PSYC 169 Midterm 2

hemispatial neglect: lesion is most common in the __ hemisphere, affecting the __ side of the body/world

[A] right, right

[B] right, left

[C] left, left

[D] left, right

B

[T/F] hemispatial neglect is a sensory disorder

false

[T/F] hemispatial neglect is an attentional disorder

true

are there sensory or motor deficits in hemispatial neglect

no

hemispatial neglect is most common after ___ in the ___

right hemisphere stroke, medial cerebral artery

hemispatial neglect patients show variability in…(4)

• quality and severity of symptoms

• lesion location

• extent and time to recovery (including responsiveness to therapy)

• affected sensory modalities (neglect all modalities in the L side, only visual stimuli, only auditory stimuli, etc)

five assessment tasks and their results for hemispatial neglect

• cancellation tasks: cross all lines, circle all As, etc

  • only cross/circle on the R side of space

• line bisection

  • drew line closer to the R side than the middle

• copying task

  • only draw the R side of the image

• eye tracking (visual search task)

  • only looks at the R side of the visual space

• reproducing an image/object from memory

  • squish numbers on the R side of the clock, miss parts of the L side of the drawing, etc

egocentric neglect

neglect with respect to the viewer

in the copying task, the patient does not draw anything on the left side of the image. what type of hemispatial neglect is this?

egocentric

allocentric neglect

neglect with respect to the object

in the copying task, the patient does not draw the left half of any object. what type of hemispatial neglect is this?

allocentric

egocentric and allocentric are two types of ___

hemispatial neglect

[T/F] hemispatial neglect is binary, not graded (you either have it or you don’t)

false

[T/F] spatial memories are intact in hemispatial neglect

true

are patients with hemispatial neglect aware of their neglect?

no

[T/F] the border between the neglected space and the non-neglected space is sharp and absolute

false

hemispatial neglect is [A] less/[B] more pronounced if there is more stimuli to attend to (ex: more letters on the page)

B

extinction, in hemispatial neglect

unawareness of stimuli in the presence of competing stimuli

in extinction in hemispatial neglect, if the experimenter holds up their R hand, the patient [A] can/[B] cannot detect it

A

in extinction in hemispatial neglect, if the experimenter holds up their L hand, the patient [A] can/[B] cannot detect it

A

in extinction in hemispatial neglect, if the experimenter holds up their L and R hands, the patient [A] can/[B] cannot detect the L hand

B

in extinction in hemispatial neglect, if the experimenter holds up their L and R hands, the patient [A] can/[B] cannot detect the R hand

A

[T/F] extinction happens in most hemispatial neglect patients

false

[T/F] anosognosia happens in most hemispatial neglect patients

true

anosognosia

being unaware of your own illness or disability

[T/F] allesthesia happens in most hemispatial neglect patients

false

three additional symptoms of hemispatial neglect

• extinction

• anosognosia

• allesthesia

allesthesia, in hemispatial neglect

patients respond to stimuli on the neglected side as if they were on the non-lesioned side

in a patient with allesthesia, stimuli on the L side leads to sensory responses on the [A] right/[B] left side

A

[A] right/[B] left hemisphere is dominant for spatial attention

A

[T/F] the R hemisphere can compensate spatially for a L hemisphere lesion

true

[T/F] the L hemisphere can compensate spatially for a R hemisphere lesion

false

lesions in which lobes are associated with hemispatial neglect?

frontal, parietal, temporal

hemianopia is a ___ defect

[A] sensory

[B] attentional

A

[T/F] hemianopia is a defect of the visual field

true

homonymous hemianopia

visual field defect that affects the same part of the visual field in both eyes

in hemianopia, a stroke in the R optic tract causes a loss of information in the [A] right/[B] left visual field

B

hemianopia vs hemispatial neglect: main deficit

hemianopia is sensory (actual loss of info)

hemispatial neglect is attentional

hemianopia vs hemispatial neglect: lesion location

hemianopia:

hemispatial neglect: frontal, parietal, or temporal lobes; medial cerebral artery; most commonly R hemisphere lesion affecting L side

