Neuropsychological test

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Neuropsychological test
MeSH D009483

Neuropsychological tests are specifically designed tasks that are used to measure a psychological function known to be linked to a particular brain structure or pathway. [1] Tests are used for research into brain function and in a clinical setting for the diagnosis of deficits. They usually involve the systematic administration of clearly defined procedures in a formal environment. Neuropsychological tests are typically administered to a single person working with an examiner in a quiet office environment, free from distractions. As such, it can be argued that neuropsychological tests at times offer an estimate of a person's peak level of cognitive performance. Neuropsychological tests are a core component of the process of conducting neuropsychological assessment, along with personal, interpersonal and contextual factors.

Contents

Most neuropsychological tests in current use are based on traditional psychometric theory. In this model, a person's raw score on a test is compared to a large general population normative sample, that should ideally be drawn from a comparable population to the person being examined. Normative studies frequently provide data stratified by age, level of education, and/or ethnicity, where such factors have been shown by research to affect performance on a particular test. This allows for a person's performance to be compared to a suitable control group, and thus provide a fair assessment of their current cognitive function.

According to Larry J. Seidman, the analysis of the wide range of neuropsychological tests can be broken down into four categories. First is an analysis of overall performance, or how well people do from test to test along with how they perform in comparison to the average score. Second is left-right comparisons: how well a person performs on specific tasks that deal with the left and right side of the body. Third is pathognomic signs, or specific test results that directly relate to a distinct disorder. Finally, the last category is differential patterns, which are typically used to diagnose specific diseases or types of damage. [2]

Categories

Most forms of cognition actually involve multiple cognitive functions working in unison, however tests can be organised into broad categories based on the cognitive function which they predominantly assess. [3]

Intelligence

Intelligence testing in a clinical setting intelligence can involve premorbid estimates, determined through a number of methods, for comparison with obtained results. For example, test results can be compared to expected achievement levels based on prior education and occupation.

Memory

Memory is a very broad function which includes several distinct abilities, all of which can be selectively impaired and require individual testing. There is disagreement as to the number of memory systems, depending on the psychological perspective taken. From a clinical perspective, a view of five distinct types of memory, is in most cases sufficient. [3] Semantic memory and episodic memory (collectively called declarative memory or explicit memory); procedural memory and priming or perceptual learning (collectively called non-declarative memory or implicit memory) all four of which are long term memory systems; and working memory or short term memory. [4] Semantic memory is memory for facts, episodic memory is autobiographical memory, procedural memory is memory for the performance of skills, priming is memory facilitated by prior exposure to a stimulus and working memory is a form of short term memory for information manipulation. [5] [6] }

Language

Language functions include speech, reading and writing, all of which can be selectively impaired.[ citation needed ]}

Executive function

Executive functions is an umbrella term for a various cognitive processes and sub-processes. [7] The executive functions include: problem solving, planning, organizational skills, selective attention, inhibitory control and some aspects of short term memory. [8] }

Visuospatial

Neuropsychological tests of visuospatial function should cover the areas of visual perception, visual construction and visual integration. [9] Though not their only functions, these tasks are to a large degree carried out by areas of the parietal lobe. [3]

Dementia specific

Dementia testing is often done by way of testing the cognitive functions that are most often impaired by the disease e.g. memory, orientation, language and problem solving.

Batteries assessing multiple neuropsychological functions

There are some test batteries which combine a range of tests to provide an overview of cognitive skills. These are usually good early tests to rule out problems in certain functions and provide an indication of functions which may need to be tested more specifically.}

Automated computerized cognitive tests

Benefits of Neuropsychological Testing

The most beneficial factor of neuropsychological assessment is that it provides an accurate diagnosis of the disorder for the patient when it is unclear to the psychologist what exactly the patient has. This allows for accurate treatment later on in the process because treatment is driven by the exact symptoms of the disorder and how a specific patient may react to different treatments. The assessment allows the psychologist and patient to understand the severity of the deficit and to allow better decision-making by both parties. [10]

See also

Related Research Articles

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<span class="mw-page-title-main">Cognitive neuropsychology</span>

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Muriel Elaine Deutsch Lezak was an American neuropsychologist best known for her book Neuropsychological Assessment, widely accepted as the standard in the field. Her work has centred on the research, assessment, and rehabilitation of brain injury. Lezak was a professor of neurology at the Oregon Health and Science University School of Medicine.

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<span class="mw-page-title-main">Trail Making Test</span> Neuropsychological test

The Trail Making Test is a neuropsychological test of visual attention and task switching. It has two parts, in which the subject is instructed to connect a set of 25 dots as quickly as possible while maintaining accuracy. The test can provide information about visual search speed, scanning, speed of processing, mental flexibility, and executive functioning. It is sensitive to cognitive impairment associated with dementia, including Alzheimer's disease.

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The Halstead–Reitan Neuropsychological Test Battery (HRNB) and allied procedures is a comprehensive suite of neuropsychological tests used to assess the condition and functioning of the brain, including etiology, type, localization and lateralization of brain injury. The HRNB was first constructed by Ward C. Halstead, who was chairman of the Psychology Department at the University of Chicago, together with his doctoral student, Ralph Reitan. A major aim of administering the HRNB to patients was if possible to lateralize a lesion to either the left or right cerebral hemisphere by comparing the functioning on both sides of the body on a variety of tests such as the Suppression or Sensory Imperception Test, the Finger Agnosia Test, Finger Tip Writing, the Finger Tapping Test, and the Tactual Performance Test. One difficulty with the HRNB was its excessive administration time. In particular, administration of the Halstead Category Test was lengthy, so subsequent attempts were made to construct reliable and valid short-forms.

