CC BY
7МЕДИЦИНСКИЕ НАУКИ
УДК: 616-009
Telzhan Venera
PhD, "ClinicalPsychology" Selinus University of Science and Literature
Rome, Italy
NEUROPSYCHOLOGICAL ASPECTS OF CLINICAL NEUROLOGY
DOI: 10.31618/ESSA.2782-1994.2022.3.77.251 Abstract. This article examines the relationship of neuropsychological aspects in clinical neurology. The integration of two different dimensions of the brain is observed and considered, which are so interconnected that they are inseparable at many levels of nervous organization. The results of the study show that some of the neural structures of the brain are responsible for a variety of functions that include many cognitive as well as neurological features and symptoms found in various neurological disorders. The aim of the study is to analyse the relationship of neuropsychological aspects in clinical neurology. The study is descriptive and based on the results of earlier published works. Collections of scientific conferences, scholarly articles, reports of forums and seminars, periodicals and other materials were used for the analysis. The significance of the study is that the results reflected in the article can be used in further research.
Key words: neuropsychology, clinical neurology, dementia, neurological disorders.
Introduction
Neuropsychology is an autonomous scientific discipline, although it is at the intersection of the two sciences, theoretical psychology and clinical neurology. It covers both general problems of the organization of higher mental functions, as well as practical medical aspects in the field of topical neurological diagnosis, clinical psychology, defectology. The main connection between neuropsychology and neuroscience lies in the claw. The claw is the brain's ability to process information in various forms. These include several functions such as memory, executive functions, language and other cognitive functions such as visual-perceptual functions and consciousness. Neurological disorders, on the other hand, include a wide range of conditions associated with brain damage. However, it is important to understand that neuropsychological disorders are an integral part of almost all neurological disorders. On the other hand, each neuropsychological disorder is a result of neuropathology and therefore is itself a neurological disorder [1]. In this regard, many researchers have addressed neuropsychological aspects in clinical neurology in one way or another. The positive results achieved in the treatment of diseases, taking into account neuropsychology and neurology, indicate that the interest of researchers in this field is growing every year.
The research question is how do aspects of the two domains, like neuropsychology and neuroscience, contribute to improving disease in these domains?
The aim of the research is to analyse the relationship between neuropsychological aspects and clinical neurology.
Research methods consist of an overview of research articles as well as the analysis of statistical indicators related to interdisciplinary research in neuropsychology and clinical neurology. The study is descriptive and based on the results of earlier published works. The study focuses mainly on the context of the
interrelationship between areas such as neuropsychology and neurology, and examines their important relationship in the detection and treatment of certain diseases in their given domains. Collections of scientific conferences, scholarly articles, reports of forums and seminars, periodicals and other materials were used for the analysis.
The practical significance of the research is that the results reflected in the article can be used in further research.
Results and discussion
The study shows that the integration of neuropsychology and clinical neurology is an inevitable and necessary process. There are several issues related to the etiology, diagnosis, and treatment of neurological disorders that can be better understood if the two fields of neuropsychology and clinical neurology are considered together.
In particular, diagnosis as well as treatment of chronic neurodegenerative disorders such as dementia, motor disorders, Parkinson's disease, are highly dependent on several specific neuropsychological functions such as memory and Alzheimer's disease, as well as the treatment of executive deficits in Parkinsonism.
However, these effects are not limited to chronic neurodegenerative disorders, but include all neurological disorders, including cerebrovascular disorders, epilepsy, neurogenetic disorders, and structural disorders of the brain, like tumors, among a number of others [2].
Tryon W. in its study shows that neuroscience focuses on physical sets of properties, and neuropsychology focuses on psychic analogues; these two disciplines may seem incomparable. However, neuroscience plays a role in neuropsychology. In fact, these two areas are not entirely separate disciplines, but can complement each other in several ways. Together, these two areas can help answer questions about, for example, knowledge and behavior, nervous system
development, neuropsychopharmacology and plasticity. Understanding how the brain works scientifically, and using technologies such as brain scanners, can help to identify correlations between the brain and mental states. Neuroscience has created new and advanced ways for scientists to assess the biological processes that underlie behavior, which in turn has enabled professionals to make more informed decisions about mental intervention and treatment [3].
