Cognitive Neuropsychology and Functional

Brain Imaging: Implications for functional and

anatomical models of cognition

Humphreys & Price, 2001

 Introduction
Neuropsychological research on patients
+
Research on normal cognition models
=
Cognitive Neuropsychology

Main aims of Cognitive Neuropsychology

● Use of normal cognition models in order to constrain
our understanding of effects of brain lesions on human
performance.
● Use data from patients in order to constrain the
developments of normal cognition models (i.e. Broca
Area).
 Introduction

What are the benefits of using functional brain

imaging techniques?
● More precise than other neuropsychological
techniques in terms of localization of the brain areas
involved in cognitive tasks
● By choosing the appropriate tasks we can isolate
particular cognitive processes and localize their neural
activity
● These techniques help us understand the functional
components of different cognitive functions
 Neuropsychology and cognitive-
anatomical models
Beginning of the 19th century: Using of case studies in order to construct normal
cognition models
Building a speech production model
(1861) Broca's Area: Motor Aspects of Speech
(1874) Wernicke's Area: Auditory Aspects of Speech
(1885) Lichtheim: Arculate Fasciculus: connection

Lichtheim proposed a speech production model

based on Broca's, Wernicke's and his own
observations
Speech Comprehension => Info Transmission => Speech Production
Wernicke's Area => Arculate Fasciculus => Broca's Area
 Neuropsychology and cognitive-
anatomical models
Speech Comprehension => Info Transmission => Speech Production
Wernicke's Area => Arcuate Fasciculus => Broca's Area

(1891) Dejerine complemented this model by observing

two different reading disorders:
Alexia with agraphia (damaged left angular gyrus)
Patients are not able to recognize and write words
Alexia without agraphia (left occipital lobe)
Occipital
Patients are not able to recognize words BUT they Lobe
are able to write

He suggested that Alexia w/o agraphia caused by disconnection of visual areas in the
left occipital lobe from the left angular gyrus and so patients can't recognize words.
 Neuropsychology and cognitive-
anatomical models
Early studies tried to answer the
question:
How does a brain lesion affect the
cognitive functions?
1) The lession damages the stored
cognitive representations
Example: Damage in Broca's Area, Damage in
Wercnicke's Area

2) The lession disconnects different Similar References in

representations Neuropsychological studies
continue even today!
Example: Damage in Arculate Fasciculus
 Problems for Cognitive-Anatomical Models
Association
Accidental Brain Lesions
=
NO functional boundaries
We can't infer that all of the affected cognitive processes depend on a common cognitive
operation.

Example:
Alexia With Agraphia after damage to the left
angular gyrus: reading and writing depend on
common visual representations for words.

BUT The same patient may manifest

Occipital “phonological dyslexia”
Lobe ●intact access to stored memories of words

“surface dysgraphia”
They can read the word “busy” ●impaired access to lexical knowledge of

but they can't spell it. spellings

They are impaired at writing This dissociation indicates that there are distinct
irregular but not regular words memory representations for writing and reading
 Problems for Cognitive-Anatomical Models
Interactive effects
Example: Some patients are able to make semantic categorizations (e.g. separate
fruits from vegetables) but they can't name the examples within these
categories (e.g. bananas, lettuce) and they have a mild deficit in the perceptual
knowledge about objects.

Question: What's the relation between all these deficits and abilities?
Answers: 1. They are totally unrelated. Patients have two different
deficits/problems:

Sensory Input Semantic Knowledge Object Naming

2. They are related

Sensory Input
Semantic Knowledge Object Naming
 Problems for Cognitive-Anatomical Models
Syndromes VS Single Cases
Often focus on “core symptoms” of syndromes
BUT there is high heterogeneity between different patients of the
same syndrome

Example: Alexia w/o Agraphia Poor transmission from a

stored visual word form to
Impairment in early visual coding of letters
other parts of words
Impairment in later stages of visual coding recognition system

● There is a need to breakdown the tested function and not to be

linked to a complex task, otherwise we fail to emphasize the
heterogeneity.
● Patient groups need to be differentiated! Emphasis on the
dissociations between single cases.
 Problems for Cognitive-Anatomical Models
Compensatory Strategies
Often, soon after the lesion, patients develop compensatory
strategies to override the normal cognitive process.
That's why:
● These compensatory strategies do not necessarily reflect the
normal cognitive process in normal population
● Sometimes is difficult to detect the original deficit caused by the
brain lesion.

