Week 1: Introduction
Article by Miller & Barr (2017):
Miller and Barr discuss the growing challenges that the field of neuropsychology faces due to the
rapid advancement of technology. They highlight the tension between traditional neuropsychological
assessments and the integration of new technological tools, such as computerized tests and
neuroimaging. The article emphasizes the need for neuropsychologists to adapt to technological
changes while maintaining the core principles of their practice, such as the importance of clinical
judgement and the human element of patient care.
The authors argue that while technology offers many potential benefits, including more objective data
collection and greater efficiency, as well as objective measures and more precise assessments of brain
functions, it also raises concerns. These concerns include the potential of over reliance on technology,
the need for proper validation of new tools, and the risk that technology could undermine the personal
connection between clinician and patient. In addition, the human element of understanding the
patient’s personal history, symptoms and behaviour is difficult to replicate with technology. The new
tools need to meet the standards of traditional neuropsychological methods, including evaluating their
reliability, validity and accuracy before integrating them into clinical practice.
The article calls for careful consideration of how best to incorporate technology into neuropsychology
practice, ensuring that it enhances rather than detracts from the clinical process. It also discusses the
necessity for ongoing training and education to ensure that practitioners stay current with
technological advances without losing sight of the discipline’s foundational principles.
Article by Kessels (2018):
In this article, Kessels discusses the need for enhanced precision in neuropsychological assessment,
particularly when diagnosing cognitive impairments. The article highlights the limitations of
traditional paper-and-pencil tests, which have long been used in neuropsychological evaluations.
These tests often lack the sensitivity and specificity needed to assess cognitive function in a way tat
aligns with advances in cognitive neuroscience. This leads to potential oversimplifications or missed
diagnoses. Paper-and-pencil tests also tend to focus on aggregate scores, missing more nuanced
cognitive patterns that could be important in diagnosing certain conditions like Alzheimer’s disease or
traumatic brain injury.
Cognitive neuroscience has made significant strides in understanding brain-behaviour relationships,
using advanced imaging techniques (like fMRI and EEG) and experimental paradigms that assess
cognitive functions more directly and precisely. For instance, tasks that measure brain responses in
real-time, such as reaction times, brain activation patterns and error rates, offer a more detailed picture
of cognitive processes. Kessels argues that these approaches can be more sensitive to the subtleties of
cognitive decline and dysfunction, especially in early stages of neurodegenerative diseases.
,The main thesis of Kessels’ article is the need to bridge the gap between these two domains. He
suggests that by integrating modern cognitive neuroscience tools (e.g., computer-based tasks that
measure reaction times or attention) into neuropsychological assessments, clinicians can obtain a
more accurate and comprehensive understanding of an individual’s cognitive state. This hybrid
approach would help create a more individualized, precise assessment that is better suited to detecting
early-stage cognitive impairments or subtle deficits that may not be captured by traditional methods.
Kessels discusses the potential for new assessment tools to be implemented in clinical practice, such
as the use of virtual reality, more sophisticated neuroimaging technologies and behavioural tasks with
greater ecological validity. There is also a call to standardize and validate these new methods,
ensuring that they are reliable and applicable across diverse clinical populations. The combination of
traditional tests with more advanced neuroscience tools would not only improve diagnosis but also
guide more personalized treatment plans and interventions.
The article emphasizes the evolving role of neuropsychologists, who must now be skilled in both
traditional and emerging techniques. Clinicians are encouraged to incorporate cognitive neuroscience
findings into their assessments, keeping pace with scientific advancements. Kessels also highlights the
importance of interdisciplinary collaboration - bringing together neuropsychologists, neuroscientists,
and clinicians in broader healthcare terms to ensure that the tools used in clinical settings are
reflective of the latest research in brain science.
Article by Parsons & Duffield (2020):
Parsons and Duffield examines the evolving landscape of neuropsychology in response to
technological advancements. The authors argue that integrating emerging technologies, such as novel
sensors, virtual reality and mobile devices, can transform neuropsychological assessment from
traditional, low-dimensional tools to more dynamic, high-dimensional evaluations.
