College 1 – Introduction to clinical neuropsychology
Clinical neuropsychology: Applied science that studies the relationship between brain (dis)function and
behaviour in patients and the application in assessment and treatment
Has become highly relevant in modern-day (mental) health care
- Increase in people with brain damage or dysfunction
- Decrease in morality rates because of improvements in medical care
- Aging
- More interest in quality of life
A clinical neuropsychologist is a scientist practitioner whose focus lies on behavioural and
cognition
A clinical neuropsychologist is not a brain researcher
ICF is useful in clinical neuropsychology
- Description of consequences of brain disease / disorder at 3
different levels: impairment, limitation, and restriction
(handicap)
- Identifying moderating factors
- Relevant for understanding subjective complaints and
problems in daily life (school – work – social functioning)
- Identify target for treatment or optimalisation
Diagnostic cycle
College 2 - Korsakoff’s syndrome and alcohol-related cognitive disorders
Memory: the ability to encode information, store it and
retrieve it
Atkinson-Shiffrin memory model
, Explicit: consciously access
- Episodic: memory for experiences of
personal past (what, where, when)
- Semantic: general knowledge
Implicit: unconscious, automatic
Neuroanatomical structures involved in memory processes
Bradley’s model of working memory
- Limited (but no fixed) duration (seconds)
- Limited capacity (visuospatial sketchpad and
phonological look) approx. 7 units
- Active processing (CE) of information in STM
- Linked to long-term memory (two-way
communication)
The dorsolateral prefrontal lobe
- Working memory: maintenance of information (short-term
memory) plus
- Central executive: active processing of information
Characteristics of working memory:
- Temporary
- Limited capacity (7+/-2 chunks)
Transition from work memory to long-term memory
- Information must be permanently stored → episode information
- Binding: associative working memory: binding together different information streams into
one episode
- Episodic buffer: involved in long-term encoding
- Also involved in the retrieval of previously encoded knowledge
,Transition from WM to long-term memory
Diencephalon and medial temporal lobe (MTL) – mammillary bodies and hippocampus
Consolidation: long-term storage
- Standard consolidation model\
- After encoding, information retained in hippocampus and neocortex
- Information recall strengthens the cortico-cortical connection
- Making the memory hippocampus independent → permanently stored in neocortex
- Multiple trace theory
- Based on distinction semantic and episodic memory
- Hippocampus always involved in retrieval and storage of episodic memories (even for
very old autobiographical memories
- Semantic memories stored in neocortex
Medial temporal lobe including the hippocampus
- Encoding new knowledge: long-term encoding (which can already take place during short-
term tasks)
- Contextual information → formation of ‘episodes’ in the memory (place, time, etc.)
- ‘Binding device’: linking item memory (the content) to source memory (the source): what,
where and when
- Consolidation: long-term storage
- Disorder: anterograde amnesia / amnesic syndrome
Amnestic syndrome: no formation of long-term memories
- Hippocampal temporal variant → e.g., H.M., Dory (forget what of why she is doing something
when she gets distracted)
- Diencephalic variant → e.g., Korsakoff’s syndrome
, Hippocampal temporal amnesia
- Impaired encoding/consolidation of facts
- No confabulation or memory-monitoring problems
- Intact working/short-term memory
- Content gets lost rather than the context
- Can arise after encephalitis, hippocampectomy or
traumatic brain injury
Korsakoff’s syndrome
- Sudden onset after Wernicke-Korsakoff psychosis (gait
ataxia, eye movement disorder and confusional state)
- Frontal and diencephalic damage (mammillary bodies and thalamus) as a result
of chronic thiamine deficiency (vitamin B1)
- Often caused by chronic alcohol abuse in combination with poor nutrition
- (Vitamin deficiency can result by other means, such as anorexia, pregnancy)
Characteristics:
- Personality changes with irritability or apathy
- Confabulation and lack of insight
- Executive dysfunction
Amnestic syndrome characterised by:
- Anterograde amnesia
- Retrograde amnesia with temporal gradient in
autobiographical memory
- Retrieval problems (information can be there but can be
difficult to retrieve)
- Contextual memory: problems with placing memories in
time
- Increased sensitivity to interference (proactive and
retroactive)
Temporal gradient in memory
Korsakoff’s patient’s (K) and healthy control group (NC): famous faces
test
The more recent a face is, the more poorly a memory is recalled
