinforcement 108
The Basal Ganglia and Learning 109
The Inferotemporal and Parietal Loops 113
Categorization and Classification 114
Positive and Negative Reinforcement Learning 121
Summary 131
References 132
The Cerebellum: Quality Control, Creativity, Intuition, and Unconscious Working Memory 138
Surface Anatomy of the Cerebellum 139
Cortex and Cerebellum-Superficial Comparison of Infrastructure 141
Infrastructure of the Cerebellum 142
The Cerebellum and Non-Motor Functions 144
The Cerebellum in Procedural Learning 146
The Cerebro-Cerebellar Circuit 147
The Cerebellum and the Principle of Lateral Crossed Control 150
The Olivo-Cerebellar System 150
Theories of Cerebellar Function 151
A Hybrid Model of Cerebellar Function 153
Three Brain Systems in Parallel 155
Dysmetria-What Does It Signify? 156
Working Memory, Expertise, Creativity, and Giftedness 158
Clinical Presentations 161
The Cerebellar Cognitive Affective Syndrome 162
The Posterior Fossa Syndrome 164
Agenesis of the Cerebellum 166
Very Pre-Term Infants 166
DSM-IV Behaviorally Defined Conditions 167
The Cerebellum as a Modulator 168
Dysmetria-Undershooting and Overshooting-An Important Paradigm 170
Summary 170
References 171
Automaticity and Higher-Order Control in Communication: A Brief Introduction to Language and Social Cognition 179
Gesture, Communication, and Speech 181
The Declarative-Procedural Model of Language 183
Social Cognition-Automatic and Higher-Order Control Systems 186
Reflexive and Reflective Systems 189
Social Intuition, Social Skill, and Non-Verbal Communication 190
Implications of Dual-System Models for Social Cognition and Language 192
Summary 194
References 195
The Vertically Organized Brain in Clinical Psychiatric Disorders 199
Obsessive-Compulsive Disorder 203
Attention Deficit Hyperactivity Disorder 206
Schizophrenia 211
The Basal Ganglia in Schizophrenia 212
The Cerebellum in Schizophrenia 214
Mapping Anatomy and Symptomology 215
Other Clinical Disorders 217
Autism Spectrum Disorder (ASD-Including Asperger Syndrome) 217
Mood Disorders 219
Alzheimer’s Disease 219
Summary 220
References 221
Familiarity and Novelty-Evaluating the Frontostriatal System 230
The Frontostriatal System 232
The Frontostriatal System in Operation 234
Interpretation Paradigms 235
Dynamically Changing Locus of Control 236
Neuropsychological Testing and the Frontostriatal System 237
Test Methodologies for Identifying the Integrity of the Frontostriatal System 239
Verbal Fluency Tasks 243
The Stroop Color Word Test 244
Traditional ‘‘Frontal Lobe’’ Problem-Solving Tests 246
Task Comparisons 254
Continuous Performance and Go-No-Go Tasks 256
Commonly Used Neuropsychological and Cognitive Tests: What Do They Measure? 260
Summary 262
References 263
Thought in Action: Procedural Learning, Processing Speed, and Automaticity 268
Processing Speed 270
The Measurement of Processing Speed 271
Processing Speed-A By-Product of Cognitive/Executive Control 273
Practice Effect 274
Types of Practice Effect 276
Procedural Learning in Neuropsychological Evaluation 279
The Wechsler Mazes 280
Trailmaking Tests 281
Perceptual-Motor Skill Learning 282
Subcircuit Differentiation 283
Motor Adaptation 284
Summary 285
References 285
The Basal Ganglia and Neuropsychological Testing 288
Interpretation Paradigm 291
Level of Performance 292
Test Score Comparisons/Pattern Analysis 292
Pathognomonic Signs 293
Body-Side Comparisons 293
Clinical Case Examples 294
Case 1 294
Case 2 304
Case 3 309
Case 4 315
Case 5 321
Summary 327
References 328
The Cerebellum in Neuropsychological Testing 332
Clinical Case Examples 333
Case 1 333
Case 2 341
Case 3 348
Case 4 358
Summary 371
References 371
The Integrated Brain: Implications for Neuropsychological Evaluation 374
It’s Not ‘‘All Cortex’’- It’s the Flexibility of Interaction 376
Clinical Applications 379
References 388
Index 391

Erscheint lt. Verlag 21.4.2009
Zusatzinfo XIII, 405 p. 19 illus., 10 illus. in color.
Verlagsort New York
Sprache englisch
Themenwelt Geisteswissenschaften Psychologie Allgemeine Psychologie
Geisteswissenschaften Psychologie Biopsychologie / Neurowissenschaften
Geisteswissenschaften Psychologie Verhaltenstherapie
Medizin / Pharmazie Medizinische Fachgebiete Neurologie
Medizin / Pharmazie Medizinische Fachgebiete Psychiatrie / Psychotherapie
Studium 1. Studienabschnitt (Vorklinik) Anatomie / Neuroanatomie
Schlagworte action • basal ganlia • cerebellum and cognition • clinical neuropsychology • Cognition • Cognitive Neuroscience • Cognitive Psychology • cortical-striatal projection • Creativity • frontal cortex • Imaging techniques • Intuition • language • learning • Memory • Neuropsychology • Neuroscience • subcoritcal structures • subcortical regions • Thought
ISBN-10 0-387-84868-1 / 0387848681
ISBN-13 978-0-387-84868-6 / 9780387848686
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