Traditional assessments often rely on static, paper-and-pencil methods with limited data capture
capabilities. These tools may not fully encapsulate the complexity of cognitive functions. Emerging
technologies offer opportunities for richer data collection and analysis. The NIH has identified four
main advances influencing scientific priorities:
- integration of neuroscience into behavioural and social sciences
- transformational advances in measurement science
- development of digital intervention platforms
- establishment of large-scale population cohorts and data integration
Embracing these technological advancements is essential for the field’s relevance and growth. There
is a need to update training programs to include technical skills, such as programming and data
analysis. Ethical and legal considerations must be addressed as digital tools become more prevalent in
assessment. The authors include that integrating digital technologies into neuropsychology can lead to
a more cohesive, darta-rich science, enhancing both research and clinical practices.
,Lecture:
Standard brain games such as ‘Lumosity’ and ‘Brain Training’ by Nintendo have claimed that brain
trainings can:
- improve performance in school/work
- delay age-related cognitive decline
- reduce impairment from health conditions
However, psychological studies have found these claims to be untrue, there was little evidence that
training enhances performance on distant related tasks or that training improves every day cognitive
performance. There is ongoing research and discussion, mainly about the near and transfer effects:
- near effect: “I get better on the task I’m training”
- far effect: doing a task that helps performance outside the task
The development of technology has significantly increased, where we used to have passive
technology (an old computer), then we had active technology (scrolling on your phone), we know also
have interactive technology (interaction with the device such as gaming but also interacting with other
people through technology). Other examples where technology has majorly increased are in:
- navigation
- education
- sports
But when we look at technology and neuropsychology, especially compared to neurology and
neuroscience, we see that our field is lacking behind. There is a large difference in the disciplines
when it comes to scientific publications including ‘computer’, ‘technology’ or ‘neuroimaging’. One of
the examples where technology is used in neuropsychology is the app ‘MetaSquare. There are several
reasons why it seems important that the field of neuropsychology innovates:
- technical development -> it is available, so let’s use it
- scientific motivation -> more insights into cognitive functions, deeper understanding of
mechanisms and disorders
- less limitation than existing materials -> more data, maybe more reliable and less susceptible
to issues
When we look at innovations in diagnostics, we see that computer-based assessment of cognition is
mainly used in the military and sports. Especially in the military, since there is more money, more
need for efficiency and less ethical standards. In clinical practice, these innovations are not used so
much. There are financial costs that can’t be covered, there is lack of normative data and concerns
about utility and validity. Rather than innovations, in CNP we mainly see digital versions of existing
standardized materials.
A study was done on neurocognitive assessment tools (NCATs) for military personnel with mTBI
after which the following recommendations for healthcare professionals were made:
- use cautiously (not standalone)
- use what “feel best fits their needs and target population”
- consider age and education as context
- remain aware of forthcoming recommendations
, Of course there are advantages as well as disadvantages of computerized NCATs:
- advantages:
- tailoring to specific needs
- ease of use
- reducing human error
- mimicking everyday situations -> measuring everyday function
- remote and portable testing
- disadvantages:
- norm data not directly transferable -> validity and reliability need to be proven
- technical requirements
- training of clinicians
- cognitive processes possibly different for digital environment
- cybersickness
- novelty costs (adjustment time needed)
- privacy issues (data storage)
A study was done on the ecological validity of VR diagnostics. When looking at locomotion in
different settings, it was found that the conditions affected performance selectively:
- landmark and route knowledge were unaffected in the different conditions
- only locomotion benefits from survey knowledge
When looking at innovations in treatment tools, these are even less developed than diagnostics. But,
there is a rapid increase. Most well-studied tools focus mostly on physical therapy. For treatment, it’s
about compensation and restoration:
- compensation = use of other functions, which reduces the impairment (e.g., changing
cognitive strategies). Situations can be presented in which the alternative strategy is used
- restoration = improve lost/reduced functions (e.g., memory training). Relevant situations can
be presented that stimulate function use
Some ethical considerations on this include:
- real or virtual?
- social interactions?
- level of understanding for patients?
eHealth is an emerging field in the intersection of medical informatics, public health business,
referring to health services and information delivered or enhanced through the internet and related
technologies. It includes: tracking and monitoring, communication, records, and self-management.
The goals are to improve access to health care resources, educate and support patients and caregivers,
empower patients to become active in disease management and treatment, and improve understing of
disease (progression).
