Higher Cortical Functions

Cerebral cortex
covers the outer por1on (1.5 mm to 5 mm)
layer of the brain o<en referred to as gray
ma?er
consists of folded
bulges (gyri)
crea1ng deep
furrows or
ssures (sulci)
Divided into lobes
 Cerebrum

Asymmetry = dominant hemisphere

 Handedness
Most apparent when skilled manipula1ons:
Wri1ng
Drawing
Holding a needle while sewing
using a toothbrush

Le< handedness slightly more frequent in men

than women


 Dominant hemisphere
Handed- Le* hemi- Right Both
ness sphere hemi-
sphere
Right 96% 4% 0
handed
Le< 70 15 15
handed
Interhemispheric
communca1on

Corpus callosum
- the largest
commissural pathway
- follow a
homotropic
arrangement in
connec1ng
homologous areas

 Integra1ve func1ons
Use of language

Learning and memory

Emo1on

Consciousness

 Objec1ve I
1. To discuss the func1ons of the higher
centers:
2. To determine and dieren1ate the levels of
consciousness
3. To discuss EEG

 Re1cular
Forma1on
Not just a diuse,
undened system
Highly organized
clusters of transmi?er-
specic cell groups that
inuence specic areas
of the CNS
Neuronal widespread
system of axon
collaterals------
extensive synap1c
contacts
 Re1cular Ac1va1ng
System
Arm of re1cular forma1on
(cluster of neurons in the
brainstem)

Func1ons as the arousal or
aler)ng system for the
cerebral cortex

Maintains consciousness
Monitored with the EEG
one
Level of
and voice. An
of Patient
Consciousness alert
(Arousal): patient
Techniques
Response and Patient Response
d and
responds fully and appropriately Abnormal Response
Patient Response
e Level
of voice.Technique
An alert patient Abnormal Response Response
Abnormal
Abnormal Response
esponds
e of voice.
Alertness
fully
An
Speak
and
to thealert
appropriately
patient in apatient
normal tone of voice. An alert patient
e. For
ne
esponds example,
of voice.
fully An
opens and
the call
alert
eyes, looks atthe
you, andpatients
patient
appropriately responds fully and appropriately A lethargic patient appears drowsy
responds fully and appropriately
to stimuli (arousal intact). but opens the eyes and looks at
For example, call the patients Ayou,
lethargicresponds patientto questions, and
appears drowsy
For example, call the patients A lethargic patient appears drowsy
e.Lethargy Speak to the patient
For example, callinthe a loud voice. For example, call the patients AAthen
patients but
lethargic falls
opens
lethargic patient asleep.
appears the eyes
drowsy
patient and looks
appears drowsyat
but opens the eyes and looks at
name or ask How are you? you,responds
but opensopens
but respondstoto
the eyes and the questions,
looks at eyes and looks at and
ening a sleeper. An
you,
you, obtundedresponds patient
to opens the
questions,
questions, eyes
and
and
you,
then
then responds to questions,
falls
falls and
asleep.
and falls asleep.
then falls looks
then
asleep. at you, but responds
asleep.
ing aa asleeper.
ing
ening sleeper.
sleeper. An
An
An obtunded
obtunded
slowly
obtunded and ispatient patient
somewhat
patient opens
opens
opens thethe
the eyes
eyes
confused.
eyes
Obtundation Shake the patient gently as if awakening a sleeper. An
and obtunded
andlooks patient
looks opens
atatthe eyes
you,you,but
butresponds
and
Alertness
and looks
looks
at you, but and
responds
but
interest inresponds
responds
the
slowly
slowly
slowly and isare and
and is somewhat
somewhat
somewhat confused.
confused.
confused.
environment
slowly and is somewhat
Alertness
Alertness andconfused. decreased.
interest
interest in
in the
the
Alertness and
environment
Alertness
interest
are in the
decreased.
and interest in the
mple, pinch a tendon, rub the Aenvironment
stuporous
environment
are decreased.
patient arouses
are arouses
decreased.from sleep
ple,
e, pinch
pinch atendon,
a(Notendon,rub
rubthe
the A environment
stuporous
A stuporous are decreased.
patient
patientstimuli. from
from sleep
arousesVerbal sleep
nail bed. stronger stimuli
nail bed. (No stronger stimuli
only
only after
after painful
painful stimuli. Verbal
e, pinch
ilStupor
bed. aApply
(No tendon,
a painful stimulus.rub
stronger Forstimulithe
example, pinch a tendon, rub the Aonly stuporous
Aresponses
stuporousafter painful
patient arouses patient
from arouses
sleep stimuli. from sleep
Verbal
responses are
are slow
slow or
or even
even absent.
absent.
ail bed. (No stronger
sternum, stimuli
or roll a pencil across a nail bed. (No stronger stimuli only
responses
only
The after
afterpatient
painful are
stimuli. painful
Verbalslow or
lapses stimuli.
into an Verbal
even absent.
The
The patient
patient lapses
lapses into
into an
needed!) responses
responses are slow or evenare
unresponsive absent.
stateslowwhenor an
even absent.
the stimulus
unresponsive
unresponsive
The
The patient patient
ceases. lapses into an lapses
There state
state when
when
is minimal the
the stimulus
an stimulus
into awareness
ceases.
ceases.
of self state There
or There
the is minimal
isstate
minimal
environment. awareness
awareness
unresponsive when the stimulus
of self or the environment.the stimulus
unresponsive when
A of self
ceases.
comatose
ceases. There isor the
minimal
There environment.
awareness
patient remainsawareness
is minimal
A unarousable
comatose
ofof
self orself patient
the environment. with eyesremains
closed. There
Aunarousable
iscomatose
no evident or the
patientenvironment.
with remains
eyes
response closed.
to innerThere
need
Coma Apply repeated painful stimuli. A
or
is comatose
unarousable
no patient
external
evident remains with
stimuli. eyes
response closed.
to innerThere
need
A comatose patient remains
orunarousable
external with eyes closed. There
stimuli.
is no evident
unarousable response
with eyes toclosed.
inner need
There
is no evident response to inner need
or external
orisexternal
no stimuli.
evident
stimuli. response to inner need
595
or external stimuli.
EEG
Sensi1ve recording
device
Non invasive
Measures electrical
ac1vity of areas in the
cerebral cortex
Epilepsy and sleep
disorders
 EEG pa?ern
Brain electrical poten1als
Brain waves ( frequency / amplitude)
> = 8 13 Hz, high voltage
= awake but relaxed with eyes closed
> = 14 - 17 Hz, low voltage
= awake, alert, a?en1ve, busy waves
> = 4 7 Hz, low voltage
= asleep, drowsy waves
> = < 4 Hz, high voltage
= deep sleep waves

