Role Of Neuropsychology Research Articles

The role of neuropsychology in the care of patients with functional neurological symptom disorder.

Functional neurological symptom disorder (FNSD) is a neuropsychiatric condition characterized by signs/symptoms associated with brain network dysfunction. FNSDs are common and are associated with high healthcare costs. FNSDs are relevant to neuropsychologists, as they frequently present with chronic neuropsychiatric symptoms, subjective cognitive concerns, and/or low neuropsychological test scores, with associated disability and reduced quality of life. However, neuropsychologists in some settings are not involved in care of patients with FNSDs. This review summarizes relevant FNSD literature with a focus on the role of neuropsychologists. A brief review of the literature is provided with respect to epidemiology, public health impact, symptomatology, pathophysiology, and treatment. Two primary areas of focus for this review are the following: (1) increasing neuropsychologists' training in FNSDs, and (2) increasing neuropsychologists' role in assessment and treatment of FNSD patients. Patients with FNSD would benefit from increased involvement of neuropsychologists in their care.

Alzheimer's disease - The role of neuropsychology. Summary of recommendations for intervention and notes on future perspectives

Alzheimer's disease - The role of neuropsychology. Summary of recommendations for intervention and notes on future perspectives

Invited Symposium 3: Pediatric Neuropsychology Medical Advances and Life Span Outcomes

Abstract & Learning Objectives:Medical advances continue to improve the outlook for pediatric patients with a variety of acquired and congenital medical conditions. Such critical advances have an impact on lifespan outcomes for affected individuals. Neuropsychology plays a critical role in evaluating outcomes and informing clinical care for pediatric patients, with an increasing role in prevention. Neuropsychologists are essential members of interdisciplinary teams and ongoing medical management. Our symposium will present examples of the latest progress made over the last decade in the areas of sickle cell disease, demyelinating disorders, congenital heart disease, and cancer. Highlights include recent research on neurocognitive surveillance for pediatric patients with sickle cell disease including identification of risk and resilience factors and ways to reduce cognitive decline; discovery of the anti-MOG antibody in patients with demyelinating disorders and associated neuropsychological outcomes; advances in the understanding of congenital heart disease, the latest initiatives in the field, and discussion of neuropsychology’s role in the care of these patients; and advances in targeted therapies for childhood cancer, risks associated with cancer and its treatment into adulthood, and an application of a developmental, lifespan approach in the care of childhood cancer survivors. Following each presentation, there will be an opportunity for discussion and questions. Upon conclusion of this course, learners will be able to: 1.Describe recent advances in medical care for pediatric sickle cell disease, demyelinating disorders, congenital heart disease, and cancer2.Explain long-term neuropsychological outcomes in pediatric medical disorders3.Assess the role of neuropsychology in advancing the field across pediatric medical disorders

30 Socially Responsible Neuropsychology (SRN) in Action: The Role of Neuropsychology in Migraine Care Among Bilingual Latina/o Patients

