The Little Black Book of Neuropsychology (eBook)

Mike R. Schoenberg, Ph.D., is an Assistant Professor of Neurology at University Hospitals of Cleveland and Case Western Reserve University School of Medicine. He completed a two year post-doctoral fellowship in clinical neuropsychology at the University of Oklahoma Health Sciences Center and an internship at the University of Kansas School of Medicine, Wichita. He provides academic instruction and supervision in clinical neuropsychology to medical students and psychology trainees, and conducts research in clinical neuropsychology. James G. Scott, Ph.D., ABPP-Cn is a Professor of Psychiatry at the University of Oklahoma Health Sciences Center. He completed two years of postdoctoral training in clinical neuropsychology at the University of Oklahoma Health Sciences Center and an internship at Tulane University Medical School. He is board certified by the American Board of Professional Psychology in clinical neuropsychology and provides academic instruction and supervision to medical students and psychology trainees in clinical neuropsychology and conducts research in clinical neuropsychology.

Acknowledgments 6
Preface 8
References 10
Contents 12
Contributors 16
The Neuropsychology Referral and Answering the Referral Question 20
Evidenced Based Neuropsychological Practice 22
Description of Neuropsychological Functioning 23
Structure and Organization of the Evaluation 23
References 46
Deconstructing the Medical Chart 57
The Medical Chart 57
References 76
Neuroanatomy Primer: Structure and Function of the Human Nervous System 77
Introduction to the Human Nervous System 81
The Central Nervous System 83
Brain Anatomy Overview 84
Cerebro-Spinal Fluid 96
Spinal Cord 99
Peripheral Nervous System (PNS) 101
Cellular Organization of the Cortex 118
Functional Neuroanatomy: Structural and Functional Networks 124
Summary 143
References and Suggested Readings 144
Components of the Neuropsychological Evaluation 145
Basics of the Neuropsychology Evaluation 146
Factors Affecting Neuropsychological Functioning 147
Time: An Important Variable in the Neuropsychological Evaluation 148
Assessment of Basic Nervous System Functions (Cranial Nerves, Sensory and Motor Functions) 148
“Higher Order” Neuropsychological Function Examination 153
References and Suggested Further Readings 155
Arousal: The Disoriented, Stuporous, Agitated or Somnolent Patient 156
Arousal Problems: A Behavioral Guide 157
Stuporous Conditions Mimicking Coma 158
Delirium 159
Assessment of Arousal 161
References and Suggested Further Reading 164
Attention/Concentration: The Distractible Patient 165
Anatomy of Attention/Concentration 166
Attention Problems: A Behavioral Guide 167
Assessment of Attention 170
Methods to Assess Attention and Concentration 171
Brief/Bedside Assessment of Attention 172
Assessment of Vigilance 173
References and Suggested Further Reading 174
Language Problems and Assessment: The Aphasic Patient 175
Overview of Language 176
Anatomical Correlates 177
Recovery of Language Function 183
Language Problems: A Behavioral Guide 184
Bedside Assessment of Language 190
Psychometric Based Assessment of Language 191
References 192
Appendix A 193
Memory and Learning: The Forgetful Patient 195
A Model of Memory 196
Types of Memory 198
Terms of Memory Impairment 200
Neuropsychological Assessment of Memory Problems 202
Anatomy of Memory 205
Temporal Lobe and Memory 206
Diencephalon and Memory 206
Frontal Lobes and Basal Forebrain and Memory 207
Laterality and Memory 207
Storage and Retrieval in Memory 208
Assessment of Memory 209
Brief Bedside (Acute) Assessment of Memory 210
Intermediate/Bedside Assessment of Memory 210
Comprehensive/Outpatient Laboratory Assessment of Memory 215
References and Suggested Further Reading 215
Deficits in Visuospatial/Visuoconstructional Skills and Motor Praxis 217
Anatomy of Visual and Visuospatial Processing 218
Visual Processing “Streams” 220
Visual and Visuospatial Deficits 221
Visuoperceptual Distortions 222
Cortical Blindness or “Blind Sight” 222
Balint’s Syndrome 222
Visual Agnosia 224
Apraxia 227
Assessment of Visuospatial (Visual-Spatial) Functioning 228
Assessment and Interpretation of Visuoconstructional Functions 230
