10 – Neuropsychological Assessment

Neurology

focuses on nervous system and its disorders

Neuropsychology

focus on the relationship between brain functioning and behavior

Neuropsychological Assessment

evaluation of brain and nervous system functioning as it relates to behavior

Behavioral Neurology

a subspecialty within the medical specialty of neurology that also focuses on brain-behavior relationships

Neurotology

branch of medicine that focuses on problems related to hearing, balance, and facial nerves

Nervous System

includes the brain, spinal cord, and a complex network of nerves

Neurons

nerve cells that make up the nervous system

Central Nervous System

consist of brain and the spinal cord

Peripheral Nervous System

consisting of the neurons that convey messages to and from the rest of the body

Cerebral Hemispheres

receives sensory information from the opposite side of the body and also controls motor responses on the opposite side of the body (contralateral control)

Corpus Callosum

meeting ground of the two hemispheres

Dominant Hemisphere

leads in such activities as reading, writing, arithmetic, and speech (commonly the left side)

Non-Dominant Hemisphere

leads in tasks involving spatial and textural recognition as well as art and music appreciation (commonly the right side)

Lesion

pathological alteration of tissue which could result from injury or infection

Focal Lesion

lesion that relatively circumscribed at one site

Diffuse Lesion

lesion that scattered at various sites

Brain Damage

general reference to any physical or functional impairment in the CNS that results in sensory, motor, cognitive, emotional, or related deficit

Neurological Damage

most inclusive because it covers not only damage to the brain but also damage to the spinal cord and to all the components of the PNS

Organicity

organic brain syndrome

Kurt Goldstein

German neurologist that studied brain-injured soldiers during WWI; signs of organic impairment included the loss of abstraction ability, deficits in reasoning ability, and inflexibility in problem-solving tasks

Heinz Werner and Alfred Strauss

examined brain–behavior correlates in brain-injured children with intellectual disability; led to understanding of behavioral consequences of brain injury in children and presumption of common patterns of cognitive, behavioral, sensory, and motor deficits

Neuropsychological Evaluation

draw inferences about the structural and functional characteristics of a person’s brain by evaluating an individual’s behavior in defined stimulus-response situations

Hard Sign

indicator of definite neurological deficit (meron talaga)

Soft Sign

indicator that is merely suggestive of neurological deficits (meron ata)

Mini-Mental State Exam

primarily measures concentration, language, orientation, memory, and attention

shorter than MSE

Neuropsychological Impairment Scale

aids to the neuropsychological screening and evaluation process

Neuropsychological Mental Status Examination

useful supplement to a structured interview for screening purposes

Noninvasive Procedures

procedures that do not involve any intrusion into the examinee’s body

Parkinson’s Disease

progressive, neurological illness that may also have several nonmotor symptoms associated with it

Substantia Nigra

Latin for “black substance”; responsible for producing adequate levels of dopamine for normal movement

Idiopathic

of unknown origin

REM Sleep Behavior Disorder

characterized by an “acting out” of dreams with vocalizations or gestures

Dyskinesias

involuntary, jerking-type movements; potential side effect of PD medications

Lewy Body Dementia

results from the formation of a number of Lewy bodies in the brainstem and cerebral cortex; causes Parkinsonian-like symptoms, Alzheimer-like symptoms, and other symptoms of dementia

Lewy Bodies

clusters of stuck-together proteins that have the effect of depleting available dopamine and other brain substances

DaTscan

use of high-tech imaging equipment to visualize the substantia nigra and gauge the amount of dopamine present

Pattern Analysis

examiner looks beyond performance on individual tests to a study of the pattern of test scores

Deterioration Quotient

quotients based on patterns of subtest scores to indicate brain damage

Wechsler Intelligence Scales

used in assessing general ability and clues to deficits like poor concentration or block design performance

Abstract Thinking Deficit

symptom commonly associated with neuropsychological deficit, regardless of the site or cause

Wechsler Similarities Subtest

task is to identify how two objects are alike

Wisconsin Card Sorting Test

requires sorting a pack of 64 cards with geometric figures; useful for screening for neurological impairment

Object Sorting Test and Color-Form Sorting Test

nonverbal tests that require sorting objects of different shapes and colors

The Proverbs Test

designed to test abstraction and related ability; task is to interpret proverbs

Executive Function

organizing, planning, cognitive flexibility, and inhibition of impulses; associated with the frontal and prefrontal lobes

Tower of Hanoi

puzzle with stacked rings; tests executive function

Porteus Maze Test

used to test planning and foresight abilities

Clock-Drawing Test

patient draws a clock face; abnormal results may reflect cognitive dysfunction such as dementia

Trail Making Test

task is to connect dots in a logical fashion

Field of Search

task is to locate a match to a sample stimulus as quickly as possible

Identification Task

involves confrontation naming

Picture Absurdity

test taker answers questions such as “What’s wrong or silly about this picture?”

Perceptual Test

evaluates sensory functioning (sight, hearing, smell, touch, taste, balance)

Motor Test

evaluates mobility and ability to move limbs, eyes, or other body parts

Perceptual-Motor Test

evaluates integration/coordination of perceptual and motor abilities

Ishihara Test

example of perceptual-motor test

Wepman Auditory Discrimination Test

measures deficit in auditory functioning

Bruininks-Oseretsky Test

assesses motor proficiency in children (4½ to 14½)

Purdue Pegboard Test

measures manual dexterity

Bender Visual-Motor Gestalt Test

used to assess visual-motor integration

Controlled Word Association Test

subject says as many words beginning with a letter in one minute; score is adjusted by gender, age, education

Reitan-Indiana Aphasia Screening Test

measures aspects of aphasia

Multilingual Aphasia Examination

aphasia screening designed for individuals of Hispanic descent

Procedural Memory

memory for things like driving, typing, or riding a bicycle

Declarative Memory

memory of factual material

Semantic Memory

memory for facts

Episodic Memory

memory for facts in a particular context or situation

Implicit Memory

“unconscious memory”

California Verbal Learning Test–II

used to assess memory

Wechsler Memory Scale (WMS-IV)

test of memory abilities

Fixed Battery

standard set of tests given to all patients

Flexible Battery

tests tailored to the specific needs of the patient

Halstead–Reitan Neuropsychological Battery

classic test battery used by researchers and clinicians

Neurosensory Center Comprehensive Examination of Aphasia (NCCEA)

battery focusing on communication deficit

Montreal Neurological Institute Battery

useful in locating specific kinds of lesions

Southern California Sensory Integration Tests

assess sensory-integrative and motor functioning in children aged 4–9

Severe Impairment Battery (SIB)

designed for use with severely impaired individuals who perform at or near the floor of existing test