16th september 2014, v1.0 draft understanding cognition
TRANSCRIPT
16th September 2014, v1.0 draft
Understanding Cognition
Understanding Cognition © Cambridge Cognition 2015. All rights reserved
Page 2
Aims of this resource
This presentation provides an introduction to cognition, and has been developed as a resource for lecturers, for the teaching of undergraduate level students and below.
Understanding Cognition © Cambridge Cognition 2015. All rights reserved
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Summary of contents
• Derivation of the word ‘cognition’ and its definition
• Overview of the complexity of the human brain and the need for simplified scientific models
• Hierarchy: how behavior is governed by cognition, which is in turn dependent on brain circuitry and chemical neuromodulators
• Introduction to key brain regions and their connections
• Role of cognition across the lifespan, from the developing fetus, through to old age
• Cognitive deficits in different disorders as treatment targets• Examples: ADHD, obesity, depression, and dementia
• Overview of different cognitive functions and their measurement using computerized tests
• Try it yourself: interactive problem solving exercise for audience participation
Understanding Cognition © Cambridge Cognition 2015. All rights reserved
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What is cognition?
Latin Latin
cognoscere cognitio- cognition
Late Middle English
“get to know”
“Mental processes relating to the acquisition, storage, manipulation, and retrieval of information”
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What is cognition?
Cognition has a physical basis in the brain
However, the brain is complex!
>100 billion nerve cells in the healthy human brain
Each nerve cell connects with up to 10,000 other nerve cells
To attempt to understand cognition, we rely on simplified scientific models, based on research work across species
conscious awareness
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Hierarchical understanding of behavior
Behavior is underpinned by discrete cognitive functions, critical for day-to-day life
Cognitive functions are regulated by discrete brain circuits and neurochemical transmitter systems
Handful of brain chemicals play major roles in regulating cognition (“neuromodulators”):
• Dopamine• Noradrenaline (norepinephrine)• Serotonin• Acetyl choline• Opioid• Glutamate• GABA
Behavior
Cognition
Brain circuits, neuromodulators
Genes Environment
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Cortico-striatal brain circuitry
Distinct brain circuits have been identified regulating different aspects of behavior1
1Arnsten et al., Bio Psych, 2011
neuromodulators
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Psychomotor speedDetecting and responding to the presence of a stimulus
AttentionAttending to specific
information and ignoring others
MemoryShort-term or long-term storage of information
Episodic memory• Associating an event with
a place and time
Working memory• Strategic thinking
Social cognitionResponding to emotion-
laden stimuli
Planning and Strategic problem solving
Response inhibition• Ability to suppress inappropriate responses
Executive functionHigh level thinking and
decision making
Mental flexibility• Ability to adapt thinking
and behaviour
Working memory• Holding and manipulating
information in mind
Sustained attention• Continuous performance
and visual sustained attention.
Choice Reaction Time• Reaction time, movement
time and vigilance
Emotion Recognition• Identifying emotions in
facial expressions
Emotional Bias• Information processing
biases for positive/negative stimuli
Recognition memory• Recognition of visual,
object and spatial information
Domains Sub-Domains
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Why is cognition important?
Cognition changes over time, influenced by genes and the environment
Environmental influences on cognition begin even before birth (e.g. fetal alcohol syndrome)
Through infancy, childhood, and adolescence, cognitive functions develop
Into middle and older age, some of these functions decline (vascular disease, loss of neurons)
Regulates behavior across the lifespan
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Why is cognition important?
Many of the biggest challenges facing the globe are conditions associated with core cognitive problems; these deficits represent key treatment targets for early intervention
Understand and treat diseases
SchizophreniaAutism
ADHD
Parkinson’s disease
Multiple sclerosis
Diabetes
Pain
Alzheimer’s disease
Drug and alcohol abuse
Down’s syndrome Mood disorders
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Why is cognition important?Example: attention deficit hyperactivity disorder (ADHD)
ADHD is the most common psychiatric disorder in children, and often persists into adulthood
Characterized by impulsivity, hyperactivity, and/or inattention
Left untreated, associated with increased risk of unwanted long term outcomes1, such as:
• Worse educational achievement• Driving accidents• Unemployment• Criminality and time in prison
First-line medication treatments for ADHD reduces cognitive impairment by enhancing frontal lobe function, thereby improving symptoms2
1Shaw et al., BMC Med, 20122Chamberlain et al., Bio Psych, 2011
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Why is cognition important?Example: obesity
Ready access to cheap, high-fat, high-sugar food
Obesity is one of the leading causes of early death across the world1
Safe, effective, medications to treat obesity are lacking
Obesity is increasingly conceptualized in terms of reward-related brain circuitry (the “food addiction” model)2.
This model has suggested novel treatment directions, which are now being investigated.
1World Health Organisation, 20142Chamberlain et al., in press, 2014
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Why is cognition important?Example: depression
Depression is the leading cause of disability worldwide1
Characterized by low mood, poor concentration, loss of interest in pleasurable activities, weight loss, reduced appetite, and poor sleep
Patients experience a number of cognitive deficits, including decrements in memory, planning, and emotional processing
Such patients show an attentional bias towards negative stimuli (such as towards unhappy faces or sad words)
Anti-depressant medications and therapies shift attention away from negative stimuli towards more positive aspects of the environment2
1World Health Organisation, 20122Harmer, Curr Top Behav Neurosci, 2013
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Why is cognition important?Example: dementia
Dementia: a collection of disorders characterized by cognitive impairment and marked functional decline
Dementia is one of the leading causes of disability worldwide: knock-on effects on caregivers, families, and society1
With an ageing population, dementia as a problem will continue to grow
The search is on for treatments capable of slowing or even reversing dementia related cognitive decline
Initial studies have found that cognitive tests can distinguish between elderly individuals likely to develop dementia, and the ‘worried well’2
1World Health Organisation, 20122Blackwell et al., Dement Geriatr Cogn Dis, 2004.
