What is Neuropsychology?
The brain is an organ of behavior. Neuropsychology is concerned with relationships between the brain and behavior. An evaluation is conducted to characterize behavioral and cognitive changes resulting from central nervous system disease or injury. Some neuropsychologists also focus on remediation of or adaptation to these behavioral and mental changes and other symptoms.
What is a Neuropsychological Evaluation?
A Neuropsychological evaluation is an assessment of brain functioning, which indirectly yields information about the structural and functional integrity of your brain.
Neuropsychological tests evaluate functioning in a number of areas including: intelligence, executive functions (such as planning, abstraction, conceptualization), attention, memory, language, visual perception, sensorimotor functions, motivation, mood state and emotion, quality of life, and personality styles.
The areas addressed in an individual's evaluation are determined by the referral question (what the referring doctor and patient wants to know), the patient's complaints and symptoms, and observations made during the neurobehavioral interview and test administration.
The neuropsychological evaluation involves an extensive interview, review of records, and the administration of tests. The tests are typically pencil and paper type tests. The tests require administration by a trained, skilled, and licensed clinican.
Neuropsychological tests (unlike bedside cognitive and behavioral neurologic screens) are standardized, meaning that they are given in the same manner to all individuals and scored in a similar manner time after time.
The data is used to determine whether one's performance on any given task represents a strength or weakness. Although individual scores are important, comprehensive data from the entire evaluation is used to determine a pattern of cognitive strengths and weaknesses and, in turn, to understand more about how the brain is functioning.
How long does a Neuropsychological Evaluation take?
A complete evaluation generally takes 10-13 hours to complete, however, may require more time depending on the complexity of the issues to be addressed by the evaluation and the patient's condition (for example, extent of physical injury, language abilities, fatigue, confusion, and motor slowing can extend the time required for an evaluation). Occasionally, it is necessary to complete the evaluation over 2 or more sessions as the clinician attempts to elicit the patient's best possible performance under optimal conditions.
Why has a Neuropsychological Evaluation been recommended?
Neuropsychological evaluation documents patterns of strengths and weakness among cognitive and behavioral functions. For example, in patients with Parkinson's disease or another movement disorder, an evaluation and interpretation of patterns of strengths and weaknesses can:
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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).
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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.
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Provide a baseline against which subsequent evaluations can be compared. In this way, 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 Deep brain Stimulation/DBS).
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Reveal areas of daily functioning (e.g., financial management) with which a patient may need assistance or 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, but there are several things that one can do to facilitate the evaluation:
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The patient should bring a current list of ALL medications and doses (because medicines may change frequently for some persons, it is important to make sure the list is up to date)
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If the patient has difficulty providing information about their history, it is helpful for a family member or friend to accompany them (for at least part of the clinical interview).
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It is helpful if the patient can provide records of previous neurodiagnostic testing (e.g., brain scans such as CT or MRI scans) and/or results from previous neuropsychological evaluations if completed at another hospital or institution.
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It will also be helpful to complete the questionnaire provided on this site prior to the initial appointment.
It is the my goal to get the best possible picture of a patient's current functioning. Several things can interfere with this goal, for instance if the patient is:
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Excessively tired or fatigued
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Not motivated to put forth their best effort
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Very emotionally distraught or has a severe psychiatric condition
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Under the influence of medications or illicit substances which interfere with cognitive functioning
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Experiencing frequent changes in the ability to move
You should let the clinician know if you anticipate that any of these issues are likely to interfere with the evaluation.
It is important to get a good night's rest before evaluation. Individuals who live far away might consider spending the evening prior to the evaluation at a local hotel or with friends/family rather than getting up and driving/flying most of the night to get to the appointment.
You are encouraged not to consume any alcohol 24 hours prior to the evaluation. If taking sleep medicine, you should check with your doctor whether it might affect test performance the next day.
Individuals should not worry about whether they will "pass" the tests. The tests cannot be passed or failed; instead they describe how well persons perform relative to peers.