SUPPORT FOR A NEUROPSYCHOLOGICAL MODEL OF SPIRITUALITY IN PERSONS WITH TRAUMATIC BRAIN INJURY

Recent research suggests that spiritual experiences are related to increased physiological activity of the frontal and temporal lobes and decreased activity of the right parietal lobe. The current study determined if similar relationships exist between self‐reported spirituality and neuropsychological abilities associated with those cerebral structures for persons with traumatic brain injury (TBI). Participants included 26 adults with TBI referred for neuropsychological assessment. Measures included the Core Index of Spirituality (INSPIRIT); neuropsychological indices of cerebral structures: temporal lobes (Wechsler Memory Scale‐III), right parietal lobe (Judgment of Line Orientation), and frontal lobes (Trail Making Test, Controlled Oral Word Association Test). As hypothesized, spirituality was significantly negatively correlated with a measure of right parietal lobe functioning and positively correlated (nonsignificantly) with measures of left temporal lobe functioning. Contrary to hypotheses, correlations between spirituality and measures of frontal lobe functioning were zero or negative (and nonsignificant). The data support a neuropsychological model that proposes that spiritual experiences are related to decreased activity of the right parietal lobe, which may be associated with decreased awareness of the self (transcendence) and increased activity of the left temporal lobe, which may be associated with the experience of specific religious archetypes (religious figures and symbols).     

Frontal brain asymmetry in depression with comorbid anxiety: a neuropsychological investigation

The approach-withdrawal model posits that depression and anxiety are associated with a relative right asymmetry in frontal brain activity. Most studies have tested this model using measures of cortical brain activity such as electroencephalography. However, neuropsychological tasks that differentially use left versus right frontal cortical regions can also be used to test hypotheses from the model. In two independent samples (Study 1 and 2), the present study investigated the performance of currently depressed individuals with or without a comorbid anxiety disorder and healthy controls on neuropsychological tasks tapping primarily left (verbal fluency) or right (design fluency) frontal brain regions. Across both samples, results indicated that comorbid participants performed more poorly than depressed only and control participants on design fluency, while all groups showed equivalent performance on verbal fluency. Moreover, comorbid participants showed "asymmetrical" performance on these two tasks (i.e., poorer design [right frontal] relative to verbal [left frontal] fluency), whereas depressed only and control participants showed approximately symmetrical profiles of performance. Results from these two samples suggest an abnormal frontal asymmetry in neurocognitive performance driven primarily by right frontal dysfunction among anxious-depressed individuals and highlight the importance of considering comorbid anxiety when examining frontal brain functioning in depression.     

Neuropsychological aspects of facial asymmetry during emotional expression: A review of the normal adult literature

This review focuses on facial asymmetries during emotional expression. Facial asymmetry is defined as the expression intensity or muscular involvement on one side of the face (“hemiface”) relative to the other side and has been used as a behavioral index of hemispheric specialization for facial emotional expression. This paper presents a history of the neuropsychological study of facial asymmetry, originating with Darwin. Both quantitative and qualitative aspects of asymmetry are addressed. Next, neuroanatomical bases for facial expression are elucidated, separately for posed/voluntary and spontaneous/involuntary elicitation conditions. This is followed by a comprehensive review of 49 experiments of facial asymmetry in the adult literature, oriented around emotional valence (pleasantness/unpleasantness), elicitation condition, facial part, social display rules, and demographic factors. Results of this review indicate that the left hemiface is more involved than the right hemiface in the expression of facial emotion. From a neuropsychological perspective, these findings implicate the right cerebral hemisphere as dominant for the facial expression of emotion. In spite of the compelling evidence for right-hemispheric specialization, some data point to the possibility of differential hemispheric involvement as a function of emotional valence. An earlier version of this paper by the first author was presented at the XV Annual Symposium of the Society of Craniofacial Genetics, July 12, 1992, Stanford University, Palo Alto, CA.     

Emotional disturbances and their interaction with neuropsychological deficits

The interaction and relationships between neuropsychological tests (which are principally oriented to intellectual and cognitive abilities) and tests of personality and emotional status are complex, but nevertheless important in the clinical assessment of brain-damaged persons. Are indications of emotional disturbances to be expected as a direct consequence of brain damage? If so, how can the indications of emotional disturbances be differentiated from results obtained with psychiatrically disturbed (non-brain-damaged) subjects? Some authors have presumed that emotional disturbances, such as depression, acute anxiety, etc., in their own right cause impaired performances on neuropsychological tests, whereas other authors have proposed that brain damage predisposes the individual to demonstrate evidence of emotional disturbances. If emotional disturbances cause impairment on neuropsychological tests, why is it that so many emotionally disturbed persons without brain damage tend to perform normally on neuropsychological tests? This review of relevant publications considers (1) different general approaches to these questions and their implications for neuropsychology, (2) evidence of differential sensitivity to brain damage of neuropsychological and emotional instruments, (3) the sensitivity and specificity of self-assessments and complaints of head-injured subjects, (4) MMPI findings among head-injured subjects and in interaction with neuropsychological measurements, and (5) principles and guidelines that may be of value in clinical application of findings reported in the literature.     

