Neuropsychological test

Neuropsychological test
MeSHD009483

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.

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] Some tests appear under multiple headings as different versions and aspects of tests can be used to assess different functions.

Intelligence

Intelligence testing in a research context is relatively more straightforward than in a clinical context. In research, intelligence is tested and results are generally as obtained, however in a clinical setting intelligence may be impaired so estimates are required for comparison with obtained results. Premorbid estimates can be determined through a number of methods, the most common include: comparison of test results to expected achievement levels based on prior education and occupation and the use of hold tests which are based on cognitive faculties which are generally good indicators of intelligence and thought to be more resistant to cognitive damage, e.g. language.

  • National Adult Reading Test (NART)
  • Wechsler Adult Intelligence Scale (WAIS)
  • Wechsler Intelligence Scale for Children (WISC)
  • Wechsler Preschool and Primary Scale of Intelligence (WPPSI)
  • Wechsler Test of Adult Reading (WTAR)

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.[4] 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.[5] 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.[6][7]

  • Benton Visual Retention Test
  • California Verbal Learning Test
  • Cambridge Prospective Memory Test (CAMPROMPT)
  • Gollin figure test
  • Memory Assessment Scales (MAS)
  • Rey Auditory Verbal Learning Test
  • Rivermead Behavioural Memory Test
  • Test of Memory and Learning (TOMAL)
  • Mental Attributes Profiling System
  • Wechsler Memory Scale (WMS)

Language

Language functions include speech, reading and writing, all of which can be selectively impaired.

Executive function

Executive functions is an umbrella term for a various cognitive processes and sub-processes.[8] The executive functions include: problem solving, planning, organizational skills, selective attention, inhibitory control and some aspects of short term memory.[9]

Visuospatial

Neuropsychological tests of visuospatial function should cover the areas of visual perception, visual construction and visual integration.[10] Though not their only functions, these tasks are to a large degree carried out by areas of the parietal lobe.[11]

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. Tests such as these are by no means conclusive of deficits, but may give a good indication as to the presence or severity of dementia.

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.

  • Barcelona Neuropsychological Test (BNT)
  • Cambridge Neuropsychological Test Automated Battery (CANTAB)
  • Cognistat (The Neurobehavioral Cognitive Status Examination)
  • Cognitive Assessment Screening Instrument (CASI)
  • Cognitive Function Scanner (CFS)
  • Dean-Woodcock Neuropsychology Assessment System (DWNAS)
  • General Practitioner Assessment Of Cognition (GPCOG)
  • Hooper Visual Organization Test
  • Luria-Nebraska Neuropsychological battery
  • MicroCog
  • Mini mental state examination (MMSE)
  • NEPSY
  • Repeatable Battery for the Assessment of Neuropsychological Status
  • Short Parallel Assessments of Neuropsychological Status (SPANS)
  • CDR Computerized Assessment System

Automated computerized cognitive tests

Traditional cognitive examinations are mostly paper and pen based. As such most of them are time consuming and require special training to be carried out. Today there is a rapidly growing number of automated computerized cognitive tests emerging, for example Brain on Track, Cogstate, CAMCI, CANTAB. Several of these new tests are shoving promising ability to discriminate between healthy individuals and different cognitive difficulties and/or to monitor cognitive impairment over time. Since these tests are easily administered to large groups of people this is opening up possibilities to, for example, regularly screen portions of the population at risk for cognitive decline and early on give adequate support and treatment.

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.[12] It is also helpful in understanding deteriorating diseases because the patient can be assessed multiple times to see how the disorder is progressing.

See also

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. ↑ 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. Lay summary – Journal of the International Neuropsychological Society (17 June 2014). {{cite book}}: Cite uses deprecated parameter |lay-date= (help)
  4. ↑ 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. Lay summary – Journal of the International Neuropsychological Society (17 June 2014). {{cite book}}: Cite uses deprecated parameter |lay-date= (help)
  5. ↑ 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.
  6. ↑ Mayes, A.R. (1988). Human organic memory disorders. New York: Cambridge University Press. p. 300. ISBN 978-0-521-34418-0.
  7. ↑ Baddeley, A. (1992). "Working Memory". Science. 255 (5044): 556–559. Bibcode:1992Sci...255..556B. doi:10.1126/science.1736359. JSTOR 2876819. PMID 1736359.
  8. ↑ Elliot R. (2003). "Executive functions and their disorders". British Medical Bulletin. 65 (1): 49–59. doi:10.1093/bmb/65.1.49. PMID 12697616.
  9. ↑ 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.
  10. ↑ Hebben, N.; Millberg, W. (2009). Essentials of Neuropsychological Assessment (2nd ed.). New Jersey: John Wiley & Sons. pp. 127. ISBN 978-0-470-43747-6.
  11. ↑ 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. Lay summary – Journal of the International Neuropsychological Society (17 June 2014). {{cite book}}: Cite uses deprecated parameter |lay-date= (help)
  12. ↑ "Neuropsychological and Psychoeducational Testing for Children and Adults". New York Assessment. December 2015. Retrieved 11 February 2016.

