Neuropsychology questions and answers

Health Description
Health Consultation Description: ..I guess I still have a few doubts about how precise the neuropsychological tests are(other than as tests of functioning) or how useful it is to try to name the specific areas in the brain which are associated with different psychological functions. I mean, does it really help people to tell them that the problem is in the front of their head or the back of their head or the middle of their head?"


Expert Reply

Condition analysis:
It could have implications for the disease process, thus potentially predicting likely prognosis and useful treatments. For a basic example, if cognitive deficits imply the 'front' part of the brain but other cognitive functions (brain areas) are spared, this might suggest a 'frontal'dementia, as opposed to if 'deep brain' functions are affected (i.e., motor, memory), this might suggest a Parkinson's type dementia. [Now you are right, our testing methods might not be this accurate yet, but this is improving all the time]. Both of these entities have different etiologies, may have no other 'objective test' or biological markers to differentiate between them, have different implications for the patient, family, and treatment options, etc. Unless of course one takes the somewhat pessimistic view that in the dementias the course is inevitably downhill anyway, so what's the difference? As suggested, sometimes the neuropsychological testing provides a 'noninvasive' way that may add to the 'soft signs' yielded, for example, by a neurological exam, even to the exquisitely good localization offered by an imaging technique,to help make the diagnosis.

This is an area of the literature I'm not too familiar with, but I believe some of the batteries of neuropsychological tests are actually more sensitive than other techniques currently available to detect, for example, Alzheimer's in its early stages, but especially to help predict any 'subtypes' and classify with a certain probability the likely rate of progression. These could be important to a patient and family.

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 Key words:  Neuropsychology

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