This document provides an overview of key concepts in neuroscience as they relate to occupational therapy. It begins with an introduction to neuroplasticity and the role of purposeful activity in facilitating recovery from nervous system injuries. It then discusses the basic anatomy and functions of the nervous system including the major parts of the brain, neurons, and neurotransmitters. Common causes and signs of neurological dysfunction are outlined. The document also reviews diagnostic tests and factors influencing treatment and recovery. Overall, the summary introduces neuroscience foundations important for understanding how occupational engagement can support clients with neurological conditions.

1. OT 537 - Neurological Aspects of
Occupational Performance
“I believe that the ordinary
rhythm of daily living is the
deep primordial
nourishment of our
existence. It is the ‘truth’ –
the primary reality for each
one of us. After all,
everyday occupation is
present in our lives at all
times and in all places.”
~Betty Risteen Hasselkus

2. Getting the Ball Rolling
• What’s the most
important thing
you want to get out
of this course?
• What are possible
obstacles/challenge
s?
• What’s one thing
you wish professors
knew about you or
your learning style?

3. Neuroscience
•
Kahoot

4. The Brain, Occupation, and
Motivation
Just something to keep in mind …

6. “By casually doing something as simple as
naming [or labeling] a child, we might be
putting lids and casting shadows on their
power. Wouldn’t we want to open doors for
them instead?” ~Aimee Mullins

7. Daily Challenge #1
Share your personal experience/interests/insight
on neuroscience and neurological dysfunction.
In response to reading the ECS Lecture
Accentuate the Positive: Reflections on Empathic
Interpersonal Interactions  Compose a related
question, quotation, and/or comment(s).

8. Common Causes of Nervous
System Dysfunction
• -Trauma – TBI or SCI
• -Infection
• -Degeneration
• -Tumor
• -Structural defect
• -Autoimmune/endocrine disorder
• -Stroke (rupture of or blockage of
flow in a blood vessel)

9. Common Signs of Neurological
Dysfunction
• -persistent or sudden headache or other type of severe pain
• -extreme or sudden inability to concentrate
• -significant loss of balance
• -impaired sensation
• - loss of muscle strength or paralysis
• -tremors
• -seizures
• -muscle twitching or tics
• -slurred speech
• -atypical lapses in memory or reasoning
• -blurred vision or visual field cut
• -loss of consciousness/seizure

10. Factors That Play a Role in
Treatment and Recovery of
Neurological Dysfunction
*premorbid physical and emotional health
*diagnostic prognosis
*belief and support system
*family involvement
*comorbid conditions and medical management
*rehab services/intervention
*motivation/occupational engagement

11. The Neuron
The neuron is the basic building block of your
nervous system.

12. Division of the Nervous
System
*Central Nervous System
Brain
Spinal Cord

13. Peripheral Nervous System
-Cranial Nerves - Emerge directly from the brain
(spinal nerves emerge from segments of the spinal cord)
-Autonomic Nervous System
(Parasymathetic/Sympathetic NS) - responsible for regulating
involuntary body functions: heartbeat, breathing, digestion,
etc.
-Somatic Nervous System - includes nerves that connect
to the skin, sensory organs and all skeletal muscles.

15. Brain Lobes
Frontal lobes- Mediate cognition
Prefrontal lobes- Mediates executive
functions and regulation of emotions

16. Parietal lobes - sensory detection,
perception & interpretation
Temporal lobes – hearing, comprehension
of language, & long-term memory
Occipital lobes- Main function is visual
processing

17. Right Hemisphere
• Largely responsible for interpretation of perceptual &
spatial information.
• Interprets abstract/creative information, tonal
inflections in language, forming abstract symbolism.
• Interprets emotional messages underlying the
concrete meaning of words.
• Controls movement on the left side of the body.
• Receives sensory information from the left side

18. Left Hemisphere
• If you are right-handed, the left hemisphere is typically
dominant.
• Plays a big role in human language - the
expression and interpretation of written and
spoken words.
• Controls the movement on the right side of the body.
• Receives sensory information from the right side
of the body.

