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Practical No. 1
Neurological Bases of Behavior (PSYP610)
Session: Spring 2023
Submitted to:
Dr. Naima Hassan
By Pin✌️.

Department of Psychology
Virtual University of Pakistan
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PRACTICAL REPORT NO.1

1. Write the Introduction of neuropsychological assessment techniques.

Neuropsychology is a relatively new discipline within the field of psychology. The
first textbook defining the field, the Fundamental of human neuropsychology, was
initially published by Kolb and Whishaw in 1980.
The term neuropsychology refers broadly to the study of behavior, the mind,
and their relationship with the central nervous system, particularly the two
cerebral hemisphere and related subcortical structure. Neuropsychology is
the scientific study of the physiological basis of the structure and function of
the nervous system, particularly brain, in relation to behavior and
psychological processes. It aims to understand brain function and its effects
on the behavior and cognition. It seeks to gain the knowledge to identify the
underlying biological causes of behaviors, from creative genius to mental
illness, that account for intellectual processes and the personality.
Definition:
Neuropsychological assessment techniques involve utilizing a variety of
standardized measures to evaluates an individual’s cognitive, behavioral, and
emotional functioning to determine any underlying neurological or psychological
conditions, these assessments typically incorporate different tests and measures to
assess area of the brain, such as memory, attention, language, spatial perception,
and executive functioning.
Purposes of neuropsychological assessment;
● Integrity of cognitive functions.
Evaluations are helpful to determine the presence, nature, and
diversity of the cognitive dysfunction. We provide baselines to monitor
future changes in cognitive abilities, mood and personality, including
treatment effects.
● Differential diagnosis – to confirm or clarify a diagnosis.
Regarding differential diagnosis, we help evaluate neurological and
psychiatric disorder. One unique contribution of the
neuropsychological assessment is the detection and evaluation of
cerebral dysfunction in the absence of clear anatomical evidence of
alternation.
● Treatment planning.
We provide treatment recommendation for cognitive disorders and
psychological adjustment, including a profile of strengths and
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weakness to guide rehabilitation, educational, vocational or other

services. We also determine levels of the cognitive functioning as they
relate to work, school and independent living.
The goals of the neuropsychological assessments to identify strengths and weakness
in cognitive functioning, diagnose any neurological or psychological disorders, and
develop appropriate treatments plans. Some commonly used neuropsychological
assessment techniques include standardized tests of cognitive functioning,
observation of behavior, self-report measures, and neuroimaging techniques such as
magnetic resonance imaging(MRI) and positron emission tomography(PET).
Standardized tests of cognitive functioning may assess various domains such as
attention, memory, language, executive function, and perceptual motor abilities.
Observation of behavior may include observing the individual’s daily activities,
interaction, and mood. Self-report measures may include questionnaires or surveys
that ask the individual about their symptoms, thoughts and emotions.
Overall, neuropsychological assessment techniques play a crucial role in diagnosing
and understand their strengths and weakness and improve their overall quality of
life.
2. Write the three Neuropsychological assessment techniques.
1.Brain imaging technique.

Techniques are available to cognitive neuroscientists, including positron emission

tomography (PET), near infrared spectroscopy (NIRS), magneto encephalon(MEG),
electroencephalography (EEG), and functional magnetic resonance imaging (fMRI).
We focus on EEG and fMRI in this article because they are the most widely used
tools. First discovered about a century ago, EEG measures electrical activities of the
brain from electrodes placed on the scalp. Usually, EEG is collected from tens to
hundreds of electrodes positioned on different locations on the scalp. Most EEG
systems used in cognitive neuroscience research today employ 64 to 256 electrodes.
Scalp EEG represents the aggregates of post-synaptic currents of millions of
neurons. Spontaneous EEG reflects neuronal responses that occur unprovoked, i.e.,
in the absence of any identifiable stimulus, with or without behavioral
manifestations. Spontaneous EEG has long been used in clinical settings to evaluate
seizure disorders, and has not been used often in cognitive neuroscience research.
Recently, there are growing interests in examining how the background brain
activities as measured by spontaneous EEG affect current cognitive activities. In
addition, spontaneous EEG may hold the key to unraveling the patterns of
functional connectivity and synchronicity among brain regions underlying the states
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of consciousness (also known as the default network). By combining with