Further reading

  • Davis, Andrew, ed. (2011). Handbook of Pediatric Neuropsychology. New York: Springer Publishing. ISBN 978-0-8261-0629-2. Retrieved 28 May 2013. Lay summary – Archives of Clinical Neuropsychology (17 June 2014). {{cite book}}: Cite uses deprecated parameter |lay-date= (help)
  • Marshall, John (2010). Gurd, Jennifer; Kischka, Udo; Marshall, John (eds.). The Handbook of Clinical Neuropsychology (Second ed.). Oxford University Press. doi:10.1093/acprof:oso/9780199234110.001.0001. ISBN 978-0-19-162578-7.
  • Loring, David W., ed. (1999). INS Dictionary of Neuropsychology. New York: Oxford University Press. ISBN 978-0-19-506978-5. Lay summary (21 November 2010). {{cite book}}: Cite uses deprecated parameter |lay-url= (help) This standard reference book includes entries by Kimford J. Meador, Ida Sue Baron, Steven J. Loring, Kerry deS. Hamsher, Nils R. Varney, Gregory P. Lee, Esther Strauss, and Tessa Hart.
  • Miller, Daniel C. (3 January 2013). Essentials of School Neuropsychological Assessment (2nd ed.). John Wiley & Sons. ISBN 978-1-118-17584-2. Retrieved 9 June 2014.
  • Parsons, Michael W.; Hammeke, Thomas A., eds. (April 2014). Clinical Neuropsychology: A Pocket Handbook for Assessment (Third ed.). American Psychological Association. ISBN 978-1-4338-1687-1. This handbook for practitioners includes chapters by Michael W. Parsons, Alexander Rae-Grant, Ekaterina Keifer, Marc W. Haut, Harry W. McConnell, Stephen E. Jones, Thomas Krewson, Glenn J. Larrabee, Amy Heffelfinger, Xavier E. Cagigas, Jennifer J. Manly, David Nyenhuis, Sara J. Swanson, Jessica S. Chapin, Julie K. Janecek, Michael McCrea, Matthew R. Powell, Thomas A. Hammeke, Andrew J. Saykin, Laura A. Rabin, Alexander I. Tröster, Sonia Packwood, Peter A. Arnett, Lauren B. Strober, Mariana E. Bradshaw, Jeffrey S. Wefel, Roberta F. White, Maxine Krengel, Rachel Grashow, Brigid Waldron-Perrine, Kenneth M. Adams, Margaret G. O'Connor, Elizabeth Race, David S. Sabsevitz, Russell M. Bauer, Ronald A. Cohen, Paul Malloy, Melissa Jenkins, Robert Paul, Darlene Floden, Lisa L. Conant, Robert M. Bilder, Rishi K. Bhalla, Ruth O'Hara, Ellen Coman, Meryl A. Butters, Michael L. Alosco, Sarah Garcia, Lindsay Miller, John Gunstad, Dawn Bowers, Jenna Dietz, Jacob Jones, Greg J. Lamberty, and Anita H. Sim.
  • Reddy, Linda A.; Weissman, Adam S.; Hale, James B., eds. (2013). Neuropsychological Assessment and Intervention for Youth: An Evidence Based Approach to Emotional and Behavioral Disorders. American Psychological Association. ISBN 978-1-4338-1266-8. OCLC 810409783. Retrieved 15 June 2014. This collection of articles for practitioners includes chapters by Linda A. Reddy, Adam S. Weissman, James B. Hale, Allison Waters, Lara J. Farrell, Elizabeth Schilpzand, Susanna W. Chang, Joseph O’Neill, David Rosenberg, Steven G. Feifer, Gurmal Rattan, Patricia D. Walshaw, Carrie E. Bearden, Carmen Lukie, Andrea N. Schneider, Richard Gallagher, Jennifer L. Rosenblatt, Jean Séguin, Mathieu Pilon, Matthew W. Specht, Susanna W. Chang, Kathleen Armstrong, Jason Hangauer, Heather Agazzi, Justin J. Boseck, Elizabeth L. Roberds, Andrew S. Davis, Joanna Thome, Tina Drossos, Scott J. Hunter, Erin L. Steck-Silvestri, LeAdelle Phelps, William S. MacAllister, Jonelle Ensign, Emilie Crevier-Quintin, Leonard F. Koziol, and Deborah E. Budding.
  • Riccio, Cynthia A.; Sullivan, Jeremy R.; Cohen, Morris J. (28 January 2010). Neuropsychological Assessment and Intervention for Childhood and Adolescent Disorders. John Wiley & Sons. doi:10.1002/9781118269954. ISBN 978-0-470-18413-4. Lay summary (15 June 2014). {{cite book}}: Cite uses deprecated parameter |lay-url= (help)
  • Strauss, Esther; Sherman, Elizabeth M.; Spreen, Otfried (2006). A Compendium of Neuropsychological Tests: Administration, Norms, and Commentary. Oxford: Oxford University Press. ISBN 978-0-19-515957-8. Retrieved 14 July 2013.
  • Sherman, Elizabeth M.; Brooks, Brian L., eds. (2012). Pediatric Forensic Neuropsychology (Third ed.). Oxford: Oxford University Press. ISBN 978-0-19-973456-6. Retrieved 14 July 2013. Lay summary – Archives of Clinical Neurology (17 June 2014). {{cite book}}: Cite uses deprecated parameter |lay-date= (help)
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