Bedside Assessment of Visuospatial ( Visuoconstructional) Skills 230
Laboratory (Outpatient) Neuropsychological Assessments 233
References and Suggested Further Reading 234
Frontal Lobe/Executive Functioning 235
Anatomy of the Frontal Lobes 236
Symptoms of Frontal Lobe Dysfunction: The “ Frontal Lobe” Patient 243
Bedside Assessment of Frontal Lobe Functions 256
References and Suggested Further Reading 263
Affect, Emotions and Mood 265
Multiaxial Diagnostic System 266
Mood/Emotions and Neurologic Illness 271
References and Suggested Further Reading 281
Aphasia Syndromes 282
Clinical Classification of Aphasias 283
Assessment 298
Ethnic, Age, Diversity and Psychiatric Considerations 301
Appendix: Rapid Review Summary for Classic Aphasia Syndromes 304
References 306
Cerebrovascular Disease and Stroke 308
Section I: Stroke Pathophysiology, Neuroanatomy, and Clinical Features 309
Cerebral Vasculature 319
Clinical Symptoms and Neuroanatomic Correlates 324
Section II: Neuropsychological Assessment of Patients after Stroke 355
Emotional Regulation/Personality Changes 363
Treatment of Stroke and Rehabilitation 365
References 369
Dementias and Mild Cognitive Impairment in Adults 372
Diagnostic Criteria and Definitions 373
Etiologies of Dementia 379
Prevalence of Dementia 379
Clinical Descriptions of Common Dementia Conditions 380
Assessment of Dementia 412
References 415
Episodic Neurologic Symptoms 419
Global Symptoms 420
Focal Symptoms 429
References 435
Epilepsy and Seizures 437
Making a Diagnosis 441
Incidence/Prevalence 443
Seizure Classification 444
Epilepsy Etiology and Syndromes 451
Selected Epilepsy Syndromes 452
Treatment of Seizures 463
Neuropsychological (Cognitive and Behavioral) Comorbidity in Epilepsy 471
Factors That May Obscure Neuropsychological Profiles in Presurgical Epilepsy Patients 483
Predicting Seizure Freedom, Side of Seizure Onset, and Cognitive Outcome Following Epilepsy Surgery 485
Psychiatric Status and Quality-of-life in Epilepsy 496
Neuropsychological Assessment Guide 501
Analysis of Change in Neuropsychology Test Scores 507
Summary 515
Appendix 1. International Classification of Epilepsies, Epileptic Syndromes, and Related Seizure Disorders 516
Appendix 2. Example of Newly Proposed Classification of Epilepsy Syndromes ( 2001) 518
References 519
Neuropsychology of Psychogenic Nonepileptic Seizures 534
Definition and Diagnosis 536
Prevalence and Incidence 539
Etiology 541
Psychological Testing and Evidence-Based Psychology Practice 546
Counting Elephants: Are There Meaningful PNES Subtypes? 550
Treatment 552
PNES in Children and Adolescents 554
Neuropsychological Assessment Strategies with PNES 554
Future Directions for Research, Detection, and Treatment of PNES 556
Appendix 556
References 557
Somatoform Disorders, Factitious Disorder, and Malingering 564
Definition/Terminology 564
Prevalence 566
Etiology 566
Malingering and Factitious Disorder 567
Differential Diagnosis: Distinguishing Somatoform Disorder from Malingering/ Factitious Conditions and Genuine Illness 568
References 574
Parkinson’s Disease and Other Movement Disorders 579
Section I: Common Movement Disorders: Neurological and Neuropsychological Features 580
Diffuse Lewy Body Disease/Dementia with Lewy Bodies 590
“Parkinson’s Plus” Syndromes 592
Drug-Induced Parkinsonism 594
Vascular Parkinsonism 595
Other Movement Disorders 596
Section II: Medical and Surgical Treatment of the Movement Disorders 601
Diffuse Lewy Body Disease/Lewy Body Dementia 602
The “Parkinson’s Plus” Syndromes 603
Presurgical Neuropsychological Evaluation 608
Ablation Techniques 609
The “Parkinson’s Plus” Syndromes 613
Essential Tremor 613
Essential Tremor 636
Dystonia 639
Tourette Syndrome 647
Chapter Summary 651
References 651
Multiple Sclerosis and Other Demyelinating Disorders 659
Clinical Features of Multiple Sclerosis 661
Neuropsychological Symptoms of Multiple Sclerosis 665
Correlates with Neuropsychological Deficits 667
Assessment of Neuropsychological Deficits in MS 669
Treatment Neuropsychological Deficits in MS 670
References 671
Moderate and Severe Traumatic Brain Injury 674
Epidemiology 675
Terminology and Classification Considerations 676
Pathoanatomy and Pathophysiology 678
