Estudos de Psicologia
Estudos de Psicologia, 24(1), janeiro a março de 2019 65-75
65
Historical-Cultural Neuropsychology: a systemic and integral
approach of psychological functions and their cerebral bases.
Yulia Solovieva. Benemérita Universidad Autónoma De Puebla (BUAP)
Luis Quintanar Rojas. Benemérita Universidad Autónoma De Puebla (BUAP)
Tatiana Akhutina. Moscow State University
Izabel Hazin. Universidade Federal do Rio Grande do Norte
Abstract
This article analyzes the theoretical foundations of neuropsychology based on the ideas of L.S. Vygotsky and A. R. Luria, with
an emphasis on the principle of systemic organization of psychological processes, their ontogenetic development and systemic
representation in the central nervous system. The article describes the need for a comprehensive study of neuropsychology,
considering its relationship with more global psychological concepts developed by representatives of the historical-cultural
concept of mental functions and the theory of activity. This paper considers the need to include neuropsychology in the context
of historical-cultural studies and the theory of activity. Finally, it is argued that one of the essential features of historical-cultural
neuropsychology is the concept of systemic, dynamic and hierarchical representation of cultural psychological processes.
Keywords: neuropsychology; Vygotsky; Luria; Historical-Cultural.
Resumo
Neuropsicologia Histórico-Cultural: uma concepção sistémica e integral acerca dos fenômenos psicológicos e suas bases
cerebrais. O presente artigo dedica-se à análise dos fundamentos teóricos da neuropsicologia a partir das ideias de L.S. Vygotsky
e A. R. Luria. Enfatiza-se o principio da organização sistêmica dos processos psicológicos, seu desenvolvimento ontogenético e sua
representação sistêmica no sistema nervoso central. O artigo descreve a necessidade de um estudo integral da neuropsicologia,
considerando sua relação com as concepções psicológicas mais globais, desenvolvidas pelos representantes da concepção
histórico-cultural e da teoría da atividade. Propõe-se a consideração da necessidade de inclusão da neuropsicologia no contexto
dos estudos histórico-culturais e da teoría da atividade. Por fim, argumentam e problematizam acerca de um dos aspectos
essenciais da neuropsicologia histórico-cultural, a saber, a concepção da representação sistêmica, dinâmica e hierárquica dos
processos psicológicos culturais.
Palavras-chave: neuropsicologia; Vygotsky; Luria; histórico-cultural.
Resumen
Neuropsicología Histórico-Cultural: una concepción sistémica e integral acerca de fenómenos psicológicos y sus bases cerebrales.
El artículo se dedica al análisis de los fundamentos teóricos de la neuropsicología desde las ideas de L.S. Vygotsky y A.R. Luria.
Se realiza énfasis en el principio de organización sistémica de los procesos psicológicos, su desarrollo ontogenético y su representación
sistémica en el sistema nervioso central. O artículo describe la necesidad de un estudio integral de la neuropsicología, considerando
su relación con las concepciones psicológicas más globales, desarrolladas por los representantes de la concepción histórico-cultural y
la teoría de la actividad. Propone considerar la necesidad de inclusión de la neuropsicología en el contexto de los estudios históricoculturales y la teoría de la actividad. Uno de los rasgos esenciales de la neuropsicología histórico-cultural es la concepción de la
representación cerebral sistémica, dinámica y jerárquica de los procesos psicológicos culturales.
Palabras clave: neuropsicología; Vygotsky; Luria; histórico-cultural.
DOI: 10.22491/1678-4669.20190008
ISSN (versão eletrônica): 1678-4669
Acervo disponível em http://pepsic.bvsalud.org
Historical-Cultural Neuropsychology: a systemic and integral approach of psychological functions and their cerebral bases
The intention of this article is to share the fundamental theoretical principles of the neuropsychological
approach based on the historical-cultural concept. The
approach was initially proposed by L.S. Vygotsky and
continued by A.R. Luria, both of whom use some key or
essential aspects without covering the entire conceptual
theoretical apparatus, methodology and application of
neuropsychology from the approach. They argue that the
term itself (“historical-cultural neuropsychology”) should
be considered valid within the theoretical-methodological concepts of contemporary neuropsychology.
One of the key aspects to revisit is the idea of
a systemic, integral and dialectical approach to the
relationship between psychological processes and the
basic material substrate, understood here as the central
nervous system (CNS). It is argued that, unlike psychology,
for neuropsychology it is particularly relevant to specify
and study the relationship between psychological processes and the CNS, that is, between the mind (psychological processes) and the brain (material substrate of these
processes). The philosophical dilemma between the ideal
and the material and the psychophysiological dilemma
about the possible relationship between the physiological and psychological level of cognitive and affective
processes are well known.
It is important to underscore that this is a relevant
and central problem in historical-cultural psychology.
In his writings and transcribed oral presentations, L.S.
Vygotsky has never refused to consider this problem,
but rather expressed ideas and points of view that are
still valid and debatable for the current development of
the neurosciences and neuropsychology.