4< /849/=>(1=!4(9148-
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 Causes of unconciousness
Reduc1on in cerebral arterial oxygen
supply = syncope
Head trauma
Neuronal suppresion basilar migraine,
hypoglycemia
Neuronal excita1on epilepsy
Drug abuse alcohol, solvents,
barbiturates
 Objec1ve 2
Learning and Memory
1. Iden1fy the types of learning
2. Give the types of memory
a. explicit and implicit memory
b.short term and long term memory
3.Give the molecular basis of learning and
memory
4. Give the neurotransmi?ers involved in Iearning
and memory

 Learning and Memory
Learning
acquisi1on of knowledge/informa1on
gathering informa1on
neural mechanism by which the individual
changes his/her behavior as the result of
experience

Memory
storage of informa1on
retrieval
recall/reten1on
 Areas involved in learning and
memory
Temporal lobe
Hippocampus
Amygdala
Prefrontal area
Structural changes in learning:

1. Development of new synapses
2. Increase in synap1c eciency

Ca++ neurotransmi?er
 Types of Learning
1. Non associa1ve
a. Habitua1on nega1ve learning
repeated ac1on poten1al Ca
neurotransmi?er
b. Sensi1za1on posi1ve learning
- in threatening s1muli
- low intensity s1mulus high response
2. Associa1ve
a. Classical condi1oning
b. Operant condi1oning
reward = + reinforcement
punishment = - reinforcement
 Two principal types of Learning Process
Classic Condi)oning:
the subject plays a rela1vely involuntary or
passive role
represent a rela1vely primi1ve , simple or
generalized learning process
Operant Condi)oning:
(trial-and-error learning)
the subject exerts a considerable degree of
voluntary control over the learning process
represent learning at a much higher level
than either classic condi1oning
 Habitua1on
Deni1on: the gradual diminu1on in the
behavioral response, which is produced by the
repeated applica1on of a s1mulus without
reinforcement
Mechanisms:
decreased release of neurotransmi?ers from the
presynap1c terminal, because a gradual inac1va1on of
Ca2+ channels decreases intracellular Ca2+ into this
terminal
can be short-term, or it can be prolonged
 Sensi1za1on

