What is Neuropsychology?
Neuropsychology is concerned with relationships between the brain and behavior. Neuropsychologists conduct evaluations to characterize behavioral and cognitive changes resulting from central nervous system disease or injury, like Parkinson’s disease or another movement disorder. Some neuropsychologists also focus on remediation of or adaptation to these behavioral and mental changes and other symptoms.
What is a Neuropsychological Evaluation?
Neuropsychological evaluation is an assessment of how one’s brain functions, which indirectly yields information about the structural and functional integrity of your brain. The neuropsychological evaluation involves an interview and the administration of tests. The tests are typically pencil and paper type tests. Some tasks might be self-reports meaning that they are completed by the patient with assistance from a technician, but the majority of the tests require administration by a neuropsychologist or trained, skilled psychometrist. Neuropsychological tests (unlike bedside cognitive and behavioral neurologic screens) are standardized, meaning that they are given in the same manner to all patients and scored in a similar manner time after time. An individual’s scores on tests are interpreted by comparing their score to that of healthy individuals of a similar demographic background (i.e., of similar age, education, gender, and/or ethnic background) and to expected levels of functioning. In this way, a neuropsychologist can determine whether one’s performance on any given task represents a strength or weakness. Although individual scores are important, the neuropsychologist looks at all of the data from the evaluation to determine a pattern of cognitive strengths and weaknesses and, in turn, to understand more about how the brain is functioning.
Neuropsychological tests evaluate functioning in a number of areas including: intelligence, executive functions (such as planning, abstraction, conceptualization), attention, memory, language, 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 want to know), patient’s complaints and symptoms, and observations made during interview and test administration.
Why would I be referred for this?
You or your medical doctor or specialist may be concerned about changes in your thinking or memory. You may have had an illness or injury such as stroke or head injury, which affects the brain. You may want to document changes after an accident. You may want to measure conditions such as attention deficit or learning disability, to plan therapy for these, or to plan changes at home, school or work which will help you function at your best. Even with “high tech” scans available these days, neuropsychological evaluation is the best method to measure how the brain affects WHAT YOU CAN DO. For some conditions, such as Alzheimer’s Disease, the best current practice is to include neuropsychological evaluation to help make the diagnosis.
What are the tests like?
Dr. Eisenman will ask for background information, and help you become comfortable in the office. A family member may be with you during an initial interview, but not during testing as this might be distracting. The tests let you try to do things like listen to and remember information, answer questions out loud, read, write, calculate, and solve puzzles. Some tests are timed and measure how quick you are, but many are not timed. Some measure your sense of touch, vision and hearing, and may require the examiner to touch you briefly on the hands or face. None of the tests hurt or cause discomfort. Should you ever become uncomfortable, or cannot concentrate or want a break, let the examiner know right away. Some people have mild “performance anxiety,” but otherwise there are no known risks or side effects.
How can you tell if my functioning has changed if you never tested me before my illness or injury?
This is a very frequent question. The neuropsychologist looks for patterns in the test scores to infer how the brain is working. This requires a thorough knowledge of the brain and the tests, and how these relate. Test results are also compared to others similar to you in age and education. In some cases school records, results from tests you may have had before, and information about specialized training, experience or work you have done may help estimate your prior abilities. Finally, some of the tests themselves help estimate how a person was functioning prior to an illness or injury.
How do I find out the results?
A report will be provided to your physician with the results of the evaluation. Your physician will review the results with you doing your next appointment. However, you are welcome to schedule a feedback session with Dr. Eisenman to go over the results if you feel you would like more information.
What else should I know?
You cannot really “study” for the tests, since these mostly measure ability rather than knowledge. You do not have to do anything special to prepare. Just go about your ordinary activities before the testing day. Try to get a good night’s sleep the night before, and eat a good breakfast. If you have questions during the testing, just ask. The only thing we cannot tell you is answers to the test questions!
What do I need to bring?
It is always helpful to bring pertinent medical records and a list of current medications. The background interview will ask questions about medical history, psychiatric history, employment history, and past schooling, so be prepared to provide your history. Some patients have brought a list of their medical problems or surgeries to expedite the process. Remember to bring reading glasses or hearing aids if needed to allow for your best performance. Also bring a snack if you are diabetic or hypoglycemic since testing can last several hours (there will be a lunch break). A bottle of water or other nonalcoholic beverages are allowed into the testing room.
When are evaluations conducted and how long will it take?
There are typically two appointments that will be set up. The first appointment will be to gather your history and background information. The first appointment helps Dr. Eisenman understand the difficulties you are having and determine which tests will be needed for the testing appointment. The testing appointment will be scheduled following the first appointment. Testing will begin around 10:00 am and end around 2:30pm or 3pm depending on the type of evaluation needed. Some evaluations are longer and complete around 4, and some evaluations are shorter and finish at noon. The length of the evaluation is tailored to the patient.