Moberg PJ. Neurology. Hodges JR, Arch Phys Med Rehabil. Clin Neuropsychol. Int J Geriatr Psychiatry. A = consistent, good-quality patient-oriented evidence; B = inconsistent or limited-quality patient-oriented evidence; C = consensus, disease-oriented evidence, usual practice, expert opinion, or case series. McCrory P, Graver CJ. Immediate, unlimited access to all AFP content. Neuropsychol Rev. Koski L. Cogn Behav Neurol. Centers for Disease Control and Prevention. Family physicians should consider referring patients when there are questions about diagnostic decision making or planning of individualized management strategies for patients with mild cognitive impairment, dementia, traumatic brain injury, and other clinical conditions that affect cognitive functioning. False-positive rates associated with the use of multiple performance and symptom validity tests. American Psychiatric Association. Visser PJ, Dikmen SS,

17. The differential effects of Alzheimer's disease and Lewy body pathology on cognitive performance: a meta-analysis. Javorsky DJ, Arch Phys Med Rehabil. Enlarge Frölich L. A neuropsychological evaluation usually consists of an interview and testing.

99/No. The clinical neuropsychologist uses psychological, neurological, cognitive, behavioral, and physiological principles, techniques and tests to evaluate patients’ neurocognitive, behavioral, and emotional strengths and weaknesses and their relationship to normal and abnormal central nervous system functioning.

2007;21(1):31–44.

Chiaravalloti ND. Bring glasses or hearing aids if you use them. Screening tests usually take five to 10 minutes to complete and are designed to screen for general cognitive impairment that may warrant a more comprehensive workup. VA/DoD clinical practice guideline for the management of concussion—mild traumatic brain injury. 2010;82(5):495–502. Assessment of older adults with diminished capacity: a handbook for psychologists. Neuropsychological evaluations are often complementary to neuroimaging and electrophysiologic procedures.5 Computed tomography and magnetic resonance imaging evaluate structural integrity within the central nervous system to identify atrophy and lesions. Meeuwisse W, https://www.cdc.gov/traumaticbraininjury/pdf/tbi_clinicians_factsheet-a.pdf. Carvalho J, et al. Amann B, et al. 14.

Finnanger TG, Early cognitive deficits in Swedish gene carriers of Huntington's disease. Approach to the patient in whom there is concern about dementia. Optum. Masson F, The pattern of your own test scores will also be reviewed to estimate whether or not there has been a change in certain abilities. VA/DoD clinical practice guideline for the management of concussion—mild traumatic brain injury. McKhann GM, Neuropsychologists routinely use performance validity tests in cases where legal issues may be confounding recovery after TBI. Cognitive predictors of academic achievement in young children 1 year after traumatic brain injury. Martin PK, Alderson A, Tremont G.

The addition of neuropsychological testing to injury severity variables (e.g., posttraumatic amnesia) increases predicted accuracy in functional outcomes.

Cholerton B, Tupper D, 38. Schroeder RW, Lacritz LH, Tests may be performed using paper and pencil or on the computer. In this way, later changes can be measured very objectively. Guidelines from several organizations stress the importance of neuropsychological assessment in the diagnosis and management of dementia. Search dates: July 26, 2017, to October 12, 2018. A neurological disorder such as hydrocephalus, epilepsy (seizures), or a brain tumor. 3. The results help to identify what target problems to work on and which strategies to use. 2016. Verbal and design fluency in patients with frontal lobe lesions. Author disclosure: No relevant financial affiliations.

Updated mild traumatic brain injury guideline for adults. 21. Cognitive impairment 3 months after moderate and severe traumatic brain injury: a prospective follow-up study. Dikmen SS, World Health Organization.

Gola TJ. Machamer JE, Amann B, Accessed August 19, 2018. Maciejewski C. Warrington EK, Gola TJ. Accessed April 12, 2018. 8. Klein-Boonschate MA, EFNS-ENS guidelines on the diagnosis and management of disorders associated with dementia. Watt S,

Encounters with Anna Thompson: the consumer's experience of neuropsychological assessment. By using database scores from large groups of healthy people for comparison, the neuropsychologist can judge whether or not your scores are normal for your age and educational background. Neuropsychological profiles differentiate Alzheimer disease from subcortical ischemic vascular dementia in an autopsy-defined cohort. 2(January 15, 2019)

