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Cognitive neuropsychology is a branch of cognitive psychology that aims to understand how the structure and function of the brain relates to specific psychological processes. Cognitive psychology is the science that looks at how mental processes are responsible for the cognitive abilities to store and produce new memories, produce language, recognize people and objects, as well as our ability to reason and problem solve. Cognitive neuropsychology places a particular emphasis on studying the cognitive effects of brain injury or neurological illness with a view to inferring models of normal cognitive functioning. Evidence is based on case studies of individual brain damaged patients who show deficits in brain areas and from patients who exhibit double dissociations. Double dissociations involve two patients and two tasks. One patient is impaired at one task but normal on the other, while the other patient is normal on the first task and impaired on the other. For example, patient A would be poor at reading printed words while still being normal at understanding spoken words, while the patient B would be normal at understanding written words and be poor at understanding spoken words. Scientists can interpret this information to explain how there is a single cognitive module for word comprehension. From studies like these, researchers infer that different areas of the brain are highly specialised. Cognitive neuropsychology can be distinguished from cognitive neuroscience, which is also interested in brain-damaged patients, but is particularly focused on uncovering the neural mechanisms underlying cognitive processes. [1]
Cognitive neuropsychology has its roots in the diagram-making approach to language disorder that started in the second half of the 19th century. The discovery that aphasia takes different forms depending on the location of brain damage provided a powerful framework for understanding brain function. [3]
In 1861, Paul Broca reported a post mortem study of an aphasic patient who was speechless apart from a single nonsense word: "Tan". Broca showed that an area of the left frontal lobe was damaged. As Tan was unable to produce speech but could still understand it, Broca argued that this area might be specialised for speech production and that language skills might be localized to this cortical area. Broca did a similar study on another patient, Lelong, a few weeks later. Lelong, like Tan, could understand speech but could only repeat the same five words. After examining his brain, Broca noticed that Lelong had a lesion in approximately the same area as his patient Tan. He also noticed that in the more than 25 patients he examined with aphasia, they all had lesions to the left frontal lobe but there was no damage to the right hemisphere of the brain. From this he concluded that the function of speech was probably localized in the inferior frontal gyrus of the left hemisphere of the brain, an area now known as Broca's area.
Karl Wernicke subsequently reported patients with damage further back in the temporal lobe who could speak but were unable to understand what was said to them, providing evidence for two potentially interconnected language centres. These clinical descriptions were integrated into a theory of language organisation by Lichtheim. [4] Subsequently, these models were used and developed to inform Dejerine's account of reading, Liepmann's theory of action and Lissauer's 1890 account of object recognition and Lewandowsky and Stadelmann's 1908 account of calculation.
However, the early 20th century saw a reaction to the overly-precise accounts of the diagram-making neurologists. Pierre Marie challenged conclusions against previous evidence of Broca's areas in 1906 and Henry Head attacked the whole field of cerebral localisation 1926.
The modern science of cognitive neuropsychology emerged during the 1960s stimulated by the insights of the neurologist Norman Geschwind who demonstrated that the insights of Broca and Wernicke were still clinically relevant. The other stimulus to the discipline was the cognitive revolution and the growing science of cognitive psychology which had emerged as a reaction to behaviorism in the mid-20th century. [5] Psychologists in the mid-1950s acknowledged that the structure of mental information-processing systems could be investigated in scientifically acceptable ways. They developed and applied new cognitive processing models to explain experimental data from not only studies of speech and language but also those of selective attention. [6] Cognitive psychologists and clinical neuropsychologists developed more research collaborations to gain a better understanding of these disorders. The rebirth of neuropsychology was marked by the publishing of two seminal collaborative papers from Marshall & Newcombe (1966) on reading and Warrington & Shallice (1969) on memory. [6] Subsequently, work by pioneers such as Elizabeth Warrington, Brenda Milner, Tim Shallice, Alan Baddeley and Lawrence Weiskrantz demonstrated that neurological patients were an important source of data for cognitive psychologists.
