Brain and Cognition 2: Clinical
Neuropsychology
Docentgegevens
Staff:
Examination ():
Multiple Choice Exam
1
,Content Book and Other Literature
Chapter/Lecture Content Page
Chapter 3 Neuropsychology in clinical practice 3
Chapter 18 Alcohol-related cognitive disorders 6
Lecture 2 Korsakoff’s syndrome and alcohol-related cognitive disorders 8
Chapter 19 Alzheimer’s disease 12
Lecture 3 Mild cognitive impairment and Alzheimer’s dementia 16
Chapter 13 Vascular cognitive impairment 19
Chapter 23 Multiple Sclerosis 21
Lecture 4 Multiple sclerosis 23
Chapter 15 Epilepsy 24
Lecture 5 Epilepsy 27
Chapter 21 The parkinson’s disease spectrum 29
Lecture 6 Parkinson’s Disease 31
Chapter 5 Plasticity, recovery and neuropsychological rehabilitation 33
Lecture 7 Neuropsychological rehabilitation 34
2
,Week 1
Chapter 3: Neuropsychology in clinical practice
Introduction
Neuropsychological assessment starts with a research question, after which a hypothesis is formed.
This is followed by data collection (medical background, clinical interview, interview with informant,
observation, test results and questionnaires. The collected data results in a conclusion. There will also
be a neuropsychological treatment in which evidence-based treatments are prioritized. Finally an
evaluation will take place, preferably an objective evaluation.
Areas of expertise
Neuropsychologist work in various fields of health care.
Hospital
Mental health care
Rehabilitation care
Long-term care
Forensic care
Neuropsychological assessment
The neuropsychological examination
The psychologists working in the field of technical neuropsychology has knowledge of the
relationship between brain abnormalities, cognition, emotion dysregulation and problematic behavior.
The neuropsychological examination is an important diagnostic method to research these relationships
within one individual. Neuropsychological
examinations consists of a complete hypothesis-
testing diagnostic cycle Analysys Analysys of
Referral complaints problems
1. Complaints analysis interview with
patient & interview with informant
2. Problem analysis tests
3. Diagnosis Analysis of Analysis of
4. Indication for treatment Treatment
indication cause
Every stage gets a hypothesis. These hypothesis gets
tested using data from
observations, interviews, Referral
question
neuropsychological tests and
questionnaires. The hypothesis Evaluation Interview
can be adjusted and rejected at with patient
any time.
Reporting Interview with
informant
Interpretation
Observation
Testing and
questionnaires
3
, Referral question and definition of the problem
A neurological assessment starts with a referral from a medical specialist. The patient gets referred
with a specific question to be assessed. During the assessment neuropsychologists might formulate
additional questions if necessary.
Interview with the patient
Purposes of interviewing a patient:
Collecting information
o Complaints
o Symptoms
o Progression
o Education
o Occupation
o Medication
o Medical history
A standard question list will not suffice. A positive note about interviewing the patient is that you are
building a working relationship.
Interview with the informant
The patient may not always be a reliable source of intel. This intel can come from a partner, child,
parent, neighbor, friend. The rule is that the patient has to agree with the interview.
Observation
As soon as the patient is spotted the observation starts. It is important that the observations are free
from interpretation.
Neuropsychological assessment
Reliability
test-retest same results, different time with same patient.
Inter-rater Same results, different researcher (Cohens kappa)
Validity
Face-validity (indrukvaliditeit) measure what it is supposed to measure
Content-validity (inhoudvaliditeit) extent to which a test is representative to the topic
Construct-validity (begripvaliditeit) measure which measures its goal
Criterion-validity (criterium validiteit) results comparing with other criteria
Ecological validity (ecologische validiteit) Predicts further function in their own environment
Confounding
A confounding factor is an element that affects performance on a test but that does not fall within the
measurement objective of a test.
Under-performance: performing worse than they are capable of.
Over-reporting: patient reports more symptoms or exaggerates them.