Article by Miller & Barr (2017):
Miller and Barr discuss the growing challenges that the field of neuropsychology faces due to the
rapid advancement of technology. They highlight the tension between traditional neuropsychological
assessments and the integration of new technological tools, such as computerized tests and
neuroimaging. The article emphasizes the need for neuropsychologists to adapt to technological
changes while maintaining the core principles of their practice, such as the importance of clinical
judgement and the human element of patient care.
The authors argue that while technology offers many potential benefits, including more objective data
collection and greater efficiency, as well as objective measures and more precise assessments of brain
functions, it also raises concerns. These concerns include the potential of over reliance on technology,
the need for proper validation of new tools, and the risk that technology could undermine the personal
connection between clinician and patient. In addition, the human element of understanding the
patient’s personal history, symptoms and behaviour is difficult to replicate with technology. The new
tools need to meet the standards of traditional neuropsychological methods, including evaluating their
reliability, validity and accuracy before integrating them into clinical practice.
The article calls for careful consideration of how best to incorporate technology into neuropsychology
practice, ensuring that it enhances rather than detracts from the clinical process. It also discusses the
necessity for ongoing training and education to ensure that practitioners stay current with
technological advances without losing sight of the discipline’s foundational principles.
Article by Kessels (2018):
In this article, Kessels discusses the need for enhanced precision in neuropsychological assessment,
particularly when diagnosing cognitive impairments. The article highlights the limitations of
traditional paper-and-pencil tests, which have long been used in neuropsychological evaluations.
These tests often lack the sensitivity and specificity needed to assess cognitive function in a way tat
aligns with advances in cognitive neuroscience. This leads to potential oversimplifications or missed
diagnoses. Paper-and-pencil tests also tend to focus on aggregate scores, missing more nuanced
cognitive patterns that could be important in diagnosing certain conditions like Alzheimer’s disease or
traumatic brain injury.
Cognitive neuroscience has made significant strides in understanding brain-behaviour relationships,
using advanced imaging techniques (like fMRI and EEG) and experimental paradigms that assess
cognitive functions more directly and precisely. For instance, tasks that measure brain responses in
real-time, such as reaction times, brain activation patterns and error rates, offer a more detailed picture
of cognitive processes. Kessels argues that these approaches can be more sensitive to the subtleties of
cognitive decline and dysfunction, especially in early stages of neurodegenerative diseases.
,The main thesis of Kessels’ article is the need to bridge the gap between these two domains. He
suggests that by integrating modern cognitive neuroscience tools (e.g., computer-based tasks that
measure reaction times or attention) into neuropsychological assessments, clinicians can obtain a
more accurate and comprehensive understanding of an individual’s cognitive state. This hybrid
approach would help create a more individualized, precise assessment that is better suited to detecting
early-stage cognitive impairments or subtle deficits that may not be captured by traditional methods.
Kessels discusses the potential for new assessment tools to be implemented in clinical practice, such
as the use of virtual reality, more sophisticated neuroimaging technologies and behavioural tasks with
greater ecological validity. There is also a call to standardize and validate these new methods,
ensuring that they are reliable and applicable across diverse clinical populations. The combination of
traditional tests with more advanced neuroscience tools would not only improve diagnosis but also
guide more personalized treatment plans and interventions.
The article emphasizes the evolving role of neuropsychologists, who must now be skilled in both
traditional and emerging techniques. Clinicians are encouraged to incorporate cognitive neuroscience
findings into their assessments, keeping pace with scientific advancements. Kessels also highlights the
importance of interdisciplinary collaboration - bringing together neuropsychologists, neuroscientists,
and clinicians in broader healthcare terms to ensure that the tools used in clinical settings are
reflective of the latest research in brain science.
Article by Parsons & Duffield (2020):
Parsons and Duffield examines the evolving landscape of neuropsychology in response to
technological advancements. The authors argue that integrating emerging technologies, such as novel
sensors, virtual reality and mobile devices, can transform neuropsychological assessment from
traditional, low-dimensional tools to more dynamic, high-dimensional evaluations.