resting-state fMRI, generators of spontaneous EEG activities can be analyzed.
Event-related potentials (ERPs) are associated with specific stimuli or thoughts. The
amplitudes of ERPs tend to be low, ranging from less than a microvolt to several
microvolts, compared to tens of microvolts for spontaneous EEG. To detect these
low-amplitude potentials against the ongoing background EEG, EKG (cardiac
artifacts), EMG (muscle activation artifacts) and other biological signals and
ambient noise, repeated stimulus presentations and signal processing techniques
(e.g., averaging) are required in ERP studies. Because most noise occurs randomly,
time-locked averaging techniques can greatly reduce the noise while preserving the
event-related signals in the EEG. Time-locked averaging can be either
stimulus-locked or response-locked.

In addition to time-locked responses, there may also be signals in the EEG that are
related to stimulus processing without a well-defined temporal relation to the event.
An example of induced activity is oscillatory activity (e.g. gamma oscillations),
which might have a different phase in each single measurement and therefore would
cancel one another in time-locked averaging. However, can be detected using
spectral analysis, in which EEG recordings are decomposed into a number of
frequency (sinusoidal) components, such as delta (0-3Hz), theta (4-7Hz), alpha
(8-12Hz), beta (12-30 Hz), gamma (30-50 Hz), and high gamma (80-150 Hz). Among
the various spectral analysis techniques, Fourier transform (FT) is traditionally the
preferred method because it is time-shift invariant in both the time and frequency
domains. However, in FT, any time-varying spectral content of the signal is ignored
because it assumes that the signal is stationary over time. This assumption is in
contradiction to the fact that EEG signals are non-stationary. To overcome this
limitation, Wavelet transform (WT) is now considered to be more suitable than
Fourier transform in analyzing induced activities

Functional Magnetic Resonance techniques.

FMRI is one of the most recently developed forms of neuroimaging technique. Since
the early 1990s, fMRI has become the dominant method in cognitive neuroscience
because of its low invasiveness, lack of radiation exposure, and relatively wide
availability. In the brain, neural activities often lead to metabolic activities such as
increased blood flow and oxygen supply to the local vasculature. The signals
associated with contrast agents are proportional to the cerebral blood volume
(CBV). Although this method can provide relatively strong signals, researchers are
reluctant to use this semi-invasive method with healthy volunteers. Perfusion fMRI
uses “arterial spin labeling” (ASL) to magnetically label hydrogen nuclei in the
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arterial blood and then images their distribution in the brain. This method is
sensitive to cerebral blood flow (CBF), which is considered as a good correlate of
neuronal activity. This method does not require any contrast agents. The signal in
perfusion fMRI is more stable and the noise is much whiter. However, the relatively
weak signal and the length of image acquisition time have limited the use of
perfusion fMRI in cognitive neuroscience.

Currently, the most widely used fMRI method is BOLD imaging, which detects the
difference in magnetic susceptibility between oxygenated hemoglobin and
deoxygenated hemoglobin. Hemoglobin is diamagnetic when oxygenated but
paramagnetic when deoxygenated. The magnetic property of blood therefore
depends on its oxygenation level. Although neuronal activities consume some
oxygen, the increase in blood flow following neuronal activities supplies more
oxygen than the neuronal consumption, resulting in an increase in oxygenated
hemoglobin and therefore increased BOLD response. Although BOLD fMRI is an
indirect measure of neuronal activities, there is strong empirical evidence that the
BOLD signals are highly correlated with neuronal activities. Because the BOLD
signals are usually stronger and require less time to acquire than perfusion signals,
BOLD fMRI is more popular than perfusion fMRI.