Objective:Migraine is one of the leading causes of disability worldwide and a recognized contributor to health disparities with public health implications. Although migraine is a highly prevalent neurological condition, research on the cognitive manifestations of migraines is inconsistent. Studies have confirmed neurocognitive compromise during the presence of a migraine attack, with it’s onset and frequency being associated with greater cognitive decline. Research on the cognitive implications of migraines in underserved communities is scarce. The American Migraine Prevalence and Prevention Study (2015) found that the prevalence of chronic migraines was the highest amongst Hispanic females compared to White females. Latina/os are 50% less likely to receive a migraine diagnosis and adequate headache medication when compared to non-Hispanic White patients. Latina women were more likely to report somatic symptoms than White and African American participants (F=8.96; p>0.001) (Liefland et al., 2014). Somatoform disorders are often diagnosed amongst Latina/os to account for medical unexplained symptoms, and if misdiagnosed can be stigmatizing and detrimental to treatment. We illustrate the critical role that neuropsychologists play by utilizing Socially Responsible Neuropsychology (SRN), a theoretical framework that promotes equitable and precise neuropsychological care to reduce misdiagnosis, elucidate cognitive implications, and address the complex medical needs of Latina/o/ patients. Given the limited literature on migraines and neurocognitive functioning, our objective is to present two case studies to illustrate the neuropsychological implications among bilingual Latina/o with chronic migraines.Participants and Methods:Two highly educated Latina/o women, ages 39 and 41 years old, with chronic migraines, cognitive decline, diagnoses and a history of somatization symptoms. The onset of symptoms was gradual, worsening in intensity and frequency, along with notable motor symptoms (e.g., paralysis, weakness, numbness, bilateral tremors), photophobia, and phonophobia. Their cognitive complaints were conceptualized as part of a somatoform presentation by their providers.Results:The SRN model guided clinical decision-making to establish reliable normative anchors to identify relative impairment compared to premorbid estimates. Testing was completed in English after establishing language dominance via English and Spanish measures of verbal fluency. Cognitive profiles identified declines in attention, processing speed, language, perceptual reasoning, visual memory, executive functioning, motor functioning, and notable decline in their functioning over several years. The neuropsychological profile discounted the presence of a somatoform disorder. One case was diagnosed with an Unspecified Mild Neurocognitive Disorder, while the other case met criteria for a Major Neurocognitive Disorder due to Multiple Etiologies (i.e., vascular contribution, migraines, history of other contributions- choking episode).Conclusions:Given the decline in each profile, it was hypothesized that the patients’ utilization of compensatory strategies and higher education may have masked the onset of symptoms. These complex cases highlight the need for comprehensive neuropsychological evaluations that are culturally and linguistically responsive to boost the sensitivity of accurate diagnosis. The ability to objectively capture neurocognitive decline offers a unique opportunity to enhance treatment, which would have otherwise remained undetected and untreated. The SRN model enhanced diagnostic considerations, treatment planning, and allowed for advocacy strategies to improve the quality of life, and access to culturally/linguistically appropriate resources.

H - 55 Socially Responsible Neuropsychology (SRN) in Action: the Role of Neuropsychology in Autism Spectrum Disorder (ASD) Care, a Case Study of a Bilingual Latino Patient.

Latinx children with ASD are diagnosed 1-3years later than their White counterparts and typically present with more severe symptoms at the time of assessment. Systemic barriers include language barriers, limited literacy about ASD, mental health stigma, mistrust in healthcare. Latinx children are at greater risk of misdiagnosis, delayed access to special education, limiting early intervention. Within neuropsychology, there are limited bicultural/bilingual neuropsychologists trained in autism evaluations, few Spanish ASD diagnostic tools, no bilingual norms, and little understanding regarding neuropsychologists' role in providing autism evaluations to culturally/linguistically diverse children. This social injustice results in unmet needs and inequities in ASD care for Latinx children. We aim to illustrate how the SRN model increases equitable ASD care amongst Latinx children. SRN model was utilized in 11-year-old bilingual Latinx male by applying culturally responsive interview to identify systemic barriers and language use, and a model of language proficiency testing. Testing was primarily in English after verbal fluency measures established language dominance. Clinical decision making identified the need for autism evaluation using Autism Diagnostic Observation Schedule (ADOS-2). His cognitive profile showed word reading and motor inefficiencies. ADOS-2 identified deficits in communication, reciprocal social interaction, restricted and repetitive behavior. Neuropsychological assessment confirmed ASD and Developmental Coordination Disorder diagnosis. His unremarkable neurocognitive profile suggested compensatory strategies may have masked symptoms. This case highlights need for bicultural/bilingual neuropsychologists with experience providing comprehensive ASD evaluations to practice from equitable framework, using the SRN model to enhance early detection, treatment recommendations, and advocacy for access to culturally/linguistically appropriate resources.