The close relationship between psychological
processes and their cerebral bases is sometimes disregarded by representatives of the historical-cultural approach
in psychology who attempt to reduce historical-cultural
studies to sociological, anthropological or intersubjective aspects, as if neuropsychology and historical-cultural
concepts were detached and separated from the discourse of the historical-cultural psychologist, as if historical-cultural psychologists were never neuropsychologists and neuropsychologists not representatives of the
historical-cultural concept (Mahn, 2010; Toomela, 2014;
Veresov, 2010).
In addition, it is precisely neuropsychology,
created and disseminated by Luria and his followers,
that provides a systemic and integral perspective of the
relationship between psychological processes and their
cerebral bases. The intention is to solve the dilemma of
the relationships that exist between the mind and the
brain, which is not clearly explained in neuropsychology
or cognitive neurosciences that postulate a static and
unilateral relationship between psychological processes and brain structures or, at least, does not exhibit
a clear expression of this relationship’s dependence on
the effects of cultural development.
Human cultural development, which is subject
to constant historical and social transformations, is by
definition a dynamic and flexible process that depends
on constant changes at all levels of organization in
society, such as linguistic, educational, communicative, technological and object phenomena. This topic
is relevant for a child’s psychological development,
because children move from one type of interaction
with society to another, whereby the type of interaction determines the dynamic and qualitative changes in
their activity and personality (Vygotsky, 1982).
Given this position, it is impossible to disregard
the importance of dynamic and qualitative changes in
children’s’ lives in terms of establishing the changes that
arise in the representation of psychological processes
in the CNS. However, this seems to go unnoticed by the
representatives of the cognitive sciences, who continue to
cite fixed “centers” and “locations” in the CNS. References
to “language centers”, “face perception centers”, and
“verb centers” can be found in a number of studies.
How can one refer to centers (bases) of language,
when newborn babies cannot speak? These bases are
formed according to their cultural acquisition of language,
provided they interact with adults, with the emergence
of dynamic and flexible functional systems in order to
understand and produce oral and written language.
These “bases” can only be consolidated as a
cultural probability in accordance with the child’s own
cultural activity, emerging based on the participating
levels and connections of the CNS. Thus, human beings
are not only subjects of their own activity, following
the expressions of Leontiev (1975), but also, indirectly,
involuntary participant-shapers of the cerebral bases of
all these activities.
The systemic position about the
relationship between psychological
processes and their cerebral bases
The important historical moment and text that
justify our position date from October 9, 1930, when
L.S. Vygotsky gave the lecture “About psychological
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systems” (Vygotsky, 1982), which contains some of
the fundamental ideas that prompted the subsequent
development of the version of neuropsychology of
A.R. Luria, his close collaborator, friend and follower.
Both authors return to a systemic and integral vision
of psychological phenomena and their representation
in the material substrate of the CNS: the human brain.
This vision is contrasted by another position that can
be found in psychology and neuropsychology, namely
the atomistic and insulating version that aims to study
psychological phenomena as individual and unique
entities, each with its own definitive relationship with
certain material structures in the brain.
Undoubtedly, every researcher or professor has
a certain vision or position about the phenomena and
objects they study. A philosophical and methodological
analysis makes it possible to identify and discriminate
these positions.
According to Russian philosopher Stiopin, the
non-traditional systemic view in science, often called
non-classical science, can be related to three criteria. The
first involves identifying the particularities of the systemic
organization of the objects of study and the images of the
world that conform to the thinking subject.
The second criterion is determining the particularities of the means and operations of research activities,
and the third the particular orientations of the objectives
and values of the subject of the research activity together
with a reflection on them. The latter forms the basis of
the philosophical view of science that the researcher
follows or accepts (Kiyaschenko & Stiopin, 2009).
The positions expressed by Vygotsky in the text
“About psychological systems” and the subsequent
works of A. R. Luria correspond to this systemic, integral
and dialectical vision of the relationship between the
psychic and the cerebral. What supports this viewpoint?
As an example, we can cite Vygotsky’s words
regarding the idea of representation of psychological
processes in the brain. Surprisingly, he writes that none
of the functions are ever related to the work of a single
center, but are the product of integral activation of the
strictly differentiated and hierarchically related centers
(Vygotsky, 1982). This demonstrates Vygotsky’s systemic idea that brain participation is the material basis of
psychological processes, that is, a psychological process
should always be considered a dynamic and complex
system of material brain participations.
Later, Vygotsky writes that the idea of a chronogenous location means that a complex function is
understood as a set of operations performed by a series
of brain devices and sectors in a specific sequence to
form a melody with its own configuration, structure
and regularities (Vygotsky, 1982). He also refers to the
complex concept of the functional system that emerges
later in physiology and neuropsychology (Anokhin, 1987;
Luria, 2003). Vygotsky anticipates this concept and
refers to dynamic constellations that are shaped and
changed throughout the ontogeny, whose content can
be analyzed in terms of its structure and regularities.
