Brain-Behavior Relationships

Overview of Topics

Dysfunctions caused by Lesions
Assessment
References

Parieto-temporal-occipital cortex

This area is a tertiary, general sensory association area that integrates visual, tactile, and auditory information.

1. Constructional Apraxia: defects in copying designs and in drawing to command (1).
   • Left hemisphere lesions: ordering of movements is disrupted, simplification of drawings, difficulty making angles (2).
   • Right hemisphere lesions: more severe deficits such as visuo-spatial defects, neglect of left side of drawing, disproportions (2).
2. Difficulties in serial ordering: comprehension of order and sequence (3).
   • Left hemisphere lesions: disruption of sequential organization of speech.
   • Right hemisphere lesions: cannot understand temporal relationships and is unable to make future plans.
3. Visual memory disturbance: defective revisualization (4, 5)
   • Left hemisphere lesions: inability to evoke visual image in response to a given word.
   • Right hemisphere lesions: inability to retain visual image of nonverbal, spatial figures.
4. Impaired recognition and comprehension of complex, symbolic stimuli.
   • Left hemisphere lesions only (1)
   • Symptoms of aphasia may also be seen (1).

TOP

B. Tests to measure the above deficits

1. Constructional apraxia
   • Copying designs: diamond, cross, cube, pipe (6).
   • Drawing to command: clock, daisy in flowerpot, house in perspective (4).
   • Match stick pattern test (7).
   • Block construction test (8).
2. Difficulties in serial ordering
   • Observations of spontaneous speech
   • Ability to order events in time: both life history events and objective events such as the Presidential terms (1).
3. Visual memory disturbance
   • Left hemisphere: Ask patient to describe objects that are not present (5)
   • Right hemisphere: Short-term visual memory for geometric patterns (9).
4. Impaired comprehension of complex symbolic stimuli
   • Ask patient to explain complex logico-gram-matical constructions such as "brother's father" (10)
   • Give commands such as "draw a circle under a square" (10).

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References

1. Lezak, M.D. Neuropsychological assessment. New York: Oxford University Press, 1976.
2. Warrington, E.K., James, P., & Kinsbourne, M. Drawing disability in relation to laterality of cerebral lesion. Brain, 1966, 89, 53-82.
3. Hecaen, H. Cerebral localization of mental functions and their disorders, In P. J. Vinken & G. F. Bruyn (Eds.), Handbook of clinical neurology, Vol.3, New York: Wiley, 1969.
4. Strub, R. L., & Black, F. M. The mental status exam in neurology. Philadelphia: F. A. Davis, 1977.
5. Critchley, M. The parietal lobes. New York: Hafner, 1966.
6. Piercy, h., Hecaen, H., & DeAjuriaguerra, J. Constructional apraxia. Brain, 1960, 83, 225-242.
7. Benson, D.J., & Barton, N.I. Disturbances in constructional ability. Cortex, 1970, 6, 19-46.
8. Benton, A. L., & Fogel, M. L. Three-dimensional constructional apraxia. Archives of Neurology, 1962, 7, 347-354.
9. Butters, N., Samuels, I., Goodglass, H., & Brody, 8. Short-term visual and auditory memory disorders after parietal and frontal lobe damage. Cortex, 1970, 6, 440-459.
10. Luria, A.R. Neuropsychological analysis of focal brain lesions. In B. B. Wolman (Ed.), Handbook of clinical psychology. New York: McGraw-Hill, 1965.