Lecture 2: Introduction to Neuropsychological Assessment

Question 1

Dissociative Seizures

Answer 1

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

Question 2

Tumors

Answer 2

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

Question 3

Glioma

Answer 3

any brain tumor arises from glial cells

Question 4

Meningiomas

Answer 4

an encapsulated brain tumor that grows from the meninges

Question 5

Metastatic Tumor

Answer 5

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

Question 6

What is mass action?

Answer 6

Karl Lashley (1920’s)

search for engram using rats

belief that extent of damage more important than locus

equipotentiality & plasticity

Question 7

What is localization of function?

Answer 7

surgical patients (Penfield)

non-human animal studies

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

Question 8

What is modularity of mind?

Answer 8

Jerry Fodor (1980’s)

encapsulated processes

essential, automatic, very fast, highly specialized systems

face recognition?

Question 9

What is a closed head injury?

Answer 9

acceleration/deceleration

no penetration of the skull but still damage

Question 10

What is cerebral oedema?

Answer 10

swelling

trauma, impact, tumors

Question 11

What is infarction?

Answer 11

neuronal necrosis due to loss of blood supply

cut off of blood supply

Question 12

What is a stroke?

Answer 12

sudden loss of blood supply

Question 13

What is ischaemia?

Answer 13

decreased blood flow due to narrowing or blockage

buildup of plaques, narrowing blood vessels, complete blockage

Question 14

What is thrombosis?

Answer 14

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

piece has broken off and travelled

Question 15

What is a hemorrhage?

Answer 15

burst in a blood vessel

Question 16

What is a tumor?

Answer 16

invasion, displacement, compression

originates in glial cells

infiltrating, hard to remove

Question 17

What is anoxia?

Answer 17

complete absence of oxygen

Question 18

What is hypoxia?

Answer 18

% absence of oxygen

Question 19

What is encephalopathy?

Answer 19

inflammation (disease/damage, toxic, physical agents)

pressure, tumor, hydrocephalus

Question 20

What is encephalitis?

Answer 20

inflammation (infection)

Question 21

What is hydrocephalus?

Answer 21

overproduction or decrease in absorption of CSF

Question 22

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

Answer 22

specific links between brain and mind (behavior)

lesion method (any type of damage)

two conceptual approaches: neural substrates, cognitive function

Question 23

What is double dissociation?

Answer 23

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

Question 24

What are the caveats to neuropsychological assessment?

Answer 24

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

lesion variability

etiology variability

indirect observation

Question 25

What are neuropsychological assessment in neurologically intact individuals?

Answer 25

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

Question 26

What is clinical neuropsychological assessment?

Answer 26

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

Question 27

What are the principles of assessment?

Answer 27

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.

Question 28

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

Answer 28

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

Question 29

What are standardized test-batteries?

Answer 29

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)

Question 30

What are individualized test-batteries?

Answer 30

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)

Question 31

What are composite test-batteries?

Answer 31

middle ground quantitative & qualitative

Question 32

What is the Halstead-Reitan battery?

Answer 32

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)

Question 33

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

Answer 33

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)

Question 34

What is the Rey Complex Figure?

Answer 34

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

Question 34

What is the Raven Progressive Matrices test?

Answer 34

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

Question 34

What is the Judgement of Line Orientation Test?

Answer 34

testing orientation can have template always visible, or let them study the template then take it away memory test

Question 35

What is the Dot Localization Test?

Answer 35

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

Question 36

What is measured in the Wisconsin Card Sorting task?

Answer 36

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

Question 37

What is the issue of validity in neuropsychological assessment?

Answer 37

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

Question 38

What is the issue of reliability in neuropsychological assessment?

Answer 38

test-retest doing it once, similar result the second time

Question 39

What is the issue of premorbid functioning in neuropsychological assessment?

Answer 39

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

Question 40

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

Answer 40

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

Question 41

Infection

Answer 41

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

Question 42

Viral Meningitis

Answer 42

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

Question 43

Bacterium

Answer 43

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

Question 44

Bacterial Meningitis

Answer 44

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

Question 45

Brain Abscesses

Answer 45

a localized collection of pus in the brain formed from tissues that have disintegrated as a result of infection

Question 46

Mycotic Infection

Answer 46

invasion of the nervous system by a fungus

Question 47

Parasite

Answer 47

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

Question 48

Amebiasis

Answer 48

an infection due to ameba that results in encephalitis and brain abscesses also known as amebic dysentery

Question 49

Malaria

Answer 49

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