What is a neuropsychological assessment?

A neuropsychological assessment is a comprehensive evaluation of a patient's cognitive, behavioral, and emotional functioning, allowing for a holistic examination of their brain function.

While brain imaging can reveal structural changes in the brain, it does not provide much insight into the effects of such changes on the patient's day-to-day functioning. A neuropsychological assessment paints an accurate picture of patients' cognitive and daily functioning, offering indispensable data for clinical diagnosis and treatment planning.

What constitutes a neuropsychological assessment?

1. Investigation: Gather insights into patients' brain functioning via:

   • Neuropsychological testing: to reveal cognitive strengths and weaknesses

   • Clinical interview with patients and an informant (usually a family member or caregiver)

   • Behavioral observation of the patient during evaluation

2. Diagnosis: Diagnose the cause of cognitive impairment through integrating a wide array of clinical data (neuropsychological assessment, self- and informant-reports, behavioral observation, brain imaging, neurological examination, and occasional lab workup).

   Assigned diagnoses typically fall into 3 categories:

   • Neurological/organic: dementia/neurodegenerative disease, strokes, traumatic brain injury, epilepsy, brain tumor, neurodevelopmental disorder (Autism spectrum disorder, ADHD, etc.)

   • Psychological: depression, anxiety, trauma-related disorders, functional neurological disorder, etc.

   • Medical: poorly controlled heart/thyroid/respiratory conditions, sleep apnea, cancer, viral/bacterial infections, etc.

3. Psychoeducation: Help patients and family understand the diagnosis and what to expect in terms of treatment and recovery trajectory (prognosis)

4. Treatment planning: Curate tailored recommendations and referrals to facilitate recovery

   • If full recovery is not possible, a neuropsychologist can offer tailored recommendations to maintain and/or improve independence and quality of life for as long as possible

   • Dr. Mo also offers cognitive rehabilitation for select patients

What to expect on testing day

A comprehensive neuropsychological assessment can take 2-4 hours, depending on the patient's speed, endurance, and level of cooperation. Here are a few things you may want to know before your appointment.

Walk me through a full neuropsychological evaluation

1. Clinical interview with patient and informant (family member or caregiver)-- 60-90 minutes

   • It is highly recommended that patients come accompanied by a family member or caregiver. Patients with cognitive impairment often have difficulty communicating or accurately recalling information and may have limited insight into their condition. Therefore, having a trusted informant will help the neuropsychologist obtain the most accurate and comprehensive information regarding patients' presenting problems.

2. Neuropsychological testing-- 60-120 minutes with breaks

   • During testing, the informant(s) will be asked to leave the room until the patient has completed the test battery.

   • The patient will be asked to complete a series of paper-and-pencil tests. A neuropsychological test battery is similar to an IQ test, but it examines specific brain functions known as cognitive domains, including attention, executive functioning, memory, language, visuospatial skills, and processing speed.

3. Feedback session-- 15-30 minutes

   • After scoring and interpretation, Dr. Mo will communicate the findings to the patient and family member or caregiver. Patient and caregiver will be educated on the diagnosis and recovery trajectory (prognosis), and will be provided with tailored recommendations and treatment planning.

   • Note: feedback session can happen at the end of the testing day if all data points are ready (neuropsychological test scores, brain MRI, neurological examination). Otherwise, feedback sessions will be held at a separate appointment.

4. Neuropsychological report

   • Patient will receive a copy of their neuropsychological report via mail or email a few weeks after their appointment. The report will include the information collected from the interview, test results, neurological exam findings, brain MRI findings, clinical diagnosis and secondary factors to cognitive impairment, and recommendations.

   • A copy of the report will also be sent to the patient's neurologist, and/or any doctors they would like to involve in their care.

   • Patients may request referrals to other care providers outlined in the recommendations (e.g., neurologists, clinical psychologists, speech/occupational/physical therapists).

Before the appointment:

• Ensure the patient is well rested the night before

• Have a nourishing meal before coming to the appointment-- testing requires a lot of energy

• Take medications as usual, but avoid taking psychoactive/sedating medications if possible

• Bring all sensory aids to the appointment (hearing aids, glasses, etc.)

• Bring snacks, water, and any necessary medication

• Ideally, patients would have already consulted with a neurologist for an elemental neurological examination and obtained a brain MRI before coming to the appointment

Ask me anything!

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