Neuro

Question 1

Neuropsychology

Answer 1

Study of relationship between brain function and behavior

Question 2

Clinical Neuropsychology

Answer 2

Application of neuropsychological knowledge to evaluate & treat conditions that affect brain functioning

Question 3

Neuropsychological Assessment

Answer 3

Evaluation of brain functioning & behavior in a specific individual

Question 4

Neuropsychological Rehabilitation

Answer 4

Interventions meant to RESTORE/improve core ability OR to COMPENSATE for loss of ability

Question 5

What are two core questions in neuropsych assessment?

Answer 5

Has there been a change (decline) in thinking skills and/or behaviour
If so, does the type and pattern of changes suggest a specific diagnosis or condition?

Question 6

Components of a neuropsych assessment

Answer 6

Preparation
Interview
Formal Testing (EFs, social, personality, emotional, IQ, sensory motor, affect)
Case formulation & integration of information
Feedback & recommendations to family, client, referral source

Question 7

Intra-individual patterns

Answer 7

Changes (decline) from estimated premorbid functioning

Question 8

Beyond diagnosis and Case formulation

Answer 8

Answer referral question (if not diagnostic)
Describe effect on functioning – e.g., specify neurobehavioural syndrome(s)
Make recommendations
E.g., compensatory strategies, follow-up evaluation/further tests, med eval/other referrals, self- care ability, return to work, etc.
TREATMENT

Question 9

TBI

Answer 9

Traumatic Brain Injury; Injury to the brain from an outside force

Question 10

TBI neurological sequelae

Answer 10

Focal, diffused, or mix

Question 11

cognitive TBI effects

Answer 11

attention, processing speed, memory/new learning,

reasoning, awareness of deficits, reduced initiation

Question 12

Emotions/personality/social TBI effects

Answer 12

frustration tolerance, disinhibition, depression, anxiety, irritability, interpersonal sensitivity and awareness

Question 13

Physical TBI effects

Answer 13

Fatigue, headaches, seizures, hemiparesis, ataxia, dysarthria, balance, sense of smell, gaze palsy, sexual dysfunction

Question 14

Amnestic syndromes

Answer 14

changes in memory functioning following

TBI

Question 15

Frontal lobe/dysexecutive syndromes

Answer 15

changes in reasoning, problem solving, mental flexibility, social awareness, etc.

Question 16

The prefrontal cortex

Answer 16

High level of connectivity with other regions of the
brain – control and direction
Most recently developed part of the brain, thought to be largely responsible for much of what makes us human

Question 17

The prefrontal cortex Three subdivisions:

Answer 17

Orbitofrontal PFC
Dorsolateral PFC
Mediofrontal PFC

Question 18

Prefrontal Syndromes: The Apathetic Type

Answer 18

The medial frontal PFC region
o Apathy/abulia
o Poor initiation of activity
(motor, speech, etc.)
o Loss of spontaneity
o Frontal lobe incontinence o Response slowing

Question 19

Prefrontal Syndromes: The Dysexecutive Type

Answer 19

The dorsolateral PFC region (blue region)
o Poor planning & monitoring of outcomes
o Perseveration/inflexibility n Remember the WCST
o Distractibility/impersistence o Poor self-care

Question 20

Prefrontal Syndromes: The Disinhibited Type

Answer 20

The orbitofrontal region (green region)
o Changes in comportment:
n Impaired inhibition of impulses
& distractibility
n Inappropriate social & sexual behavior with no insight
n Impaired judgment
n emotional lability, irritability, silly, odd sense of humor, explosive anger, no remorse

Question 21

TBI Spontaneous recovery:

Answer 21

Most occurs in the first 12 months after injury some further recovery can occur after that time. Most with mild TBI recover to pre-injury levels within several months

Question 22

Primary factors affecting TBI outcome

Answer 22

Injury severity, location, medical complications

Question 23

Secondary factors potentially affecting outcome

Answer 23

Premorbid personality, coping style/resources
n Premorbid psychopathology, substance abuse
n Education/Premorbid functional level, cognition n Age
n Current family & social support
n Support from employer/school
n Financial circumstances

Question 24

Neuropsychological Rehabilitation

Answer 24

Therapeutic changes achieved by:
n Reestablishing or strengthening premorbid skills
n Use of internal compensatory strategies
n Use of external compensatory devices or interventions
n Assist adaptation to cognitive disabilities

Question 25

Rehabilitation of Executive Dysfunction

Answer 25

-Training for attention deficits
n during post-acute phase of rehabilitation
-Formal problem-solving training
n For executive deficits during post-acute phase of rehabilitation
-Other Metacognitive strategy training
n for deficits in executive function, including emotional self-regulation

Question 26

Formal problem-solving training

Answer 26

Goal Management Training

• Orientation “STOP”
• Goal Selection – “Define the main task”
• Break into subtasks – “List the steps”
• Encode and retain task and subtasks – “do I know the task/steps?”
• Monitor – “am I doing what I planned to do?

Question 27

TBI: Emotional and behavioural self-regulation treatment

Answer 27

CBT-based interventions
Group treatments to foster social communication, emotional regulation
Behavioural management, behavioural contracting, token economies

Question 28

TBI: Fostering self-awareness

Answer 28

Metacognitive strategy training
Interactive, use of feedback, e.g. “pause, prompt, praise”
Or e.g., patients predict their task performance, given feedback regarding discrepancy between prediction and actual performance