19. CRANIAL NERVES
I. Olfactory
II. Optic Nerve
III. Oculomotor Nerve
IV. Trochlear Nerve
V. Trigeminal Nerve
VI. Abducens Nerve

20. CRANIAL NERVES
VII. Facial Nerve
VIII. Vestibulocochlear Nerve
IX. Glossopharyngeal Nerve
X. Vagus Nerve
XI. Accessory Nerve
XII. Hypoglossal Nerve

21. Neuroplasticity (Cortical Remapping)
Until the 1960’s, researchers believed that changes in the brain could only take
place during infancy and childhood. It was said that by early adulthood the
brain’s physical structure was permanent.
Modern research has shown that the brain continues to create new neural pathways
and alter existing ones in order to adapt to new experiences, learn new information,
and create new memories.
Neurogenesis

24. Facilitating Neuroplasiticity In Treatment:
Therapeutic, purposeful activity is essential in
functional recovery from nervous system injury or
disease.
Most goals focus on learning a new skill or
relearning a lost skill.
Requires neuroplasticity of the brain, spinal cord,
& peripheral nervous system.

25. Example: If one hemisphere of the brain is damaged,
the intact hemisphere may take over some of its
functions.
• The brain compensates for damage in effect by reorganizing
and forming new connections between intact neurons.
• In order to reconnect, the neurons need to be stimulated
through activity (occupational performance).
https://www.youtube.com/watch?v=2MKNsI5CWoU

26. Neuroplasticity

27. Neurotransmitters: The Neurochemical
Basis of Human Behavior
• Regulate much of human behavior
• Relay and modulate messages between neurons
• Can be excitatory or inhibitory depending on which
receptor sites to which they bond
• Can overlap in function

28. Links (or possible links) Between
Neurotransmitters and Neurological Conditions
• Name of neurotransmitter (+ abbreviation if available)
• Description
• Function
• How/where/when it’s produced
• Effects of too much
• Effects of too little

29. Neurotransmitters
• Acetylcholine (ACh) – an excitatory neurotransmitter
described as a neuromodulator in the CNS and PNS
• Governs muscle contractions in the PNS and causes
glands to secrete hormones
• Associated with voluntary movement
• The first neurotransmitter to be identified (1915)

30. Neurotransmitters
• Gamma-aminobutyric acid (GABA) – the major inhibitory
neurotransmitter of the brain
• Helps control muscle activity/regulate muscle tone and is an
important part of the visual system

31. Neurotransmitters
• Glutamate (GLU) –most common neurotransmitter in the
CNS; accounts for ~half of all neurochemicals in the brain
• A major excitatory neurotransmitter – works to balance out
GABA
• Has a significant role in learning, alertness, and memory
• Present in a wide variety of foods and food additives (MSG)
and is responsible for the taste of umami (meaty/hearty)
• When a brain insult occurs, 1000x
more GLU than normal is released,
which can cause neuronal damage
and cell death (excitotoxicity)

32. Neurotransmitters
• Serotonin (5-HT) – an inhibitory
neurotransmitter synthesized in the CNS and
in the GI tract from the amino acid tryptophan
• Constricts blood vessels and brings on sleep
and is also involved in temperature regulation,
pain regulation, mood/emotional control, and
GI-related tendencies such as
nausea/vomiting and binging behaviors

33. Neurotransmitters
• Dopamine (DA) - an inhibitory neurotransmitter involved in
mood and the control of complex movements
• Has a major affect on the motor system, cognition, and
motivation/reward (behavior)

34. The Link Between DA and ADD
Prevalence: 3-5% of the population on record worldwide
Etiology: unknown,
although abnormally low
levels of DA is thought to
be a contributing factor.
Dopamine is the “feel
good” chemical in the
brain, and levels of it are
said to increase naturally
in response to mental or
physical stimulation.
Tattoo of a DA molecule

35. Neurotransmitters
• Norepinephrine (NE) – aka Noradrenaline
• In the CNS, is released into the bloodstream
by the adrenal glands as a hormone
• An excitatory neurotransmitter that plays a
major role in arousal and survival
• Beta-blockers prevent NE from binding to beta
receptors, which prevents sweating, rapid
heart rate, and other sympathetic nervous
system signs that may occur in stressful
situations.

36. Neurotransmitters
• Substance P – a neuropeptide that functions as a
neurotransmitter
– Associated with mood regulation, stress,
neurogenesis, vasodilation, and pain perception
– Involved in transmission of pain signal from PNS to
CNS (possible role in fibromyalgia?)
• Opioid Peptides (includes endorphins) –
neurotransmitters produced by the pituitary
gland and hypothalamus; the body’s natural pain-
killers.

37. The Blood-Brain Barrier
Like bouncers at a night club, an assembly line of cells in the brain's blood system
lets only a few molecules into the nervous system's inner sanctum – the brain.
The capillaries that feed the brain are lined with tightly-bound cells, which keep
out large molecules. Special proteins in the barrier transport necessary nutrients
and substances into the brain. Only an elite few make it through.

38. The Blood-Brain Barrier
• Serves to protect the brain by
keeping out “invaders” but
can also keep out lifesaving
medications. Physicians
trying to treat brain cancer
can use drugs to open the
junctions between cells, but
that leaves the brain
temporarily vulnerable to
infection.
• Permeable to water, oxygen,
carbon dioxide, and small
lipid-soluble substances and
small electrolytes.

39. Things That Can Break Down
The Blood-Brain Barrier
• Hypertension
• Development: the BBB is not fully formed at
birth.
• Hyper-osmolitity: a high concentration of a
substance in the blood
• Microwave/Radiation Exposure
• Infection
• Trauma, Ischemia, Inflammation, Pressure:
injury to the brain can open the BBB.

40. Neuro-diagnostic Testing
Link: https://www.youtube.com/watch?v=OKz8-OFaxpc

41. Examples of Diagnostic Neurological Tests:
Lumbar puncture (LP) -Also called a spinal tap. Used to remove a
sample cerebrospinal fluid from the subarachnoid space for
diagnostic evaluation
Mylogram - Invasive procedure uses x-ray technology and contrast
agents to evaluate the condition of the spine/spinal canal/nerve
roots/vertebral discs. Used to diagnose:
- Spinal cord tumors
- Spinal abscesses
- Herniated discs causing nerve root impingement
CT Scan - Computerized Tomography - numerous x-rays pass through the
skill and brain at angles and join to produce cross-sectional images of
structures.

42. Examples of Diagnostic Neurological Tests:
PET scan – Positron Emission Tomography - Integration of CT and radioactive
tracers – can measure cellular changes - preferred to measure the growth rate
of malignant tumors
EEG - Electroencephalography - Electroencephalography- noninvasive test records neural
electrical patterns of brain waves. Commonly used to diagnose:
- Seizures
- Epilepsy
- Herpes simplex encephalitis
- Global dementia
Evoked Potential Testing- measure electrical activity in the brain in response to stimulation of
sight, sound, or touch.
Angiography - Invasive procedure- entering a catheter into
the body to inject contrast material through the carotid arteries.
Useful in detecting:
Acute CVA
Aneurysm
AVM

43. Examples of Diagnostic Neurological Tests:
MRI – Magnetic Resonance Imaging - uses magnets and radio waves to detect
subtle electromagnetic fields in the brain. Noninvasive with no contrast
material.
Functional Magnetic Resonance Imaging -examine how brain structures
function in neurologic pathologies (schizophrenia, depression, autism)
Brain mapping
Single Photon Emission Computed Tomography- SPECT – a form of nuclear imaging that is
primarily used to view how blood flows through arteries and veins in the brain.
Genetic screenings

44. OT
537

45. OT
537

46. References
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and Management, 9.
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ed.). Baltimore: Lippincott, Williams & Wilkins.
Hakkennes, S., & Keating, J. L. (2005). Constraint-induced movement therapy following stroke: a
systematic review of randomised controlled trials. Australian Journal of Physiotherapy, 51(4),
221-231.
Huntington, G. (2003). On chorea. The Journal of neuropsychiatry and clinical neurosciences, 15(1),
109-112.
Kane, J. M., Woerner, M., & Lieberman, J. (1985). Tardive dyskinesia: prevalence, incidence, and risk
factors. In Dyskinesia (pp. 72-78). Springer Berlin Heidelberg.
National Institutes of Health:
https://www.nichd.nih.gov/about/overview/50th/discoveries/Pages/neuroplasticity.aspx
Spalding, K. L., et al. (June 2013). Dynamics of hippocampal neurogenesis in adult humans. Cell,
153(6), 1219 – 1227.
Wilson, J. R., Cadotte, D. W., & Fehlings, M. G. (Sept. 2012). Clinical predictors of a neurological
outcome: a systemic review. Journal of Neurosurgery, 17(1), 11 – 26.
Webster, R. (Ed.). (2001). Neurotransmitters, drugs and brain function. John Wiley & Sons.