BUT modern techniques provide us the means to try and address

the residual cognitive processes
 Problems for Cognitive-Anatomical Models
Damaging Representations,
Disconnections and Sampling Bias

Some brain regions more vulnerable to damage

2 than others.

3 Some cognitive precesses are represented

bilaterally, making their disturbances rare.
 Cognitive Neuropsychology
● C.N. links brain lesions with functional models (not 1to1 relations)
example: Distributed Associative Memory model
Functional Level Anatomical Level
Perceptual Functional Perceptual Functional
properties properties properties properties

Lesion on these two anatomical units: no “pure” deficits.

Functional Interaction between the DAM functional units

B
A
C
 Cognitive Neuropsychology
Modern Models are more complex, enabling us to explain
better the differences between similar deficits
1890 2000

Components are Functionally Isolable

 Cognitive Neuropsychology
Data from cognitive neuropsychology studies can be used to argue
for the functional necessity of the particular processes of a given
task.
Example: Disorders of semantic knowledge disrupt object naming but not word
naming. That means that activation of semantic knowledge is necessary in
order to name an object, but not in order to name a word.

BUT We can't argue about localization of a brain function based on case

studies. No generalization is possible.

There are some constraints in making direct inferences about the

functional necessity: a)dependency on associations/dissociations
b) hard to distinguish damaged from
disconnected brain areas
 Functional Imaging: Advantages
● Better localization / more accurate
measurements
● Some lesions tend to occur infrequently. With F.I.
We can analyze the cognitive functions related
to these areas.
● Not biased studies towards cognitive functions
that are commonly affected by neural damage.
● We can analyze and make inferences for the
whole brain, not only for the damaged sites.

WHERE ==> WHAT ==> MULTIPLE ROLES

Functional Imaging & Cognitive Neuropsychology

Using tasks patients can perform

Important because if we use tasks patients can't perform:
CASE A: No activation in damaged area, but activation in other areas.
1) The known damaged area will show no activation. We know that!
2) The contribution of the activated regions to normal task performance
cannot easily be deducted.

CASE B: Reduced activation in damaged area and in other remote areas.

1) This could mean that these areas are linked with the to the damaged
region
2) An alternative explanation is that these areas are unrelated to damaged
region but they receive the products of the processing in the damaged
areas. No output, no input, no activatio.
Functional Imaging & Cognitive Neuropsychology
FI can reveal the activity of distant areas
Example: Patients with damage in Broca's area VS Normal Subjects
Task: Response to words and consonant strings, containing letter
with an ascender (b,d,f,h,g).
Previous studies showed activation of Broca's area in normal
subjects. The aim was to examine how the word processing was
affected by the lesion

Underactivity in left posterior inferior temporal cortex indicates that

this region interacts functionally with the Broca's area.
Functional Imaging & Cognitive Neuropsychology
Necessary and sufficient brain systems
FI studies can reveal the necessity and sufficiency in neural
level.

Example: Patients with atrophy of temporal lobes, anterior

middle temporal cortices, the anterior cingulate and the right
cerebellum and a patient with damage in left inferior frontal
cortex were able to perform semantic judgments.
Conclusion: these areas are not necessary for semantic
access

The remaining areas are sufficient to support the semantic

retrieval.
Functional Imaging & Cognitive Neuropsychology

Imaging Functional Recovery

We want to know the functional recovery of patients.
– This may facilitate the development of rehabilitation programmes, especially for
patients with common characteristics in terms of recovery.
– This may us understand if patients use alternative strategies or the residual
normal processes when they perform a given task.
Three types of recovery functions:
– peri-infract activation = surrounding neurons support the
processing
– neuronal reorganization = the same cognitive architecture uses
different neuronal structures
– cognitive reorganization = patient uses a new cognitive strategy