Neuropsychological
Assessment
- Samenvatting Hoorcolleges
2020-2021
1
,Hoorcollege 1 Introduction
– geraldina gaastra
Neuropsychologist has a lot of tasks, including testing, multidisciplinary meetings etc.
Learning goals
- Basic skills that are important for neuropsychological assessments:
o Determine for which disorders the neuropsychological tests that were introduced
can be used
o Interpret the results of a neuropsychological assessment
o Use the neuropsychological tests that were introduced in differential diagnostics
o Integrate and interpret the results of multiple neuropsychological tests
o Critically judge the use of tests with regard to the manual, test instructor, behavior of
the patient and environmental factors.
Case report:
- Focused on writing a neuropsychological report
- Complete the neuropsychological report by writing:
o Hypotheses, including supporting arguments
o Test results of tests that were not described yet
o Conclusion
o Advice
o Reflection
- Deadline 1 nov – 1 group member can email GG the report
Video assignment:
- Focused on gaining knowledge about tests
o Assessments in healthy individual
o Assessments in patient
o Assessment with examiner making errors
- Answer questions related to these videos
- 2 chances
- Deadline 22 okt
Exam:
- 6 nov 12.15-14.15
- 4 or 5 open essay questions
- Digital home exam
Literature for video is not part of exam – exam only lectures and reading list
2
,Purpose
1. Diagnosis
- Distinguish between different neurological disorders (e.g. different types of dementia)
- Discriminating between psychiatric and neurological disorders
- Identifying a possible neurological disorder (when there is a strong suspicion of a
neuropsychological disorder)
- Neuropsychological assessment cannot localize the site of a lesion! So we can not make
statements about the damaged brain areas. Only say something about functions that are
impaired. Therefore you would need:
o Neuroimaging techniques (MRI, PET)
o Brain networks
different brain areas that are involved during a task
2. Patient care and planning
- Identifying cognitive strengths and weaknesses
- Identifying behavioral alterations
- Identifying personality characteristics
o needed for optimal and careful management of many disorders
o irrespective of a diagnosis
3. Treatment planning and remediation
- What is the most appropriate cognitive rehabilitation treatment
4. Treatment evaluation
- Did the treatment have an effect? Is there improvement, and for which functions?
5. Research
6. Forensic neuropsychology
- In the context of claims of injury and loss of function
- In criminal cases:
o Is there reason to suspect brain dysfunction that contributes to misbehavior?
o Is the defendants mental capacity sufficient to stand trial?
Neuropsychological assessment: Diagnostic cycle
NPA starts with referral questions (e.g. can complaints be objectified?). When there are
discrepancies between anamnesis and heteroanamnesis this can mean that the patient has little
insight.
3
, Evidence-based medicine : take into account
Clinical judgement, relevant scientific
Evidence and patients values and
Preferences.
Why hypotheses?
If you do not formulate hypotheses and go through the diagnostic cycle you will easily make
interpretation errors.
Interpretation errors:
- The tendency to rely strongly on some results and to disregard others
- Disregarding the base rate of disorders
o A neuropsychologist who works a lot with patients with Alzheimer’s disease will have
the tendency to diagnose AD more often.
- Confirmation bias
o Looking for results that support the hypotheses
- Thinking that subjective complaints are objective disorders
Neuropsychological assessment: Two classical approaches
4
Assessment
- Samenvatting Hoorcolleges
2020-2021
1
,Hoorcollege 1 Introduction
– geraldina gaastra
Neuropsychologist has a lot of tasks, including testing, multidisciplinary meetings etc.
Learning goals
- Basic skills that are important for neuropsychological assessments:
o Determine for which disorders the neuropsychological tests that were introduced
can be used
o Interpret the results of a neuropsychological assessment
o Use the neuropsychological tests that were introduced in differential diagnostics
o Integrate and interpret the results of multiple neuropsychological tests
o Critically judge the use of tests with regard to the manual, test instructor, behavior of
the patient and environmental factors.
Case report:
- Focused on writing a neuropsychological report
- Complete the neuropsychological report by writing:
o Hypotheses, including supporting arguments
o Test results of tests that were not described yet
o Conclusion
o Advice
o Reflection
- Deadline 1 nov – 1 group member can email GG the report
Video assignment:
- Focused on gaining knowledge about tests
o Assessments in healthy individual
o Assessments in patient
o Assessment with examiner making errors
- Answer questions related to these videos
- 2 chances
- Deadline 22 okt
Exam:
- 6 nov 12.15-14.15
- 4 or 5 open essay questions
- Digital home exam
Literature for video is not part of exam – exam only lectures and reading list
2
,Purpose
1. Diagnosis
- Distinguish between different neurological disorders (e.g. different types of dementia)
- Discriminating between psychiatric and neurological disorders
- Identifying a possible neurological disorder (when there is a strong suspicion of a
neuropsychological disorder)
- Neuropsychological assessment cannot localize the site of a lesion! So we can not make
statements about the damaged brain areas. Only say something about functions that are
impaired. Therefore you would need:
o Neuroimaging techniques (MRI, PET)
o Brain networks
different brain areas that are involved during a task
2. Patient care and planning
- Identifying cognitive strengths and weaknesses
- Identifying behavioral alterations
- Identifying personality characteristics
o needed for optimal and careful management of many disorders
o irrespective of a diagnosis
3. Treatment planning and remediation
- What is the most appropriate cognitive rehabilitation treatment
4. Treatment evaluation
- Did the treatment have an effect? Is there improvement, and for which functions?
5. Research
6. Forensic neuropsychology
- In the context of claims of injury and loss of function
- In criminal cases:
o Is there reason to suspect brain dysfunction that contributes to misbehavior?
o Is the defendants mental capacity sufficient to stand trial?
Neuropsychological assessment: Diagnostic cycle
NPA starts with referral questions (e.g. can complaints be objectified?). When there are
discrepancies between anamnesis and heteroanamnesis this can mean that the patient has little
insight.
3
, Evidence-based medicine : take into account
Clinical judgement, relevant scientific
Evidence and patients values and
Preferences.
Why hypotheses?
If you do not formulate hypotheses and go through the diagnostic cycle you will easily make
interpretation errors.
Interpretation errors:
- The tendency to rely strongly on some results and to disregard others
- Disregarding the base rate of disorders
o A neuropsychologist who works a lot with patients with Alzheimer’s disease will have
the tendency to diagnose AD more often.
- Confirmation bias
o Looking for results that support the hypotheses
- Thinking that subjective complaints are objective disorders
Neuropsychological assessment: Two classical approaches
4