Taylor HG, 24. Fulton JB, Neuropsychological evaluation can be useful in determining decision-making capacity in persons with cognitive impairment. Walz NC, Hanks RA, The American Academy of Neurology has endorsed the use of neuropsychological evaluation in the assessment and treatment of a variety of conditions, including cerebrovascular disease/stroke, Parkinson disease, human immunodeficiency virus encephalopathy, multiple sclerosis, epilepsy, neurotoxic exposure, and chronic pain.42 Research also demonstrates that neuropsychological evaluations can detect cognitive changes caused by psychiatric conditions such as schizophrenia and bipolar disorder20,43; identify cognitive changes that may emerge before motor abnormalities in the early stage of Huntington disease44; and measure cognitive changes after surgery in patients with brain tumors.45 Neuropsychological evaluations can also detect cognitive issues in patients with developmental disabilities, illnesses, and central nervous system abnormalities.27, Referrals for neuropsychological consultation are commonly made by family physicians, neurologists, psychiatrists, and other primary care clinicians. Maurette P, Klein-Boonschate MA, Baker LD, Medicare coverage summary: psychological and neuropsychological testing. Encounters with Anna Thompson: the consumer's experience of neuropsychological assessment. Reed B, 2007;116(6):453–460. Test results can be used to understand your situation in a number of ways: Studies have shown how scores on specific tests relate to everyday functional skills, such as managing money, driving, or readiness to return to work. Battistin L, Lydersen S, Neuropsychological testing can differentiate Alzheimer dementia from nondementia with nearly 90% accuracy. Alderson A, 47. Geneva, Switzerland: World Health Organization; 1993. Lydersen S, Early detection and differential diagnosis of Alzheimer's disease and depression with neuropsychological tasks. A typical neuropsychological evaluation will involve assessment of the following: Some abilities may be measured in more detail than others, depending on your needs. : Pearson Education; 2009. Craft S. et al. Verbal and design fluency in patients with frontal lobe lesions. Moafmashhadi P, Because of the unique data that neuropsychological testing provides, physicians have increasingly utilized neuropsychological services.5 In satisfaction surveys, more than 80% of primary care physicians reported that referral questions were satisfactorily answered, and approximately 90% agreed with the diagnostic impressions and treatment recommendations.6  Overall, they found the consulting report useful, and they indicated they would continue to refer patients for neuropsychological evaluations. 2010;91(12):1904–1913. Spitz G, Clinical neuropsychology is a specialty profession that focuses on brain functioning. 2019 Jan 15;99(2):101-108. Wolfsgruber S, Clinical neuropsychologists use this knowledge in the assessment, diagnosis, treatment, and/or rehabilitation of patients across the lifespan with neurological, medical, neurodevelopmental and psychiatric conditions, as well as other cognitive and learning disorders. Am J Geriatr Psychiatry. RYAN W. SCHROEDER, PsyD; PHILLIP K. MARTIN, PhD; and ANNE WALLING, MB, ChB, University of Kansas School of Medicine–Wichita, Wichita, Kansas. Don't miss a single issue. https://www.providerexpress.com/content/dam/ope-provexpr/us/pdfs/clinResourcesMain/guidelines/mcs/ptMCS.pdf. Skandsen T, Bondi MW,

afpserv@aafp.org for copyright questions and/or permission requests. Bondi MW, Br J Sports Med. Gerosa M. Koski L. 2005;65(1):102–106. Delis DC, Changes in neuropsychological performance after traumatic brain injury from inpatient rehabilitation to 1-year follow-up in predicting 2-year functional outcomes. For information about the SORT evidence rating system, go to https://www.aafp.org/afpsort. DeLuca J, 16. Reprints are not available from the authors. Neuropsychological testing provides an objective assessment of the cognitive, behavioral, and emotional manifestations from cerebral injury or disease. A neuropsychologist may also talk to family members and your other doctors. 45. Other medical problems such as diabetes, chronic heart or breathing problems, certain genetic disorders, or treatment for childhood cancer. et al. For example, the results can help to plan and monitor rehabilitation or to follow the recovery of skills after a stroke or traumatic brain injury. A neuropsychologist may also talk to family members and your other doctors. Cognitive screening tests versus comprehensive neuropsychological test batteries: a National Academy of Neuropsychology education paper. Arch Clin Neuropsychol. Outcome 3 to 5 years after moderate to severe traumatic brain injury. Neuropsychological assessment and employment outcome after traumatic brain injury: a review. Dement Geriatr Cogn Disord. Considerations for neurologists. Address correspondence to Ryan W. Schroeder, PsyD, University of Kansas School of Medicine, 1010 N. Kansas St., Wichita, KS 67214 (e-mail: American Academy of Clinical Neuropsychology (AACN) practice guidelines for neuropsychological assessment and consultation. Kaufmann P, Chertkow H, Chiou KS, The clinical utility of structural neuroimaging with MRI for diagnosis and differential diagnosis of dementia: a memory clinic study. et al. Gavett BE.

Cognitive screening tests versus comprehensive neuropsychological test batteries: a National Academy of Neuropsychology education paper. Battistin L, Thompson RN. Ramirez-Gomez L, Bercaw EL, The American Academy of Clinical Neuropsychology, National Academy of Neuropsychology, and Society for Clinical Neuropsychology (APA Division 40) 2015 TCN professional practice and ‘salary survey’: professional practices, beliefs, and incomes of U.S. neuropsychologists. Puente AE, 2017;44(1–2):1–11. Stefanidis KB, Alaoui P, Watson GS, Stern RA. Kreis M, 33. Clin Neuropsychol. Wade SL. Summers MJ, This has been highlighted by research showing that screening test items weakly correlate with scores in the same cognitive domains on neuropsychological testing (correlations range from 0.04 to 0.46).4 Neuropsychological testing typically requires several hours to complete because it comprehensively examines multiple cognitive domains to provide a detailed assessment of the nature and severity of cognitive impairments. To reduce patient stress and optimize outcomes, physicians should briefly discuss with patients the reason for the referral, the anticipated benefit of the assessment, and the general testing format. Bennett-Levy J, , you can submit your question or comment in the contact form below, or you can always call us at 314-324-3800. Aakre J, Sherer M, 2017;27(4):354–388. Test results can also be used to help differentiate among illnesses, which is important because appropriate treatment depends on accurate diagnosis. Arch Phys Med Rehabil.

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