124b - Neuropsychological Assessment

Question 1

Describe the process of making a memory

Which structures are involved?

Where is it stored?

Answer 1

• Incoming stimulus is rehearsed in working memory (prefrontal cortex) for as long as necessary…
• to consolidate by mesial temporal cortex (hippocampus)
• Stored as long term memory in different parts of the cortex
• Retrieved w/help of hippocampus and prefrontal cortex

Question 2

The normal range is ___ standard deviations around the mean

What does this mean for percentiles?

Answer 2

The normal range is 1.3 standard deviations around the mean

This translates to 9th-90th percentiles

(Mean = 100, standard deviation = 15)

Question 3

How is this patinet’s encoding?

Retreival?

Retention?

What is the most likely diagnosis?

Answer 3

• Impaired encoding
  
  • Does not learn additional words with more repetition
• Impaired retreival
  
  • But makes sense, bc not encoded
• Intact retention
  
  • Retains what is learned, but cannot access/retreive without the examiner asking “have you seen this word before”

The diagnosis from the lection is vascular dementia

• Poor encoding, normal retention

Question 4

Which brain structures are involved in anterograde memory?

Answer 4

Anterograde memory = learning and consolidating new information

• Mesial temporal cortex (hippocampus)
  
  • Consolidates and distributes memories for long-term storage
• Prefrontal cortex
  
  • Memory eencoding and retreival

Question 5

How is this patinet’s encoding?

Retreival?

Retention?

What is the most likely diagnosis?

Answer 5

• Preserved encoding
  
  • Learns additional words with increased repetition
• Impaired retreival
  
  • Fewer workds immediately and after delay
• Impaired retention
  
  • We would expect ~5/12 correct when asking yes/no questions

This is likely Alzheimer’s

Normal encoding, poor retention

Question 6

What is the mean and standard deviation of a Standard Score?

Answer 6

Mean = 100

Standard deviation = 15

Question 7

When is a neuropsychology consultation indicated?

Answer 7

• Suspected dementia
• Assess cognitive sequalae
  
  • TBI
  • HIV/Aids
  • Autoimmune conditions
  • Psychiatric conditions
• Suspected developmental disorder
• Pre/post treatment baseline

The neurocognitive test is long; requires patients to have intact decision making capacity and to be cooperative

Not necessary for reversible causes of altered mental status