Podcast
Questions and Answers
What is the primary goal of neuropsychology?
What is the primary goal of neuropsychology?
What is the role of neuropsychologists in diagnostic questions?
What is the role of neuropsychologists in diagnostic questions?
What is a neuropsychological assessment used for?
What is a neuropsychological assessment used for?
What is the significance of 'norming' in neuropsychological tests?
What is the significance of 'norming' in neuropsychological tests?
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What is dementia?
What is dementia?
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What percentage of dementia cases are accounted for by Alzheimer's disease?
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?
How can a definitive diagnosis of Alzheimer's disease be made?
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What is required to become a neuropsychologist in Australia?
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?
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?
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?
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?
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?
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?
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?
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?
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.
