Tuesday, February 24, 2009

Luria: frontal lobes and memory

Working brain 210-225.
Patients' actual memories are preserved, but ability to create stable motives, active effort, ability to switch from one trace to another is not preserved. List learning shows an early plateau.

Clinical tests
thematic picture-- will focus on one element and stop. (eg p215 picture of man falling through ice). Picture Unexpected Return p218. Eye movements show absent scanning. Arithmetic-- trouble with serial 7's or 13's; trouble with alternating operations (plus then minus). Only partially effective treatment is dividing into consecutive questions with external supports for each one.

jackson-- Frontal lobes not only are the most recent and largest part of the brain, but the least organized. Lesions can be compensated for or appear asymptomatic. However, Luria divides frontal lobes into the lateral zones, which cause disintegration of motor and in left sided lesions, of speech activity. The medial basal frontal lobes connect to reticular formation and the limbic brain. Luria notes potential effects on olfactory structures, generalized disinhibition and gross changes in affective processes. Impulsiveness and fragmentation occur preventing many tasks.
Some of the terms used by Luria for medial zone lesions include the "oneroid state," diminihsed critical faculty, disturbance of action acceptor apparatus, disturbance of selectivity of mental actions, disturbance of memory and confabulations.

No comments: