16th september 2014, v1.0 draft understanding cognition

16th September 2014, v1.0 draft

Understanding Cognition

Understanding Cognition © Cambridge Cognition 2015. All rights reserved

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.


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


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”


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


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


Cortico-striatal brain circuitry

Distinct brain circuits have been identified regulating different aspects of behavior1

1Arnsten et al., Bio Psych, 2011

neuromodulators


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


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


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


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


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


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


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.


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


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


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


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


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


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


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


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.


Try it yourself!Executive planning test

COPY THIS


CANTAB in translationExecutive planning test

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2

2.5

Bra

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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


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

Clinical Trials © Cambridge Cognition 2014. All rights reserved

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16th september 2014, v1.0 draft understanding cognition

Documents

cognition neuromodulators

word cognition

connections role of

rights reserved page

discrete brain circuits

healthy human brain

key brain regions

retrieval of information