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Brein & Cognitie 2 Hoorcolleges / College-aantekeningen

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Hoorcolleges Brein & Cognitie 2. Ik heb alle hoorcollege bijgewoond en meegeschreven. Inclusief diagrammen etc.

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  • October 16, 2017
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  • 2017/2018
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Brain & Cognition 2

Werkgroepen niet verplicht; opdrachten in handleiding
Deadline final assignments: 3 november 23.59 (telt 20%)

Hoorcollege 1 – Introductie

Clinical neuropsychology: scientific area that studies the relations between brain
and behaviour especially the clinical applicability of diagnosis and treatment.
• Societal factors
o Increase in people with brain damage or disfunction
▪ Decrease in mortality rates because of medical progression
▪ Aging
• All kinds of dysfunctions
▪ Increase in the importance of quality of life
• Time spirit
o Everything is explained by the brain (damage or dysfunction)

Je kan mensen makkelijker overtuigen met MRI onderzoek of conclusies. Als je die
zin m.b.t. MRI studies toevoegt, geloven mensen het eerder dan zonder die zin.
Ookal zijn de conclusies of onderzoeken fout.

Intuïtief: geheel vertrouwen op eigen ervaring
Reflectief: balans tussen interne en externe oriëntatie
Technocratisch: geheel vertrouwen op techniek

Behavioural symptoms  neurocognitive  brain (dis)functions
• Je moet ook kijken naar de genetische symptomen. Dit kan allemaal een
relatie hebben met het brein, gedrag etc.
• Er is ook altijd een context; omgeving, school, vrienden etc.

Diagnostic cycle
Complaints   problems: hypotheses   cause analysis   indication
It starts with referral; can come from a doctor, or the patient itself. The referral is not
the question, it’s something subjective. Then file anamnesis. Then you will formulate
hypotheses. At least you have to interpret*. It ends with advise.
Complaint 1, 2 ..  symptom 1, 2..  syndrome (DSM or ICF to classify)

Sources of information
• Anamnesis
o Read medical files or other available correspondences
o Intake
▪ Interview: minimal structure  specific questions
▪ Heteroanamnesis: you ask someone else about the person, but
not the person itself. A supportive person in the environment.
o Structured questionnaires
• Behavioural observations (anamnesions, testing, natural environment)
• Tests and questionnaires
 Requirements on methods used

,Guidelines: Algemeen Standaard Testgebruik-NIP (AST) (2010)
Guidelines: COTAN: rating/judging tests on test construction, technical manual, test
material, reliability, validity and availability of norms.

Links: taal
Rechts: ruimtelijke taken

,Hoorcollege 2

Parkinson’s hoofdtrekken:
• Tremor
• Sloomheid
• Stijfheid

Er is een heel Parkinson spectrum




Parkinson’s disease
Familial type: genetic
Idiopathic PD: when you don’t know why the person developed the disease

Atypische vormen van Parkinson
Vascular Parkinson: allemaal kleine hersenbloedingen wat leidt tot symptomen van
Parkinson
Multiple system atrophy: degenerative neurological disorder, degeneration of brain
areas that are most effected by parkinon’s disease like substantia nigra or striatum
Drug-induced: person takes certain medication and this causes symptoms of
Parkinson. Bepaalde medicijnen wekken symptomen van Parkinson op
Corticobasal degeneration: degenerative neurological disorder, mainly effect the
cerebral cortex and the basal ganglia
Dementia with lewy bodies: brain disorder, lewy bodies are built up in areas in the
brain that regulate behaviour, cognition and emotion
Progressive supranuclear paralysis: veroorzaakt door de dood van specifieke
breinvolumes, bv. Breinstam, basale ganglia
 verschillen niet belangrijk: ze lijken allemaal op PD maar hebben andere klinische
kenmerken en andere pathologie. In het algemeen is PD beter behandelbaar dan
deze atypische vormen.

Parkinson’s disease (PD)
• Progressive disorder
• Typically starts on one side; symptoms remain on one side of the body at first,
after a couple of years it will also appear on the other half of the body. But
often the symptoms remain stronger on the side that was first affected.
• Onset – gradual
• They are feeling weakness, fatigue; not because they are tired but they will get
noticed that it takes longer to initiate the movement
• The side of where the trumor will appear is not related to which side is the
dominant, like the dominant hand of the person
• Changing in handwriting; start writing smaller
• Soft voice, reduction in facial expression

, • Depression or anxiety are early symptoms
• When the patients are stressed, the symptoms are worse

Primary motor symptoms of PD
• Resting tremor (in the foot, hand or one side of the body)
o Consists of shaking movements, appears when the muscles are at rest.
When the person starts to moves, then the tremor disappears
o Not everyone with PD develops this tremor
• Bradykinesia (slow movement)
o A decrease in facial expression
o You see more difficulty with movements at the side which is more
effected
o They walk in more small shuffling steps
o It also effects the voice, they are harder to understand
o They can also have akinesia  absence of movements
• Rigidity
o Cause stiffness and inflexibility of the limbs, the neck and the trunk
o Movements will be less flexible
o No swinging with the arms while walking because of the stiffness
• Postural instability
o Most common
o Lost some of the reflexes to maintain a upright posture

Secondary motor symptoms of PD
• Freezing of gait
o Cannot be explained by rigidity or bradykinesia
o Feet are clued to the floor: they just cannot move
o After a couple of seconds they can walk less normally
o No freezing when walking on the stairs (unclear why)
• Micrographia
o Difficulty with repetitive movements
• Mask-like expression
o rigidity or bradykinesia
• Unwanted accelerations (tachyphemia and festination)
o Can effect walking and also speech
o People all of a sudden speak/walk faster and faster
o Weird combination: freezing and accelerations

Additional secondary motor symptoms (not experienced by everybody)
• Stooped posture, a tendency to lean forward
• Dystonia: involuntary muscle contractions
• Impaired fine motor dexterity and motor coordination
• Impaired gross motor coordination
• Poverty of movement (decreased arm swing)
• Akathisia: movement disorders of feelings of restlessness
• Speech problems (softness of voice or slurred speech)
• Difficulty swallowing
• Sexual dysfunction
• Cramping

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