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27 results

Page 1 of 2

  • 6 - Arousal
  • from Section I - Structural and Functional Neuroanatomy
  • Edited by David B. Arciniegas, C. Alan Anderson, Christopher M. Filley
  • Book: Behavioral Neurology & Neuropsychiatry
  • Published online: 05 February 2013
  • Print publication: 24 January 2013, pp 88-97
  • View extract

    Summary

    The arousal system involves multiple distributed neural networks working in harmony to permit normal sleep-wake cycles, satisfy internal drive states, and respond to environmental demands. Disorders of arousal involve pathology of the brainstem, thalamus, or widespread areas of both cerebral hemispheres. A parallel series of distinct neural networks using dopamine, histamine, serotonin, acetylcholine, and norepinephrine as neurotransmitters originates in the brainstem. Brain death represents the most severe disturbance of arousal, with total and irreversible cessation of any brain function. Coma is the state of neurological unconsciousness exhibited by unarousable unawareness of the external environment that is due to extensive damage to or depressed function of both cerebral hemispheres, bilateral diencephalic structures, or the ascending reticular activating system. A specific rehabilitative strategy is coma stimulation, in which structured sensory stimulation is administered for the purposes of improving sensory awareness and facilitating improvements in arousal and awareness.
  • 33 - Rehabilitation and pharmacotherapy ofcognitive impairments
  • from Section III - Treatments in Behavioral Neurology & Neuropsychiatry
  • Edited by David B. Arciniegas, C. Alan Anderson, Christopher M. Filley
  • Book: Behavioral Neurology & Neuropsychiatry
  • Published online: 05 February 2013
  • Print publication: 24 January 2013, pp 511-542
  • View abstract

    Summary

    Neuropsychological assessment is an important component of the comprehensive neurodiagnostic evaluation of many patients with suspected or known brain dysfunction. Neuropsychological evaluations are covered by most major insurance carriers using the American Medical Association's Current Procedural Terminology (CPT) codes for the procedures. A clinical interview with the patient, focusing upon the presenting complaint and history of potential central nervous system (CNS) risk factors or other demographic and background characteristics, might contribute to symptoms or impact current test performance. The neuropsychological evaluation typically begins with a review of the referral question and available medical records. Neuropsychological tests vary in terms of their available normative comparison groups, although some represent large databases comprised of representative samples of the general population. Neuropsychological reports vary widely depending upon the practitioner, his or her background and current setting, the nature and extent of the evaluation, and the referral base of the neuropsychologist's practice.
  • Section III - Treatments in Behavioral Neurology & Neuropsychiatry
  • Edited by David B. Arciniegas, C. Alan Anderson, Christopher M. Filley
  • Book: Behavioral Neurology & Neuropsychiatry
  • Published online: 05 February 2013
  • Print publication: 24 January 2013, pp 498-648
  • View abstract

    Summary

    This chapter presents an overview of the mental status examination, its core elements, and its most commonly used methods. The mental status examination focuses on cognitive, emotional, behavioral, and related sensorimotor functions and their disturbances - i.e., neuropsychiatric symptoms, signs, and syndromes. Through observation, interview, and testing, the mental status examination identifies the symptoms and signs of structural and/or functional disturbances of the brain. Neuropsychiatric symptoms and signs are sometimes categorized as positive or negative. Atypical clinical presentations sometimes are neurological condition-specific variants of typical neuropsychiatric syndromes. The observational components of the mental status examination are undertaken at the first moment of any form of contact with a patient and continue throughout the entire clinical encounter. Observation continues throughout the clinical interview, during which the examiner attends to the patient's appearance, behavior, statements, manner of communicating, and interpersonal interactions with examiner.
  • 27 - Advancedneuroimaging
  • from Section II - Neurobehavioral and Neuropsychiatric Assessment
  • Edited by David B. Arciniegas, C. Alan Anderson, Christopher M. Filley
  • Book: Behavioral Neurology & Neuropsychiatry
  • Published online: 05 February 2013
  • Print publication: 24 January 2013, pp 430-441
  • View abstract