It took less than one decade for neuropsychology to be fully re-established. More achievements in neuropsychology were recognized: the establishment of the first major book discussing neuropsychology using a cognitive approach, Deep Dyslexia, in 1980 after a scientific meeting about the topic in Oxford in 1977, the birth of the Cognitive Neuropsychology journal in 1984, and the publishing of the first textbook of neuropsychology, Human Cognitive Neuropsychology in 1988. [6]
A particular area of interest was memory. Patients with amnesia caused by injuries to the hippocampus in the temporal cortex and midbrain areas (especially the mamillary bodies) were of early interest. A patient with severe case of amnesia will not be able to remember meeting the examiner if they leave the room and return, let alone events of the previous day (episodic memory), but they will still be able to learn how to tie their shoes (procedural memory), remember a series of numbers for a few seconds (short-term memory or working memory) and be able to recall historical events they have learned in school (semantic memory). By contrast, patients may lose their short-term memory abilities while retaining their long term memory functions. Many other studies like this have been done in the field of neuropsychology examining lesions and the effect they have on certain areas of the brain and their functions.
Studies on the amnesic patient Henry Molaison, formerly known as patient H.M., are commonly cited as some of the precursors, if not the beginning of modern cognitive neuropsychology. Molaison had parts of his medial temporal lobes surgically removed to treat intractable epilepsy in 1953. Much of the hippocampus was also removed along with the medial temporal lobes. The treatment proved successful in reducing his dangerous seizures, but left him with a profound but selective amnesia. After the surgery, Molaison was able to remember some big events from before the surgery, such as the stock market crash in 1929, but was confused about many others and could no longer form new memories. This accidental experiment showed scientists how the brain processes different types of memory. Because Molaison's impairment was caused by surgery, the damaged parts of his brain were known, information which was usually not knowable in a time before accurate neuroimaging became widespread. Scientists concluded that while the hippocampus is needed in the creation of new memories, it is not needed in the retrieval of old ones; they are two separate processes. They also realized that the hippocampus and the medial temporal lobes, both of the areas removed from Molaison, are the areas responsible for converting short-term memory to long-term memory.
Much of the early work of cognitive neuropsychology was carried out with limited reference to the detailed localisation of brain pathology. Neuroimaging was relatively imprecise and other anatomically based techniques were also limited. The emphasis of many researchers as late as 1990 was on the analysis of patterns of cognitive deficit rather than on where the injury was located. [7] Despite the lack of detailed anatomical data, studies of reading, language and memory had a number of important implications. The first is that certain cognitive processes (such as language) could be damaged separately from others, and so might be handled by distinct and independent cognitive (and neural) processes. (For more on the cognitive neuropsychological approach to language, see Eleanor Saffran, among others.) The second is that such processes might be localized to specific areas of the brain. Whilst both of these claims are still controversial to some degree, the influence led to a focus on brain injury as a potentially fruitful way of understanding the relationship between psychology and neuroscience.
A key approach within cognitive neuropsychology has been to use single case studies and dissociation as a means of testing theories of cognitive function. For example, if a theory states that reading and writing are simply different skills stemming from a single cognitive process, it should not be possible to find a person who, after brain injury, can write but not read or read but not write. This selective breakdown in skills suggests that different parts of the brain are specialized for the different processes and so the cognitive systems are separable.
The philosopher Jerry Fodor has been particularly influential in cognitive neuropsychology, particularly with the idea that the mind, or at least certain parts of it, may be organised into independent modules. Evidence that cognitive skills may be damaged independently seem to support this theory to some degree, although it is clear that some aspects of mind (such as belief for example) are unlikely to be modular. Fodor, a strict functionalist, rejects the idea that the neurological properties of the brain have any bearing on its cognitive properties and doubts the whole discipline of cognitive neuropsychology.
