A cognitive neuropsychological and psychophysiological
investigation of a patient who exhibited an acute exacerbated behavioural
response during innocuous somatosensory stimulation and movement
Affiliations: Department of Psychology, University of Keele,
Staffordshire, UK | Department of Neurology, Royal Infirmary,
Stoke-on-Trent, Staffordshire, UK
Abstract: We report findings from a cognitive neuropsychological and
psychophysiological investigation of a patient who displayed an exacerbated
acute emotional expression during movement, innocuous, and aversive
somatosensory stimulation. The condition developed in the context of
non-specific white matter ischaemia along with abnormalities in the cortical
white matter of the left anterior parietal lobe, and subcortical white matter
of the left Sylvian cortex. Cognitive neuropsychological assessment revealed a pronounced
deficiency in executive function, relative to IQ, memory, attention, language
and visual processing. Compared to a normal control group, the patient [EQ]
displayed a significantly elevated skin conductance level during both innocuous
and aversive somatosensory stimulation. His pain tolerance was also
significantly reduced. Despite this, EQ remained able to accurately describe
the form of stimulation taking place, and to rate the levels of pain intensity
and pain affect. These results suggest that EQ's exaggerated behavioural response and
reduced pain tolerance to somatosensory stimulation may be linked to cognitive
changes, possibly related to increased apprehension and fear, rather than
altered pain intensity or pain affect per se.
