Emotional Functioning and Insight - Exam 2 Neuropsychology

What does the universality of emotion relate to?

Basic human emotions are universal across cultures, which is reflected in the facial emotions that are expressed similarly everywhere and that can be recognized by “everyone”

What are the “by the book” definitions of emotion, affect, and mood?

emotion: the cognitive interpretation of subjective feelings

• mood: internal experience 

affect: conscious, subjective feeling about a stimulus that also includes a behavioral component

• affect is also defined as external expression

What is the difference between emotion generation versus emotion regulation?

emotion generation: having feelings

emotional regulation: managing those feelings 

What was Papez’s theory?

• it involved the limbic lobe serving as the home for emotion (generation and regulation)

• prior to this theory, there were no known neurological bases for emotion

• this theory identified anatomical structures that had NO known function

What happens in regards to affective or emotional changes after neurological injury and/or disease? For example, what is the pseudobulbar affect, or PBA?

• we can use human and animal examples for this

the pseudobulbar affect, or PBA, is a neurological condition that causes people to experience sudden, uncontrollable, and inappropriate episodes of laughing or crying

• this is also known as emotional incontinence

• it’s disproportionate to this person’s emotional state, involving a mismatch of the internal (emotion) and external (affect)

What is the pathophysiology of the pseudobulbar affect? What network does it involve, what network does it receive info (input) from, and what regions of the brain inhibit it?

• normally, it’s from an emotional motor expression network (since remember facial expressions need motor commands to be initiated) that gets info from the cortico-ponto-cerebellar network 

• This allows the cerebellum to function as a gate-control mechanism for the MOTOR expression of emotions (i.e. through facial expressions) —> leads to an output of VOLUNTARY laughing or crying

• How is this inhibited? By sensory cortices

For the pseudobulbar affect pathophysiology, what shows that inhibition is broken on some level?

In PBA, because this pathology results in uncontrollable laughing or crying episodes, there is a diminished inhibitory influence at the cortical level (sensory cortices), which leads to ABNORMAL activation within the network

• this INCREASED activation manifests as the episodes of laughing or crying (involuntary)

What does PBA or the pseudobulbar affect result from, in terms of pathophysiology?

• ALS and stroke

• MS

• Alzheimer’s

• Parkinson’s

• TBI (traumatic brain injury)

Who discovered Kluver-Bucy syndrome, and when?

In 1939, Heinrich Kluver and Paul Bucy discovered a behavioral syndrome called Kluver-Bucy syndrome.

!! Kluver-Bucy syndrome is DIFFERENT from the pseudobulbar affect

What are the key characteristics or symptoms of Kluver-Bucy syndrome?

• hyperorality: compulsion to put things in the mouth

• hypersexuality

• compulsive eating (bulimia might also be involved)

• pica, or eating inappropriate objects (the pregnant woman thing)

• visual agnosia

• placidity (lack of fear or anger responses, or docility)

• amnesia

• hypermetamorphosis, or the tendency to touch everything

What are potential causes of Kluver-Bucy sundrome?

• ALS (amyotrophic lateral sclerosis, which affects the motor neurons in the brain and spinal cord) and stroke

• MS, or multiple sclerosis

• Alzheimer’s

• Parkinson’s

• TBI, or traumatic brain injury

What is the pathophysiology of Kluver-Bucy syndrome - as in, what are the two theories

• Norman-Geschwind theory: visual-limbic disconnection (leading to a lack of ability to recognize objects, or agnosia, and also a lack of ability to regulate your emotions thanks to limbic system damage)

• Muller theory: thalamus-prefrontal cortex-limbic system disconnection (impulse control issues thanks to prefrontal cortex, emotional regulation issues, emotional blunting thanks to problems with the amygdala)

What are some other considerations we should include in regards to lesions, neural degeneration, or other forms of damage to the brain (such as a TBI)?

• Anosagnosia, or lack of insight or awareness of the condition

• Mood disorders (an increased susceptibility to anxiety or depression after trauma to the brain)

• personality changes

How does assessment - or measurement - of emotions and insight work?

• personality testing (minnestota multiphasic personality inventory + personality assessment inventory)

• mood —> self report measures (ex. the GAD7 for anxiety)

• insight (into the person’s ability to live their life and function independently —> so we obtain the patient’s perspective, family perspective, clinician perspective and compare) —> self report measures (ex. awareness questionnaire)