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Questions and Answers
What is the primary goal of neuropsychology?
What is the role of neuropsychologists in diagnostic questions?
What is a neuropsychological assessment used for?
What is the significance of 'norming' in neuropsychological tests?
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What is dementia?
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What percentage of dementia cases are accounted for by Alzheimer's disease?
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How can a definitive diagnosis of Alzheimer's disease be made?
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What is required to become a neuropsychologist in Australia?
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What is the most reliant genetic risk factor for Alzheimer's disease?
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What is the name of the protein that makes up neurofibrillary tangles in Alzheimer's disease?
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What is the term for the disruption of the brain's blood supply that results in permanent tissue death?
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What is the name of the genetic mutations that can be inherited as a dominant trait in Alzheimer's disease?
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What is the term for the abnormal patches of beta amyloid on axons and within blood vessels in Alzheimer's disease?
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What are the four A's that characterize the neuropsychological features of Alzheimer's disease?
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What type of haemorrhage occurs when there is a bleed directly into brain tissue?
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What can be used to help diagnose Alzheimer's disease?
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Study Notes
Neuropsychology and Neuropsychologists
- Neuropsychology is a specialty field within psychology that seeks to understand and treat patients with cognitive impairments.
- Neuropsychologists understand the relationships between the nervous system and behavior, and use this knowledge to:
- Contribute to diagnostic questions, such as diagnosing the type of dementia.
- Inform management/rehabilitation programs, assessing cognitive profiles and developing support strategies.
- Conduct capacity assessments, determining decision-making capacity on their own behalf.
- Assist with discharge planning, from hospital to home/rehab service.
- Conduct medico-legal work, such as assessing NDIS funding.
- Assess treatment response, evaluating patient improvement.
- Plan educational strategies for children.
- Conduct research.
- In Australia, a specialized postgraduate course (Masters or Clinical PhD) is required to become a neuropsychologist.
Neuropsychological Assessment
- Neuropsychological assessment is the core of neuropsychological practice.
- It involves using standardized instruments (neuropsychological tests) to evaluate underlying cognition and behavior.
- Tests are "normed", meaning individual scores are compared to the normal population of scores.
- Neuropsychologists can select tests based on hypotheses or administer a full battery of tests.
- Factors that can impact test performance, such as pain, fatigue, depression, test anxiety, medications, and motivation, must be considered.
Cognitive Domains
- Classic cognitive domains assessed include:
- Attention
- Executive functions
- Memory
- Language
- Visuospatial skills
- Processing speed
Neuropsychological Disorders
- Dementia is a syndrome (a collection of symptoms) rather than a disease.
- Alzheimer's disease (AD) is a disease process that accounts for 60-90% of all dementia cases.
Alzheimer's Disease (AD)
- A definitive diagnosis of AD can only be made post-mortem, requiring autopsy evidence.
- Living patients are diagnosed with:
- Probable AD, based on genetic testing, learning and memory impairments, and a steady decline in cognitive function without plateaus.
- Possible AD, based on less clear evidence.
- Diagnosis can be aided by neuropsychological testing, biomarker evidence (in CSF/Blood), PET scans, and MRI.
- The ε4 variant of the apolipoprotein (APOE) gene is the most reliable genetic risk factor.
- AD can also be inherited as a dominant trait due to mutations in three genes: APP, PSEN1, or PSEN2.
AD - The Clinical Syndrome
- The four A's summarize the neuropsychological features of AD:
- Amnesia
- Aphasia/Anomia
- Apraxia
- Agnosia
AD - The Disease Process
- Characterized by:
- Neurofibrillary tangles (made of detached tau protein molecules)
- Amyloid plaques (abnormal patches of beta amyloid on axons and within blood vessels)
- Oxidative stress
- Disruption of microRNAs (miRNA) functioning
PET Scans for Amyloid
- Used to diagnose AD
Vascular Disease (Stroke)
- A stroke is a disruption to the brain's blood supply, resulting in permanent tissue death.
- Stroke can result from:
- Hypertension (high blood pressure)
- Structural abnormalities in the arteries serving the brain (e.g., aneurysm, AVM)
- Blood diseases (e.g., leukemia)
- Exposure to toxic chemicals
Stroke - Cerebral Haemorrhage
- Intracerebral haemorrhages: bleeds directly into brain tissue.
- Subarachnoid haemorrhages: bleeds into the surface of the brain (spread via the pathways of the CSF).
- Subdural haemorrhages: burst veins and arteries in meninges.
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Description
Explore the field of neuropsychology, its applications, and the role of neuropsychologists in diagnosing and treating cognitive impairments.