A repeated s1mulus produces a greater response
if it is coupled one or more 1mes with an unpleasant
or a pleasant s1mulus
intensica1on of the arousal value of s1muli occurs
in humans
E,g, a mother who sleeps through many kinds of
noise wakes promptly when her baby cries
The short-term prolonga1on of
sensi1za1on:
due to a Ca 2+ mediated change in adenylyl cyclase
that leads to a greater produc1on of cyclic AMP
Long-term poten1a1on:
a involves protein synthesis and growth of the
presynap1c and postsynap1c neurons and their
connec1ons
phenomenon of increased excitability and altered chemical
state on repeated s1mula1on of synapses
a condi1on that persists beyond cessa1on of electrical
s1mula1on
 Learning disabili1es

Dyslexia in reading
le?er and word recogni1on
understanding words and ideas
Dyscalculia in math
Dysgraphia in wri1ng
neatness and consistency of wri1ng
accurately copying le?ers and words
spelling consistency
Dyspraxia in motor skills
Aphasia/Dysphasia in language
 Types of memory
Short term memory - recall dura1on in
seconds
- working memory
Intermediate minutes to hours
- may be disrupted
Long term long las1ng, permanent
- dicult to disrupt
- structural changes at synapse:
= increased vesicle release sites
= increased number of synap1c
terminals
 Temporal domains of memory:
short-term and long-term memory

Short-term memories are like the memory for a

telephone number that last several minutes

Long-term memory are memories that last days,

weeks or a life1me
seman1c episodic
 DRM test

James Deese, Henry Roediger and Kathleen

McDermo?
memory is more like taking a picture and tearing it
up into small pieces and puwng the pieces in
dierent drawers
memory is then recalled by reconstruc1ng the
memory from the individual fragments of the
memory

 Other memory tests
(declara1ve memory)

object recogni)on test involves presen1ng a subject with
two dierent objects and they are asked to remember those
objects; pause and then two objects are shown again, one of
which is new and the other having been shown previously.
Subjects are asked to iden1fy the novel object, and to do so,
they need to remember which one was shown previously

object loca)on test in which subjects are asked to

remember the loca1on of an object on a two-
dimensional surface
 Localiza1on of Memory
Imaging

fMRI (func1onal magne1c resonance imaging)

PET (positron emission tomography) allows one to see

areas of the brain that are ac1ve during specic brain
tasks
Brain lesions
small parts of the brains of mice or rats are surgically
removed or chemically inac1vated and the animals are
systema1cally examined to determine whether the
lesion aected any memory system
Brain disease and injury
A classic study on localiza1on of memory was the result of
surgery performed on Henry Molaison, a pa1ent who was only
known to the scien1c community as H.M. un1l his death in
2008
H. M. is famous in the neuroscience literature because his brain
provided major insights into the localiza1on of memory
func1on
In the 1950 s, H.M. was diagnosed with intractable epilepsy,
and while there are pharmacologic treatments, in some cases
the only treatment is to remove the por1on of the brain that is
causing the seizures.
Consequently, H.M.'s hippocampus was removed bilaterally
before the opera)on: H.M. had a ne memory

aBer the opera)on:

H.M. had a very severe memory decit

ability to form any new memories for facts and events was
severely impaired
great diculty learning any new vocabulary words

could not remember what happened the day before.

This study clearly indicated that the hippocampus was

cri1cal for memory forma1on. But whereas H.M. had great
diculty forming new memories for facts and events, he s1ll
had all of his old memories for facts and events
(anterograde amnesia)
 Model systems to study
memory mechanisms

Aplysia californica and its nerve

cells.
Aplysia californica is found in the
1dal pools along the coast of
Southern California
Pioneering discoveries of Eric
Kandel
Nobel Prize in Physiology or
Medicine in 2000
 Mechanisms of sensi1za1on
Sensi1zing s1muli lead to the release of the neurotransmi?er
serotonin (5-HT)-----modulates the strength of the connec1on
between the sensory neuron and the motor neuron
An ac1on poten1al in the sensory neuron before the learning
produces a small excitatory postsynap1c poten1al (EPSP) in the
motor neuron and leads to a larger synap1c poten1al in the
motor neuron
A larger synap1c poten1al in the motor neuron increases the
probability that the motor neuron will be ac1vated to a greater
extent and produce a larger contrac1on of the muscle
 Mechanisms of short-term sensi1za1on
The sensi1zing s1mulus leads to release of the
neurotransmi?er 5-HT
5-HT binds the two types of receptors on the sensory
neuron:
DAG/PKC system

cyclic AMP/PKA system

Mechanisms of long-term sensi1za1on
2 major dierences between short-term and long-
term memories:
involve changes in protein synthesis and gene regula1on

involve structural modica1ons

Long-term memory involves changes in the structure

of neurons including growth of new processes and
synapses
 Factors aec1ng consolida1on of
memory
Emo1onal state - mo1va1on
Level of consciousness alert, aroused
Rehearsal or prac1ce
Associa1on of new informa1on with old
experiences
Mnemonics

