Clinically Relevant Functional Neuroanatomy临床相关的功能性神经解剖学.ppt

Introduction to Neuroanatomy Russell M. Bauer, Ph.D. January 9, 2006 Caveats What you need to know about anatomy Changes with each individual case Involves both local and global knowledge Depends on your practice and referral question What I can give you in 90 minutes Conceptual understanding of organization Tools to think about deeper levels of analysis Ways of decomposing deficits Key Concepts Functional Systems: patterns of connectivity Localized damage has systemic effects Segregated patterns of inputs and outputs Excitatory and inhibitory control Parallel vs. serial processing Cerebral Cortex Language Areas: 22, 39, 40, 44, 45 Posterior Parietal Association Area: 5, 7 (39, 40) body image Temporal Association Area: 20, 21, 37, 38 (22) multisensory integration, conceptual ideation Prefrontal Association Area: 9, 10, 11, 12, 46, 47 (44,45) executive skills, judgment, planning, emotion-regulation Association Areas Unimodal and Polymodal Association Neuropsychological Manifestations of Temporal Lobe Lesions Lateral (20,21,38,37) A) Posterior: visual recognition disturb-ances (severity depends on whether unilateral or bilateral B) Anterior: anomia for objects (left), anomia for facial expressions (right), full-blown anomia, retrograde memory disturbance (bilateral) Mesial (27,28 and limbic structures) Anterograde amnesia for verbal (left) or nonverbal (right) material; bilateral lesions produce severe material non-specific defect Tranel, 1992 Neuropsychological Manifestations of Occipital Lobe Lesions Dorsal(17,18,19,39,7) Partial or mild Balint’s syndrome (unilateral), severe Balint’s syndrome (bilateral), defective motion perception, astereopsis, severe visuospatial disturbance, simultanagnosia Ventral (17,18,19) Hemiachromatopsia (unilateral), pure alexia (left), apperceptive visual agnosia (unilateral, R>L), defective imagery Bilateral lesions produce severe agnosia, prosopagnosia