In addition, the work of B. G. Ananyev and his staff on the problem of hemispheric interaction of the brain has made a significant contribution to the construction of modern neuropsychological
representations about brain organization of mental processes [4].
Neurological research by G. V. Gershuni on the auditory system, which has revealed two modes of operation, is of great value for the development of neuropsychology: analysis of long sounds and analysis of short sounds, which led to a new approach to the symptoms of damage to the temporal cortex in humans, as well as many other studies of sensory processes [5].
Going back to the research question, neuropsychology and neuroscience interact to produce positive effects. The researchers have made some important discoveries about the following conditions affecting mental health and behavior (table 1).
Table 1.
Neuroscience and neuropsychology in disease
Name of the disease Content
Parkinson's disease A degenerative disease of the nervous system, Parkinson's disease, causes damage to the nerve cells in the brain that control movement, which also affects a person's ability to make decisions. Neurology helps to better understand the course of the disease in a variety of ways, including the creation of computational models that give an idea of the strength of connections in the basal ganglia of the brain. How the connections differ in Parkinson's patients could help neuropsychologists create treatments tailored to patterns of neural degeneration.
Alzheimer's disease Alzheimer's disease, characterized by cognitive decline, leads to a decrease in a person's intellectual abilities and can cause changes in personality and behavior. Using neuroscience applied to animals, the researchers found that age-related memory loss could be reversible using a gene transfer approach. In monkey studies, scientists have determined that control neurons in an area of the brain shrink with age and stop producing regulatory chemicals that affect reasoning and memory. By injecting nerve growth factor into cells and re-introducing it into monkey brains, the scientists were able to restore the number and function of the cells, providing invaluable insight into the possibilities of treating age-related disorders in humans. This discovery is an invaluable contribution to neuropsychology.
Huntington's disease A neurological disorder that causes involuntary movements and impaired intelligence, Huntington's disease is caused by a faulty DNA sequence that creates a toxic protein and damages the affected neurons. There is no cure yet for Huntington's disease, but Neupsychology is helping to find a solution. In recent years, various types of gene therapy have been used in research, but in 2018 a new system was created that promises to be safer and more specific than previous developments. The newly developed system was able to cut the DNA strand, deactivate the faulty gene and prevent the production of the toxic protein, providing vital data for the development of a potential future cure for Huntington's disease. This result was achievable due to the connection of the two areas of study.
Autism Covering a wide range of conditions, autism is characterized by problems in areas such as social skills, behavior, and both verbal and non-verbal communication. Research in neuroscience provides important information about when and how autism is diagnosed, as well as insight into the characteristics of the condition in terms of brain activity. The researchers were able to identify both structural and functional differences in the brains of people with autism and related spectrum disorders by finding that the amygdala brain region is underactive, for example, when people with autism try to read facial expressions. Because more men than women suffer from autism, the researchers also looked at the effects of fetal testosterone levels and found that higher prenatal testosterone levels are associated with reduced social skills, but higher attention to detail in infants, markers of autism that may help with early identification.
Clinical depression Clinical depression, characterized by persistent depressed mood, is studied in various branches of neurology. Studies have used pre-treatment brain scans to detect changes in people with depression, and results have shown that some treatments work better for people with relatively normal baseline subgenual anterior cingulate cortex (sgACC) activation, while some worked. better for people with abnormal baseline sgACC activation. Data can be collected from such studies and used to inform treatment choices for people with clinical depression. Some respond best to psychological treatment; others to pharmacological treatment, for example.
Anxiety disorders Anxiety disorders are characterized by a constant feeling of restlessness or restlessness. Treatment for anxiety disorders may take the form of therapy and/or medication, with varying degrees of success. However, a recent breakthrough in neuroscience could re-formulate some anxiety medications after researchers identified a brain pathway that could be a new target for
The above listed diseases as Parkinson's, Alzheimer's and Huntington's are considered dementia. In clinical neurology, neuropsychology plays the most important role in dementia. The diagnosis of dementia remains a difficult task, requiring the joint efforts of neurologists, psychiatrists and neuropsychologists.