The influence of maternal anxiety and depression symptoms on fNIRS brain responses to emotional faces in 5- and 7-month-old infants

Greater relative right (versus left) frontal cortical activation to emotional faces as measured with alpha power in the electroencephalogram (EEG), has been considered a promising neural marker of increased vulnerability to psychopathology and emotional disorders. We set out to explore multichannel fNIRS as a tool to investigate infants’ frontal asymmetry responses (hypothesizing greater right versus left frontal cortex activation) to emotional faces as influenced by maternal anxiety and depression symptoms during the postnatal period. We also explored activation differences in fronto-temporal regions associated with facial emotion processing. Ninety-one typically developing 5- and 7-month-old infants were shown photographs of women portraying happy, fearful and angry expressions. Hemodynamic brain responses were analyzed over two frontopolar and seven bilateral cortical regions subdivided into frontal, temporal and parietal areas, defined by age-appropriate MRI templates. Infants of mothers reporting higher negative affect had greater oxyhemoglobin (oxyHb) activation across all emotions over the left inferior frontal gyrus, a region implicated in emotional communication. Follow-up analyses indicated that associations were driven by maternal depression, but not anxiety symptoms. Overall, we found no support for greater right versus left frontal cortex activation in association with maternal negative affect. Findings point to the potential utility of fNIRS as a method for identifying altered neural substrates associated with exposure to maternal depression in infancy.     

The psychological neuroscience of depression: implications for understanding effects of deep brain stimulation

In this article it is suggested that current psychological theories of depression presuppose that this condition will develop as a result of a vicious circle involving negatively biased communication between systems of emotional stress-/alarm-signaling, executive functions and mood regulation. These systems may from a neuroanatomical point of view be located in the limbic system, the orbitofrontal and lateral prefrontal cortex and the hypothalamus-pituitary-adrenal (HPA-) axis respectively. The theoretical and practical implications of this model for the understanding of pharmacological treatments of depression are briefly discussed and this theory is related to the catecholamine hypothesis of depression. The model is furthermore discussed in relation to deep brain stimulation (DBS) of treatment resistant major depression. Similarities and differences between this perspective and the one advocated by the "homeostatic theory" of depression are discussed. It is concluded that a topographical psychological theory may offer a useful heuristic in thinking about depression and that it offers several testable predictions about treatments of the disorder.     

Emotion and Pain: A Functional Cerebral Systems Integration

Emotion and pain are psychological constructs that have received extensive attention in neuropsychological research. However, neuropsychological models of emotional processing have made more progress in describing how brain regions interact to process emotion. Theories of emotional processing can describe inter-hemispheric and intra-hemispheric interactions during emotional processing. Due to similarities between emotion and pain, it is thought that emotional models can be applied to pain. The following review examines the neuropsychology of emotion and pain using a functional cerebral systems approach. Specific comparisons are made between pain and anger. Attention is given to differences in cerebral function and physiology that may contribute to the processing of emotion and pain. Suggestions for future research in emotion and pain are given.     

Cortical morphology associated with language function in neurofibromatosis,type I

Neurofibromatosis, type I (NF-I) is associated with verbal and nonverbal neuropsychological deficits and neuroanatomical anomalies. Few relationships between CNS abnormalities and cognitive function in this population, however, have been found. Reading disabilities and developmental language impairments in the general population have been associated with particular morphologic features in inferior frontal gyrus (IFG) and Heschl's gyrus (HG). We compared the morphology of these regions in children with NF-I and controls. Verbal skills in NF-I were related to IFG morphology, such that individuals with NF-I who showed "typical" gyral patterns in the right hemisphere performed worse across language measures than those showing an extra "atypical" gyrus. A doubling of HG in the left and right hemispheres was also significantly associated with performance on several neuropsychological measures. This is the first study to link regional gyral morphology with language function in NF-I. A possible molecular basis for the observed relationships is discussed.     

Cognitive and AI models of reasoning

Although relatively few in number, cognitive neuroscience studies of reasoning have two general implications for cognitive theories of deduction. First, an important distinction among these theories is whether they focus on the effect of personally relevant content on the processes and representations underlying deductive reasoning. Evidence is reviewed indicating that there is a neuroanatomical basis for both content-independent and content-dependent theories of deduction. Clinical and neuroimaging studies appear to show that content-independent reasoning is mediated by the left hemisphere, whereas content-dependent reasoning is mediated by regions in the right hemisphere and the bilateral ventromedial frontal cortex. In normal subjects, reasoning is likely to be based on contributions from both hemispheres. Second, clinical evidence indicates that the visuospatial processes used in deductive reasoning are mediated by the posterior areas of the left hemisphere, and that verbal and visuospatial reasoning representations overlap at the neuroanatomical level. This finding weighs against the claims of mental-model theory that deduction involves a significant nonverbal component. Further investigation, particularly with contemporary neuroimaging methods, is needed to test these preliminary conclusions.     