Views on the relationship between psychological processes and the brain have a long history. As such,
it is important to emphasize that the ideas expressed by
Vygotsky in the aforementioned text and reiterated by
Luria in his research do not appear in a vacuum, but are
based on the previous or contemporary philosophical
ideas of the authors. Likewise, just as in philosophy there
is no consensus or a single philosophical theory, in psychology, a science that can be considered one of the daughters
of philosophy, there is no single viewpoint regarding the
origin and functioning of psychological processes.
The concept of philosophical science as a study
of human consciousness emerged in the seventeenth
century, with this same object of study adopted in the
psychology of the nineteenth century (Zhdan, 2004).
Data generalization was the main method used to
construct a theory and is obtained through experience.
It was initially an introspective, subjective experience
of the study participant, who was also a researcher
and subject of study. Thus, while natural sciences deal
with the world of objects, psychology is the world of
consciousness of each subject.
Under this meaning, subjects are both researchers and the objects of their experiment, applying
the “introspection” method by feeling, experiencing
and recording their own awareness. Thus, as a method
in any natural or psychological science, it is the inductive experimental method that records and generalizes experiences (Kiyaschenko & Stiopin, 2009). In this
same stage of shaping sciences, an attempt is made to
locate or represent the psyche as consciousness in some
material sectors (Luria, 1969).
In the 18th and 19th centuries, the locationists
tried to find brain zones for different abilities and
elements of psychic life. Hall’s phrenology was replaced
by Broca’s attempt to locate the motor word centers and
Wernick’s to find sensory word centers (Xomskaya, 2005).
A different concept was expressed by representatives of the opposite point of view, who considered
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Historical-Cultural Neuropsychology: a systemic and integral approach of psychological functions and their cerebral bases
the brain an indivisible unit that participated in the
behavioral processes. We want to point out that each
of these positions contained its share of true rationality. Localizationism claimed that there are specialized
sectors in brain functioning, while antilocalizationism
stated that the brain works as a whole. However, a dialectical concept was needed to unify both points of view
without contradictions.
To that end, a non-classical or dialectical outlook
was needed to understand the functioning of complex
systems that cannot be limited to the analysis of their
components or the contrary consideration of an indivisible unit. Complex systems consist of elements, but not
limited to them. The operation of a system cannot be
explained as the sum of the elements, but rather as an
integral product of each element’s contribution.
The semiologist Lotman proposed that human
culture can be understood as a complex system of
constant self-regulation and self-renewal. These systems
underlie the course of life in human society that cannot
be understood without its cultural mechanisms. Cultural
exchange is one of these mechanisms (Lotman, 2001).
Complex functional systems in physiology were proposed by Bernstein (2003) and Anokhin (1987). These
systems underlie the life of each organism at various
levels of biological evolution. Biological necessity as an
objective of future action is one of the mechanisms that
shapes functional systems (Bernstein, 2003).
All complex autoregulation systems guarantee their operation through information and direction
processing with the help of direct and indirect return
afferents. Since mechanistic determinism is insufficient to explain the dynamic changes in these systems,
there is a need for relative or probabilistic determinism
(Kiyaschenko & Stiopin, 2009). Thus, we can assume
that the relationship between psychological processes
and their cerebral bases should be considered a probability and not a postulate.
One of the examples of a non-classical point of
view was the cerebral representation of psychological
processes and their location, as put forth in the theory of
English neurologist H. Jackson. In the 1860s, this author
expressed ideas contrary to those of Broca and Wernicke
(Luria, 1969). He was against attempts to locate human
abilities in specific centers, considering them complex
functions and expressing their dependence on work at
various levels of the CNS (Bernstein, 2003).
According to Jackson, each function was represented at lower and higher levels of the brain. The
lower level consisted of the spinal cord and the brainstem, the intermediate level, the primary motor and
sensory sectors, and the upper level, the frontal lobes
(Luria, 1969). The higher levels involve a greater degree
of voluntary functions, while the lower levels a lower
degree, that is, exhibited more spontaneous manifestations (York & Steinberg, 2006). The levels of organization
of the functions are in a particular hierarchy, with each
ensuing level, being more evolutionarily advanced, built
on a lower level.
In the face of a pathological process, the first to
suffer are evolutionarily superior formations, leaving
the oldest formations without “voluntary control”.
Pathological processes can lead to negative symptoms
in the absence of voluntary control, as well as positive
symptoms such as the release of this control (York &
Steinberg, 2006). The author underscores the possibility
of self-regulation of these systems with the intervention
of lower levels in cases of pathology.
Vygotsky (2016) expresses the three laws of
emancipation of nerve centers. The first of these laws is
called “the function stage”. “This means that functions
that were initially performed with the lower centers of
the brain during development begin to be performed
with the higher centers” (Vygotsky, 2016). This phenomenon is true for both phylogenesis and ontogenesis. For example, the direction of movement in birds is
controlled by the cerebellum, which is dependent on
the cerebral cortex in mammals.
The second law refers to the fact that during the
development and movement of functions upwards,
the lower centers are not totally separated from that
function, but “participate in it as a substance subordinated to the higher centers” (Vygotsky, 2016). This
position presumes that in the same function different
levels of brain organization participate in different
ontogenetic moments.