One major technical challenge for fMRI is that the hemodynamic responses are
relatively slow, weak, and noisy. The typical BOLD hemodynamic response
following a single stimulus event starts to rise after 1 to 2 seconds, peaks at 4-6
seconds, and returns to its baseline after 12-16 seconds. The typical BOLD signal
change following a single stimulus event captured on a 3T scanner is about 1-2%
and varies greatly across different event types and different brain regions. To
increase the statistical power of fMRI studies, many repetitions of the same event
type are necessary. The same types of stimuli are grouped together in each block,
was used in many studies.

2. Trail Marking test.

TMT has been highly correlated with driving performance (Hopewell, 2002). The
trail making test was initially designed as a part of the U.S. Norms are available for
persons aged 18 to 89 years, and it has been noted that scores decrease for
individuals with advanced age or lower education levels (NHTSA, 2003).
TMT is freely available, timed, neuropsychological test that involves visual scanning
and working memory. The TMT has two parts; the TMT-A (rote memory) and
TMT-B (executive functioning). In each test the participants are asked to draw a line
between 24 consecutive circles that randomly arranged on a page. The TMT-A uses
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all numbers, whereas the TMT-B alternates numbers and letters requiring the
patient to switch between numbers and letters in consecutive order. The TMT is
scored by how long it takes to complete the test. The time includes correction of
errors prompted by the examiner. If the person cannot complete test in 5 minutes,
the test is discontinued.
An average score for TMT-A is 29 seconds and a deficient score is greater than 78
seconds. For TMT-B an average score is 75 seconds and deficient score is greater
than 273 seconds. Norms have been established based on age and education. In
addition, both forms of the trail making test are highly dependent upon motoric
speed, and may not be appropriate for patients with marked motor impairment b
(e.g., Parkinson’s disease).
More than 60% of patients with dementia cannot complete standard executive
measures such as Stroop test or TMT-B. The choice of executive tasks to be used in a
dementia clinic is made based on their simplicity and their minimal reliance upon
the basic cognitive processes, such as language, visuospatial, and memory functions.
The task instruction should be short, straightforward, and easy to remember, and
the test material needs to be easily handled. In patients with movement disorders
accuracy scores should not be time-dependent. Whereas most traditional executive
tasks engage mostly dorsolateral frontal pathways, the presence of environmental
dependency syndrome, frequently seen in both FTD and PSP, may alert the clinician
to the potential involvement of other frontal areas (i.e. mesial, orbitofrontal, front
striatal, or front thalamic tracts). Importantly, both EDS and disinhibition may be
examples of environmentally driven rather than internally generated patterns of
behavior.

3.Wisconsin Card Sorting Test (WCST).

The Wisconsin Card Sorting Test (WCST) is a neuropsychological test that is

frequently used to measure such higher-level cognitive processes as attention,
perseverance, WM, abstract thinking, CF, and set shifting. It is particularly used in
clinical fields to measure perseverative behavior that refer to an individual’s
insistence on wrong behavior. Moreover, to be able to change category, one needs to
have high intellectual flexibility and ability in concept formation.

The WCST consists of two card packs having four stimulus cards and 64 response
cards in each. Each card measures 7×7 cm, and there are various geometric shapes
in different colors and numbers. The participants are expected to accurately sort
every response card with one of four stimulus cards through the feedback (right or
wrong) given to them based on a rule. Among various versions, the version of
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WCST with 128 cards developed by Heaton was used in this study. The test was
applied individually, and 12 scores were obtained. A reliability study could not be
conducted due to the nature of the test.

PRACTICAL REPORT NO. 2

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1. Write the introduction of neurophysiological assessment techniques.