Functional cerebral asymmetry in hostility: a dual task approach with fluency and cardiovascular regulation

The influence of hostility levels on verbal and nonverbal fluency, and the concurrent cerebral regulation of autonomic nervous system functioning was examined in 48 right-handed males, half classified as low-hostile, and half as high-hostile. Recent research has supported inhibitory roles for the anterior right cerebrum in sympathetic regulation, and the anterior left cerebrum in parasympathetic regulation. Two neuropsychological tests purportedly mediated by left and right anterior cerebral systems, respectively, are the Controlled Oral Word Association Test and the Ruff Figural Fluency Test. Fluency and perseverative errors were assessed using these measures. Systolic and diastolic blood pressure, and heart rate were assessed with a digital blood pressure meter. It was predicted that high-hostile men would evidence interference on cardiovascular regulation concurrent with the nonverbal fluency task in comparison to low-hostile males. Further, interference was expected to manifest in the cognitive variable with more perseverative errors on the nonverbal fluency task in high-hostile males than in low-hostile males. The results support a capacity-limited prediction. High-hostile males evidenced significantly heightened systolic blood pressure during the nonverbal fluency task in comparison with low-hostile males. Further, high-hostile males displayed more perseverative errors in nonverbal fluency than did the low-hostile males. These results support the expectation that differences exist between high- and low-hostile males for right frontal functioning. These findings were discussed within the proposed anterior-posterior inhibition model of hostility.     

时间认知神经科学研究进展

当前对时间认知的脑机制探讨有三个模型：特异化计时模型、分布网络模型和定域计时模型。在这些模型的框架下,时间认知的神经心理学研究集中探讨了小脑、基底神经节、前额叶在时间信息加工中的作用和大脑两半球在时间认知中的不对称性。小脑作为内部计时系统对时间控制具有重要作用,在周期性动作任务中,小脑对不连续动作计时具有特异性。基底神经节在时间加工任务中与小脑存在明显的作用分离,其具体机制还有待深入研究。前额叶的计时功能可能与注意和工作记忆对时间信息的获得、维持和组织有关。此外,还发现大脑右半球与时问信息的加工关系密切。     

外显和内隐情绪韵律加工的脑机制：近红外成像研究

准确识别言语中的情绪韵律信息对社会交往非常重要。本研究采用功能近红外成像技术, 探索外显和内隐情绪加工条件下愤怒、恐惧、快乐三种情绪韵律加工过程中的大脑皮层神经活动。结果表明, 对愤怒、恐惧、快乐韵律进行特异性加工的脑区分别为左侧额极/眶额叶、右侧缘上回、左侧额下回, 其中右侧缘上回脑区同时受到情绪和任务的调控。此外, 右侧颞中回、颞下回和颞极在情绪外显任务中的激活明显强于内隐任务。本研究的结果部分支持了情绪韵律的层次模型, 也对该模型的第三层次, 即“额区对语音情绪信息的精细加工需要外显性情绪加工任务参与”提出了质疑。     

Neuropsychological function and memory suppression in conversion disorder

Conversion disorder (CD) is a condition where neurological symptoms, such as weakness or sensory disturbance, are unexplained by neurological disease and are presumed to be of psychological origin. Contemporary theories of the disorder generally propose dysfunctional frontal control of the motor or sensory systems. Classical (Freudian) psychodynamic theory holds that the memory of stressful life events is repressed. Little is known about the frontal (executive) function of these patients, or indeed their general neuropsychological profile, and psychodynamic theories have been largely untested. This study aimed to investigate neuropsychological functioning in patients with CD, focusing on executive and memory function. A directed forgetting task (DFT) using words with variable emotional valence was also used to investigate memory suppression. 21 patients and 36 healthy controls completed a battery of neuropsychological tests and patients had deficits in executive function and auditory‐verbal (but not autobiographical) memory. The executive deficits were largely driven by differences in IQ, anxiety and mood between the groups. A subgroup of 11 patients and 28 controls completed the DFT and whilst patients recalled fewer words overall than controls, there were no significant effects of directed forgetting or valence. This study provides some limited support for deficits in executive, and to a lesser degree, memory function in patients with CD, but did not find evidence of altered memory suppression to support the psychodynamic theory of repression.     