The third law establishes different effects for
injuries or decompensations that can occur in the brain
of adults or children. In the case of weakening of an
adult’s upper center, the function immediately passes
to the respective center below the injury. This lower
center resumes its independent performance from the
previous stages of development. On the other hand,
injury to a child’s lower center affects all the upper
centers that should take part in this function. If the
brain center of an adult is affected, the center below
it suffers, whereas an affected center in childhood
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means the center above it that participates in the same
function will also suffer (Vygotsky, 2016).
This allows us to understand that the consequences of brain injuries and immaturity differ in children and
adults. Bernstein writes that “a chronogenous location”,
that is, different correlations in the locations of the same
function in different periods of its development, are
clearly illustrated in Vygotsky’s observations and in the
laws he established regarding the development and disintegration of functions. Bernstein agrees with Vygotsky’s
laws and that the correlations between various brain
sectors change during development. We can assume that
psychological actions involve mechanisms participating
at different subcortical and cortical levels and that, the
smaller the child, the greater the participation of subcortical levels in their functional systems.
In relation to levels of organization, Bernstein
developed the systemic concept about the levels of
psychophysiological organization of complex human
movements, underscoring that each movement is carried
out at different levels simultaneously, with each level
participating according to the conditions and objective
of each movement. From the concept described, the
psychophysiological bases of movements can be considered from their hierarchical, dynamic and systemic organization, which can never be reduced to the same type or
level of organization in the CNS. The organization level of
the sphere of movements depends on the objective of
the action, voluntary or involuntary aspect, the degree of
automation and the real conditions of the given situation
that led to the movement (Luria, 2003).
It is important to underscore the fact that in
his book Bernstein (2003) quotes both Vygotsky and
Jackson, demonstrating the necessary representation
of a complex function, such as a motor act or human
movement directed at various levels of the peripheral
and central nervous system.
This is extremely important in understanding the
roots of the complex functional system in non-classical
physiology. Given this position, it is not surprising that
the peripheral nervous system (or subcortical levels)
can perform complex functions (motor reactions) due
to the disconnected participation of the upper brain
centers or to the pathological or artificial separation of
the cerebral hemisphere, since this is observed in the
“divided brain” experiments.
This eliminates the need to look for a “homunculus” located in the prefrontal areas and “regret their
absence”, because other levels of the nervous system
are responsible for performing tasks of movement
recognition and execution when the upper levels are
excluded or disorganized (Gazzaniga, 2012).
As previously indicated, on October 9, 1930, L.S.
Vygotsky introduced his paper “About psychological
systems” at the Clinic of Nervous Diseases of Moscow State
University. Why is this paper considered so important?
Causality changes in post-classical science; complex
systems are characterized as very different open systems,
with the capacity for self-reorganization and exchange
with external effects. In addition, the emergence of more
complex levels due to previous causes affects return
afferentation, whereby the consequence functions as
the cause of future changes. In other words, cause-effect relationships are constantly changing. A historical,
dialectical and flexible vision of a process and consideration of its constant changes and modifications is proposed (Kiyaschenko & Stiopin, 2009).
A useful example for neuropsychology may be
that, with the child’s acquisition of reading and writing,
its level of oral language expression changes, which can
lead to effective communication or acquisition of intellectual abilities, including enhanced reading and writing.
This does not rule out the claim that the possibilities of
acquiring literacy in a child are based on the previous
level of their oral language development. On the other
hand, in some clinical cases of adult patients with brain
damage, absolutely disintegrated oral language must
necessarily be based on prior rehabilitation of the
reading and writer process, which can lead to gradual
progress in their oral language.
These changes are observed in adult patients with
dynamic aphasia (Akhutina, 2002). We consider that
the examples presented of a “non-classical” position
are opposed to a linear viewpoint, which suggests total
separation and independence of oral language and
literacy, or forced rehabilitation of oral language before
reading and writing.
The title of Vygotsky’s presentation demonstrates
the importance of the systemic nature of psychological
processes: psychological systems. Vygotsky states that “in
the development process, and historical development in
particular, it is not so much the functions that change,
as we have studied before (and this was our mistake),
or their structure, but rather that new groupings arise in
the relationships between the functions, which were not
known in the previous steps” (Vygotsky, 1982). The most
important part of the paper, according to Vygotsky, is the
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Historical-Cultural Neuropsychology: a systemic and integral approach of psychological functions and their cerebral bases
relationship between new systems and their substrate,
that is, the brain (Vygotsky, 1982).
What does Vygotsky mean? What was this error?
A process of internalization of habits or means
arises, whereby the child perceives an object and
compares it with another, etc. These studies have led
us to a dead end, while others have clearly shown that
the development of perception is modified because it
is included in a complex synthesis with other functions,
for example, language” (Vygotsky, 1982).
Vygotsky states that as a consequence of the systemic principle that “the upper and lower functions are not
built on two floors”, he rejects the previous ideas expressed in his earlier texts about a division between natural
and cultural functions. In 1932, Vygotsky wrote that
“voluntary attention is a domain of involuntary attention,
which can mean these two floors” (Zavershneva, 2008).
