op cit 1973.
Activation and attention.
Luria cites the importance of the brainstem/reticular activating system ascending systems, but wonders about descending systems. Luria cites importance of "frontal" zones in producing "expectancy waves" or contingent negative waves) . EEG, GSR, EP and others by Sokolov (orienting reflex) and Homskaya et al. were important. In general, verbal instructions to mobilize attention (counting, etc.) led to higher eeg frequency including patients with posterior lesions. Patients with frontal lesions, esp. mesial and basal could not evoke these changes. Luria emphasizes not only frontal lesions, but also the role of verbal instruction.
Consciousness:
Vygotsky showed voluntary organization of conscious actions have a social origin and cannot be understood just by biological growth. It begins with childhood, when adults begin actions that children learn and finish. After children achieve speech, they give themselves instructions and inner speech is a well developed and important mental act. Frontal lesions that do not affect sensory, motor, or speechfunctions cause deterioration of complex functions that involve internalor external speech. Goal driven behavior is replaced by impulsive or echopraxic movements. Pribham and Anokhin showed impaired complex reaction times.
Testing os accomplished through contrasting program motor tasks.
Memory:
Cites Scoville and Milner the Papez circuit
Long discussion not included
Rehabiliation
Loss of function occurs but so does inhibition of function (diaschisis or functional asynapsia). The latter can be treated pharmacologically as done on ww I veterans and in children with cerebral palsy. Luria cites Russian sources for overproduction of cholinesterase can be overcome with prostigmine and other antichlinesterase drugs. If the whole functional system is damaged, rehab training should involve the "planned reorganization of functional systems." Doing so requires a careful psychological qualification of the deficit, ways to reorganize, and step by step sequence of neuropsychological methods.
Friday, July 4, 2008
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In other publications Luria cites re rehab Pavlov's observation that when the normal tone of the cortex is damaged, the "law of force" is lost and with it the ability of the brain to differentiate among stimuli. Normally, cortex responds to powerful and important stimuli and not to feeble or insignificant stimuli, but cannot do so if the cortex is damaged, inhibited drowsy oo asleep.
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