Fundamentals of Human Neuropsychology, Sixth Edition Chapter 28 Lecture PPT

1. Bryan Kolb & Ian Q. Whishaw’s Fundamentals of Human Neuropsychology, Sixth Edition Chapter 28 Lecture PPT Prepared by Gina Mollet, Adams State College

2. Neuropsychological Assessment

3. Portrait: Lingering Effects of Brain Trauma • R.L. • Sustained whiplash in a car accident • Unable to read, impaired verbal abilities • Apraxia • Frontal lobe patients • Problems with response inhibition • Perseveration • Assessment: Wisconsin Carding Sorting Test

4. The Changing Face of Neuropsychological Assessment • First tests: • Goal was to establish a cutoff between brain damaged and non-brain damaged • Modern Assessment influenced by: • Functional Imaging • Cognitive Neuroscience • Managed Health Care

5. Functional Imaging • Investigators can identify changes in cerebral processing via images instead of looking for behavioral symptoms • Patients now referred for rehabilitation or general cognitive functioning • Functional imaging does not predict the extent of behavioral disturbances

6. Cognitive Neuroscience • 1950s–1980s • Development of test batteries • Still use cutoff scores • 1990s • Cognitive theory and structural and functional imaging were used to understand how the brain works

8. Managed Care • Managed care produces pressure to reduce time and money • Clinical Assessment Should: • Focus on matters linked to treatment • Reduce costs • Be time efficient • Monitor progress and outcome evaluation

9. Rationale Behind Neuropsychological Assessment • Standardized tests • Easy to administer • Need to understand the brain to interpret • Luria’s neurological approach • Strategy for examining the brain • Tailored to each person • Composite batteries • Looks at qualitative performance on a number of tests • Example: Boston Process Approach

12. Factors Affecting Test Choice • What area of the brain is most likely to be damaged? • How sensitive is the test? • What characteristics does the individual have? • Age • Culture • IQ • Sex

14. Goals of Neuropsychological Assessment • Diagnose the presence of cortical damage and localize it if possible • Facilitate patient care • Identify mild disturbances • Identify unusual brain organization • Identify the cause of disorders • Rehabilitation • Help the patient and their family understand the disorder

15. Intelligence Testing in Neuropsychological Assessment • WAIS • Subscales for verbal ability and performance • Can be useful as a rough measure of right- and left-hemisphere functioning • Problems: Pre-injury intelligence is often not known

16. Categories of Neuropsychological Assessment • Waber and colleagues • Normative data on children age 6-18 on a wide range of measures • Linked to an MRI developmental database • Sports Medicine Assessment • Automated batteries for tracking concussion

17. Neuropsychological Tests and Brain Activity • Imaging indicates that neuropsychological tests produce localized and distributed activation • Test performance and brain activity is also influenced by individual differences

18. The Problem of Effort • Malingering • Exaggerating cognitive deficits • Green and colleagues • Effort influences performance more than brain damage • External incentives play a role in performance

19. Case Histories • Case 1 • History of seizures • Left-frontal lobe lesion • Impairment on the Wisconsin Card-Sorting Test

20. Case Histories • Case 2 • History of seizures in the left side of his face and left hand • Had the right facial area and part of the right frontal lobe removed • Difficulties on the Wisconsin Card-Sorting Test and the Rey Complex Figure • Finger position deficits

22. Case Histories • Case 3 • Six week coma and brain infection • Poor nonverbal memory • Motor handicaps • Apraxia • Ataxia • Anarthria • Successful rehabilitation