The new functional systems work according to the new
regularities (Vygotsky, 1982; 1984). These viewpoints are
similar to those of the Russian physiologists N. Bernstein
and P. Anokhin, who developed their own concepts of
systems with complex functions and the different levels
that they encompass.
Starting with the location of new systems in the
brain, Vygotsky begins to discuss this issue in the context
of the social genesis of higher psychological functions,
in which internalization is related to the formation of
interfunctional relationships. This will be discussed in
detail. With respect to voluntary action, Vygotsky identifies three stages of internalization.
entire cerebral apparatus,” in which “a number of different sectors collaborate” (Vygotsky, 1982).
Thus, in the 1930 conference, Vygotsky tried to
formulate the principle of the systemic organization of
higher psychological functions, relating it to the social
genesis principle of these same functions. In the studies of
other authors who defended this principle, there was no
relationship between systemic organization and genesis.
In the concept of functional systems formulated
by Anokhin (1987), the importance of the unit of analysis of systems for physiology in general is considered,
without differentiating between studies with animals
and humans. Even physiology may exhibit a systemic
posture that analyzes various levels of the central and
peripheral nervous system during the performance of
tasks in animals. On the other hand, the non-systemic
position is limited in its description of the participation of structures on a same level; for example, cortical
structures (Machinskaya, 2012).
Bernstein (2003) places special emphasis on
the importance of considering systemic physiological and psychophysiological studies, including the
very strong position of the social and cultural genesis
of these processes. In 1975, Luria wrote that systemic psychophysiology has yet to develop as a science.
Leontiev (1975) has always stressed the need to include
the systemic nature of human activity in experiments
and the possibilities of its formation from the external
to the internal level.
We can see that contemporary and post-Vygotsky
authors have reiterated his ideas about the principles of
social genesis and systemic organization. With regard
to Luria and Leontiev, we can assume that they developed these ideas from coexisting and collaborating with
Vygotsky, while Bernstein and Anokhin reached a similar
conclusion from the data of physiological studies. Both
paths suggest the usefulness of these principles for
neuropsychology and experimental neurophysiology
(Machinskaya, 2012).
In addition, in the text cited above, Vygotsky also
introduced a very important third principle for neuropsychology: the dynamic organization of higher psychological functions. Vygotsky’s conference concludes with
the words: “It seems to me that the systems and their
destiny are the alpha and omega for us and our future
work” (Vygotsky, 1984).
Another significant contribution by Vygotsky was
the paper entitled “Diagnosis of the development and
pediatric clinic of a difficult childhood”, written in 1931
First, there is the interpsychological stage: I order,
you execute; then we move to the extrapsychological stage: I start talking to myself; followed by the
intrapsychological stage: two points in the brain,
which are externally activated, begin to act in a
single system and become an intracortical point
(Vygotsky, 1982, p. 130).
As a response to external behavior, a functional system emerges that includes various components.
An external grouping or mediatization, such as the use
of external media, produces the need to form internal relationships, in other words, a functional system.
Vygotsky calls this internalization “extra cerebral organization” within the functional system or as a structural
and functional unit (Vygotsky, 1982).
In relation to the location of higher psychological
functions, Vygotsky states that “the cerebral substrate
of psychological processes must be understood not
as isolated sectors, but as the complex systems of the
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formations, may also have a compensatory aspect,
reflecting the high plasticity of a child’s brain. That is
precisely why secondary symptoms can be better solved
“from pedagogical interaction” (Vygotsky, 1983).
In addition to discussing development in the
context of various contrary trends, Vygotsky promotes development as a probabilistic, continuous process,
subject to complex self-organization, that is, a process,
in which all stages unfold “as if acting in a drama”
(Vygotsky, 1983). According to Vygotsky, the main objective of a pedagogical study is “to discover the internal logic
of the drama of child development” (Vygotsky, 1983).
Thus, Vygotsky’s dynamic and causal approach
was aimed at identifying the internal regularities of
development, discovering the primary mechanisms
of change and separating them from secondary and
tertiary formations, instead of finding symptoms and
difficulties, as is customary until now in the clinic of
difficulties in development and school learning.
(Vygotsky, 1983), which contains recommendations for
the psychological evaluation of children. Its objective is
a positive characteristic of children and identification of
their weaknesses. The positive characteristics should
help determine useful recommendations for proper
parenting and whether this is appropriate or not for the
common public school.
In his 1932 lecture at the Psychoneurological
Academy of Ukraine, “About the work plan for genetic
and clinical psychology”, based on the systemic principle, Vygotsky reaches an important conclusion about
the need for “psychological qualification of symptoms”,
that is, dividing them into the primary and secondary.
The primary symptoms represent the product of
altered peripheral or central brain structures, while the
secondary symptoms arise as a result of the inappropriate social situation for the child’s development. This
idea reflects the systemic principle that Vygotsky proposed to diagnose childhood problems, insists on qualitative analysis of the difficulties that arise.