With improved neuroimaging techniques, it has been possible to correlate patterns of impairment with a knowledge of exactly which parts of the nervous system are damaged, allowing previously undiscovered functional relationships to be explored (the lesion method). Contemporary cognitive neuropsychology uses many of the same techniques and technologies from the wider science of neuropsychology and fields such as cognitive neuroscience. These may include neuroimaging, electrophysiology and neuropsychological tests to measure either brain function or psychological performance. Useful technology in cognitive neuropsychology includes positron-emission tomography (PET) and functional magnetic resonance imaging (fMRI). These techniques make it possible to identify the areas of the brain responsible for performing certain cognitive tasks by measuring blood flow in the brain. PET scans sense the low-level radiation in the brain and produce 3-D images, whereas an fMRI works on a magnetic signal and is used to “map the brain”. Electroencephalography (EEG) records the brain’s electrical activity and can identify changes that occur over milliseconds. EEG is often used in patients with epilepsy to detect seizure activity.
The principles of cognitive neuropsychology have recently been applied to mental illness, with a view to understanding, for example, what the study of delusions may tell us about the function of normal belief. This relatively young field is known as cognitive neuropsychiatry.
In neuroscience and psychology, the term language center refers collectively to the areas of the brain which serve a particular function for speech processing and production. Language is a core system that gives humans the capacity to solve difficult problems and provides them with a unique type of social interaction. Language allows individuals to attribute symbols to specific concepts, and utilize them through sentences and phrases that follow proper grammatical rules. Finally, speech is the mechanism by which language is orally expressed.
Broca's area, or the Broca area, is a region in the frontal lobe of the dominant hemisphere, usually the left, of the brain with functions linked to speech production.
Cognitive neuroscience is the scientific field that is concerned with the study of the biological processes and aspects that underlie cognition, with a specific focus on the neural connections in the brain which are involved in mental processes. It addresses the questions of how cognitive activities are affected or controlled by neural circuits in the brain. Cognitive neuroscience is a branch of both neuroscience and psychology, overlapping with disciplines such as behavioral neuroscience, cognitive psychology, physiological psychology and affective neuroscience. Cognitive neuroscience relies upon theories in cognitive science coupled with evidence from neurobiology, and computational modeling.
Neuropsychology is a branch of psychology concerned with how a person's cognition and behavior are related to the brain and the rest of the nervous system. Professionals in this branch of psychology focus on how injuries or illnesses of the brain affect cognitive and behavioral functions.
Henry Gustav Molaison, known widely as H.M., was an American who had a bilateral medial temporal lobectomy to surgically resect the anterior two thirds of his hippocampi, parahippocampal cortices, entorhinal cortices, piriform cortices, and amygdalae in an attempt to cure his epilepsy. Although the surgery was partially successful in controlling his epilepsy, a severe side effect was that he became unable to form new memories. His unique case also helped define ethical standards in neurological research, emphasizing the need for patient consent and the consideration of long-term impacts of medical interventions. Furthermore, Molaison's life after his surgery highlighted the challenges and adaptations required for living with significant memory impairments, serving as an important case study for healthcare professionals and caregivers dealing with similar conditions.
The temporal lobe is one of the four major lobes of the cerebral cortex in the brain of mammals. The temporal lobe is located beneath the lateral fissure on both cerebral hemispheres of the mammalian brain.
Brenda Milner is a British-Canadian neuropsychologist who has contributed extensively to the research literature on various topics in the field of clinical neuropsychology. Milner is a professor in the Department of Neurology and Neurosurgery at McGill University and a professor of Psychology at the Montreal Neurological Institute. As of 2020, she holds more than 25 honorary degrees and she continued to work in her nineties. Her current work covers many aspects of neuropsychology including her lifelong interest in the involvement of the temporal lobes in episodic memory. She is sometimes referred to as the founder of neuropsychology and has been essential in its development. She received the Balzan Prize for Cognitive Neuroscience in 2009, and the Kavli Prize in Neuroscience, together with John O'Keefe, and Marcus E. Raichle, in 2014. She turned 100 in July 2018 and at the time was still overseeing the work of researchers.
