Neuropsychology Clinical Skills

Question 1

what is cognition

Answer 1

the mental processes involved in making sense of the world and the use of that information to guide behaviour.
the ability to perceive and react, process and understand, store and retrieve information, make decisions and produce appropriate responses.

Question 2

what are the main causes of congitive dysfunction

Answer 2

neurodegenerative (alzheimers, MND, parkinsons, prion)
neurological conditions (epilepsy, NM disorders)
vascular (V dementia, stroke, sub arachnoid haemorrhage, AVM, small vessel disease, blood disorders)
trauma
inflammation (MS, lupus)
metabolic (mictochondrian, endocrine)
hereditary/ congenital (movement disorders, ataxia, chromosome disorders)
infections
medications
sleep disorders
functional
psychiatric

Question 3

when do you not screen someones cognition

Answer 3

Low GCS (<13), PTA, delirium, medically unstable, post-traumatic seizures, intoxicated, psychotic. 
Not too frequently (practice effects). 
Patient distressed or refuses. 
Patient has learning disability.
ACE-III only suitable for age 50+
poor envirnoment

Question 4

what are the ACE-III cut off

Answer 4

<82 impairment
82-88= borderline
89-100 no further assessment needed unless clinical concerns

Question 5

what does ACE-III test

Answer 5

memory

Question 6

what are executive functions

Answer 6

A range of skills that allow a person to establish new ways of thinking and behaviour patterns; and to introspect. Associated with frontal brain regions.
-Cognitive functions:
Planning and organisation, problem solving, attention, goal setting.
-Energisation:
Ability to initiate and sustain a response.
-Behaviour & Emotional regulation:
Impulse control, social awareness.
-Meta-cognition:
Empathy, theory of mind, aspects of personality, social cognition (including the ability to make social judgements) humour, self-awareness and self-reflection.

Question 7

what can executive dysfunction look like

Answer 7

Severe attention disorder.
Inability to sustain goal directed behaviours.
Slowing, a lack of spontaneity, apathy and in the most severe cases akinetic mutism.
Deficits of inhibitory control, resulting in distractibility, hyperactivity, impulsive behaviour, disinhibition, hyper-sexuality, over-eating and argumentative behaviour.
Changes in personality, lack of empathy, unconcern for others, and inappropriate behaviour.

Question 8

what does frontal assessment battery assess

Answer 8

basic executive functions

Question 9

what are the fab cut offs

Answer 9

12 or less= dysfunction