This approach became the fundamental feature
for the entire theory of neuropsychological diagnosis,
later developed by Luria (2003). The same approach
is currently applied by his followers (Akhutina &
Pilayeva, 2008; Solovieva & Quintanar, 2017a, 2017b).
Finally, on April 28, 1934, in his last presentation,
Vygotsky discovers the principle of dynamic and systemic organization and the location of higher psychological functions. The consequence of this principle is that,
according to Vygotsky, a same injury leads to absolutely different consequences due to its location in adults
and children. In the case of the child, it is largely the
upper levels that suffer, whose incomplete development requires the participation of the lower levels in
accordance with the principle of systemic organization. In adults, the lower levels suffer and the defect is
compensated for by the upper level, which have fully
developed (Vygotsky, 1982).However, it is important
to underscore that this relative regularity depends not
only on the type and degree of the injury, but also on
the type of cultural interactions the child is exposed to.
Thus, a partial deficit in the child, such as weak
visual perception, may hamper the development of
most other functions, for example, poor vocabulary,
and changes in language and logical-verbal thinking
(Vygotsky, 1995), a situation later called “cascading
developmental effect” (Karmiloff-Smith, 2002).
However, in addition to exhibiting a negative
meaning as complementary complications, secondary
Neuropsychological theory
as a systemic theory
Vygotsky’s position in these texts and presentations, made late in life, were reiterated and developed in neuropsychology, first by Luria, with regard to
neuropsychology, but it is also important to underscore that all the authors mentioned here were assisted
by groups of collaborators and students. In addition,
it should be noted that other authors have used the
same approach, not necessarily in neuropsychology,
but in areas of developmental (Elkonin, Bozhovich,
Zaporozhech) educational, pedagogical (Galperin,
Talizina, Leontiev), and general psychology (Rubinsten,
Leontiev, Smirnov), although it would not be feasible to
mention all of them here.
Luria began his work as a medical doctor at the
Institute of Neurosurgery of N. N. Burdenko in Moscow
in 1937. He created a system of neuropsychological
diagnosis methods related to changes in higher psychological functions caused by local brain lesions. While
developing these methods, he relied on the systemic
structure of the higher psychological functions proposed by Vygotsky, and considered them to be functional
systems that include a multitude of elements.
There is no doubt that Luria also relied on the
work of physiologists who proposed a systemic concept
corresponding to the vital needs of the organism in
animals and humans. Functional systems always conform
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depending on the objective and anticipated result that
must be achieved under the given conditions. This notion
is similar to the concept of Leontiev’s activity theory
(1983), underscoring that human goals and means are
always products of human culture. Functional systems
also vary with the objectives and means. This refers to
the potential high plasticity and flexibility of various CNS
levels of the functional systems (Luria, 2003).
According to Luria, each link in the functional system is related to a specific aspect of psychological function and is guaranteed by various levels of brain
activity. Psychological functions are based on “complex
systems, each making its own contribution to the complex
psychological processes that may be located far from the
brain” (Luria, 2003, p. 77). When the work of one of the
links is altered, so is that of the entire system. “This change
also depends on the specialization of each of the elements
of the functional system” (Luria, 2003, p. 77).
The diagnosis system proposed by Luria made it
possible to assess all the links of various functional systems
under the new logic of its “similarity to the syndrome”.
He suggested that syndromic analysis involves a detailed
qualification of symptoms. In other words, it was a correlation of some symptoms and their main related factors
with other symptoms that appeared according to the
laws of the systemic organization of higher psychological
functions. At the same time, the conserved aspects of each
patient should be determined (Xomskaya, 2005).
It is important to underscore that this qualitative
proposal in the neuropsychological clinic is not limited to
an empirical description of phenomena and difficulties, as
is often the case. The current dichotomy that exists in the
neuropsychological analysis of cases refers on one hand to
an alternative analysis based on numerical data obtained
in psychometric procedures and, on the other, a description of the difficulties, based on observation and identification of the parameters of psychological functions such as
language, attention, memory, some personality data and /
or the social environment of the child’s life.
None of these alternatives is related, as such, to
the idea of “syndromic analysis”, which involves discovering the central mechanism that underlies the difficulties encountered in the case. This cannot be obtained from numerical data, and neither can it be reduced
to a description of the case. Rather, it requires identifying the working unit of the brain, a particular neuropsychological factor for the participation of cortical an / or
subcortical elements of functional brain work. This mechanism or factor will determine the entire series of difficulties
that children experience in their verbal, nonverbal activity,
behavior and personality (Solovieva & Quintanar, 2017a).
Psychological syndrome analysis consists of contrasting
types of errors and ways of obtaining assistance during
the individual interactive evaluation with each patient.
Errors must emerge systemically and constantly in order
to clearly identify a specific neuropsychological syndrome.
In 1940, Luria began to compile three papers,
all related to aphasia. The first presented an analysis of
sensory aphasia, which was the subject of the author’s
doctoral thesis, defended in medical science in 1944.
