1. Early discoveries of brain function and localisation
Dr. Paul Dockree, History of Psychology: PS1203, 2009

2. What is neuropsychology?
“In any well-made machine one is ignorant of most of the parts – the better they work the less we are conscious of them…it is only fault that draws attention to the existence of a mechanism at all.” (Craik, K., 1943)
TV set analogy:
Faulty TV sets:-
-no sound but intact picture
-no picture but intact sound
-picture without colour (ie black & white pic)
-colour without picture?

3. What is neuropsychology?
The experimental neuropsychologist asks, “What pattern of behavioural dysfunction occurs when a particular brain region is damaged or lesioned?”
The clinical neuropsychologist asks, “How can normal function be restored or compensated for in the brain?”
Science-Practitioner Model

4. How did the field evolve?
John Hughlings Jackson’s ( ) first credible human localisationist view – evidence from epileptic patients.

5. Broca’s Aphasia How did the field evolve?
In 1862, showing brain lesions in a stroke patient who could understand language but could not speak (could only say "tan"), he demonstrated that the left frontal lobe was responsible for articulation of speech.

6. Wernicke’s Aphasia How did the field evolve?
Like Broca, Wernicke investigated a similar stroke victim. But this time the patient could speak but made no sense. The damaged area was around where the temporal and parietal lobes meet in the posterior part of the left hemisphere. His findings further revived the localisationist view.
Wernicke’s aphasics show deficits in language comprehension but intact articulation

7. Speech content of a Broca’s and Wernicke’s aphasic
How did the field evolve?
Speech content of a Broca’s and Wernicke’s aphasic
To mean: "The dog needs to go out so I will take him for a walk.“
a Wernicke’s aphasic patient says:
“You know that smoodle pinkered and that I want to get him round and take care of him like you want before.”
an Broca’s aphasic patient says:
“Walk dog.”

8. Function X: speech articulation Function Y: speech comprehension
The logic of lesion analysis
Function X: speech articulation Function Y: speech comprehension 
Area A: Broca’s area Area B: Wernicke’s area
Brain function
Structures to be Lesioned
Area A
Broca’s area
Area B
Wernicke’s area
Function X
Speech articulation
Impairment
Can’t speak fluently
No Impairment
In fluent speech
Function Y
Speech comprehension
Understanding speech of others
Can’t understanding speech of others

9. Function X: speech articulation Function Y: speech comprehension
The logic of lesion analysis
Function X: speech articulation Function Y: speech comprehension 
Area A: Broca’s area Area B: Wernicke’s area
Brain function
Structures to be Lesioned
Area A
Broca’s area
Area B
Wernicke’s area
Function X
Speech articulation
Impairment
Can’t speak fluently
No Impairment
In fluent speech
Function Y
Speech comprehension
Understanding speech of others
Can’t understanding speech of others

10. The logic of lesion analysis
Function X (articulation of speech) depends on area A (Broca’s area) but not area B,
whereas function Y (comprehending speech) depends on area B (Wernicke’s area) but not area A.
Double dissociation – Gold standard of neuropsychological research

11. Wilder Penfield How did the field evolve?
Growing evidence for localisationist view in early 20th century – direct evidence from motor and sensory maps in the brain from early work of Wilder Penfield.
Features drawn according to how much brain space they take up in somatosensory cortex.

12. Wilder Penfield How did the field evolve?
Stimulating the temporal lobes could he elicit meaningful, integrated responses. Physical basis for memory: an "engram.”

13. How did the field evolve?
Holistic approach:
Karl Lashley (1935) – lesions made throughout the brain do not necessary create problems when learning a new task (e.g., maze learning in rats).
A lesioned brain is like a new system, not an old system with one part missing.

14. Localisation vs holistic:
How did the field evolve?
Localisation vs holistic:
A Compromise-
Complex functions (e.g., perception, memory, reasoning) cannot be accomplished by a single brain process or brain region; integration of functional neuroanatomy – holistic view
Nevertheless, the simple processes themselves that are recruited to exercise complex functions are localised – localisation view
Brain damage may reveal something about the underlying organisation of the system.