    Summary

    This chapter illustrates the complexity of personality by the exploration of its neurobiology, including neurochemistry, and neuroanatomy via the temperament and character dimensional model and its relationship to psychiatric and neurological disorders. Thomas and Chess conceptualized temperament as the stylistic component of behavior, as differentiated from the motivation and content of behavior. Character is influenced by socio-cultural learning and matures in progressive steps throughout life. Character can be measured in three dimensions: self-directedness, cooperativeness, and self-transcendence. Personality dimensions involve complex adaptive systems of multiple genetic and environmental variables. Both gene-gene and gene-environment interactions are expected for understanding quantitative developmental phenomena and these have been abundantly confirmed for personality. Gene-environment interaction has also been demonstrated for novelty seeking and for harm avoidance in prospective population-based studies. Twin studies show that human personality traits are roughly equally influenced by genetic and by environmental influences.
  • 35 - Pharmacotherapyof behavioral disturbances
  • from Section III - Treatments in Behavioral Neurology & Neuropsychiatry
  • Edited by David B. Arciniegas, C. Alan Anderson, Christopher M. Filley
  • Book: Behavioral Neurology & Neuropsychiatry
  • Published online: 05 February 2013
  • Print publication: 24 January 2013, pp 566-586
  • View abstract

    Summary

    This chapter focuses on the basic principles of computed tomography (CT) and magnetic resonance imaging (MRI) used for imaging the brain structure. Indications for brain imaging in Behavioral Neurology & Neuropsychiatry (BN&NP) patients include: poison or toxin exposures, dementia or cognitive decline of unknown etiology, delirium, brain injuries of any type with ongoing symptoms, new-onset psychiatric symptoms, abnormal neurological findings suggesting brain pathology, and new-onset atypical psychosis. Imaging of the brain with MRI depends on the polar characteristics of the water molecule and its unique behavior within a strong magnetic field. Factors important to consider when choosing an imaging modality include type of suspected pathology, acuity of the illness, and desired planes of section. Doppler ultrasound (US) evaluation has been used successfully in clinical neurology as a screening tool to evaluate internal carotid artery (ICA) disease.
  • 1 - Introduction
  • Edited by David B. Arciniegas, C. Alan Anderson, Christopher M. Filley
  • Book: Behavioral Neurology & Neuropsychiatry
  • Published online: 05 February 2013
  • Print publication: 24 January 2013, pp 1-11
  • View extract

    Summary

    Neurology and psychiatry are securely established medical specialties with well-demarcated areas of clinical and research expertise. Behavioral neurology (BN) is widely held to have begun with the work of Norman Geschwind in the mid-twentieth century. A neuropsychiatric approach to patient care began to reemerge and steadily gain momentum as physicians increasingly appreciated the neurologic bases of psychiatric disease and the psychiatric aspects of neurologic disease. The prospect of BN and neuropsychiatry (NP) drawing together finds considerable support in academia. Annual scholarly meetings are held conjointly by the Society for Behavioral and Cognitive Neurology and the American Neuropsychiatric Association in order to disseminate new research findings and educate practitioners. Traumatic brain injury occupies a major portion of the practice of many subspecialists in BN&NP and additional studies are needed to better define the best methods of neurorehabilitation.
  • 16 - Executivefunction
  • from Section I - Structural and Functional Neuroanatomy
  • Edited by David B. Arciniegas, C. Alan Anderson, Christopher M. Filley
  • Book: Behavioral Neurology & Neuropsychiatry
  • Published online: 05 February 2013
  • Print publication: 24 January 2013, pp 225-249
  • View abstract