Visual Recogni1on Memory
The ability to recognise elements in the surrounding environment such
as faces or places, as well as the ability to learn about and orient
ourselves within that environment are crucial to our func1oning in the
world

Spa1al memory:
an essen1al part of our ability to func1on as an individual within our
environment

Internal map -consists of three elements: what items are present,

where are they in rela1on to each other and where am I in rela1on to
both those items and the room

Specialised neurons in the hippocampus, known as place cells, allow us

to perform this func1ons
 Amnesia
Loss of memory
Types of amnesia
1. Anterograde inability to add new memories
- No new long term memory is formed
- injury of hippocampus
2. Retrograde temporary disrup1on or loss of events
that occurred prior to injury
- loss of recent event memory
 Demen1a
Degenera1on which aects memory,
a?en1on span, intellectual capacity,
personality and motor control
Disease condi1on with demen1a
- Senile
- Alzheimer
- Hun1ngton
- AIDS
 Objec1ve 3
Language and Speech
1. Describe the dierent areas in the cortex associated
with language
a. Give the func1on of Brocas area
b.Iden1fy the func1on of Wenickes area
c.Determine the structure involved in the following
language disturbances
dyslexia aphasia
alelia apraxia
agraphia agnosia
d. Dieren1ate between motor and sensory aphasia

 Language
System by which sounds, symbols and
gestures are used for communica1on

Comes into our brain through the visual and

auditory systems

Motor systems produce speech (verbal and

wri?en)
Language areas
 Wernickes area
le< temporal lobe
processes auditory words and
language inputs
- represent words
- interpret words
- produce speech
sensory
 Brocas area
lies in the le< frontal lobe
responsible for language produc1on
- process the sounds making up words
(phonemes)
- produce verbal output
- ac1vate the motor centers of the
tongue and mouth
- remember verbal material
- motor

 Le< angular gyrus
Transfers and associates visual, auditory, and tac1le informa1on
Combines visual and auditory informa1on needed for reading and
wri1ng
Connects objects and words for objects, which is essen1al for learning
language
Becomes more uent in language
Holds words in working memory long enough to process the words
Spells words
Remembers the meaning of words
Puts words into categories and combine words to form ideas and
concepts
Stores the rules for transla1on from wri?en to spoken language
Deals with the structure of language
 Right angular gyrus
Goes beyond the literal meanings of words
Adds prac1cal implica1ons to words (pragma1cs)
Understands implied meanings used in humor,
metaphor, singing
Integrates the emo1onal and tonal components of
language through pathways to the emo1onal
gatekeeper (amygdala) and the thinking brain's
emo1onal processing center (posterior cingulate)
 Non-verbal component of
communica1on
Func1on of the nondominant hemisphere
Prosody = musical intona1on
Emo1onal gesturing
Prosodic comprehension
Comprehension of emo1onal gesturing
 Stages of development of language
Ave. age Language ability
6 mo babbling
1 yr 3 word speaker Language understanding
1 yrs 30-50 words used singly,
no sentences
2 yrs 2 words tele- 50 words, 2 words phrases
graphic speaker arranged according to syntax

2 yrs Combina1on of 3 words, good

understanding
3 yrs Vocabulary of 1000 words, less
error in speech
4 yrs Close to adult competence
Testing for Aphasia

Word Comprehension Ask the patient to follow a one-stage

command, such as Point to your nose.
Try a two-stage command: Point to your
mouth, then your knee.
Repetition Ask the patient to repeat a phrase of one-
syllable words (the most difficult repetition
task): No ifs, ands, or buts.
Naming Ask the patient to name the parts of a watch.
Reading Comprehension Ask the patient to read a paragraph aloud.
Writing Ask the patient to write a sentence.
 Aphasia loss of language abili1es
Brocas motor area of speech
- expressive aphasia = nonuent speech
- unable to convert thought to meaningful
language
Wernickes sensory area of speech
- uent speech, jargon speech or word salad
- impaired comprehension of language
Conduc1on aphasia involves the arcuate
fascilicus
- impaired repe11on of words
the
thecentral
central or peripheralnervous
or peripheral nervoussystem,
system, parkinsonism,
parkinsonism, and cerebellar
and cerebellar disease.disease.
Aphasia referstotoaadisorder
Aphasia refers disorderin inproducing
producing or understanding
or understanding language.
language. It iscaused
It is often oftenbycaused
lesionsbyin lesions in the dominant
the dominant
cerebral
cerebral hemisphere (usuallythetheleft).
hemisphere (usually left).
Compared below
Compared belowarearetwo
twocommon
common types of aphasia:
types (1) Wernickes,
of aphasia: a fluenta(receptive)
(1) Wernickes, aphasia, and
fluent (receptive) (2) Brocas,
aphasia, and (2)a non-
Brocas, a non-
fluent(or
fluent (or expressive)
expressive) aphasia.
aphasia.There
There areare
other less common
other kinds kinds
less common of aphasia, which may
of aphasia, whichbe distinguished from each other
may be distinguished from each other
by differing responses on the specific tests listed. Neurologic consultation is usually indicated.
by differing responses on the specific tests listed. Neurologic consultation is usually indicated.

