Cognitive

neuropsychology

Cognitive neuropsychology is a branch of cognitive psychology that aims to understand how the
structure and function of the brain relates to specific psychological processes. Cognitive
psychology is the science that looks at how mental processes are responsible for the cognitive
abilities to store and produce new memories, produce language, recognize people and objects,
as well as our ability to reason and problem solve. Cognitive neuropsychology places a particular
emphasis on studying the cognitive effects of brain injury or neurological illness with a view to
inferring models of normal cognitive functioning. Evidence is based on case studies of individual
brain damaged patients who show deficits in brain areas and from patients who exhibit double
dissociations. Double dissociations involve two patients and two tasks. One patient is impaired
at one task but normal on the other, while the other patient is normal on the first task and
impaired on the other. For example, patient A would be poor at reading printed words while still
being normal at understanding spoken words, while the patient B would be normal at
understanding written words and be poor at understanding spoken words. Scientists can
interpret this information to explain how there is a single cognitive module for word
comprehension. From studies like these, researchers infer that different areas of the brain are
highly specialised. Cognitive neuropsychology can be distinguished from cognitive
neuroscience, which is also interested in brain-damaged patients, but is particularly focused on
uncovering the neural mechanisms underlying cognitive processes.[1]
History

"Front and lateral view of the

cranium, representing the
direction in which the iron
traversed its cavity..."[2]

Cognitive neuropsychology has its roots in the diagram-making approach to language disorder
that started in the second half of the 19th century. The discovery that aphasia takes different
forms depending on the location of brain damage provided a powerful framework for
understanding brain function.[3]

In 1861, Paul Broca reported a post mortem study of an aphasic patient who was speechless
apart from a single nonsense word: "Tan". Broca showed that an area of the left frontal lobe was
damaged. As Tan was unable to produce speech but could still understand it, Broca argued that
this area might be specialised for speech production and that language skills might be localized
to this cortical area. Broca did a similar study on another patient, Lelong, a few weeks later.
Lelong, like Tan, could understand speech but could only repeat the same five words. After
examining his brain, Broca noticed that Lelong had a lesion in approximately the same area as
his patient Tan. He also noticed that in the more than 25 patients he examined with aphasia, they
all had lesions to the left frontal lobe but there was no damage to the right hemisphere of the
brain. From this he concluded that the function of speech was probably localized in the inferior
frontal gyrus of the left hemisphere of the brain, an area now known as Broca's area.
Karl Wernicke subsequently reported patients with damage further back in the temporal lobe
who could speak but were unable to understand what was said to them, providing evidence for
two potentially interconnected language centres. These clinical descriptions were integrated into
a theory of language organisation by Lichtheim.[4] Subsequently, these models were used and
developed to inform Dejerine's account of reading, Liepmann's theory of action and Lissauer's
1890 account of object recognition and Lewandowsky and Stadelmann's 1908 account of
calculation.

Broca's area and Wernicke's area.

However, the early 20th century saw a reaction to the overly-precise accounts of the diagram-
making neurologists. Pierre Marie challenged conclusions against previous evidence of Broca's
areas in 1906 and Henry Head attacked the whole field of cerebral localisation 1926.

The modern science of cognitive neuropsychology emerged during the 1960s stimulated by the
insights of the neurologist Norman Geschwind who demonstrated that the insights of Broca and
Wernicke were still clinically relevant. The other stimulus to the discipline was the cognitive
revolution and the growing science of cognitive psychology which had emerged as a reaction to
behaviorism in the mid-20th century.[5] Psychologists in the mid-1950s acknowledged that the
structure of mental information-processing systems could be investigated in scientifically
acceptable ways. They developed and applied new cognitive processing models to explain
experimental data from not only studies of speech and language but also those of selective
attention.[6] Cognitive psychologists and clinical neuropsychologists developed more research
collaborations to gain a better understanding of these disorders. The rebirth of neuropsychology
was marked by the publishing of two seminal collaborative papers from Marshall & Newcombe
(1966) on reading and Warrington & Shallice (1969) on memory.[6] Subsequently, work by
pioneers such as Elizabeth Warrington, Brenda Milner, Tim Shallice, Alan Baddeley and Lawrence
Weiskrantz demonstrated that neurological patients were an important source of data for
cognitive psychologists.
It took less than one decade for neuropsychology to be fully re-established. More achievements
in neuropsychology were recognized: the establishment of the first major book discussing
neuropsychology using a cognitive approach, Deep Dyslexia, in 1980 after a scientific meeting
about the topic in Oxford in 1977, the birth of the Cognitive Neuropsychology journal in 1984, and
the publishing of the first textbook of neuropsychology, Human Cognitive Neuropsychology in
1988.[6]