The history of neurophysiological assessment techniques can be traced back to the
late 19th century, when scientists began to explore the electrical activity of the brain
and nervous system. In1875, Richard caton recorded the first electrical signals from
brains of animals, using a device called a capillary electrometer. Neurophysiological
assessments techniques refer to a range of methods used to measure and evaluate
the functioning of the nervous system. These techniques are used to diagnose and
evaluate various neurological disorders assessments can make use of a variety of
tools and technologies, including electroencephalography (EEG), nerve conduction
studies (NCS), electromyography (EMG), and evoked potentials (EP). These
assessments may be carried out in clinical or research settings, and typically
performed by trained professionals, such as neurologists, clinical neurophysiologist.
Purposes of neurophysiological assessment techniques.
The purpose of neurophysiological assessment techniques is to measure and evaluate
the functioning of the nervous system. These techniques are used to diagnose and
evaluate various neurological disorders like dementia and stroke etc. The
information obtained from neurophysiological assessments can help healthcare
professional to make accurate diagnosis, monitor the progression of neurological
disorders, and develop treatments. Also these assessments can be used to study the
neural mechanisms underlying cognitive processes, such as attention and memory,
and to investigate the effect of drugs or other
The goals of neurophysiological assessment techniques are to evaluate the function
and integrity of the nervous system at different levels, from the brain to peripheral
nerves and muscles. These techniques are used to diagnose and monitor a variety of
neurological conditions, such as epilepsy, stroke, neuropathies and spinal cord
injuries.
It identifies abnormalities in the electrical activity of the brain, which can help to
diagnose conditions such as brain tumors etc. It’s also evaluating the function and
integrity of the nervous system which can be help diagnoses conditions such as
peripheral neuropathies, myopathiesetc. It also helps to monitor the progression of
neurological disorders and effects of treatments, such as medication or
neurosurgery. Also aid in surgical planning, by identifying regions of the brain that
are responsible for specific functions such
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Overall, neurophysiological assessment techniques are a critical tool in the

management of neurological condition, allowing physicians to diagnose accurately
and treat patients more effectively.

3. Write the three neurophysiological assessment techniques.

There are several different neurophysiological assessment techniques used to
evaluate the function and integrity of the nervous systems. Some common
techniques are.
1. Electroencephalography (EEG)
Electroencephalograph (EEG) provides a convenient, but often opaque, ‘window on
the mind,’ allowing observations of electrical processes near the brain surface. The
outer brain layer is the cerebral cortex, believed to be largely responsible for
cognition: perception, memory, thinking, emotions, actions, and behaviors. Cortical
processes involve electrical signaling between neurons that change over many times
in the 10 ms (0.01 s) range. EEG is the only widely available technology with
sufficient temporal resolution to follow these quick dynamic changes.
EEG can be recorded using electrodes placed inside the skull to study nonhuman
mammals or human epilepsy patients. Such intracranial recordings provide
measures of cortical dynamics at small spatial scales, dependent on electrode size.
However, there are significant limitations to intracranial EEG recording for studies
of cognition and behavior. Intracranial recordings in humans are mostly limited to
patients with intractable epilepsy, often in preparation for brain surgery. These
recordings are called electrocardiograms. Eco recordings are usually obtained only
over a very limited portion of the cortex, areas which vary widely across individuals,
partly guided by EEG recordings of epileptic activity using electrodes placed on the
scalp prior to surgery.
In both clinical and research studies, EEG is nearly always recorded from electrodes
placed on the scalp. Each scalp electrode records electrical activity at large scales,
measuring electric currents (or potentials) generated in cortical tissue containing
about 30 million to 500 million neurons. Luckily, these large-scale estimates provide
important measures of brain dysfunction for clinical work and cognition or
behavior for basic scientific studies. Human ‘mind-measures’ are easily obtained at
the large scale of scalp recordings. EEG monitors the state of consciousness of
patients in clinical work or experimental subjects in basic research. Oscillations of
scalp voltage tell a very limited but important part of the story of brain functioning.
For example, states of deep sleep, coma, or anesthesia are mostly associated with
very slow EEG oscillations and larger amplitudes. Modern signal analyses allow for
identification of distinct sleep stages or quantitative measures of the depth of
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anesthesia. More sophisticated experimental designs and methods of signal analysis

have revealed robust connections to detailed cognitive events.
On the other hand, EEG spatial resolution is poor, compared to modern brain
functional imaging methods such as PET and MRI. But these latter methods have
very poor temporal resolutions on the timescale of seconds and thus do not offer
detailed information about the rapid neural dynamics available to EEG. The related
technology, magneto encephalography (MEG), consists of recordings of the
magnetic field generated by brain current sources. MEG also provides high
temporal resolution and low spatial resolution, similar to EEG. MEG is
preferentially sensitive to brain current sources oriented tangential to the scalp
surfaces, which are typically located in the sulcal walls (folded cortex), while EEG is
more sensitive to radial sources that are mainly located in the gyral surface.

