Generalization of function To what extent does the brain function in a generalized
manner?
Localization of function What is the evidence for localization of function?
Connectionistic approach How does Geschwind's connectionistic approach explain
cognitive functions?
Hierarchial systems approach How does Luria's hierarchical systems approach aid in
understanding brain function.
Stability vs. Plasticity neuropsychological assessment assumes stability of function.
If recovery of function involves plasticity (other areas taking over function) what does this
do to our ability to locate dysfunction?
Recovery of function What is the difference between recovery of function and
compensation? How do they explain recovery from traumatic brain injury?
Higher cortical functions Select a more specific function
Working memory
attention
problem solving
Qualitative vs. quantitative analysis How much should you depend on test scores and how much on how the patient obtains the test score?
Test battery vs. individualized assessment (empirical vs. theoretical). What are the advantages and disadvantages of a single test versus a battery of tests?
Test construction and/or selection How can tests be selected to measure brain dysfunction?
Left vs. Right Hemisphere Functions Can be more selective such as
frontal lobes
temporal lobes
parietal lobes
occipital lobes
Cerebral Dysfunction vs. Psychiatric Disturbance Can be general or specific
frontal lobes and schizophrenia
cingulate gyrus lesions and obsessive compulsive disorders
Age, IQ, interaction with cortical dysfunction
Age Effects on cognitive function
IQ Effects on cognitive function
Orientation, Gestalt distortion
Impairment index vs. Profile Analysis Average score versus the pattern of scores
Depression vs. Dementia
Ecological Validity of Neuropsychological Tests What can you predict with neuropsychological test results?
Fixed vs. Flexible batteries
Speed of Processing as a measure of cognitive functioning The use of reaction time to assess brain function.
Variability changes with neurological damage How does variability change with damage to the brain?
Criterion measures and neuropsychological research.
40% of articles do not specify criteria
x-ray 75% false negative
Arteriogram 38% false negative
EEG 80% seizure detection [low with other]
CTScan 5%false positive 30% tumor detection
Blind analysis, individual assessment, vs systems approach
Evaluate strategies vs range of function
Reserve theory of cognitive recovery
Compensation strategies and their lack in an evaluation.
Laterality Determination
| Test
| Discriminative Value
|
| WAIS
| 10.8%
|
| Key
| 46.6%
|
| Standard Deviation
| 68.5%
|
| Discrim. (2 different formulas for left vs right)
| 81.08%
|
| Delayed Memory
| No value in lateralizing but significant for dysfunction
|
- Demographic Data - Age, IQ, interaction with cortical dysfunction
- Sex - No significant differences on Halstead Reitan Battery tests between males & females.
- Age - Significant age effects across most variables.
- Shift occurs after 35 and again after 55.
- Without age correction 50% false positive in 55 +
- ABOVE 25 - 20% misclassified using Impairment Index
- ABOVE 45 - 45% misclassified
- Decline is greatest with TPT, Trails, and Memory
- Decline is least with Tapping.
- Orientation, Gestalt distortion
- Impairment index vs. Profile Analysis
- Emotion
- Cerebral Dysfunction vs. Psychiatric Disturbance
- No significant differences in DEPRESSION Lateralized impairment
- Anterior-posterior determinations
- General sector data
- General Relationships
- Specific differences