The second, about parietal aphasia or semantic aphasia,
which was not concluded, contains syndromic analysis
of language alterations caused by temporal, parietal and
occipital lesions in the left hemisphere in relation to global
visual perception, that is, simultaneous spatial synthesis
and schematization of the patient’s experiences as a follow-up from the body scheme to the amodal categories and
conceptual schemes (Akhutina & Agris, 2018). The third
volume about motor aphasias was only initiated by Luria.
These materials demonstrate the particularities
of Luria’s neuropsychological approach as a systemic
and interdisciplinary principle. Luria’s literature quotes
always refer to areas of neurology and linguistics,
among others, with special emphasis on historical and
social aspects in the analysis of psychological processes
related to human activities and the evolution of symbolic systems, including language.
During the Second World War (1941-1945), Luria
was the head of rehabilitation at the Military Hospital for
evacuated military personnel in Kisegach, in the Southern
Ural region (Cheliabinsk region). Based on clinical studies
carried out before the war, his working group of more
than thirty collaborators diagnosed and rehabilitated
the psychological functions of patients with brain injuries.
At another military hospital in a nearby town, rehabilitation work involved voluntary movements as a result
of peripheral injuries, coordinated by A.N. Leontiev and
A.V. Zaporozhets.
At the end of 1944, upon returning to Moscow
and working at the Institute of Neurology and the
Institute of Neurosurgery, Luria developed the studies
that made him internationally acclaimed. These included “Traumatic Aphasia”, published in 1947 and “Higher
cortical functions”, published in 1962. In the latter, Luria
describes the basic neuropsychological syndromes that
arise from injuries to different cortical sectors, along with
the diagnostic methods that identify these alterations.
A vertical approach was used that included various cortical
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Y. Solovieva, et al.
and subcortical levels. Luria was primarily interested in
“processes by which the brain produces and controls the
level of its own activation” (Akhutina & Agris, 2018). Luria’s
conception of three structural and three functional blocks
of the brain (tone and wake regulation block, reception
block, information processing and conservation, programming block, regulation and control of complex forms of
activities) is based on this approach (Luria, 2003).
It is worth mentioning that Luria’s concept of
cerebral functional organization is widely known and
referenced. However, the greatest difficulty in the methodological and clinical application of this concept lies in the
limited understanding of the term beyond the more global
conceptions, for example, outside the historical-cultural
approach in psychology proposed by L. S. Vygotsky.
What is the relationship between these apparently
different concepts?
The historical-cultural origin of the human psyche
presumes a systemic and dialectical view of functioning at both the psychological and brain level. From this
approach, brain blocks do not work separately to produce
certain functions. The joint participation of all three
functional blocks is absolutely necessary to ensure a task
is carried out. An example of such a task is writing, reading
a sentence or a child’s drawing on a sheet of paper. The
task can be constructive, with the use of concrete blocks
or even objects, or related to mathematics, geometry or
any other type of conceptual knowledge. Various tasks
can be carried out at different levels of action: concrete
material, concrete perceptive, materialized symbolic,
schematic perceptual, oral verbal, written verbal, etc.
(Galperin, 2000; Solovieva, 2014; Talizina, 2009). All of
these tasks or actions are formed and acquired during the
life of the subjects in their constant interaction (optimal
or deficient) with other people in the world of cultural
objects or units (Eco, 2005). This line of ideas unites us
with the historical-cultural origin of the human psyche of
the Vygotsky paradigm.
According to this systemic and dialectical view,
because the three brain blocks participate in each of
these tasks, it is impossible to propose individual tasks
or “functions” for each block. When assessing subjects’
performance of each task, neuropsychologists must
identify the signs and evidence of the weakness in one of
the three functional blocks, but cannot design and apply
specific tasks for each one.
Naturally everything becomes even more complex
if we consider that the participation of different cortical
and subcortical mechanisms, within each of the three
functional ones, is selective and varies with age, degree of
automation or domain, depending on the content of each
particular cultural action.
This position is alien to a traditional understanding
of analysis and evaluation of cognitive functions separate
from the search for a cerebral correlate for each function.
This lack of understanding means that although Luria’s
work is cited, the methodology proposed is not understood or fully utilized.
Conclusions and reflections
This article considered the main ideas of L.S.
Vygotsky and A.R. Luria and certain moments of the historical emergence of their ideas. What objective and specific
traits were identified as unconventional?
First, the principle of the systemic structure of
higher psychological functions assumes its complex systemic and hierarchical consideration. This structure varies
and changes at different ontogenetic times, producing
different qualitative levels. The systems are also altered
by the cultural effects of the activity, labor, profession and
forms of communication that individual subjects participate in during their lifetime. The hierarchical structure
means that, at different psychological ages, different
activities play a leading role. The complex psychological
systems, which two of the authors of this article (Solovieva
and Quintanar) prefer to call activities, are products of
the life and interaction of human beings in culture, precisely through the performance of activities. The activity
becomes an intermediate level or link that allows us to
combine culture with the psychological processes of each
subject that can only be formed in the activity and not
outside it. Although psychological processes cannot exist
without social and cultural life, the effects of this cultural
environment do not arise spontaneously or immediately,
but are mediated by the activity of each subject.
