neuropsychology Flashcards
What is neuropsychology
Branch of psychology that studies how a person’s COGNITION and BEHAVIOUR are related to the BRAIN and the rest of the NERVOUS SYSTEM
> Relation between (dysfunctional) brain and (dysfunctional) behavior
Subdomains of cognition
Attention/concentration
Memory
Language
Executive functions
Information processing speed
Visuospatial functions
Cognition
Cognition includes all forms of knowing and awareness
ATTENTION/CONCENTRATION
In practice: Listening to someone with background noise
Watching a complicated movie
types of attention
selective attention: focusing on specific aspect of experience that is relevant while ignoring others
divided attention: concentrating on more than one activity at a time
sustained attention: maintain focus on selected stimulus over prolonged period; called vigilance
executive attention: focus on action planning, goals, errors and compensation, monitoring
MEMORY
(acquiring, retaining and retrieving new information)
➢ VISUAL
➢ VERBAL
In practice: Remembering a list of groceries or birthdays
Knowing what you did last week
Short-term (working)
Long-term
> explicit (conscious) > episodic, semantic
> implicit (unconscious) > priming, procedural
LANGUAGE
Understanding language
Word finding
Speaking
Broca’s area (hesitant, aware), wernicke’s area (fluent sounding, unaware)
EXECUTIVE FUNCTIONS
(planning, prioritizing, decision-making)
In practice: Cooking a meal
Financial administration
INFORMATION PROCESSING SPEED
In practice: Keeping up with fast conversation
Motor reaction time
Visuospatial functions
(the ability to relate visual information to the space around you)
In practice: Navigating in a new surrounding
Playing computer games
Neuropsychological assessment
- Clinical interview
- Testing
- Scoring
- Report
What info would you get from a clinical interview and anamnesis
*Demographics (age, sex, education, etc.)
* Referral
* Neuroimaging and laboratory tests
* Motivation
* Previous diagnosis
* Family history
* Mood
* Comorbidity
* Sleep
* List medications (and whether or not they are taking them)
How does Testing work?
Objective measurement of cognitive abilities
- Compared to HC
- Compared to T0 (baseline levels, to evaluate progression)
- Different types of tests to assess different cognitive domains
- Several different tests are available
Testing confounders
Age
Education level
Vision, audition
Native language
Fatigue
Depression
Coping style
Alcohol/drugs
Medication
Pain
Motivation
Comorbidity
Testing environment
Major life events
How to deal with confounding variables?
- Appropriate scoring method (correct for age, sex and education level)
- Glasses/hearing aid
- Questionnaires (e.g. for depression, fatigue)
Observation is very important!
Test for working memory and verbal learning
California Verbal Learning Test II
Test for visuospatial memory
10/36 Spatial recall test (SPART) 10 sec
Brief Visuospatial Memory Test- 10 sec
Rey–Osterrieth Complex Figure - 10 sec
Judgment of Line orientation
Test for information processing speed
Symbol digit modalities test
Test for language
Word list generation
Test for executive functioning
Delis-Kaplan Executive
Function System Sorting Subtest
Test for attention and executive function
Stroop Test
Test batteries
Standardized test batteries
* Research
* E.g. BICAMS, BRB-N, MACFIMS
Test for working memory and/or processing speed
Paced Auditory Serial Addition Test
Test characteristics
*Sensitivity: CP as not CI
* Specificity: CI as not CP
* Validity (measures what it’s supposed to measure)
* Reliability (reproduced under same conditions)
* Test-retest effect
Scoring
Scoring test on the basis of normative data
- Healthy participants
- Patient populations
When is a score abnormal?
* - Rule of thumb:
if the Z-score is 1.5-2 standard
deviations below the normative
average score
Z-score= X-Xgem/SD