Clinical neuropsychology: Applied science that studies the relationship between brain (dis)function and
behaviour in patients and the application in assessment and treatment
Has become highly relevant in modern-day (mental) health care
- Increase in people with brain damage or dysfunction
- Decrease in morality rates because of improvements in medical care
- Aging
- More interest in quality of life
A clinical neuropsychologist is a scientist practitioner whose focus lies on behavioural and
cognition
A clinical neuropsychologist is not a brain researcher
ICF is useful in clinical neuropsychology
- Description of consequences of brain disease / disorder at 3
different levels: impairment, limitation, and restriction
(handicap)
- Identifying moderating factors
- Relevant for understanding subjective complaints and
problems in daily life (school – work – social functioning)
- Identify target for treatment or optimalisation
Diagnostic cycle
College 2 - Korsakoff’s syndrome and alcohol-related cognitive disorders
Memory: the ability to encode information, store it and
retrieve it
Atkinson-Shiffrin memory model
, Explicit: consciously access
- Episodic: memory for experiences of
personal past (what, where, when)
- Semantic: general knowledge
Implicit: unconscious, automatic
Neuroanatomical structures involved in memory processes
Bradley’s model of working memory
- Limited (but no fixed) duration (seconds)
- Limited capacity (visuospatial sketchpad and
phonological look) approx. 7 units
- Active processing (CE) of information in STM
- Linked to long-term memory (two-way
communication)
The dorsolateral prefrontal lobe
- Working memory: maintenance of information (short-term
memory) plus
- Central executive: active processing of information
Characteristics of working memory:
- Temporary
- Limited capacity (7+/-2 chunks)
Transition from work memory to long-term memory
- Information must be permanently stored → episode information
- Binding: associative working memory: binding together different information streams into
one episode
- Episodic buffer: involved in long-term encoding
- Also involved in the retrieval of previously encoded knowledge
,Transition from WM to long-term memory
Diencephalon and medial temporal lobe (MTL) – mammillary bodies and hippocampus
Consolidation: long-term storage
- Standard consolidation model\
- After encoding, information retained in hippocampus and neocortex
- Information recall strengthens the cortico-cortical connection
- Making the memory hippocampus independent → permanently stored in neocortex
- Multiple trace theory
- Based on distinction semantic and episodic memory
- Hippocampus always involved in retrieval and storage of episodic memories (even for
very old autobiographical memories
- Semantic memories stored in neocortex
Medial temporal lobe including the hippocampus
- Encoding new knowledge: long-term encoding (which can already take place during short-
term tasks)
- Contextual information → formation of ‘episodes’ in the memory (place, time, etc.)
- ‘Binding device’: linking item memory (the content) to source memory (the source): what,
where and when
- Consolidation: long-term storage
- Disorder: anterograde amnesia / amnesic syndrome
Amnestic syndrome: no formation of long-term memories
- Hippocampal temporal variant → e.g., H.M., Dory (forget what of why she is doing something
when she gets distracted)
- Diencephalic variant → e.g., Korsakoff’s syndrome
, Hippocampal temporal amnesia
- Impaired encoding/consolidation of facts
- No confabulation or memory-monitoring problems
- Intact working/short-term memory
- Content gets lost rather than the context
- Can arise after encephalitis, hippocampectomy or
traumatic brain injury
Korsakoff’s syndrome
- Sudden onset after Wernicke-Korsakoff psychosis (gait
ataxia, eye movement disorder and confusional state)
- Frontal and diencephalic damage (mammillary bodies and thalamus) as a result
of chronic thiamine deficiency (vitamin B1)
- Often caused by chronic alcohol abuse in combination with poor nutrition
- (Vitamin deficiency can result by other means, such as anorexia, pregnancy)
Characteristics:
- Personality changes with irritability or apathy
- Confabulation and lack of insight
- Executive dysfunction
Amnestic syndrome characterised by:
- Anterograde amnesia
- Retrograde amnesia with temporal gradient in
autobiographical memory
- Retrieval problems (information can be there but can be
difficult to retrieve)
- Contextual memory: problems with placing memories in
time
- Increased sensitivity to interference (proactive and
retroactive)
Temporal gradient in memory
Korsakoff’s patient’s (K) and healthy control group (NC): famous faces
test
The more recent a face is, the more poorly a memory is recalled