Neurological and Neuropsychiatric Problems 685
Functional and Neuropsychological Outcome 691
Neuropsychological Assessment Issues 694
Psychosocial Outcome 695
Conclusions 698
References 699
Mild Traumatic Brain Injury 708
Epidemiology of MTBI 709
Terminology and Diagnostic Criteria 709
Neuropsychological Outcome 713
Early Intervention and Return to Work 717
Depression and Mild TBI 718
Mild Traumatic Brain Injury in the Military 719
Conclusions 722
References 724
Sport-Related Concussion 731
Neurobiology and Pathophysiology 732
Recovery Time 735
Classification Systems 736
Multiple Concussions 738
Emerging Evidenced-Based Neuropsychology 739
Return to Play 744
Conclusions 748
References 749
Post-Concussion Syndrome 755
Diagnostic Criteria 756
Diagnostic Challenges 758
Factors Relating to the Perception and Reporting of Symptoms 760
Post-Concussion Syndrome in Children 765
Is the Post-Concussion Syndrome Caused by Brain Damage? 767
Conclusions 767
References 768
Definition and Prevalence of Pediatric TBI 774
Pediatric Traumatic Brain Injury (TBI): Overview 774
Symptoms of TBI 776
Differences Between Pediatric TBI and Adult TBI 778
Neuropsychological Assessment of Pediatric TBI 779
Proposed Neuropsychological Assessment Protocol ( Clinical/ Research:) 781
Outcome and Recovery from TBI 783
Variables Affecting Outcome and Recovery 787
Management and Rehabilitation Issues 788
Conclusions 791
References 791
Brain Tumors 796
Types of Tumors 797
Epidemiology 799
Signs and Symptoms 800
Diagnosis and Neuroimaging 802
Classification and Survival Rates 803
Treatment 806
Neuropsychological Assessment Issues 808
Summary and Conclusions 814
References 815
Neurotoxicity in Neuropsychology 821
Definitions 822
Principals of Identifying and Evaluating Neurotoxic Exposure 828
The Neurotoxicity Syndrome 832
Assessment for Neurotoxicity 834
References 842
Cognitive Decline in Childhood or Young Adulthood 847
Metabolic Diseases 849
Acute Disseminated Encephalomyelitis (ADEM) 855
Rassmussen’s Encephaolpathy 856
Vitamin B12 Deficiency (Cobalamin Disorders) 858
Galactosemia 859
Hallervorden-Spatz Syndrome 860
Rett Syndrome 860
Hydrocephalus 861
Psuedotumor Cerebri (Idiopathic Intracranial Hypertension) 863
Sickle Cell Disease 864
Lafora Disease (Aka Lafora Progressive Myoclonic Epilepsy) 865
HIV Associated Progressive Encephalopathy (HPE)/HIV-Associated Neurocognitive Disorders 866
Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy ( CADISIL) 867
Wilson’s Disease (Hepatolenticular Degeneration) 867
References 868
Application of Motivational Interviewing to Neuropsychology Practice: A New Frontier for Evaluations and Rehabilitation 870
A New Approach to Noncompliance and Patient Feedback: Emerging Empirical Support 871
What Is Motivational Interviewing? 872
Core Concepts and Principles of MI 873
Transtheoretical Model of Change 873
Principles and SPIRIT of MI 874
MI Skills and Examples of Strategies 875
Summary 877
References 877
Reliability and Validity in Neuropsychology 879
Reliability in Neuropsychology 880
Internal Reliability 881
Test–Retest Reliability 884
Alternate Form Reliability 885
Interrater Reliability 886
Evaluating a Test’s Reliability 888
Limits to Reliability, Practice Effects, and Effects of Prior Exposure 889
Validity in Neuropsychology 892
Validity Models 892
How to Evaluate the Validity of a Test 893
Conclusions 896
References 897
Psychometric Foundations for the Interpretation of Neuropsychological Test Results* 899
Interpreting and Communicating Test Performance in Clinical Practice 900
Sample Characteristics and Test Score Interpretation 902
Comparing Scores Between Tests 909
Normal Variability across Test Batteries and the Prevalence of Low Scores 913
Assessing Change over Time 915
Summary and Conclusions 924
References 926
Improving Accuracy for Identifying Cognitive Impairment 929
Conceptualizing Cognitive Impairment 930
Classifying Cognitive Impairment 932
DSM-IV Cognitive Disorder NOS ( Mild Neurocognitive Disorder) 934
Evaluating Cognitive Impairment: Five Psychometric Principles to Consider 935
Identifying Cognitive Impairment: New Psychometric Criteria for Cognitive Disorder NOS 946
Conclusions 951
References 953
Index 957