What is Neuropsychology?

• Study of how brain structure/function affects thoughts, emotions, behaviour.
• Identifies how brain dysfunction impacts daily life.

Neuropsychological Assessments

Purpose:

• Detect brain dysfunction
• Understand cognitive strengths/weaknesses
• Guide diagnosis & treatment planning

Assessment looks at:

• Medical history
• Education
• Behavioural observations
• Reported symptoms

Areas Neuropsychologists Work With

• Acquired brain injury
• Neurological conditions (stroke, epilepsy)
• Neurodegenerative disorders (Alzheimer’s, Parkinson’s)
• Neurodevelopmental conditions (ADHD, ASD)
• Neuropsychiatric disorders (schizophrenia, mood disorders affecting cognition)

Impacts of Neurological Damage

• Slower information processing
• Language deficits
• Short-term memory problems
• Reduced concentration
• Spatial disorientation
• Executive dysfunction
• Difficulty multitasking
• Emotional/psychiatric issues

Assessment Components

Initial Interview

• Review medical notes
• Early behavioural observations

Clinical Interview

• Patient’s self-report
• Collateral info (family, carers, clinicians)
• Further observations

Testing

• Standardised paper tasks
• Computerised cognitive tests

Cognitive Domains Assessed

• Attention
• Memory
• Processing speed
• Executive functions
• Mood / emotional functioning

Importance of Assessments

• Differential diagnosis
• Determine presence of neurological issues
• Provide medical/legal documentation
• Inform rehabilitation strategies

Brain Regions & Disorders

Frontal Lobe

Functions: planning, decision-making, inhibition, personality, motor control
Disorders / Damage Effects:

• Traumatic brain injury (TBI) → poor impulse control, disinhibition
• Frontotemporal dementia (FTD) → personality change, apathy, social inappropriateness
• Stroke (ACA/MCA) → motor deficits, executive dysfunction
• Schizophrenia → disrupted executive functioning, working memory issues
• ADHD → impaired inhibition, planning, attention

Temporal Lobe

Functions: memory, language comprehension, emotional processing
Disorders / Damage Effects:

• Alzheimer’s disease → hippocampal degeneration → severe episodic memory loss
• Temporal lobe epilepsy → déjà vu, intense emotions, memory disturbances
• Wernicke’s aphasia (left temporal) → fluent but nonsensical speech; impaired comprehension
• Klüver–Bucy syndrome → hyperorality, hypersexuality, emotional blunting

Parietal Lobe

Functions: spatial awareness, sensation, attention
Disorders / Damage Effects:

• Right parietal stroke → hemispatial neglect (ignoring left side of space)
• Gerstmann syndrome (left parietal) → acalculia, agraphia, finger agnosia, left–right confusion
• Apraxia → difficulty executing learned movements
• Difficulty with visuospatial tasks → misjudging distances, poor navigation

Occipital Lobe

Functions: visual processing
Disorders / Damage Effects:

• Cortical blindness → vision loss with intact eyes
• Visual agnosia → cannot recognise objects despite normal vision
• Prosopagnosia (occipito-temporal involvement) → face blindness

Cerebellum

Functions: coordination, balance, motor learning
Disorders / Damage Effects:

• Ataxia → unsteady gait, coordination problems
• Dysmetria → overshooting or undershooting movement
• Slurred speech (scanning dysarthria)
• Some cognitive-affective symptoms → “cerebellar cognitive affective syndrome”

Brainstem

Functions: breathing, arousal, sleep, autonomic function
Disorders / Damage Effects:

• Severe strokes → impaired consciousness, life-threatening autonomic issues
• Parkinson’s disease involvement (midbrain) → motor slowing, rigidity
• REM sleep behaviour disorder (early sign of synucleinopathies)

Basal Ganglia

Functions: movement initiation, reward, habit formation
Disorders / Damage Effects:

• Parkinson’s disease → bradykinesia, tremor, rigidity
• Huntington’s disease → chorea, behavioural disinhibition
• OCD → overactivation of cortico-striatal loops
• Tourette’s syndrome → tics from dysregulation of movement pathways

Limbic System (Amygdala, Hippocampus, etc.)

Functions: emotion regulation, memory, motivation
Disorders / Damage Effects:

• PTSD → hyperactive amygdala, intrusive memories
• Depression → reduced hippocampal volume
• Anxiety disorders → overactive fear circuits
• Temporal lobe epilepsy → intense emotional experiences

Corpus Callosum

Functions: communication between hemispheres
Disorders / Damage Effects:

Multiple sclerosis → lesions causing slowed processing

Split-brain syndrome → impaired interhemispheric transfer

Normative Data

• Baseline scores derived from large, representative samples
• Used to compare an individual’s performance to population norms
• Shows how many SDs above/below mean a score falls

Factors Considered During Assessment

• Everyday functional behaviour
• Performance on cognitive tasks
• Context: education, culture, language, history
• Present mental state (mood, stress, psychiatric symptoms)

Best Practices (Dingwall, Pinkerton & Lindeman, 2013)

• Optimal assessment = observations + interviews
• Not solely reliant on formal tests

Importance Of Psychoeducation in Initial Interview

• Frames assessment as therapeutic
• Reduces anxiety
• Increases cooperation and accuracy