Aggravating: exaggerating complaints
Simulating: pretending cognitive complaints
4
Neuropsychology
Docentgegevens
Staff:
Examination ():
Multiple Choice Exam
1
,Content Book and Other Literature
Chapter/Lecture Content Page
Chapter 3 Neuropsychology in clinical practice 3
Chapter 18 Alcohol-related cognitive disorders 6
Lecture 2 Korsakoff’s syndrome and alcohol-related cognitive disorders 8
Chapter 19 Alzheimer’s disease 12
Lecture 3 Mild cognitive impairment and Alzheimer’s dementia 16
Chapter 13 Vascular cognitive impairment 19
Chapter 23 Multiple Sclerosis 21
Lecture 4 Multiple sclerosis 23
Chapter 15 Epilepsy 24
Lecture 5 Epilepsy 27
Chapter 21 The parkinson’s disease spectrum 29
Lecture 6 Parkinson’s Disease 31
Chapter 5 Plasticity, recovery and neuropsychological rehabilitation 33
Lecture 7 Neuropsychological rehabilitation 34
2
,Week 1
Chapter 3: Neuropsychology in clinical practice
Introduction
Neuropsychological assessment starts with a research question, after which a hypothesis is formed.
This is followed by data collection (medical background, clinical interview, interview with informant,
observation, test results and questionnaires. The collected data results in a conclusion. There will also
be a neuropsychological treatment in which evidence-based treatments are prioritized. Finally an
evaluation will take place, preferably an objective evaluation.
Areas of expertise
Neuropsychologist work in various fields of health care.
Hospital
Mental health care
Rehabilitation care
Long-term care
Forensic care
Neuropsychological assessment
The neuropsychological examination
The psychologists working in the field of technical neuropsychology has knowledge of the
relationship between brain abnormalities, cognition, emotion dysregulation and problematic behavior.
The neuropsychological examination is an important diagnostic method to research these relationships
within one individual. Neuropsychological
examinations consists of a complete hypothesis-
testing diagnostic cycle Analysys Analysys of
Referral complaints problems
1. Complaints analysis interview with
patient & interview with informant
2. Problem analysis tests
3. Diagnosis Analysis of Analysis of
4. Indication for treatment Treatment
indication cause
Every stage gets a hypothesis. These hypothesis gets
tested using data from
observations, interviews, Referral
question
neuropsychological tests and
questionnaires. The hypothesis Evaluation Interview
can be adjusted and rejected at with patient
any time.
Reporting Interview with
informant
Interpretation
Observation
Testing and
questionnaires
3
, Referral question and definition of the problem
A neurological assessment starts with a referral from a medical specialist. The patient gets referred
with a specific question to be assessed. During the assessment neuropsychologists might formulate
additional questions if necessary.
Interview with the patient
Purposes of interviewing a patient:
Collecting information
o Complaints
o Symptoms
o Progression
o Education
o Occupation
o Medication
o Medical history
A standard question list will not suffice. A positive note about interviewing the patient is that you are
building a working relationship.
Interview with the informant
The patient may not always be a reliable source of intel. This intel can come from a partner, child,
parent, neighbor, friend. The rule is that the patient has to agree with the interview.
Observation
As soon as the patient is spotted the observation starts. It is important that the observations are free
from interpretation.
Neuropsychological assessment
Reliability
test-retest same results, different time with same patient.
Inter-rater Same results, different researcher (Cohens kappa)
Validity
Face-validity (indrukvaliditeit) measure what it is supposed to measure
Content-validity (inhoudvaliditeit) extent to which a test is representative to the topic
Construct-validity (begripvaliditeit) measure which measures its goal
Criterion-validity (criterium validiteit) results comparing with other criteria
Ecological validity (ecologische validiteit) Predicts further function in their own environment
Confounding
A confounding factor is an element that affects performance on a test but that does not fall within the
measurement objective of a test.
Under-performance: performing worse than they are capable of.
Over-reporting: patient reports more symptoms or exaggerates them.
Aggravating: exaggerating complaints
Simulating: pretending cognitive complaints
4