2. Magnetic Resonance imaging.

A magnetic resonance imaging (MRI) scan is a common procedure around the
world. MRI uses a strong magnetic field and radio waves to create detailed images
of the organs and tissues within the body. Since its invention, doctors and
researchers continue to refine MRI techniques to assist in medical procedures and
research. The development of MRI revolutionized medicine. An MRI scan uses a
large magnet, radio waves, and a computer to create a detailed, cross-sectional
image of internal organs and structures. The scanner itself typically resembles a
large tube with a table in the middle, allowing the patient to slide in. An MRI scan
differs from CT scans and X-rays, as it does not use potentially harmful ionizing
radiation.

❖ The development of the MRI scan represents a huge milestone for the medical
world. The following are examples in which an MRI scanner would be used:
anomalies of the brain and spinal cord
❖ Tumors, cysts and other anomalies in various parts of the body

❖ Breast cancer screening for women who face a high risk of breast cancer

❖ Injuries or abnormalities of the joints, such as the back and knee

❖ Certain types of heart problems

❖ Diseases of the liver and other abdominal organs

❖ The evaluation of pelvic pain in women, with causes

including fibroids and endometriosis
❖ Suspected uterine anomalies in women undergoing evaluation for infertility. A
person will probably be unable to have an MRI if they have any metal inside
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their body, such as bullets, shrapnel, or other metallic foreign bodies. This can
also include medical devices such as cochlear implants, and pacemakers. Patients
will sometimes receive an injection of intravenous (IV) contrast liquid to improve
the visibility of a particular tissue that is relevant to the scan. Once in the
scanner, the MRI technician will communicate with the patient via the intercom
to make sure that they are comfortable. They will not start the scan until the
patient is ready.

During the scan, it is vital to stay still. Any movement will disrupt the images, much
like a camera trying to take a picture of a moving object. Loud clanging noises will
come from the scanner. This is perfectly normal. Depending on the images, at times
it may be necessary for the person to hold their breath if the patient feels
uncomfortable during the procedure, they can speak to the MRI technician via the
intercom and request that the scan be stopped. It is extremely rare that a patient
will experience side effects from an MRI scan. However, the contrast dye can cause
nausea, headaches and pain or burning at the point of injection in some people.
Allergy to the contrast material is also seldom seen but possible, and can
cause hives or itchy eyes. Notify the technician if any adverse reactions occur.

An MRI scanner contains two powerful magnets. These are the most important
parts of the equipment. The human body is largely made of water molecules, which
are comprised of hydrogen and oxygen atoms. At the center of each atom lies an
even smaller particle called a proton, which serves as a magnet and is sensitive to
any magnetic field. Normally, the water molecules in the body are randomly
arranged, but on entering an MRI scanner, the first magnet causes the water
molecules to align in one direction, either north or south. The second magnetic field
is then turned on and off in a series of quick pulses, causing each hydrogen atom to
change its alignment when switched on and then quickly switch back to its original
relaxed state when switched off. Although the patient cannot feel these changes, the
scanner can detect them and, in conjunction with a MRI scans vary from 20 to 60
minutes, depending on what part of the body is being analyzed and how many
images are required. Computer, can create a detailed cross-sectional image for
radiologist

Functional magnetic resonance imaging or functional MRI (fMRI) uses MRI

technology to measure cognitive activity by monitoring blood flow to certain areas
of the brain. The blood flow increases in areas where neurons are active. This gives
an insight into the activity of neurons in the brain. This technique has revolutionized
brain mapping, by allowing researchers to assess the brain and spinal cord without
the need for invasive procedures or drug injections. Functional MRI helps
researchers learn about the function of a normal, diseased, or injured brain
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MRI stands for magnetic resonance imagery. This type of scan uses radio waves and
magnets to create images. During an MRI scan, a person lies down in an MRI
scanner, which is a machine that creates a constant magnetic field and uses radio
waves to bounce off water molecules and fat cells in the body. The scanner also
sends images to a computer. T scans are more common and less expensive than
MRIs. However, MRI scans produce a better image than CT scans.