Psychological development as an acquisition of
human cultural experience cannot exist without the participation of each subject as subjects of their own activity
and the exchange with cultural objects that are both
objects and subjects (Leontiev, 2009).
At the same time, the psychophysiological mechanisms of this activity (Gippenreitor, 1996; Leontiev, 2012)
also acquire new, stable and flexible functional levels
in this same activity and not outside it. These mechanisms are consolidated and united in complex functional
systems (Anokhin, 1987) that underlie cultural actions, at
the psychophysiological or neurophysiological level. Each
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Historical-Cultural Neuropsychology: a systemic and integral approach of psychological functions and their cerebral bases
action represents a complex psycho- and neurophysiological system. These complex functional systems cannot
appear spontaneously, without participation in the motor
and objective activities of real life.
This forms part of a conceptual logic that the
brain is a material substrate of such activities, considering that the pathological, dysfunctional or injured
status of a brain area in children and adults leads to
different effects. Vygotsky’s laws considered the participation of the lower and upper levels in cases of pathology of the central and peripheral nervous system in
childhood and adulthood (Vygotsky, 2016).
These positions not only confirm the essence of the
historical-cultural paradigm of development, but further
consolidate them. Vygotsky’s position on the principle
of extra-cortical organization of psychological processes
acquires greater importance and methodological value.
This principle means that the “brain lowers its own
limits” or is formed in a space that lowers these limits, a
space of intersubjective activity where several participants
interact to achieve a shared objective. Not surprisingly,
Vygotsky wrote that to understand “human thought, it is
necessary to go beyond the limits of the human brain.”
Consequently, it is understood that, according
to the social origin principle of the human psyche,
the source of development must not be sought within
the brain or psyche, but in the relationships between
people: in instruments, signs, and human language
(Karmiloff-Smith, 2002; Luria, 1979).
The structure of higher psychological functions
always assumes mediation through signs, language
proficiency, and different inter and intracultural symbolic systems. All sign systems are undoubtedly products
of past, present and future human history, because
history never ends. This underlines both the social and
historical origin of human processes. Everything discussed here confirms the need to study psychological and
neuropsychological processes as flexible processes,
constantly changing and developing.
It is important to note that the term “activity” better
expresses and establishes the idea of social relations, referring not only to relationships, but the activity motivated
and aimed at the objectives.
In addition to the above, psychological processes
are considered systems in constant development, training
that leads to high levels of self-regulation. This self-regulation is not manifested from the beginning, but is considered an ideal and dialectical possibility, as a potential for
cultural development that is not decisive, but only probable under certain conditions.
The progressive formation of psychological
processes according to the gradual internalization
of external social interactions is a complex dialectical and dynamic process that is probable rather than
mandatory. At a high level of functioning, psychological systems can be self-regulating and self-organizing
(Zinchenko & Pervichko, 2012). Luria, in turn, defined
the higher psychological functions as “processes of
complex self-regulation” “conscious and voluntary
processes through their functioning” (Luria, 1969).
At the same time, Vygotsky and Luria postulate a
dynamic and systemic organization of higher psychological
processes with constant changes within ontogenesis. This
principle is epitomized in the concept of guiding activities
that lead to the creation of new psychological formations
at various childhood ages. At each age, the possibilities
of cerebral regulation and performing the same function
with varied and diverse structures at different brain levels
change (Akhutina & Pilayeva, 2008). This position cannot
be understood based on the cognitive paradigm that
continues to seek the unique, eternal and innate correlates of cognitive functions of the cerebral substrate. Luria’s
idea is very similar to the notion of brain plasticity and
flexible confirmation of cortical and subcortical systems
(Bernstein, 2003).
This approach requires correlating different levels
of psychological, neuropsychological, cultural and cerebral
analysis, which changes the relationships between causes
and effects from different levels and participation of the
variable links. The tasks involved in the activities are always
analyzed based on the real conditions in which problems
and tasks are established, making it possible to identify the
brain mechanisms that participate in the corresponding
functional systems (Solovieva & Quintanar, 2017b).
Thus, one can refer to a line of research and methodology of neuropsychology studies from the historical-cultural viewpoint, initiated by Vygotsky and Luria, but which
has a considerable number of followers around the world.
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Yulia Solovieva, doutora em neuropsicologia, é professora na
Benemérita Universidad Autónoma de Puebla (BUAP).
E-mail: yulia.solovieva@correo.buap.mx
Luis Quintanar Rojas, doutor em neuropsicologia
pela Moscow State University, é professor na
Benemérita Universidad Autónoma de Puebla (BUAP).
E-mail: luis.quintanar@correo.buap.mx
Tatiana Akhutina, doutora em ciência pela Moscow State
University, é chefe do Laboratório de Neuropsicologia da Moscow
State University. E-mail: akhutina@mail.ru
Izabel Hazin, doutora em psicologia cognitiva pela Universidade
Federal de Permambuco, é docente na Universidade Federal do
Rio Grande do Norte. E-mail: izabel.hazin@gmail.com
Received in 10.april.19
Revised in 24.sep.19
Accepted in 10.dec.19
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