Traditional assessments often rely on static, paper-and-pencil methods with limited data capture
capabilities. These tools may not fully encapsulate the complexity of cognitive functions. Emerging
technologies offer opportunities for richer data collection and analysis. The NIH has identified four
main advances influencing scientific priorities:
- integration of neuroscience into behavioural and social sciences
- transformational advances in measurement science
- development of digital intervention platforms
- establishment of large-scale population cohorts and data integration
Embracing these technological advancements is essential for the field’s relevance and growth. There
is a need to update training programs to include technical skills, such as programming and data
analysis. Ethical and legal considerations must be addressed as digital tools become more prevalent in
assessment. The authors include that integrating digital technologies into neuropsychology can lead to
a more cohesive, darta-rich science, enhancing both research and clinical practices.
,Lecture:
Standard brain games such as ‘Lumosity’ and ‘Brain Training’ by Nintendo have claimed that brain
trainings can:
- improve performance in school/work
- delay age-related cognitive decline
- reduce impairment from health conditions
However, psychological studies have found these claims to be untrue, there was little evidence that
training enhances performance on distant related tasks or that training improves every day cognitive
performance. There is ongoing research and discussion, mainly about the near and transfer effects:
- near effect: “I get better on the task I’m training”
- far effect: doing a task that helps performance outside the task
The development of technology has significantly increased, where we used to have passive
technology (an old computer), then we had active technology (scrolling on your phone), we know also
have interactive technology (interaction with the device such as gaming but also interacting with other
people through technology). Other examples where technology has majorly increased are in:
- navigation
- education
- sports
But when we look at technology and neuropsychology, especially compared to neurology and
neuroscience, we see that our field is lacking behind. There is a large difference in the disciplines
when it comes to scientific publications including ‘computer’, ‘technology’ or ‘neuroimaging’. One of
the examples where technology is used in neuropsychology is the app ‘MetaSquare. There are several
reasons why it seems important that the field of neuropsychology innovates:
- technical development -> it is available, so let’s use it
- scientific motivation -> more insights into cognitive functions, deeper understanding of
mechanisms and disorders
- less limitation than existing materials -> more data, maybe more reliable and less susceptible
to issues
When we look at innovations in diagnostics, we see that computer-based assessment of cognition is
mainly used in the military and sports. Especially in the military, since there is more money, more
need for efficiency and less ethical standards. In clinical practice, these innovations are not used so
much. There are financial costs that can’t be covered, there is lack of normative data and concerns
about utility and validity. Rather than innovations, in CNP we mainly see digital versions of existing
standardized materials.
A study was done on neurocognitive assessment tools (NCATs) for military personnel with mTBI
after which the following recommendations for healthcare professionals were made:
- use cautiously (not standalone)
- use what “feel best fits their needs and target population”
- consider age and education as context
- remain aware of forthcoming recommendations
, Of course there are advantages as well as disadvantages of computerized NCATs:
- advantages:
- tailoring to specific needs
- ease of use
- reducing human error
- mimicking everyday situations -> measuring everyday function
- remote and portable testing
- disadvantages:
- norm data not directly transferable -> validity and reliability need to be proven
- technical requirements
- training of clinicians
- cognitive processes possibly different for digital environment
- cybersickness
- novelty costs (adjustment time needed)
- privacy issues (data storage)
A study was done on the ecological validity of VR diagnostics. When looking at locomotion in
different settings, it was found that the conditions affected performance selectively:
- landmark and route knowledge were unaffected in the different conditions
- only locomotion benefits from survey knowledge
When looking at innovations in treatment tools, these are even less developed than diagnostics. But,
there is a rapid increase. Most well-studied tools focus mostly on physical therapy. For treatment, it’s
about compensation and restoration:
- compensation = use of other functions, which reduces the impairment (e.g., changing
cognitive strategies). Situations can be presented in which the alternative strategy is used
- restoration = improve lost/reduced functions (e.g., memory training). Relevant situations can
be presented that stimulate function use
Some ethical considerations on this include:
- real or virtual?
- social interactions?
- level of understanding for patients?
eHealth is an emerging field in the intersection of medical informatics, public health business,
referring to health services and information delivered or enhanced through the internet and related
technologies. It includes: tracking and monitoring, communication, records, and self-management.
The goals are to improve access to health care resources, educate and support patients and caregivers,
empower patients to become active in disease management and treatment, and improve understing of
disease (progression).