3.Evoked Potential.
Evoked potentials are simple in concept, despite the sophistication of the equipment
that is used. Just as the electroencephalogram (EEG) records the spontaneous
electrical activity of the brain (cerebral cortex), evoked potentials record the
electrical potentials produced after stimulation of specific neural tracts. The most
commonly utilized evoked potentials are those produced by stimulation of
the sensory system. Stimulation of the sensory tract initiates an electrical volley that
travels to the cerebral cortex and can be measured at several locations along the
neural tracts involved.
The recorded plot of voltage versus time has an initial artifact representing the
stimulation of the tract followed by the neuronal response, which is recorded as a
series of peaks and valleys Peaks may be positive or negative (with respect to the
active electrode) and may be plotted downward or upward, depending on
convention. The peaks (and valleys) are thought to arise from specific neural
generators (often more than one neural structure) in a fashion similar to the peaks
on an electrocardiogram that follows a pacemaker-initiated response. The
information recorded is usually the amplitude (peak to adjacent trough) and the
time from the stimulation to peak.

When the response is large in comparison with background noise, one single
measurement or response may be sufficient. However, for most sensory responses,
the evoked response is very small (1-2 microvolts) compared with the much larger
EEG (50-100 microvolts) and electrocardiogram (1000-2000 microvolts). Because
the signals are often small, an amplifier reduces the electrical noise by subtracting
the signal at a reference electrode from the recording electrode. Filtering of this
signal and by further reducing noise in a third, ground electrode helps focus on the
evoked response of interest. Because the evoked response always occurs at a set time
after stimulation, averaging responses increases the time-locked response, whereas
the background activity acts as a random signal and averages out to zero. The time
required for this signal averaging may be sufficient to delay rapid feedback to the
surgeon. To solve this problem, some novel monitoring techniques are employed. In
some instances, new responses are averaged with previously recorded averages.
More commonly, stimuli are staggered so that the second response does not overlap
the first. When an evoked response changes, the physiologic, anesthetic, and surgical
environment must be assessed to determine its contribution to the
change. Ischemia generally produces a loss of response, particularly if synaptic
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components are involved. In general, tolerance to ischemia (e.g., time to irreversible

injury) is related directly to the residual blood flow and inversely to the metabolic
demand of the tissue. Fortunately, the evoked response is altered at a level of blood
flow well above the level that produces irreversible injury. Hence, unless the
permanent ischemic injury is very severe, time is usually available for intervention
before permanent injury results.
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PRACTICAL REPORT NO.3

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References

Carina Coulacoglou, D. H. (2017). Wisconsin Card Sorting Test.

https://www.sciencedirect.com/topics/neuroscience/wisconsin-card-sorting-test

Cathy Haines Ciolek, S. Y. (2018). Trail Making Test.

https://www.sciencedirect.com/topics/medicine-and-dentistry/trail-making-test

Bao, X. L. (2010). Brain Imaging Techniques and Their Applications in

Decision-Making Research.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2849100/

Lam, P. (2018). What know about to MRI scans.

https://www.medicalnewstoday.com/articles/146309#what-is-an-mri-scan
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R. Srinivasan, P. N. (2012). Electroencephalography.

https://www.sciencedirect.com/topics/agricultural-and-biological

sciences/electroencephalography

Tod B. Sloan, .. D. (2010). Evoked Potential.

https://www.sciencedirect.com/topics/medicine-and-dentistry/evoked-potential