In neurology, retrograde amnesia (RA) is the inability to access memories or information from before an injury or disease occurred. RA differs from a similar condition called anterograde amnesia (AA), which is the inability to form new memories following injury or disease onset. Although an individual can have both RA and AA at the same time, RA can also occur on its own; this 'pure' form of RA can be further divided into three types: focal, isolated, and pure RA. RA negatively affects an individual's episodic, autobiographical, and declarative memory, but they can still form new memories because RA leaves procedural memory intact. Depending on its severity, RA can result in either temporally graded or more permanent memory loss. However, memory loss usually follows Ribot's law, which states that individuals are more likely to lose recent memories than older memories. Diagnosing RA generally requires using an Autobiographical Memory Interview (AMI) and observing brain structure through magnetic resonance imaging (MRI), a computed tomography scan (CT), or electroencephalography (EEG).
Explicit memory is one of the two main types of long-term human memory, the other of which is implicit memory. Explicit memory is the conscious, intentional recollection of factual information, previous experiences, and concepts. This type of memory is dependent upon three processes: acquisition, consolidation, and retrieval.
Comparative neuropsychology refers to an approach used for understanding human brain functions. It involves the direct evaluation of clinical neurological populations by employing experimental methods originally developed for use with nonhuman animals.
Brodmann area 22 is a Brodmann's area that is cytoarchitecturally located in the posterior superior temporal gyrus of the brain. In the left cerebral hemisphere, it is one portion of Wernicke's area. The left hemisphere BA22 helps with generation and understanding of individual words. On the right side of the brain, BA22 helps to discriminate pitch and sound intensity, both of which are necessary to perceive melody and prosody. Wernicke's area is active in processing language and consists of the left Brodmann area 22 and Brodmann area 40, the supramarginal gyrus.
The lateralization of brain function is the tendency for some neural functions or cognitive processes to be specialized to one side of the brain or the other. The median 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.
In neuropsychology, dissociation involves identifying the neural substrate of a particular brain function through identification of case studies, neuroimaging, or neuropsychological testing.
In human neuroanatomy, brain asymmetry can refer to at least two quite distinct findings:
Retrospective memory is the memory of people, words, and events encountered or experienced in the past. It includes all other types of memory including episodic, semantic and procedural. It can be either implicit or explicit. In contrast, prospective memory involves remembering something or remembering to do something after a delay, such as buying groceries on the way home from work. However, it is very closely linked to retrospective memory, since certain aspects of retrospective memory are required for prospective memory.
The neuroanatomy of memory encompasses a wide variety of anatomical structures in the brain.
Amnesia is a deficit in memory caused by brain damage or brain diseases, but it can also be temporarily caused by the use of various sedative and hypnotic drugs. The memory can be either wholly or partially lost due to the extent of damage that is caused.
Executive functions are a cognitive apparatus that controls and manages cognitive processes. Norman and Shallice (1980) proposed a model on executive functioning of attentional control that specifies how thought and action schemata become activated or suppressed for routine and non-routine circumstances. Schemas, or scripts, specify an individual's series of actions or thoughts under the influence of environmental conditions. Every stimulus condition turns on the activation of a response or schema. The initiation of appropriate schema under routine, well-learned situations is monitored by contention scheduling which laterally inhibits competing schemas for the control of cognitive apparatus. Under unique, non-routine procedures controls schema activation. The SAS is an executive monitoring system that oversees and controls contention scheduling by influencing schema activation probabilities and allowing for general strategies to be applied to novel problems or situations during automatic attentional processes.
The following outline is provided as an overview of and topical guide to the human brain:
Nina Dronkers is an American cognitive neuroscientist. She is known for her studies of aphasia and their application for understanding brain systems involved in normal language abilities. She is a professor in the Psychology Department at the University of California, Berkeley, and a faculty member of the Helen Wills Neuroscience Institute. She is also an Emerita Research Career Scientist of the Veterans Administration Northern California Health Care System where she established the Center for Aphasia and Related Disorders. She serves as a consultant for the Memory and Aging Center at UCSF Medical Center. In addition, she is an adjunct professor in the Department of Neurology, University of California, Davis, School of Medicine. She has published over 120 scientific papers and is the co-author with Lise Menn of a textbook: Psycholinguistics: Introduction and Applications, Second edition.
The term cognitive neuropsychology often connotes a purely functional approach to patients with cognitive deficits that does not make use of, or encourage interest in, evidence and ideas about brain systems and processes