Abstract
Neuropsychological diagnosis requires a structure-function correlation model or a Nervous System. The unpredictably variable, widespread, and multifocal nature of pathological changes in multiple sclerosis (MS) challenges the neuropsychological localizationist assumption. To be adapted to MS pathological and clinical heterogeneity, a Conceptual Nervous System should explain impairments associated with multifocal, subcortical, and white matter lesions that cause information processing slowing and working memory/executive function impairment. Our main goal in this theoretical study was to develop a Conceptual Nervous System for MS by integrating current neuropsychological conceptions of structural-functional correlations in MS with a model of conscious mental activity developed by Ernst Poppel , based on periodic reentrant activity between cortical and subcortical structures. Neuropsychological profiles in MS can be explained by both threshold and multiple disconnection mechanisms. The Conceptual Nervous System encompasses a functional and structural model of the human brain-mind. The functional model classifies mental function into material and formal. Material/semantic functions are modularly organized, and their impairment causes classical focal neuropsychological symptoms. Multiple sclerosis preferentially impairs formal/syntactic function related to widespread patterns of activation and temporal organization. The structural model specifies the system anatomically functions. The neuropsychological adequacy of the proposed Conceptual Nervous System to MS is analyzed by comparing its predictions to results of extant meta-analytic studies.
Highlights
Neuropsychological diagnosis depends on a localizationist assumption
Gainotti (2006) suggested that neuropsychological impairment profiles in multiple sclerosis (MS) could be explained in terms of a multiple disconnection model, according to which interruption at multiple sites of cortico-subcortico-cortical loops interferes with functioning in domains that require coordinated activity of wide areas of brain tissue, such as episodic memory and executive function, contributing to the slowing of information processing
To initially assess the appropriateness of the model, we examine the results from extant meta-analyses that reviewed the neuropsychological manifestations of MS, white matter hyperintensities (WMH) related to normal aging, and Alzheimer’s disease
Summary
Neuropsychological diagnosis depends on a localizationist assumption. Patterns of deficits and preserved functions observed in patients are interpreted in terms of a structural or functional brain model. The main goal of the present article is to formulate a model of anatomo-functional correlations that account for the symptomatic manifestations of MS, preserving the assumption of neuropsychological localizationism. To fulfill the needs of the neuropsychology of MS, we argue that a structuralfunctional correlation model must include an additional dimension of impairment, represented by the speed of information processing. To corroborate this model, evidence is examined from extant meta-analyses that compared neuropsychological impairment in MS, normal aging associated white matter lesions, and dementia of the Alzheimer’s type to normal controls
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
