Adult Assessment

Neurocognitive changes may occur in PD over time, but individual patterns of change greatly differ.

 Neuropsychological testing helps to set a baseline for later comparison when done early, and helps to identify cognitive weaknesses that can be targeted by specific therapies in many cases. 

Pre- and post-surgical testing is the gold standard when deep brain stimulation (DBS) implantation is selected for treatment. 

There have been many recent successes in the treatment of MS, and people with MS are subsequently enjoying longer and more active lives. 

Cognitive changes are sometimes noted in MS, particularly in processing speed. Neuropsychological testing can identify weaknesses and recommend targeted therapies to compensate or rehabilitate. 

Dementias include Alzheimer's disease (AD), vascular dementias, fronto-temporal dementia (FTD), and Lewy body disease, among others. 

The pattern of cognitive changes often helps to differentiate between types. More importantly, it can identify areas of cognitive change that may benefit from remediation, therapy, and supports to increase life enjoyment.

Cognitive changes due to epileptic seizures and associated treatments are common, but they vary widely between patients. 

Identifying the weak areas through neuropsychological assessment allows for appropriate supports and therapies to be put into place, allowing the patient to optimize their lifestyle, education, and occupation. 

Neuropsychological evaluation also plays a valuable role in pre- and post-surgical evaluations when selected as a treatment. 

Autoimmune disorders – when the body's defenses inappropriately attack healthy structures – are little understood. 

However, there is the growing implication of inflammation and autoimmune reactions having roles in many chronic diseases. In some cases, cognitive function may suffer. 

It is important to characterize these changes (particularly in autoimmune encephalopathy) with repeated neuropsychological testing to assess for target therapies and possible changes over time. 

Neuropsychological evaluation is often implemented pre- and post-surgery for a number of conditions (e.g., deep brain stimulation [DBS]; responsive neurostimulation [RNS]).

Sometimes, an abbreviated psychological assessment is used pre-surgery to establish emotional fitness and readiness for surgery and follow-up procedures (bariatric and spinal stimulation). 

The priority in cancer treatments is maintaining life. Unfortunately, some cognitive side effects may result from treatment adverse effects, proportional to treatment intensity, method, and location. 

A neuropsychological evaluation can establish any resulting cognitive weaknesses and recommend restorative therapies in some cases. 

Many older adults experience cognitive changes as they age, but have questions about whether these changes are considered normal. Often, they compare their memory to what they "used to be able to do." 

A neuropsychological evaluation does two things in these cases: First, it sets a baseline for future comparison; second, it eases anxiety in many by establishing that the changes are within expectations. 

Use of alcohol, cocaine, marijuana, and benzodiazepines may be associated with neurological changes. 

Achieving sobriety is the first priority. Then, obtaining a cognitive baseline may be recommended. 

This is a somewhat controversial subject. Dr. Brown, a well-known ADHD expert, gives more information. 

Characterized by confusion, urinary incontinence, and walking difficulties (odd gait), NPH may mimic non-reversible conditions such as dementia. 

It may occur in up to 6 percent of adults over 80 years old. 

TBI and concussions have been in the news in recent years in relation to sports, but the effects of sudden impact to the head have been known since World War I. Alexander Luria established the basis for modern neuropsychological testing while caring for brain-injured WWII soldiers.

Neuropsychological assessment is useful in determining deficits and possible supports and rehabilitative treatments. 

Brain tumors pose a risk factor to healthy cognition whether benign or malignant. 

For malignant tumors, surgical or radiotherapy/chemotherapy treatment may also contribute to neurocognitive change. 

Neuropsychological testing can help establish that the pattern of deficits is consistent with tumor location, and necessary supports and rehabilitation processes for recovery. 

Carbon monoxide poisoning, lead exposure, and pesticide/herbicide exposures have been implicated in cognitive changes. 

Neuropsychological testing can identify the scope and magnitude of these changes so that proper rehabilitative therapy can be implemented where possible.