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NE-High Cortical Function (大腦構造與皮質功能 (皮質功能與構造上的相關 (language skill：left…

- - - - 患者在記憶形成的過程中(encoding / storage / retrieval)有缺陷
      - 患者是否會重複詢問相同的問題、是否記得最近對話
      - Memory Deficit
        
        Papez Circui：gyrus cinguli - hippocampal formation - mamilliary body - anterior nuclei of the thalamus四者成一個迴路
        
        Amygdala Prefrontal Circuit
      - 如何評估：remote memory (中秋節幾月幾號、回憶個案年齡生日等)、recent memory (剛才請你記住的三樣物品是什麼)、non verbal learning (for working memory，請你記住下列五樣東西)
      - Memory Network：thalamus、cingulate gyrus、hippocampus (medial temporal lobe)
    - - 因CNS lesion (left dominant cerebral hemisphere) (usually secondary)導致對於comprehension或production of language感到有困難
      - 患者對發音/拼字/對談有困難、停止閱讀、無法書寫
      - lesion的分類：Broca / Wernicke / Conduction / Transcortical / Anomic aphasia
      - 如何評估：spontaneous speech (讀寫為非必要的測試) / understanding of spoken language / naming objects / repetition / reading (alexia失讀症) / spontaneous writing (agraphia)
      - Alexia失讀症：不能讀文章，與學習能力無關，通常為sensory aphasia，與posterior temporal lobe有關
        Alexia WITH Agraphia：usually with a lesion of angular gyrus
        Alexia WITHOUT Agraphia：disruption of the splenium of the corpus callosum
    - - Confusional State混亂狀態：a disorder of global attention
      - Spatial Neglect：asymmetry of attentional processes
      - 患者是否容易分心、有無辦法完成任務
      - Disease：delirium、distractibility、hemi-neglect
      - 如何評估：訊息登錄、digit forward (記一系列的數字)、serial subtraction test (系列減法測驗，例如100-7)
      - Attention Network：reticular formation、cingulate gyrus、posterior parietal cortex、frontal cortex
    - - a sign of dysfunction in the prefrontal cortex
      - 除了執行能力以外，與情緒也有關
      - 如何評估：Wisconsin Card Sorting Test (WCST-S) (for testing perseveration)
      - Syndrome
        
        orbitofrontal syndrome：poor social decision making / environmental dependency
        
        dorsolateral syndrome：impaired decision making & working memory / executive memory dysfunction
        
        medial syndrome：akinesia運動不能 / mutism緘默 / apathy冷漠
        
        subcortical syndrome：slowed thought / apathy / impaired decision making
      - Signs：positive / impaired decision making / distractibility / instability of emotion / social disinhibition / perseveration固著行為 / impulsiveness / 飲食過量
    - - 分類：visual / finger / anosognosia沒有病識感 / autotopagnosia不知道身體的部位是什麼
      - elementary sensory perception正常，但患者無法將正確的涵義與感知做連結
      - 分成三個面向
        
        History：認不得人、在家裡附近迷路
        
        Visual Perception：對燈光、顏色、方向的感知
        
        Visual Recognition：與其他皮質功能的連結有關，例如語言或空間感
      - 如何評估：line orientation test or overlap figure、copy figure (MMSE) or drawing picture、figure naming or face recognition
    - - 無法使用工具，例如：剪刀、杯子、梳子
      - 可能因elementary motor、extrapyramidal、cerebellar疾病有關
      - 通常是left parietal lobe lesion
      - 如何評估
        
        ideational apraxia：concept problem
        
        ideomotor apraxia：production problem (通常是left inferior parietal lobe lesion)
        
        dressing difficulty