Left hemianopia patient cannot see on the __ side, and has a lesion in the __ optic tract

[A] right, right

[B] left, left

[C] right, left

[D] left, right

D

stimulus in the right visual field

which participant(s) can say they detect this?

control

hemispatial neglect

left homonymous hemianopia

control: can detect

hemispatial neglect: can detect

left homonymous hemianopia: can detect

stimulus in the left visual field

which participant(s) can say they detect this?

control

hemispatial neglect

left homonymous hemianopia

control: can detect

hemispatial neglect: can maybe detect, due to extinction

left homonymous hemianopia: cannot detect

stimulus in the right and left visual fields

which participant(s) can say they detect the stimulus on the right side?

control

hemispatial neglect

left homonymous hemianopia

control: can detect

hemispatial neglect: can detect

left homonymous hemianopia: can detect

stimulus in the right and left visual fields

which participant(s) can say they detect the stimulus on the left side?

control

hemispatial neglect

left homonymous hemianopia

control: can detect

hemispatial neglect: cannot detect, due to extinction (two stimuli at the same time)

left homonymous hemianopia: cannot detect

touch participant’s left hand

which participant(s) can say they detect this?

control

hemispatial neglect

left homonymous hemianopia

control: can detect

hemispatial neglect: can detect, due to extinction; or detects on the R hand, due to allesthesia

left homonymous hemianopia: can detect

touch participant’s right hand

which participant(s) can say they detect this?

control

hemispatial neglect

left homonymous hemianopia

control: can detect

hemispatial neglect: can detect

left homonymous hemianopia: can detect

touch both hands simultaneously

which participant(s) can say they detect the stimulus on the right side?

control

hemispatial neglect

left homonymous hemianopia

control: can detect

hemispatial neglect: detects R hand being touched, not L

left homonymous hemianopia: can detect

three recoveries/therapies for hemispatial neglect

• visual scanning training

• prism adaptation

• TMS over the intact hemisphere

visual scanning training

using anchors (ex: highlight the L border of a canvas or the L side of a book) to bring awareness to the neglect

prism adaptation

patients wear prism goggles that shift their field of vision towards the right; multiple sessions can lead to long-lasting effects

[T/F] the reasoning behind hemispatial neglect therapies is understood and not controversial

false

interhemispheric rivalry model

in typical people, both hemispheres are in constant rivalry and inhibit each other. if the R hemisphere is damaged, it can no longer inhibit the L hemisphere, leading to an overrepresentation of the L hemisphere/R visual field and a neglect of the L visual field

rTMS, in hemispatial neglect

repetitive TMS over the intact (L) hemisphere can reduce activity and neglect symptoms

three symptoms of Balint’s syndrome

• optic ataxia

• simultanagnosia

• oculomotor apraxia

lesion location in Balint’s syndrome

parietal lobe, bilateral (both hemispheres)

[T/F] visual system is intact in Balint’s syndrome

true

optic ataxia

• impairment of visually guided actions (reaching or grasping)

• lack of coordination between visual input and motor output

• might misreach, orient the hand incorrectly, or have difficulty shaping their grip based on the object’s visual properties

• most apparent for objects in the visual periphery

• can be unilateral or bilateral (as in Balint’s syndrome)

simultanagnosia

• impairment of detecting/perceiving more than one object at a time

• makes reading very difficult (letters are perceived separately)

oculomotor apraxia

• impairment in making appropriate eye movements

• jerking head movements, since they cannot shift their gaze

• muscles are intact, but sending the signal (motor planning of eye movement) is not

[T/F] optic ataxia is worse when reaching for items in the periphery

true

[T/F] visual system is intact in optic ataxia

true

[T/F] motor system is intact in optic ataxia

true

[T/F] when describing an image, simultanagnosia patients focus on relationships between people/objects

false

[T/F] patients with oculomotor apraxia can move their eyes

true

[T/F] patients with oculomotor apraxia can focus on specific visual stimuli

false

[T/F] if they are looking forward, patients with oculomotor apraxia might shift their gaze if stimuli is placed in front of them

true

[T/F] in oculomotor apraxia, eye muscles are not intact

false

[T/F] in oculomotor apraxia, motor planning/signaling is not intact

true

paresis

muscle weakness; common after a stroke

paresis vs apraxia

paresis is motor weakness, while apraxia is a deficit in motor planning (muscles are intact)

