Lecture 2: Introduction to Neuropsychological Assessment Flashcards

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1
Q

Dissociative Seizures

A

a seizure or an attack that features many of the characteristics associated with focal seizures, including either retention or loss of awareness accompanied by no discernable change in EEG or any other brain scan measure

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2
Q

Tumors

A

a neoplasm, a mass of new tissue, that persists and grows independently, surrounds healthy tissue, and has no physiological use

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3
Q

Glioma

A

any brain tumor arises from glial cells

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4
Q

Meningiomas

A

an encapsulated brain tumor that grows from the meninges

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5
Q

Metastatic Tumor

A

a tumor that arises through the transfer of tumor cells from elsewhere in the body

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6
Q

What is mass action?

A

Karl Lashley (1920’s)

search for engram using rats

belief that extent of damage more important than locus

equipotentiality & plasticity

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7
Q

What is localization of function?

A

surgical patients (Penfield)

non-human animal studies

anterior intraparietal (AIP) sulcus lesions in macaques lead to inability to pre-shape hands during grasping

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8
Q

What is modularity of mind?

A

Jerry Fodor (1980’s)

encapsulated processes

essential, automatic, very fast, highly specialized systems

face recognition?

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9
Q

What is a closed head injury?

A

acceleration/deceleration

no penetration of the skull but still damage

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10
Q

What is cerebral oedema?

A

swelling

trauma, impact, tumors

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11
Q

What is infarction?

A

neuronal necrosis due to loss of blood supply

cut off of blood supply

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12
Q

What is a stroke?

A

sudden loss of blood supply

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13
Q

What is ischaemia?

A

decreased blood flow due to narrowing or blockage

buildup of plaques, narrowing blood vessels, complete blockage

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14
Q

What is thrombosis?

A

blood clot at point of formation, or embolism (not just clot)

piece has broken off and travelled

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15
Q

What is a hemorrhage?

A

burst in a blood vessel

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16
Q

What is a tumor?

A

invasion, displacement, compression

originates in glial cells

infiltrating, hard to remove

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17
Q

What is anoxia?

A

complete absence of oxygen

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18
Q

What is hypoxia?

A

% absence of oxygen

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19
Q

What is encephalopathy?

A

inflammation (disease/damage, toxic, physical agents)

pressure, tumor, hydrocephalus

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20
Q

What is encephalitis?

A

inflammation (infection)

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21
Q

What is hydrocephalus?

A

overproduction or decrease in absorption of CSF

22
Q

What are the neuropsychology approaches to studying patients with circumscribed brain damage?

A

specific links between brain and mind (behavior)

lesion method (any type of damage)

two conceptual approaches: neural substrates, cognitive function

23
Q

What is double dissociation?

A

damage to A but not B leads to a deficit in X not Y

lesion A –> deficit A but NOT deficit B
lesion B –> deficit B but NOT deficit A

24
Q

What are the caveats to neuropsychological assessment?

A

large variability in population: age, sex, handedness, education, experiences, therapy

lesion variability

etiology variability

indirect observation

25
Q

What are neuropsychological assessment in neurologically intact individuals?

A

control group: people who come to the ER, but not for brain injury

matched subjects: case by case basis

non-human animals: parietal cortex, attention, memory, visual-motor control

26
Q

What is clinical neuropsychological assessment?

A

cognitive capacity profile: strengths & weaknesses, e.g., language function, memory, spatial ability

provides a baseline for rehab assessment

prognosis: level of expectation

done in conjunction with full neurological exam

27
Q

What are the principles of assessment?

A

identify presence and type of mild disturbances: interview has not yielded conclusions

differentiate between brain injury and psychological disorders (e.g., depression)

deficit evaluation and rehabilitation planning (e.g., degree of speech therapy in aphasia); preserved abilities too

evaluate effects of surgery and drug therapy

evaluate scholastic problems in children (e.g., emotional?)

provide objective data for research

legal forensics (detective work) for attribution of blame

legal assessment for suitability of a person to work, retain child custody, etc.

28
Q

What are the components of a Mini Mental State Exam (MMSE)?

A

orientation: year, month, day, date, season? where are we? probe for specificity

registration: name 3 unrelated objects & repeat back; presented as a recall task

attention & calculation: WORLD backwards, count back from 100 by 7’s (numbers)

recall: ask for names of three previous objects (delayed recall)

language: naming (watch), 3 stage commands, repeat “no ifs ands or buts”, write a sentence (spontaneous), copy geometric figure

29
Q

What are standardized test-batteries?