    Summary

    This chapter outlines behavioral measures related to the control of attention and functional theories of attention based on such measures. It focuses on the control of visual attention in both normal and neurologically impaired individuals. The major types of attention are: spatial attention, in which stimuli are selected based on their position in space; object-based attention, in which stimuli are selected based on their identity; attentional selection in visual working memory, in which attention selects items that will be remembered; and executive attention, in which attention is involved in choosing which task or behavior an observer will perform. The chapter provides evidence for a number of cerebral sites that appear to be involved in the overall control of attention. Understanding how these sites interact and how they relate to functional theories of attentional control increases understanding of normal and disordered attentional control processes.
  • 23 - Mental status examination
  • from Section II - Neurobehavioral and Neuropsychiatric Assessment
  • Edited by David B. Arciniegas, C. Alan Anderson, Christopher M. Filley
  • Book: Behavioral Neurology & Neuropsychiatry
  • Published online: 05 February 2013
  • Print publication: 24 January 2013, pp 344-393
  • View abstract

    Summary

    This chapter discusses the neuroanatomy underlying visuospatial function. It discusses anatomical organization of visuospatial processing, and visuospatial syndromes relevant to clinical disorders. Studies on visuospatial memory have distinguished between visuospatial working memory and memory for visuospatial information. Su and colleagues studied 37 patients with basal ganglia hemorrhage and found that visuospatial function and memory were the most affected cognitive domains. The chapter considers visuospatial impairment in common neurologic diseases such as Alzheimer's disease (AD) and Parkinson's disease (PD). Less common disorders such as Huntington's disease (HD) and Williams syndrome (WMS) are also described to emphasize the variety of etiologies that may affect the visuospatial system. Posterior cortical atrophy (PCA) is a clinically homogeneous but pathologically heterogeneous syndrome in which the onset of a progressive dementia is characterized by visual deficits. AD is the most common pathological correlate of PCA.
  • Section I - Structural and Functional Neuroanatomy
  • Edited by David B. Arciniegas, C. Alan Anderson, Christopher M. Filley
  • Book: Behavioral Neurology & Neuropsychiatry
  • Published online: 05 February 2013
  • Print publication: 24 January 2013, pp 12-309
  • View extract

    Summary

    This chapter focuses on aspects of structural and functional neuroanatomy relevant to Behavioral Neurology & Neuropsychiatry (BN&NP). It considers the general structure of the brain from the brainstem through the cerebral cortex, including a review of white matter anatomy, the cerebral vasculature, and the ventricular system. The brainstem comprises the medulla oblongata, pons and cerebellum, and midbrain. Each of these areas and the neurobehaviorally salient structures they contain are reviewed briefly in the chapter. The reticular formation (which is contributed to by several brainstem substructures) and the cranial nerves (some, but not all, of which are located within the brainstem) also are discussed in the chapter. The diencephalon includes the thalamus, metathalamus (medial and lateral geniculate nuclei), epithalamus (habenula, stria medullaris, and pineal body), and subthalamus. The chapter considers briefly the thalamus, hypothalamus (and pituitary), and the epithalamus.
Behavioral Neurology & Neuropsychiatry
  • Behavioral Neurology & Neuropsychiatry
  • Edited by David B. Arciniegas, C. Alan Anderson, Christopher M. Filley
  • Published online: 05 February 2013
  • Print publication: 24 January 2013
  • View description
    The merger of behavioral neurology and neuropsychiatry into a single medical subspecialty, Behavioral Neurology & Neuropsychiatry, requires an understanding of brain-behavior relationships and a clinical approach that transcends the traditional perspectives of neurology and psychiatry. Designed as a primer of concepts and principles, and authored by a multidisciplinary group of internationally known clinical neuroscientists, this book divides into three sections:Structural and Functional Neuroanatomy (Section I) addresses the neuroanatomy and phenomenology of cognition, emotion, and behaviorClinical Assessment (Section II) describes neuropsychiatric history taking, neurological and mental status examinations, neuropsychological assessment, and neuroimaging, electrophysiologic, and laboratory methodsTreatment (Section III) discusses environmental, behavioral, rehabilitative, psychological, social, pharmacological, and procedural interventions for cognitive, emotional, and behavioral disorders.By emphasizing the principles of Behavioral Neurology & Neuropsychiatry, this book will improve your understanding of brain-behavior relationships and inform your care of patients and families affected by neurobehavioral disorders.
  • 2 - Behavioralneuroanatomy
  • from Section I - Structural and Functional Neuroanatomy
  • Edited by David B. Arciniegas, C. Alan Anderson, Christopher M. Filley
  • Book: Behavioral Neurology & Neuropsychiatry
  • Published online: 05 February 2013
  • Print publication: 24 January 2013, pp 12-31
  • View extract