A particular area of interest was memory. Patients with amnesia caused by injuries to the
hippocampus in the temporal cortex and midbrain areas (especially the mamillary bodies) were
of early interest. A patient with severe case of amnesia will not be able to remember meeting the
examiner if they leave the room and return, let alone events of the previous day (episodic
memory), but they will still be able to learn how to tie their shoes (procedural memory),
remember a series of numbers for a few seconds (short-term memory or working memory) and
be able to recall historical events they have learned in school (semantic memory). By contrast,
patients may lose their short-term memory abilities while retaining their long term memory
functions. Many other studies like this have been done in the field of neuropsychology examining
lesions and the effect they have on certain areas of the brain and their functions.

Most of Molaison's hippocampus was removed

bilaterally.

Studies on the amnesic patient Henry Molaison, formerly known as patient H.M., are commonly
cited as some of the precursors, if not the beginning of modern cognitive neuropsychology.
Molaison had parts of his medial temporal lobes surgically removed to treat intractable epilepsy
in 1953. Much of the hippocampus was also removed along with the medial temporal lobes. The
treatment proved successful in reducing his dangerous seizures, but left him with a profound but
selective amnesia. After the surgery, Molaison was able to remember some big events from
before the surgery, such as the stock market crash in 1929, but was confused about many
others and could no longer form new memories. This accidental experiment showed scientists
how the brain processes different types of memory. Because Molaison's impairment was caused
by surgery, the damaged parts of his brain were known, information which was usually not
knowable in a time before accurate neuroimaging became widespread. Scientists concluded
that while the hippocampus is needed in the creation of new memories, it is not needed in the
retrieval of old ones; they are two separate processes. They also realized that the hippocampus
and the medial temporal lobes, both of the areas removed from Molaison, are the areas
responsible for converting short-term memory to long-term memory.

Much of the early work of cognitive neuropsychology was carried out with limited reference to
the detailed localisation of brain pathology. Neuroimaging was relatively imprecise and other
anatomically based techniques were also limited. The emphasis of many researchers as late as
1990 was on the analysis of patterns of cognitive deficit rather than on where the injury was
located.[7] Despite the lack of detailed anatomical data, studies of reading, language and
memory had a number of important implications. The first is that certain cognitive processes
(such as language) could be damaged separately from others, and so might be handled by
distinct and independent cognitive (and neural) processes. (For more on the cognitive
neuropsychological approach to language, see Eleanor Saffran, among others.) The second is
that such processes might be localized to specific areas of the brain. Whilst both of these
claims are still controversial to some degree, the influence led to a focus on brain injury as a
potentially fruitful way of understanding the relationship between psychology and neuroscience.

Methods
A key approach within cognitive neuropsychology has been to use single case studies and
dissociation as a means of testing theories of cognitive function. For example, if a theory states
that reading and writing are simply different skills stemming from a single cognitive process, it
should not be possible to find a person who, after brain injury, can write but not read or read but
not write. This selective breakdown in skills suggests that different parts of the brain are
specialized for the different processes and so the cognitive systems are separable.

The philosopher Jerry Fodor has been particularly influential in cognitive neuropsychology,
particularly with the idea that the mind, or at least certain parts of it, may be organised into
independent modules. Evidence that cognitive skills may be damaged independently seem to
support this theory to some degree, although it is clear that some aspects of mind (such as
belief for example) are unlikely to be modular. Fodor, a strict functionalist, rejects the idea that
the neurological properties of the brain have any bearing on its cognitive properties and doubts
the whole discipline of cognitive neuropsychology.

