WHAT IS A NEUROPSYCHOLOGICAL EVALUATION?
WHAT IS NEUROPSYCHOLOGY?
Neuropsychology is concerned with relationships between the brain and behavior. Neuropsychologists conduct evaluations to characterize behavioral and cognitive changes that can help the medical team provide information about the structural and functional integrity of your brain.
WHAT IS A NEUROPSYCHOLOGICAL EVALUATION?
The neuropsychological evaluation involves an interview and the administration of tests. The tests are typically pencil and paper type tests. Some tasks might be self-reports meaning that they are completed by the patient with assistance from a technician, but the majority of the tests require administration by a neuropsychologist or trained, skilled psychometrist.
Neuropsychological tests (unlike bedside cognitive and behavioral neurologic screens) are standardized, meaning that they are given in the same manner to all patients and scored in a similar manner time after time. An individual’s scores on tests are interpreted by comparing their score to that of healthy individuals of a similar demographic background (i.e., of similar age, education, gender, and/or ethnic background) and to expected levels of functioning. In this way, a neuropsychologist can determine whether one’s performance on any given task represents a strength or weakness. Although individual scores are important, the neuropsychologist looks at all of the data from the evaluation to determine a pattern of cognitive strengths and weaknesses and, in turn, to understand more about how the brain is functioning.
Neuropsychological tests evaluate functioning in a number of areas including: attention, general intellect, executive functions (such as planning, abstraction, conceptualization), learning and memory, language, visual-perception, motor and sensory functions, mood and personality styles.
WHY HAS A NEUROPSYCHOLOGICAL EVALUATION BEEN RECOMMENDED?
A neuropsychological evaluation documents patterns of strengths and weakness among cognitive and behavioral functions. For example, individuals with Parkinson’s disease or another movement disorder, an evaluation and interpretation of this pattern of strengths and weaknesses can:
Assist in a differential diagnosis (e.g., to determine whether possible mental and behavioral changes are related to the movement disorder, depression, another brain disease or treatment);
Assist with evaluation before and after functional neurosurgical procedures (e.g., deep brain stimulation) to help determine if a given treatment is appropriate for a particular person and whether treatment has had any positive or negative effects on mental functions and behavior;
Provide a baseline against which subsequent evaluations can be compared. Thereby your doctors can decide whether your functioning has declined because of the disease process or document whether your functioning has worsened or improved as a result of treatment (e.g. medications or DBS);
Reveal areas of daily functioning (e.g., financial management) with which the patient may need assistance indicate rehabilitation potential. For example, will the individual benefit from certain cognitive or behavioral treatments, occupational therapy, or pharmacotherapy?
IS THERE ANY WAY TO PREPARE FOR A NEUROPSYCHOLOGICAL EVALUATION?
These are not tests that one can study for. Patients should not worry about whether they will “pass” the tests. The tests cannot be passed or failed; instead they describe how well a person performs relative to peers.
It is the goal of the neuropsychologist to get the best possible picture of the patient’s current functioning. Several things can interfere with this goal such as if the patient is:
Excessively tired or fatigued or has sudden, unexpected “sleep attacks”;
Not motivated to put forth their best effort;
Very emotionally distraught or has an active severe psychiatric condition;
Under the influence of medications or illicit substances which interfere with cognitive functioning;
Experiencing any visual difficulties, hearing difficulties, or fine motor difficulties.
Patients should let Dr. Burchette know if they anticipate that any of these issues to be present on the day of the evaluation since they may interfere with obtaining a valid and accurate representation of your cognition.