Wernickes Aphasia Brocas Aphasia

Wernickes Aphasia Brocas Aphasia
Qualities of Spontaneous Fluent; often rapid, voluble, and Nonfluent; slow, with few words and laborious effort.
Speech effortless. Inflection and articulation Inflection and articulation are impaired but words are
Qualities of Spontaneous areFluent; often rapid, voluble, and Nonfluent; slow, with few words and laborio
good, but sentences lack meaning meaningful, with nouns, transitive verbs, and important
Speech andeffortless.
words areInflection
malformedand
(paraphasias) Inflection
articulationadjectives. and articulation
Small grammatical areoften
words are impaired but w
dropped.
or are good,(neologisms).
invented but sentences
Speech meaning meaningful, with nouns, transitive verbs, and
lackmay
be and words
totally are malformed (paraphasias) adjectives. Small grammatical words are often
incomprehensible.
Word Comprehension or invented (neologisms). Speech may
Impaired Fair to good
Repetition be totally incomprehensible.
Impaired Impaired
Word Comprehension
Naming Impaired
Impaired Fairthough
Impaired, to good
the patient recognizes objects
Reading Comprehension
Repetition Impaired
Impaired Fair to good
Impaired
Writing Impaired Impaired
Naming Impaired Impaired, though the patient recognizes obj
Location of Lesion Posterior superior temporal lobe Posterior inferior frontal lobe
Reading Comprehension Impaired Fair to good
Diculty in RecepGve Expressive
problems dis1nguishing
ar1culatory problems e.g. 'nk'
Phonology between sounds as in 'van' and
for 'think'
'than'
problems extrac1ng meaning
from gramma1cally complex gramma1cal construct
Syntax sentences e.g. thinking that 'the interferes with meaning e.g.
cat was bi?en by the dog' means 'the cat that dog bit'
'the cat bit the dog'

SemanGcs understanding meaning communica1ng meaning

understanding the
communica1ve purpose of
language, including non-literal using language in a socially
meaning as in sarcasm, irony appropriate way e.g. tone of
PragmaGcs and metaphor e.g. an au1s1c voice, eye-contact, turn-taking,
child may see a sign saying maintaining a shared topic
'Please knock the door' and
knock each 1me he passes
 EMOTIONS
Objec1ve:

To iden1fy the cor1cal structures associated with
emo1on, mo1va1on and behavior
Emo1on:
complex feeling state with psychic and
soma1c components
related to aect and mood

Aect observed expression of emo1on
Basic: needs and drive
General: love, hate, anger, fear,
sadness

 Limbic lobe:
coined by Paul Brocka in 1878
limbus La1n for border
not related to emo1ons

Cannon, Bard, et.al. - in 1930s:
suggested limbic structures are involved in emo1on

Emo1on system proposed by James Papez in 1950s =
Papez circuit

Kluver-Bucy syndrome
Heinrich Kluver and Paul Bucy found that temporal
lobectomy has a drama1c eect on aggressive tendencies
and responses to fearful situa1ons
Limbic systems
Amygdala involved with encoding of memories that
evoke fear

Thalamus feelings of pleasantness and
unpleasantness

Hypothalamus feeding and saGety center

Frontal lobe eliminates rage and decreases anxiety
lateral hypothalamus - anger
medial hypothalamus - aggression

Temporal lobe establishes the feeling of
dj vu
jamais vu

 Theories of emo1ons
Darwin and Freud - considered the role of the brain
 References
Bates Guide to Physical Examina1on
Physiology Books: Berne and Levy, Ganong, Guyton,
Rhoads and Bell
Bear, Connors abd Paredico Neuroscience
John H.Byrne,PhD,Department of neurobiology and
Anatomy,UTMS. Chapter 7: Learning and
Memory.Neuroscience