Supporting patients and families following an out-of-hospital cardiac arrest: Developing a multidisciplinary care pathway and the role of neuropsychology

This article outlines the current guidelines and recommendations for pre- and post-discharge care and rehabilitation of survivors of out-of-hospital cardiac arrest (OHCA) and their families. Although many OHCA survivors make an overall good physical and neurological recovery, many others experience a combination of cognitive decline, emotional problems, fatigue and difficulties in reintegrating in the community and in the workplace. Current pathways of care in the UK are not well suited in identifying and addressing these issues. Neuropsychologists, in particular, are rarely involved in the care of these often-complex patients who fall on the boundaries of neurology, cardiology and critical care.In this article we summarise the current best practice in the development of a pathway of care and rehabilitation for OHCA survivors in the UK. The role of Neuropsychology is discussed, and clinics are invited to collaborate in the development and evaluation of this pathway of care.

The Role of Neuropsychology in Adult Cardiology.

The neuropsychologist is specialized in brain-behavior interactions and assesses mental functions, while considering health and psychological factors. Cardiovascular diseases are associated with lower cognitive performances, as well as increased dementia risks. Although heart-brain interactions are increasingly recognized, the neuropsychologist's role and contribution in cardiology remains to be defined. The neuropsychologist can determine whether a patient has objective cognitive impairment and advise the medical team accordingly. With the aging population and the increasing prevalence of cardiovascular diseases with aging, neuropsychologists can play a pivotal role in empowering patients, supporting cardiology teams, and preventing cognitive decline and dementia.

A-6 Pediatric Cerebral Cavernous Malformation, Type 1 (CCM1): Cognitive and Psychosocial Functioning, The Role of Neuropsychology, and Emerging Clinical Care Guidelines

Abstract Objective: CCM1 is a rare condition that confers risk for negative neurological sequelae, including hemorrhage, seizures, and chronic headache. This study examines cognitive and psychosocial functioning in pediatric patients with CCM1 and describes emerging clinical care guidelines. Method: Twenty-two children and adolescents with CCM-1 and 7 non-affected relatives participated in this cross-sectional pilot study. Cognitive testing and behavior and emotion questionnaires were completed. A subset of participants with CCM1 (n = 11) had repeat brain MRI (average 4.89 years between scans). Results: Patients with CCM1 and their non-affected relatives did not differ on the NIH Toolbox Fluid and Crystallized composites (p > 0.05). Processing speed also did not significantly differ, although both group means were below average normatively (NIH Toolbox Pattern Comparison T-score; CCM1 = 31.50 [12.02], non-affected relatives = 37.57 [14.58]). In the subgroup with repeat imaging, slower processing speed was associated with an increase in large lesions (p = 0.03) and with younger age at CCM1 diagnosis (p = 0.04). Self- and parent-reported internalizing problems and parent-reported externalizing problems did not differ between groups (p > 05). In the CCM1 group, patient-reported disengaged coping was associated with more internalizing problems (p = 0.03). Conclusions: Neuropsychological evaluation is an important component of long-term, multi-disciplinary care for pediatric patients with CCM1, particularly if lesions are progressive. The pilot sample was overall well-adjusted behaviorally and emotionally. The use of disengaged coping strategies was associated with more internalizing symptoms and coping may be a key modifiable risk factor in this population. Psychosocial monitoring may therefore be warranted.

Curatorship applications: The role of neuropsychology

This article highlights ethical issues that may arise in the relationship between curatorship applications and neuropsychology. In South Africa (SA), curatorship applications for the elderly diagnosed with dementia require substantiation from two medical professionals, one of whom should be a practising psychiatrist deemed competent to provide this. Concurrently, there is often a request for a psychologist to conduct a neuropsychological assessment and to produce a relevant report. The process may result in ethical issues at various stages of the assessment. The balance between protecting the patient’s rights v. freedom of autonomy becomes a central issue. Psychiatrists and psychologists are cautioned to adhere to best practices throughout the assessment, maintaining a critical and reflective stance. The limitations of cognitive assessment as a predictor of functionality should be considered. Furthermore, neuropsychological training in SA differs across institutions, resulting in variable practitioner competency. ‘Competency’ itself is an ambiguous legal term that may be interpreted variably. This article outlines the definitions and requirements of the curatorship process, as well as the role and limitations of neuropsychology, with emphasis on the ethical dilemmas that may arise.

Role of neuropsychology in identification of CSWS in a school-aged child with a remote neurological insult

Electrical status epilepticus of slow-wave sleep (ESES) is characterized by excessive interictal spike-wave discharges on EEG during sleep and can occur in the absence of overt clinical seizures. Continuous spike-wave during slow wave sleep (CSWS), an epilepsy syndrome associated with ESES, is associated with a plateau/decline in cognitive development and increases in behavioral and emotional dysregulation. Here we present a case in which neuropsychological (NP) evaluation initially ordered based on memory and attention concerns led to the identification of subclinical seizure activity and an evolving epileptic encephalopathy in an 11-year-old child with a history of remote neurological insult. The patient was referred for an initial NP evaluation at age 8 which revealed weaknesses in functions typically mediated by the dominant (usually left) hemisphere juxtaposed with her left hemiparesis. EEG was recommended which showed independent, multifocal spike and sharp wave discharges exacerbated by sleep. Follow-up NP evaluations over the following 26months, during which time aggressive treatment was initiated, coincided with EEG findings of an evolving epileptic encephalopathy in the patient who continued to remain free from clinical seizures. This case highlights the importance of comprehensive epilepsy care and routine involvement of neuropsychology in the management of complex epilepsy patients.

Executive Functions: Definition, Contexts and Neuropsychological Profiles

Starting from the concept of "executive functions", we proceeded to describe the object under examination in a more complete and functional way, and their possible role in neuropsychology and developmental psychopathology. The use of statistical methods and clinical observation have allowed us to emphasize the understanding of the multicomponential structure of the processes themselves. Paying particular attention to the psychopathological contents listed in the DSM-V psychiatric manual, the main pathological forms were then analyzed to better contextualize the present discussion, also from a psychotherapeutic point of view, with the preferential choice of the strategic approach for the management of pathological disorders related to the deficit of executive functions

The Role of Neuropsychology in the Evaluation of Concussion

Neuropsychologists play an important role in the clinical evaluation of many children and adolescents who have sustained concussions. This paper discusses clinical approaches and concerns in conducting neuropsychological evaluations of middle and high school aged students during the acute, subacute, and more chronic phases of concussion recovery. Issues of baseline testing and validity assessment are reviewed. Typical clinical recommendations arising from the neuropsychological evaluation are outlined, with an emphasis on the relationship between test findings and common academic accommodations.

Role of neuropsychology in continuum of health care in neurological conditions.

Role of neuropsychology in continuum of health care in neurological conditions.

16.3 The Role of Neuropsychology in the Evaluation and Management of Autoimmune Encephalopathy

16.3 The Role of Neuropsychology in the Evaluation and Management of Autoimmune Encephalopathy

Evaluation and Treatment of Mild Traumatic Brain Injury: The Role of Neuropsychology.

Awareness of mild traumatic brain injury (mTBI) and persisting post-concussive syndrome (PCS) has increased substantially in the past few decades, with a corresponding increase in research on diagnosis, management, and treatment of patients with mTBI. The purpose of this article is to provide a narrative review of the current literature on behavioral assessment and management of patients presenting with mTBI/PCS, and to detail the potential role of neuropsychologists and rehabilitation psychologists in interdisciplinary care for this population during the acute, subacute, and chronic phases of recovery.

Current standards of neuropsychological assessment in epilepsy surgery centers across Europe.

We explored the current practice with respect to the neuropsychological assessment of surgical epilepsy patients in European epilepsy centers, with the aim of harmonizing and establishing common standards. Twenty-six epilepsy centers and members of "E-PILEPSY" (a European pilot network of reference centers in refractory epilepsy and epilepsy surgery), were asked to report the status of neuropsychological assessment in adults and children via two different surveys. There was a consensus among these centers regarding the role of neuropsychology in the presurgical workup. Strong agreement was found on indications (localization, epileptic dysfunctions, adverse drugs effects, and postoperative monitoring) and the domains to be evaluated (memory, attention, executive functions, language, visuospatial skills, intelligence, depression, anxiety, and quality of life). Although 186 different tests are in use throughout these European centers, a core group of tests reflecting a moderate level of agreement could be discerned. Variability exists with regard to indications, protocols, and paradigms for the assessment of hemispheric language dominance. For the tests in use, little published evidence of clinical validity in epilepsy was provided. Participants in the survey reported a need for improvement concerning the validity of the tests, tools for the assessment of everyday functioning and accelerated forgetting, national norms, and test co-normalization. Based on the present survey, we documented a consensus regarding the indications and principles of neuropsychological testing. Despite the variety of tests in use, the survey indicated that there may be a core set of tests chosen based on experience, as well as on published evidence. By combining these findings with the results of an ongoing systematic literature review, we aim for a battery that can be recommended for the use across epilepsy surgical centers in Europe.

A-20The Role of Neuropsychology in Identifying Frontotemporal Dementia Associated with C9ORF72 Genetic Mutation: A Case Study

A-20The Role of Neuropsychology in Identifying Frontotemporal Dementia Associated with C9ORF72 Genetic Mutation: A Case Study

Neuropsychological Assessment of Adolescents and Emerging Young Adults with Childhood Epilepsy

Childhood-onset epilepsy is associated with significant cognitive, behavioral, and social morbidities that have a lifespan impact on an individual's growth and development. Increased expectations for autonomy and self-direction that begin during adolescence are particularly challenging for children and families. Emerging young adults are faced with the complexities of educational and health care transitions. Early and persistent involvement of neuropsychologists in the care of individuals with childhood epilepsy will promote successful attainment of adult outcomes by facilitating treatment decision making, academic planning, psychosocial adjustment, and transitions. This article emphasizes the role of neuropsychology in promoting successful outcomes in adolescents and emerging young adults with epilepsy.

Diffusion MRI and its Role in Neuropsychology.

Diffusion Magnetic Resonance Imaging (dMRI) is a popular method used by neuroscientists to uncover unique information about the structural connections within the brain. dMRI is a non-invasive imaging methodology in which image contrast is based on the diffusion of water molecules in tissue. While applicable to many tissues in the body, this review focuses exclusively on the use of dMRI to examine white matter in the brain. In this review, we begin with a definition of diffusion and how diffusion is measured with MRI. Next we introduce the diffusion tensor model, the predominant model used in dMRI. We then describe acquisition issues related to acquisition parameters and scanner hardware and software. Sources of artifacts are then discussed, followed by a brief review of analysis approaches. We provide an overview of the limitations of the traditional diffusion tensor model, and highlight several more sophisticated non-tensor models that better describe the complex architecture of the brain's white matter. We then touch on reliability and validity issues of diffusion measurements. Finally, we describe examples of ways in which dMRI has been applied to studies of brain disorders and how identified alterations relate to symptomatology and cognition.

The Role of Neuropsychology on an Epilepsy Monitoring Unit: A Peek Behind the “Do Not Disturb” Sign

ABSTRACT.Neuropsychological services are considered an essential component of specialized epilepsy centers. In such a multidisciplinary setting, neuropsychologists interact regularly with other professionals involved in epilepsy patients' care. For these other professionals, this article provides an overview of the background of neuropsychologists, the services they provide, and how their findings contribute to the evaluation of the epilepsy patient. Two case examples are included to illustrate how neuropsychological evaluations are employed in the epilepsy monitoring unit setting.