A

fixed criteria for organicity

distinguish between symptoms not related to brain pathology (designed to look at specific types of functioning; if poor score, then there is something wrong with the brain)

straightforward administration, scoring, & interpretation (comparative norms)

30
Q

What are individualized test-batteries?

A

testing tailored to patient (e.g., etiology, deficits)

requires theoretical knowledge to administer & interpret

more qualitative that quantitative (commonality of deficits across number of tasks)

31
Q

What are composite test-batteries?

A

middle ground

quantitative & qualitative

32
Q

What is the Halstead-Reitan battery?

A

standardized; 3-8 hours

abstract reasoning (categories test)

tactual performance (foam board with shapes)

rhythm test (nonverbal sounds - pairs S/D)

speech perception (“ee” nonsense syllables - choose from four)

10s finger-tapping

trail making (2 levels)

Wechsler Adult Intelligence Scale (WAIS-IV)

33
Q

What is the Wechsler Adult Intelligence Scale (WAIS-IV)?

A

verbal & nonverbal subsets (e.g., visuospatial; visuomotor)

some indices include: verbal comprehension, perceptual organization/reasoning, working memory (e.g., *5Y6U1), processing speed (e.g., visual search)

34
Q

What is the Rey Complex Figure?

A

geometric figure

ask people: copy the figure (have full vision of it while copying)

if deficit in copying: visual perceptual issue, likely not seeing it as a whole

is deficit specific to vision, perception, global LTM deficit? (delay task)

scoring: number of features and time to completion

34
Q

What is the Raven Progressive Matrices test?

A

what are the rules of the matrix?

rule for rows and rule for columns, piece needs to fit both

figure out relationship between objects to figure out the missing piece

34
Q

What is the Judgement of Line Orientation Test?

A

testing orientation

can have template always visible, or let them study the template then take it away

memory test

35
Q

What is the Dot Localization Test?

A

visuospatial processing to determine what numbers they would cover on the bottom

36
Q

What is measured in the Wisconsin Card Sorting task?

A

a person’s ability to categorize

a person’s ability to suppress a response; not get stuck on an idea

37
Q

What is the issue of validity in neuropsychological assessment?

A

construct validity: does it test targeted cognitive function?

localization validity: does it reflect focal lesions?

diagnostic validity: does is diagnose disease?

ecologic validity: does it predict everyday-relevant behavior

38
Q

What is the issue of reliability in neuropsychological assessment?

A

test-retest

doing it once, similar result the second time

39
Q

What is the issue of premorbid functioning in neuropsychological assessment?

A

performance levels prior to injury

low-functioning: risk of misattributing low scores to injury

high-functioning: risk of overlooking a dysfunction due to compensatory strategies

40
Q

What is the issue of compliance and malingering in neuropsychological assessment?

A

exaggerate mild deficit

extend deficit to match popular conception of deficit, even when deficit is legitimate

not always blatant “faking”: level of self awareness could be low

MMPI includes validity measures to help identify exaggerated or unrealistic response patterns (test question norms show even severely impaired people get it right)

professional discretion

41
Q

Infection

A

an invasion and multiplication of pathogenic microorganisms in body tissues and the reaction of the tissues to their presence and to the toxins they generate

42
Q

Viral Meningitis

A

inflammation of the brain’s triple-layered protective covering due to a bacterial or viral infection

43
Q

Bacterium

A

generic name for any microorganism (typically one-celled) that has no chlorophyll and multiples by simple cell division

44
Q

Bacterial Meningitis

A

inflammation of the brain’s triple-layered protective covering by a bacterial infection

45
Q

Brain Abscesses

A

a localized collection of pus in the brain

formed from tissues that have disintegrated as a result of infection

46
Q

Mycotic Infection

A

invasion of the nervous system by a fungus

47
Q

Parasite

A

a plant or an animal that lives on or within another living organism, at whose expense it obtains some advantage

48
Q

Amebiasis

A

an infection due to ameba that results in encephalitis and brain abscesses

also known as amebic dysentery

49
Q

Malaria

A

an infectious febrile disease caused by protozoa of teh genus Plasmodium, which are parasitic in red blood cells

transmitted by the bites of infected mosquitos

cerebral malaria arises when the plasmodia infect the brain’s capillaries, producing local hemorrhages and subsequent degeneration of neurons