16th September 2014, v1.0 draft - PowerPoint Presentation

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16th September 2014, v1.0 draft

Understanding Cognition

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Aims of this resourceThis presentation provides an introduction to cognition, and has been developed as a resource for lecturers, for the teaching of undergraduate level students and below.

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Summary of contentsDerivation of the word ‘cognition’ and its definitionOverview 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

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What is cognition?Latin

Latin

cognoscere

c

ognitio

-

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 brainHowever, the brain is complex! >100 billion nerve cells in the healthy human brainEach nerve cell connects with up to 10,000 other nerve cellsTo attempt to understand cognition, we rely on simplified scientific models, based on research work across species

c

onscious

awareness

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Hierarchical understanding of behaviorBehavior is underpinned by discrete cognitive functions, critical for day-to-day lifeCognitive functions are regulated by discrete brain circuits and neurochemical transmitter systemsHandful 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 circuitryDistinct brain circuits have been identified regulating different aspects of behavior1

1

Arnsten et al., Bio Psych, 2011

neuromodulators

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Psychomotor speed

Detecting and responding to the presence of a stimulus

Attention

Attending to specific information and ignoring others

Memory

Short-term or long-term storage of information

Episodic memory

Associating an event with a place and time

Working memory

Strategic thinking

Social cognition

Responding to emotion-laden stimuli

Planning and Strategic problem solving

Response inhibition

Ability to suppress inappropriate responses

Executive function

High 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 memoryRecognition 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 environmentEnvironmental influences on cognition begin even before birth (e.g. fetal alcohol syndrome)Through infancy, childhood, and adolescence, cognitive functions developInto 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

Schizophrenia

Autism

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 outcomes

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, 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 symptoms

2

1

Shaw et al., BMC Med, 2012

2

Chamberlain et al., Bio Psych, 2011

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Why is cognition important?Example: obesityReady access to cheap, high-fat, high-sugar foodObesity is one of the leading causes of early death across the world

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Safe, effective, medications to treat obesity are lacking

Obesity is increasingly conceptualized in terms of reward-related brain circuitry (the “food addiction” model)

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.

This model has suggested novel treatment directions, which are now being investigated.

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World Health Organisation, 2014

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Chamberlain et al., in press, 2014

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Why is cognition important?Example: depressionDepression is the leading cause of disability worldwide1Characterized 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 environment

2

1

World Health Organisation, 2012

2

Harmer,

Curr

Top

Behav

Neurosci

, 2013

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Why is cognition important?Example: dementiaDementia: a collection of disorders characterized by cognitive impairment and marked functional declineDementia is one of the leading causes of disability worldwide: knock-on effects on caregivers, families, and society

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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

1

World Health Organisation, 2012

2

Blackwell et al., Dement

Geriatr

Cogn

Dis, 2004.

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Types of cognitionCognition can be considered in terms of Intelligence Quotient (IQ): a composite measure of intellect, comparing summative measures to the background populationHowever, cognition is not unitary: various cognitive functions (or cognitive ‘domains’) have been identifiedThese functions overlap to some extent, and operate synergisticallyModern 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 cognitionCognitive functionDescription

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 junctionDecision-makingWeigh up

risks, respond to rewards, avoid punishmentChoosing between university degree courses

Social cognitionEvaluate 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 cognitionCognitive functionDescription

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 furnitureResponse speed

Act quickly to simple environmental cueHit brake pedal when traffic light changes to red

Response inhibitionSuppress 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 assessmentCognitive 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

E

xtensive

normative and clinical

data

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Psychomotor speed

Attention

Memory

Social cognition

Executive function

Reaction

Time

Visual Information Processing

Paired Associates Learning

Spatial Working Memory

Compulsivity

Emotion Recognition

Verbal Recall

Alzheimer's disease

Depression

ADHD

Schizophrenia

Abuse Liability

Parkinson's disease

Pain

Sleep

Down’s syndrome

Multiple 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

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Try it yourself!Executive planning testYou 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.

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Try it yourself!Executive planning test

COPY THIS

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Try it yourself!

Executive planning test

COPY THIS

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Try it yourself!

Executive planning test

COPY THIS

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CANTAB in translationExecutive planning test

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 treatment

1

1

van

Tol

et al.,

Acta

Psych

Scand

, 2011; see also Fitzgerald et al., Hum Brain

Mapp

, 2008

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SummaryUnderstanding cognitionCognition: 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

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US Office2750 Rasmussen RoadPark CityUtah 84098USATel +1 (801) 891-6155Email 

info@camcog.com

UK Headquarters

Cambridge Cognition 

Tunbridge

Court, Tunbridge Lane

Bottisham

, Cambridge

CB25

9TU 

UK

Tel +44 (0)1223 810700

Email info@camcog.com