[T/F] there is muscle weakness in apraxia

false

apraxia

the inability to perform learned purposeful movements despite intact motor and sensory function

apraxia is a ___ disorder

[A] sensory

[B] motor

[C] cognitive

C

apraxia is common after a lesion in the [A] right/[B] left hemisphere

B

[T/F] apraxias can be general or specific to tasks

true

most common form of apraxia

idemotor apraxia

ideomotor apraxia: lesion location

left parietal

ideomotor apraxia

• unable to copy movements/make gestures when prompted

• but, can make gestures spontaneously

• impairment: connecting the idea to the motor command

[T/F] even if you give them the object, someone with ideomotor apraxia still wouldn’t be able to show how they use it

false

ideational apraxia

• impaired action sequences; unable to use/describe objects for the right function

• intact: imitating gestures; gesture knowledge; object recognition

• impairment: conceptualization and organization of complex action sequences

someone with ideational apraxia [A] can/[B] cannot imitate gestures

A

someone with ideational apraxia [A] can/[B] cannot recognize objects

A

someone with ideational apraxia [A] can/[B] cannot use objects properly

B

someone seen brushing their teeth with a spoon probably has

ideational apraxia

someone with ideational apraxia [A] can/[B] cannot explain what an object is used for

B

someone with ideational apraxia [A] can/[B] cannot name objects

A

ideational apraxia: lesion location

right middle cerebral artery, affecting the frontal, parietal, and temporal lobes

limb-kinetic apraxia

• difficulty with fine, precise and coordinated limb movement; cannot break complex movements down into smaller steps

• hard to diagnose (may just appear clumsy)

• intact: pantomiming, imitation, gesture knowledge, sequential action, conceptual knowledge of object function

limb-kinetic apraxia: lesion location

premotor and supplementary motor areas, in the frontal cortex

[T/F] motor function is intact in limb-kinetic apraxia

true

[T/F] sensory function is intact in limb-kinetic apraxia

true

big picture for each apraxia

• ideomotor

  • impaired: translation of idea into motor command

  • intact: idea for the motor action

• ideational

  • impaired: concept/organization of action, particularly for complex/multi-step actions (involving tools)

  • intact: imitating gestures, gesture knowledge, object recognition

  
  

• limb-kinetic

  • impaired: precise and coordinated movements

  • intact: action concept and motor planning

apraxia is usually caused by a lesion to the [A] right/[B] left hemisphere, regardless of handedness

B

task: recognize a hammer and nail

ideomotor, ideational, limb-kinetic apraxia results

ideomotor: can recognize

ideational: can recognize

limb-kinectic: can recognize

task: verbally describe how to use a hammer and nail

ideomotor, ideational, limb-kinetic apraxia results

ideomotor: can describe

ideational: cannot describe

limb-kinectic: can describe

task: pantomime how to use a hammer and nail

ideomotor, ideational, limb-kinetic apraxia results

ideomotor: cannot pantomime

ideational: probably, depends on how complex the action/severe the deficit is

limb-kinectic: can pantomime

task: copy someone else’s pantomime

ideomotor, ideational, limb-kinetic apraxia results

ideomotor: cannot copy

ideational: probably, depends on how complex the action/severe the deficit is

limb-kinectic: can copy

task: use a hammer and nail

ideomotor, ideational, limb-kinetic apraxia results

ideomotor: can use

ideational: cannot use

limb-kinectic: cannot use

optic ataxia: hand vs field effects

hand effect: errors when reaching with the contralateral hand (L hem lesion, R hand deficit)

field effect: errors when reaching into the contralateral visual field (L hem lesion, R visual field deficit)

three streams for visual processing and the 5 Ws

• dorso-dorsal stream: where

• ventro-dorsal stream: how

• ventral stream: what