With improved neuroimaging techniques, it has been possible to correlate patterns of

impairment with a knowledge of exactly which parts of the nervous system are damaged,
allowing previously undiscovered functional relationships to be explored (the lesion method).
Contemporary cognitive neuropsychology uses many of the same techniques and technologies
from the wider science of neuropsychology and fields such as cognitive neuroscience. These
may include neuroimaging, electrophysiology and neuropsychological tests to measure either
brain function or psychological performance. Useful technology in cognitive neuropsychology
includes positron-emission tomography (PET) and functional magnetic resonance imaging
(fMRI). These techniques make it possible to identify the areas of the brain responsible for
performing certain cognitive tasks by measuring blood flow in the brain. PET scans sense the
low-level radiation in the brain and produce 3-D images, whereas an fMRI works on a magnetic
signal and is used to “map the brain”. Electroencephalography (EEG) records the brain’s
electrical activity and can identify changes that occur over milliseconds. EEG is often used in
patients with epilepsy to detect seizure activity.

The principles of cognitive neuropsychology have recently been applied to mental illness, with a
view to understanding, for example, what the study of delusions may tell us about the function
of normal belief. This relatively young field is known as cognitive neuropsychiatry.

See also

Capgras delusion Philosophy

portal
CDR computerized
Psychology
assessment system portal
Clive Wearing
Cognitive bias
Cognitive neuropsychiatry
Cotard delusion
Emotion and memory
Erotomania
Face perception
Fregoli delusion
HM (patient)
Neuropsychological test
Outline of brain mapping
Outline of the human brain
Phineas Gage
 Primary sensory cortex
Prosopagnosia
Retinotopy

References

1. Schacter, Daniel L. (2000).

"Understanding Implicit memory: A
cognitive neuroscience approach". In
Gazzaniga, M.S. (ed.). Cognitive
Neuroscience: A Reader (https://book
s.google.com/books?id=99q2QgAACA
AJ) . Wiley. ISBN 978-0-631-21659-9.
"The term cognitive neuropsychology
often connotes a purely functional
approach to patients with cognitive
 deficits that does not make use of, or
encourage interest in, evidence and
ideas about brain systems and
processes"
2. Harlow, John Martyn (1868). "Recovery
from the Passage of an Iron Bar
through the Head" (https://en.wikisour
ce.org/wiki/Index:Recovery_from_the_
passage_of_an_iron_bar_through_the_
head.djvu) . Publications of the
Massachusetts Medical Society
(Original publication). 2: 327–347.
3. Coltheart, Max (2008). "Cognitive
neuropsychology" (https://doi.org/10.4
249%2Fscholarpedia.3644) .
 Scholarpedia. 3 (2): 3644.
Bibcode:2008SchpJ...3.3644C (https://
ui.adsabs.harvard.edu/abs/2008Schp
J...3.3644C) .
doi:10.4249/scholarpedia.3644 (http
s://doi.org/10.4249%2Fscholarpedia.3
644) . ISSN 1941-6016 (https://www.w
orldcat.org/issn/1941-6016) .
4. Carlson, Neil R. (2013). Physiology of
Behavior. NJ, U.S: Pearson Education,
Inc., p. 132.
5. Miller, G. A. (2003). The cognitive
revolution: a historical perspective.
Trends in Cognitive Sciences, 7(3),
 141-144. doi: 10.1016/s1364-
6613(03)00029-9.
6. Coltheart, M. (2008). Cognitive
neuropsychology. Scholarpedia, 3(2),
3644. doi: 10.4249/scholarpedia.3644.
7. Shallice, Tim (October 2009). From
Neuropsychology to Mental Structure.
Cambridge University Press.
ISBN 9780511526817.

Further reading

Shallice, Tim (1988). From

Neuropsychology to Mental Structure (htt
ps://archive.org/details/fromneuropsyc
 hol0000shal) . Cambridge University
Press. ISBN 0-521-31360-0.

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