what is neuropsychological (neurocognitive)...
TRANSCRIPT
NORTHWEST AIDS EDUCATION AND TRAINING CENTER
What Is Neuropsychological (Neurocognitive) Testing? Eric Strachan, Ph.D. Psychologist, Madison Clinic Assistant Professor, UW Psychiatry
Last Updated: 9/29
The Plan
• Appreciate the complexities of cognition
• Understand the domains of typical neuropsychological testing
• Apply the domains to HIV-associated Neurocognitive Disorders
A Classic…
• Aoccdrnig to a rsecreearch at Cmabrigde Uinervtisy, it deosn't mttaer in waht oredr the ltteers in a wrod are, the olny iprmoetnt tihng is taht the frist and lsat ltteer be at the rghit pclae. The rset can be a total mses and you can sitll raed it wouthit a porbelm. Tihs is bcuseae the huamn mnid deos not raed ervey lteter by istlef, but the wrod as a wlohe.
• Tihs is an uarbn mtyh, by the way, although the premise is true.
My Point
• Thinking (“cognition”) is a complex, multifaceted phenomenon
• Perception • Transformation • Decoding • Integration • Experience
The Domains of Cognition
• Visual spatial ability
• Language
• Executive Functioning
• Motor Functioning
• Emotional Behavior
• Processing speed
• Attention/Working memory
• Learning
• Memory
Processing Speed
Attention/Working Memory
Imagining Impairment in Processing Speed and Working Memory
• Remember this 10-digit string…
3 0 3 4 2 0 2 6 4 0
Imagining Impairment in Processing Speed and Working Memory
• Got it?
Imagining Impairment in Processing Speed and Working Memory
• Now, remember these instructions… – Go out of the building and take a left. – Go 3 blocks until you see the sign for N. Ogren. – Turn left. – The address is 416 N. Ogren.
Imagining Impairment in Processing Speed and Working Memory
• Who can tell me the number AND the instructions?
Imagining Impairment in Processing Speed and Working Memory
3 0 3 4 2 0 2 6 4 0
- Go out of the building and take a left. - Go 3 blocks until you see the sign for N. Ogren. - Turn left. - The address is 416 N. Ogren.
Memory
• I’m going to read you a list of words…
• I’m going to read you a short story…
• Immediate recall and delayed recall - Correlated but not perfectly - The information can “get in there” even if initial recall is difficult
Language
• F A S
• Tell me the names of all the kinds of…
• Picture naming
Executive Function
• Control and management of other cognitive functions • Necessary for
- Planning/Decision making - Error control/Troubleshooting - Novel situations (not part of routine) - Dangerous or difficult situations - Response override (“I want that cake, but…”)
Executive Function
Red Blue Green Yellow
Blue Red Orange Green
Green Orange Yellow Blue
Yellow Red Blue Orange
Executive Function
HAND Definition
• Impairment in at least 2 cognitive domains - 1 or 2 standard deviations depending
• Interference with day-to-day functioning
• At least 1 month
• No competing explanations
General Overview of Interventions
Limited treatment trials in HIV-associated cognitive impairments but several general approaches should work given the deficits
• Verbal, Written, Visual (the 4 V’s?)
• Check for understanding
• Simplify, if possible