In the various definitions of dementia syndrome, five general provisions can be identified:
1) cognitive (intellectual) abilities should decrease compared to the initial (i.e., existing before the disease) level;
2) the cognitive defect should be diffuse or at least cover several cognitive areas (memory, speech, praxis, attention, thinking, orientation, visuospatial functions, etc.), and not be limited to any one cognitive area ;
3) cognitive disorders must disrupt daily (professional or household) activities (and not just the performance of neuropsychological tests);
4) the cause of cognitive impairment should be a certain organic (structural or metabolic) lesion of the brain;
5) other mental disorders that can lead to impaired cognitive functions (confusion, delirium, depression, etc.) should be excluded [6].
The diagnosis of dementia is also complicated by the fact that, in the case of different brain diseases, its neuropsychological structure has its own peculiarities, predicated on different localizations of the pathological process and different scenarios of its spread.
A discovery made in neuropsychology by Pillon B. identified 3 groups of extrapyramidal diseases with neuropsychological profiles [7]. This separation has greatly helped in the treatment of dementia both in clinical neurology and neuropsychology itself.
The first group includes diseases in which moderate neurodynamic and regulatory cognitive disorders are detected, but dementia may be absent until the very late stage of the disease (multisystem atrophy, some cases of Parkinson's disease).
The second group included diseases with a pronounced subcortical-frontal cognitive defect, the progression of which can lead to dementia (including the attachment of cortical lesions): progressive supranuclear palsy, Parkinson's disease with dementia, and Huntington's disease.
The third group includes diseases in which severe operational disorders caused by dysfunction of the limbic, temporal-parietal or other parts of the cortex are observed already at an early stage (dementia with Lewy bodies, Alzheimer's disease with extrapyramidal disorders, Creutzfeldt-Jakob disease).
Thus, the study of the neuropsychological profile allows a more accurate picture of the involvement of various brain structures in the pathological process, and
thus can contribute to the differential diagnosis of extrapyramidal diseases.
Conclusion
Achievements in both areas equally challenge each other, which contributes to progress in both areas. Important experimental neuropsychological studies were also carried out on the basis of neurological clinics. The complex nature of the knowledge on which neuropsychology relies and which is used to build its theoretical models is determined by the complex, multifaceted nature of its central problem - "the brain as a substratum of mental processes." This problem is interdisciplinary, and progress towards its solution is possible only with the help of the joint efforts of many sciences, including neuropsychology. In order to develop the actual neuropsychological aspect of this problem, i.e., to study the brain organization of higher mental functions, primarily on the basis of local brain lesions, neuropsychology must be armed with the entire amount of modern knowledge about the brain and mental processes, drawn from both psychology and neurology.
Reference
1. Posner M. I. & Digirolamo G. J. Cognitive Neuroscience: Origins and Promise, Psychological Bulletin, - 2020, - no 126(6), - pp. 873—889.
2. Strik W., Stegmayer K., Walther S., Dierks T. Systems Neuroscience of Psychosis: Mapping Schizophrenia Symptoms onto Brain Systems. Neuropsychobiology, - 2017, - no 75, - pp.100 - 116.
3. Tryon, W. Cognitive Neuroscience and Psychotherapy: Network Principles for a Unified Theory, Available at: https://www.sciencedirect.com/science/article/pii/B97 80124200715000028 (date accessed: 07.12.2019).
4. Frontiers Science News. Modeling brain connections to understand Parkinson's disease, Available at: https://blog.frontiersin.org/2017/10/03/parkinsons-disease-brain-basal-ganglia-frontiers-in-computational-neuroscience/ (date accessed: 10.03.2017).
5. Brown R.G., Lacomblez L., Bernard G. Cognitive impairment in patients with multiple system atrophy and progressive supranuclear palsy // Brain. -2010. - no 133(23), - pp. 2382-2393.
6. Kertesz A., McMonagle P. Behavior and cognition in corticobasal degeneration and progressive supranuclear palsy // J. Neurol. Sci. - 2009. - no 289, - pp. 138-143.
7. Pillon B., Dubois B., Agid Y. Testing cognition may contribute to the diagnosis of movement disorders // Neurology. - 1996. - Vol. 46. -pp. 329-333.
anxiety-reducing drugs. By evaluating a brain chemical messenger called NPY in relation to the stress-sensitive area of the brain in the amygdala, the scientists determined the mechanism by which this chemical helps reverse the stress response caused by the hormone CRH. Both chemicals use the same channels, and the researchers were able to identify and inhibit the production of the anxiety-producing protein until the channels eventually disappear, a potential target for new drug production._