15. Psychometric testing: database of standardised scores
What are the methods used in neuropsychology?
Psychometric testing:
database of standardised scores
Clinical patients vs. healthy controls
Clinical observation:
Diagnosis
Assessment
Rehabilitation
Neuroanatomy:
Connectional studies in animal studies
projection maps (e.g., LGN to visual cortex)

16. What are the methods used in neuropsychology?
Lesion analysis:
selection of animals or humans with discrete brain damage to areas thought to be essential in a particular processing chain.
one of the oldest methods for studying brain function in humans and animals.
single most informative technique available for understanding the neural bases of behaviour.

17. What are the methods used in neuropsychology?
Types of lesions:
cerebrovascular accidents (CVA; stroke); occurs when blood flow to the brain is disrupted;

18. penetrating head injuries, from gunshot or other incidents;
What are the methods used in neuropsychology?
Types of lesions:
penetrating head injuries, from gunshot or other incidents;

19. What are the methods used in neuropsychology?
Types of lesions:
Following traumatic brain injury (TBI), diffuse white matter damage typically co-occurs with more focal lesions or hematomas (blood clots) and contusions (bruising) damaging the dense collections of cell bodies (grey matter)

20. What are the methods used in neuropsychology?
Types of lesions:
Neurodegeneration: widespread area of tissue death or abnormal cell functioning due to neuropathology (AD, PD);
healthy older person
Pt with AD

21. Deliberate lesions - on experimental animals.
What are the methods used in neuropsychology?
Deliberate lesions - on experimental animals.
tissue excision, where tissue is deliberately removed (usually by aspiration);
tissue destruction, tissue is destroyed electrolytically or chemically (e.g., MPTP, a chemical agent to create an animal model of Parkinson’s disease);

22. What are the methods used in neuropsychology?
tissue deactivation, where tissue is reversibly deactivated via injections of local anaesthetic or through chemical cooling;
tissue disconnection, where brain areas are left intact but fibre tracts which communicate between these areas are permanently cut or temporarily interrupted (by anaesthetic or cooling);

23. What are the methods used in neuropsychology?
Neurosurgery is often conducted on humans in order to relieve conditions such as drug-resistant epilepsy (patient H.M.), relief from intractable pain or brain tumours.

24. The Wada test: sodium amytal technique
Laterality
The Wada test: sodium amytal technique
Sodium amytal is injected into one hemisphere at a time
The effect is to shut down any language and/or memory function in that hemisphere in order to evaluate the other hemisphere ("half of the brain").
Then the patient is engaged in a series of language and memory related tests

25. Broca and aphasia therapy (1865)
Neurorehabilitation
Broca and aphasia therapy (1865)
Broca concluded that the patient, “could recognize a word as one would a face or landscape, the details of which had never been analysed”
it deosn't mttaer waht oredr the ltteers in a wrod are, the olny iprmoetnt tihng is taht the frist and lsat ltteres are at the rghit pclae. The rset can be a tatol mses and you can sitll raed it wouthit a porbelm. Tihs is bcuseae we do not raed ervey lteter by it slef but the wrod as a wlohe.

26. Neurorehabilitation
WW1- German rehabilitation (Popplereuter, Goldstein)
Cologne and Frankfurt centres
WWII – Alexandra Luria: theoretical perspective from which to predict recovery
Restoration of function via:
De-inhibition
Transfer to opposite hemisphere
Reorganisation of the system
Luria stressed the importance of premorbid personality and motivation

27. Is there any point to lesion analyses now?
A reading of the last fifteen years of the functional imaging literature - imaging literature largely concerned with the high-tech confirmation of the preceding one hundred and fifty years of careful neuropsychological analysis.
PET and fMRI studies do not provide a definitive conclusion about whether or not a particular area is absolutely required in a processing chain.
The only way to definitively decide if function X is dependent on area A is to remove that area from the processing chain.

28. Is there any point to lesion analyses now?
Lesion analysis complements functional imaging by identifying necessary and contributing components of the processing chain; functional imaging also allows the identification of specific components of the processing chain.
Overall one strategy complements and underlines the other.
nb: All of the above techniques require that you get the psychology right - if you do not have a good functional theory, applying technology will not get you a meaningful answer.
Further understanding of lesions and their functional role is key for targeted rehabilitation of function and the guided recovery of patients.