Neuropsychological consequences of right thalamic haemorrhage: case study and review

The neuropsychological performance of a right-handed man is examined following haemorrhage from the anterior sections of the right thalamus. A pattern of temporally graded retrograde amnesia, global anterograde amnesia, impaired short-term memory, behavioural changes, and severe executive deficits were identified. The deficits evident in this case are discussed in reference to existing neuropsychological literature regarding the consequences of thalamic infarction. It is proposed that damage to the anterior thalamic nuclei results in a frontal dysexecutive syndrome and that such a dysexecutive syndrome can explain the neuropsychological deficits observed in this case.     

Affective aprosodia from a medial frontal stroke

BACKGROUND AND OBJECTIVES: Whereas injury to the left hemisphere induces aphasia, injury to the right hemisphere's perisylvian region induces an impairment of emotional speech prosody (affective aprosodia). Left-sided medial frontal lesions are associated with reduced verbal fluency with relatively intact comprehension and repetition (transcortical motor aphasia), but persistent affective prosodic defects associated with right medial frontal lesions have not been described. METHODS: We assessed the prosody of a man who sustained a right medial frontal cerebral infarction seven years prior. RESULTS: While propositional speech expression was normal including syntactic prosody, the patient was impaired at expressing emotions using prosody. His comprehension and repetition of prosody were also impaired but less so than expression. CONCLUSIONS: Right medial frontal lesions can induce an affective aprosodia that primarily impairs expression.     

Anterior cerebral asymmetry and the nature of emotion.

This article presents an overview of the author's recent electrophysiological studies of anterior cerebral asymmetries related to emotion and affective style. A theoretical account is provided of the role of the two hemispheres in emotional processing. This account assigns a major role in approach- and withdrawal-related behavior to the left and right frontal and anterior temporal regions of two hemispheres, respectively. Individual differences in approach- and withdrawal-related emotional reactivity and temperament are associated with stable differences in baseline measures of activation asymmetry in these anterior regions. Phasic state changes in emotion result in shifts in anterior activation asymmetry which are superimposed upon these stable baseline differences. Future directions for research in this area are discussed.     

Recognition of emotional facial expressions in depressed children and adolescents

Of the neurobiological models of children's and adolescents' depression, the neuropsychological one is considered here. Experimental and clinical evidence has allowed us to identify a lateralization of emotional functions from the very beginning of development, and a right hemisphere dominance for emotions is by now well-known. Many studies have also correlated depression with a right hemisphere dysfunction in patients of different ages. The aim of our study was to analyze recognition of different facial emotions by a group of depressed children and adolescents. Patients affected by Major Depressive Disorder recognized less fear in six fundamental emotions than a group of healthy controls, and Dysthymic subjects recognized less anger. The group of patients' failure to recognize negative-aroused facial expressions could indicate a subtle right hemisphere dysfunction in depressed children and adolescents.     

Reward sensitivity in depression: a biobehavioral study

The approach-withdrawal model posits 2 neural systems of motivation and emotion and hypothesizes that these systems are responsible for individual differences in emotional reactivity, or affective styles. The model also proposes that depression is characterized by a deficit in reward-seeking behavior (i.e., approach motivation) and is associated with a relative decrease in left frontal brain activity. The authors tested aspects of this model by comparing the electroencephalogram alpha power of depressed and nondepressed individuals during a task that manipulated approach motivation. The study found that control participants and individuals with late-onset depression exhibited the hypothesized increase in left frontal activity during the approach task but individuals with early-onset depression did not. This suggests that early-onset depression may be associated with a deficit in the hypothesized approach motivation system.     

Processing the emotions in words: The complementary contributions of the left and right hemispheres

A dual-process model is suggested for the processing of words with emotional meaning in the cerebral hemispheres. While the right hemisphere and valence hypotheses have long been used to explain the results of research on emotional stimulus processing, including nonverbal and verbal stimuli, data on emotional word processing are mostly inconsistent with both hypotheses. Three complementary lines of research data from behavioral, electrophysiological, and neuroimaging studies seem to suggest that both hemispheres have access to the meanings of emotional words, although their time course of activation may be different. The left hemisphere activates these words automatically early in processing, whereas the right hemisphere gains access to emotional words slowly when attention is recruited by the meaning of these words in a controlled manner. This processing dichotomy probably corroborates the complementary roles the two hemispheres play in data processing.     

The frontal lobe and aggression

Frontal lesions often lead to psychosocial problems. It is not surprising that frontal lobe dysfunctions have been proposed to underlie antisocial behaviour in individuals without apparent lesions. However, physical aggression and violence have never been systematically related to acquired lesions. Whereas, traditional neuropsychological testing identifies problems in cognitive and emotional information processing, recent brain-imaging studies have revealed both the frontal structural and functional underpinnings of antisocial behaviour. Careful characterization of antisocial behaviour subtypes seems to indicate that cognitive-neuropsychological function is systematically poor in physical aggression and hyperactivity. Recent refinements point to biological and genetic moderators of that association.