The Luria–Nebraska Neuropsychological Battery (LNNB) is a standardized test that identifies neuropsychological deficiencies by measuring functioning on fourteen scales. It evaluates learning, experience, and cognitive skills. The test was created by Charles Golden in 1981 and based on previous work by Alexander Luria that emphasizes a qualitative instead of quantitative approach. The original, adult version is for use with ages fifteen and over, while the Luria–Nebraska Neuropsychological Battery for Children (LNNB-C) can be used with ages eight to twelve; both tests take two to three hours to administer. The LNNB has 269 items divided among fourteen scales, which are motor, rhythm, tactile, visual, receptive speech, expressive speech, writing, reading, arithmetic, memory, intellectual processes, pathognomonic, left hemisphere, and right hemisphere. The test is graded on scales that are correlated to regions of the brain to help identify which region may be damaged. The Luria–Nebraska has been found to be reliable and valid; it is comparable in this sense to other neuropsychological tests in its ability to differentiate between brain damage and mental illness. The test is used to diagnose and determine the nature of cognitive impairment, including the location of the brain damage, to understand the patient's brain structure and abilities, to pinpoint causes of behavior, and to help plan treatment.

The Delis–Kaplan Executive Function System (D-KEFS) is a neuropsychological test used to measure a variety of verbal and nonverbal executive functions for both children and adults. This assessment was developed over the span of a decade by Dean Delis, Edith Kaplan, and Joel Kramer, and it was published in 2001. The D-KEFS comprises nine tests that were designed to stand alone. Therefore, there are no aggregate measures or composite scores for an examinee's performance. A vast majority of these tests are modified, pre-existing measures ; however, some of these measures are new indices of executive functions.

The Wechsler Test of Adult Reading (WTAR) is a neuropsychological assessment tool used to provide a measure of premorbid intelligence, the degree of Intellectual function prior to the onset of illness or disease.


The Boston Process Approach is a neurological assessment tool developed by Edith Kaplan and her colleagues, Harold Goodglass, Nelson Butters, Laird Cermak, and Norman Geschwind at the Boston Veterans Medical Center. The main purpose of the Boston Process Approach is to assess brain damage as well as cognitive impairments in patients through a series of tests that are related to memory, attention, intelligence, and other aspects of information processing. This approach is one of the more flexible and qualitative neurological assessments because it emphasizes how a patient performs a task instead of whether they succeeded or failed at it.

Developmental neuropsychology combines the fields of neuroscience and developmental psychology, while drawing from various other related disciplines. It examines the relationship of behavior and brain function throughout the course of an individual's lifespan, though often emphasis is put on childhood and adolescence when the majority of brain development occurs. Research tends to focus on development of important behavioral functions like perception, language, and other cognitive processes. Studies in this field are often centered around children or other individuals with developmental disorders or various kinds of brain related trauma or injury. A key concept of this field is that looks at and attempts to relate the psychological aspects of development, such as behavior, comprehension, cognition, etc., to the specific neural structures; it draws parallels between behavior and mechanism in the brain. Research in this field involves various cognitive tasks and tests as well as neuroimaging. Some of the many conditions studied by developmental neuropsychologists include congenital or acquired brain damage, autism spectrum disorder, attention deficit disorder, executive dysfunction, seizures, intellectual disabilities, obsessive compulsive disorder, stuttering, schizophrenia, developmental aphasia, and other learning delays such as dyslexia, dysgraphia, and dyspraxia.

References

  1. ↑ Boyle, G.J., Saklofske, D.H., & Matthews, G. (2012). (Eds.), SAGE Benchmarks in Psychology: Psychological Assessment, Vol. 3: Clinical Neuropsychological Assessment. London: SAGE. ISBN   978-0-85702-270-7
  2. ↑ Seidman, Larry J. (1998). Neuropsychological testing. Harvard Mental Health Letter, 14 (11), 4-6.
  3. 1 2 3 Lezak, Muriel D.; Howieson, Diane B.; Bigler, Erin D.; Tranel, Daniel (2012). Neuropsychological Assessment (Fifth ed.). Oxford: Oxford University Press. ISBN   978-0-19-539552-5 . Retrieved 17 June 2014.
  4. ↑ Mayes, A. R. (2000). "The neuropsychology of memory". In Berrios, G. E.; Hodges, J. R (eds.). Memory disorders in psychiatric practice. Cambridge: Cambridge University Press. p. 506. ISBN   978-0-521-57671-0.
  5. ↑ Mayes, A.R. (1988). Human organic memory disorders. New York: Cambridge University Press. p. 300. ISBN   978-0-521-34418-0.
  6. ↑ Baddeley, A. (1992). "Working Memory". Science. 255 (5044): 556–559. Bibcode:1992Sci...255..556B. doi:10.1126/science.1736359. JSTOR   2876819. PMID   1736359.
  7. ↑ Elliot R. (2003). "Executive functions and their disorders". British Medical Bulletin. 65 (1): 49–59. doi: 10.1093/bmb/65.1.49 . PMID   12697616.
  8. ↑ Morgan, A. B.; Lilienfeld, S. O. (2000). "A meta-analytic review of the relation between antisocial behaviours and neuropsychological measures of executive function". Clinical Psychology Review. 20 (1): 113–136. doi:10.1016/S0272-7358(98)00096-8. PMID   10660831. S2CID   8544684.
  9. ↑ Hebben, N.; Millberg, W. (2009). Essentials of Neuropsychological Assessment (2nd ed.). New Jersey: John Wiley & Sons. pp.  127. ISBN   978-0-470-43747-6.>
  10. ↑ "Neuropsychological and Psychoeducational Testing for Children and Adults". New York Assessment. December 2015. Retrieved 11 February 2016.

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