PSYC37H3 Lecture Notes - Lecture 9: Neurodegeneration, Neuropsychology, Functional Skills Qualification

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Published on 13 Apr 2013
LECTURE 9 – WK 10 MAR 19TH 2013
Neuropsychological Assessment and Screening
What are the Uses Clinical Neuropsychological Assessment?
In clinical Neuropsychology (brain and behavior relationships),
brain function is evaluated by objectively testing memory and
thinking skills
oSubjectively – uses impression instead of objective
methods, less accurate
A very detailed answers of abilities is done, and the pattern of
strengths and weaknesses is used in important health care
areas such as diagnosis and treatment planning
oMajor memory problems -> reminders for memory
Why might a patient be referred to a Clinical Neuropsychologist?
Neuropsychological evaluations are requested specifically to help
your doctor and other professionals understand how the diff.
areas and systems of the brain are working
Testing is usually recommended when there are symptoms or
complaints involving memory or thinking
oMMSE -> 30/30 is good
Why might a Clinician Detect Changes in a Patient’s Functioning
Changes may be signaled by a change in concentration,
organization, reasoning, memory, language, perception,
coordination, and/or personality <- frontal-temporal dementia,
brain injury
The change may be due to any of a number of medical,
neurological, psychological, or genetic causes
What Cognitive Domains are Assessed?
- General intellect
- Executive functions
- Attention and concentration
- Learning and Memory
- Language
- Visual-Spatial skills
- Motor and Sensory Skills
All the domains corr. w/each other, overlap, and are NOT mutually
exclusive domains
Test scores obtained from Neuropsychological Testing?
- Typically, scores are interpreted based on referencing norms
(especially for age, and sometimes education)
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- The pattern of test score is also reviewed to estimate whether or
not there might be a change in certain abilities
- Using these methods, cognitive strengths and weaknesses can be
What do the results tell you and how can they be used?
- To identify weaknesses in certain cognitive domains
Tests are not always reliable
oWhen problems are very mild, testing may be the only way
to detect them
oFor example, determining whether memory problem are
normal age-related changes or reflect a neurological
- To help differentiate among illnesses which is important b/c
appropriate treatment depends on accurate diagnosis
oDiff. illnesses result in diff. patterns of strengths &
weaknesses on testing
oResults can be helpful in determining which areas of the
brain might be involved and what illness might be operating
-> for instance, differentiating among Alzheimer’s, stroke,
and depression
- To establish a “baseline”, or document a person’s skills before
there is any problem
oIn this way, later changes can be measured objectively
oFor example, determining whether there may be a
progressive deterioration in cognitive functioning (e.g. a
neurodegenerative disorder) or whether a concussion has
affected an athlete’s cognition
- To plan treatments that use strengths to compensate for
oResults help to identify what target problems to work on
and which strategies to use
oEx. The results can help to plan and monitor rehabilitation
or to follow the recovery of skills after a stroke or traumatic
brain injury
- To understand what problems patients may have in everyday life,
which helps to guide planning for assistance or treatment
oStudies have shown that scores on specific tests relate to
everyday functional skills, such as managing money,
driving, or readiness to return to work
An Example of Neuropsychological Assessment: Case of EA
- R-handed 65 yo married W female
- Referred by neurologist
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