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Types of cognition
Cognition can be considered in terms of Intelligence Quotient (IQ): a composite measure of intellect, comparing summative measures to the background population
However, cognition is not unitary: various cognitive functions (or cognitive ‘domains’) have been identified
These functions overlap to some extent, and operate synergistically
Modern cognitive testing batteries are able to tease apart distinct cognitive functions, dependent on different brain circuits and neuromodulatory systems
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Types of cognition
Cognitive function Description Example
Sustained attention Maintain attention on a given aspect of the environment
Listening attentively to a lecture
Divided attention Sharing attention resources across different locations
Checking both sides of the road for cars before pulling out at a junction
Decision-making Weigh up risks, respond to rewards, avoid punishment
Choosing between university degree courses
Social cognition Evaluate the intentions of other people and their mental state; pick up social ‘cues’
Noticing a friend is upset
Core examples
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Types of cognition
Cognitive function Description Example
Working memory Holding multiple pieces of information ‘in mind’ and manipulating them
Keeping track of shopping list and already-acquired items at the supermarket
Recognition memory Recall of previous sensory experience
Recognising a friend in the street
Executive planning Planning sequences ahead of time and implementing them
Putting together Ikea furniture
Response speed Act quickly to simple environmental cue
Hit brake pedal when traffic light changes to red
Response inhibition Suppress action or response that would normally be undertaken
Stop impulsive act such as spending money or losing temper
Core examples
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Methods of cognitive assessment
Cognitive assessment initially relied on pen/paper tests, before the advent of computer technology
Computerized assessment is now the gold standard, with potential advantages:
- Objectively tease apart distinct cognitive abilities
- Automated data collection and processing; quality control
- Accuracy (such as in measurement of response speeds)
- Can be made less reliant on complex motor skill; special interface technology
- Translational: neuroimaging, animal models
Development of objective computerized tests
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Cambridge Neuropsychological Test Automated Battery (CANTAB)
Comprehensively captures all important cognitive domains
Established validation including excellent psychometric properties
Proven sensitivity to drug and disease effects where cognition is a factor
Comprehensively validated by >30 years of global translational research, and >1300
peer-reviewed papers
Used in over 700 academic research institutions worldwide
Extensive normative and clinical data
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Psychomotor speed
Attention MemorySocial
cognitionExecutive function
Reaction Time
Visual Information Processing
Paired Associates Learning
Spatial Working Memory
CompulsivityEmotion RecognitionVerbal Recall
Alzheimer's disease
Depression ADHD Schizophrenia Abuse Liability
Parkinson's disease
Pain SleepDown’s
syndromeMultiple sclerosis
Cardiovascular disease
Huntington’s disease
Traumatic brain injury
Autism Cancer
Validated touchscreen tests
Measuring effects across cognitive domains
Applied to research of disorders and syndromes Drug efficacy Drug Safety
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Stop Signal Task
Verbal Recall / Recognition Memory
Reaction Time
Delayed Matching to Sample
Paired Associates Learning
Spatial Working Memory
Stockings of Cambridge
Attention Switching Task
Pattern or Spatial Recognition Memory
Affective Go/No-go
Emotion Recognition Test
Rapid Visual Information Processing
CANTAB Cognitive Tests and Brain Regions
Understanding Cognition © Cambridge Cognition 2015. All rights reserved
Page 22
Try it yourself!Executive planning test
You will see a pattern of colored balls, hanging in stockings (or socks), at the top and bottom of the screen.
The idea is to make the bottom arrangement look like the top.
Understanding Cognition © Cambridge Cognition 2015. All rights reserved
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Try it yourself!Executive planning test
COPY THIS
Understanding Cognition © Cambridge Cognition 2015. All rights reserved
Page 24
Try it yourself!Executive planning test
COPY THIS
Understanding Cognition © Cambridge Cognition 2015. All rights reserved
Page 25
Try it yourself!Executive planning test
COPY THIS
Understanding Cognition © Cambridge Cognition 2015. All rights reserved
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CANTAB in translationExecutive planning test
Health
y Con
trols
Remitt
ed D
epre
ssio
n
Mild D
epre
ssio
n
≥ Mod
erat
e Dep
ress
ion
0
0.5
1
1.5
2
2.5
Bra
in a
ctiv
ati
on in
dors
ola
tera
l co
rtex
(OTS)
abnormal brain activation
* p < 0.05
The CANTAB executive planning test is sensitive to cognitive impairment in depression. Also, when used in the brain scanner (functional magnetic resonance imaging), it detects abnormal frontal cortex activation in depression, which normalizes with treatment1
1van Tol et al., Acta Psych Scand, 2011; see also Fitzgerald et al., Hum Brain Mapp, 2008
Understanding Cognition © Cambridge Cognition 2015. All rights reserved
Page 27
SummaryUnderstanding cognition
• Cognition: mental processes relating to the acquisition, storage, manipulation, and retrieval of information
• Important through life, in health and disease, across the age span: we touched upon four examples
• ADHD• Obesity• Depression• Dementia
• Cognition can be separated into multiple distinct functions, dependent on particular brain circuits and neuromodulators (e.g. dopamine, serotonin, noradrenaline)
• Computerized cognitive testing has been developed and validated: advantages over older ‘pen/paper’ methods
Additional resources available from Cambridge Cognition:
‘Assessing cognition’ slide pack‘Cognitive impairment’ slide pack
Research funding and grant application guide
Page 28Clinical Trials © Cambridge Cognition 2014. All rights reserved
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