    Summary

    This chapter focuses on aspects of structural and functional neuroanatomy relevant to Behavioral Neurology & Neuropsychiatry (BN&NP). It considers the general structure of the brain from the brainstem through the cerebral cortex, including a review of white matter anatomy, the cerebral vasculature, and the ventricular system. The brainstem comprises the medulla oblongata, pons and cerebellum, and midbrain. Each of these areas and the neurobehaviorally salient structures they contain are reviewed briefly in the chapter. The reticular formation (which is contributed to by several brainstem substructures) and the cranial nerves (some, but not all, of which are located within the brainstem) also are discussed in the chapter. The diencephalon includes the thalamus, metathalamus (medial and lateral geniculate nuclei), epithalamus (habenula, stria medullaris, and pineal body), and subthalamus. The chapter considers briefly the thalamus, hypothalamus (and pituitary), and the epithalamus.
  • 18 - Emotion
  • from Section I - Structural and Functional Neuroanatomy
  • Edited by David B. Arciniegas, C. Alan Anderson, Christopher M. Filley
  • Book: Behavioral Neurology & Neuropsychiatry
  • Published online: 05 February 2013
  • Print publication: 24 January 2013, pp 266-298
  • View abstract

    Summary

    This chapter discusses the processes by which one comes to know the environment, namely sensation, perception, and recognition. Perception builds upon basic sensation by extracting more complex attributes from sensory elements. For example, visual perception includes the ability to detect motion, differentiate colors, and distinguish basic forms. Recognition involves identification of a sensory stimulus via access to and integration of stored representations of previously encountered stimuli. Acquired brain damage and developmental abnormalities may affect each level of processing, including primary sensation, cortically mediated perception, or higher-order aspects of perception or recognition. Negative perceptual symptoms involving hearing may affect primary sensory processes, secondary perceptual abilities, or recognition. Cortical auditory disorder or auditory agnosia refers to a non-specific loss of the ability to discriminate both speech and environmental auditory stimuli. Sensory loss may arise from damage at any point within the somatosensory system.
  • 38 - Proceduralinterventions
  • from Section III - Treatments in Behavioral Neurology & Neuropsychiatry
  • Edited by David B. Arciniegas, C. Alan Anderson, Christopher M. Filley
  • Book: Behavioral Neurology & Neuropsychiatry
  • Published online: 05 February 2013
  • Print publication: 24 January 2013, pp 627-648
  • View abstract

    Summary

    Magnetoencephalography (MEG) systems use superconducting electronics and magnetic shielding to detect the magnetic fields generated by synaptic neuronal activity. This chapter focuses on two types of quantitative analyses of human electrophysiological data: spectral analysis methods and evoked potentials. Spectral analysis of Electroencephalography (EEG) and MEG signals across multiple sensor locations reveals clear spatial patterns. EEG and MEG activity can be subdivided into three major subdivisions: spontaneous activity, evoked responses, and induced responses. Evoked responses are time domain averages across multiple trials of a repeating stimulus or response. Electroencephalographic and MEG methods based on time-frequency transformation are usually concerned with capturing changes in the brain's oscillatory phenomena produced by stimuli, mental events, or responses. A valid measure of connectivity between regions of the brain engaged in the same cognitive process or behavior is among the most highly prized uses of EEG and MEG data.

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