Neuropsychiatric Testing

Question 1

Clinical components of a neuropsychological interview

Answer 1

1) start by reviewing the brain trauma/lesion

2) orientation
- A & O x4?
- ask about how much they know about their incident
- will never forget if they smoke regardless of the trauma/lesion/level of consciousness

3) language skills
4) awareness of the situation
5) mood

6) neurobehavioral presentation
- can they initiate activity/ask for things?
- can they plan and initiate simple daily tasks?
- how are they interacting with the physician?

7) psychosocial and vocational history
- how were they before the trauma
- social/abuse/psychiatric/family histories
- childhood as well if possible

Question 2

Grading the severity of a TBI

Answer 2

1) mild TBI
- loss of consciousness < 30 min
- post traumatic amnesia <24 hrs
- Glasgow coma scale = 13-15

2) moderate TBI
- loss of consciousness 30 min-24 hrs
- post traumatic amnesia 24 hrs - 7 days
- Glasgow coma scale = 9-12

3) severe TBI
- loss of consciousness > 24hrs
- post traumatic amnesia > 7 days
- Glasgow coma scale = 3-8

Question 3

Ruff figured fluency test

Answer 3

Tests nonverbal fluency and capacity for fluid/divergent thinking

Tests ability to shift cognition, planning strategies and executive ability for coordination processes

right frontal lobe dysfunction is what this test tests for

ask them to connect the dots to make shapes, make as many shapes as possible but cant make the same shape

Question 4

Stroop color word test

Answer 4

Tests ability to inhibit cognitive interference

• ask them to read the words as fast as possible (1st page)
• ask them to read the color of the ink the word is printed in (2nd page)

tests frontal lobe dysfunctions/injuries

Question 5

Trail making test

Answer 5

Tests executive abilities, mental flexibility, visual scanning and motor function

connect the dots in order of increasing numbers and then letter vs corresponding number

doesnt test a specific lesion and instead tests general brain dysfunction

Question 6

Rey complex figure test

Answer 6

Tests visuospatial construction ability, visual memory, planning , fine motor skills and short term memory

Ask the patient to trace the figure (1st) and then take the figure away and have them redraw it from memory (2nd)

tests for right hemisphere brain lesions