What is neuropsychology?

Hello friends!

Although this text was published a while ago, it will be part of our Free Online Neuroscience Course. In order to continue the study of the area, this text corresponds, therefore, to our 3rd Lesson.

See too:

Lesson 1 – What is neuroscience?

Lesson 2 – History of Neuroscience

The term neuropsychology was first used in 1913 in a lecture given by Sir William Osler in the United States. It also appeared as a subtitle in Donald Hebb’s 1949 work “The Organization of Behavior: A Neuropsychological Theory.” (KRISTENSEN, ALMEIDA and GOMES, 2001).

The concept of Neuropsychology for Luria (1981) is the science whose specific objective is the investigation of the role of individual brain systems in complex forms of mental activity. And for Lezak (apud AMBRÓZIO, RIECHI 2005, p.3) “Science dedicated to studying the behavioral expression of brain dysfunctions.”

According to Malloy-Diniz (2010) Neuropsychology is concerned with the complex brain organization and its relationships with behavior and cognition, both in disease states and in normal development, and is defined as the applied science that studies the behavioral expression of brain dysfunctions.

The neuropsychologist’s main objective is to correlate the changes observed in the patient’s behavior with the possible brain areas involved, essentially carrying out clinical investigation work that uses neuropsychological tests and exercises. (Malloy-Diniz, 2010)

According to Luria (1981) there are three types of interaction between the brain and the mental process necessary for the development of mental activity: the attention unit, the coding and processing unit, and finally, the planning unit.

Neuropsychological assessment is an investigative strategy designed to identify, obtain and provide data and information about the subjects’ mental functioning. Malloy-Diniz (2010) considers as a demand for neuropsychological assessment:

“1. the detailed quantification and qualification of changes in cognitive functions, seeking diagnosis or early detection of symptoms, both in clinical practice and in research; 2. Assessment and reassessment to monitor surgical, drug and rehabilitation treatments; 3. Assessment directed towards treatment, aiming mainly at programming neuropsychological rehabilitation; 4. Assessment focused on legal aspects, generating information and documents about the occupational conditions or mental disabilities of people who have suffered a cerebral insult or disease, affecting the central nervous system. (Malloy-Diniz, 2010, p. 51)

According to Alcantâra and Ferreira (2010) the role of the clinical neuropsychologist in neuropsychological assessment is a method of investigating attention, perception, memory, language and reasoning (cognitive functions) and behavior, using interview techniques and quantitative and qualitative tests. Being in the quantitative approach based on norms, analyzes and studies of validity, with the method of comparison and standards to determine the differences between the pre and post treatment from scales, mean and standard deviation. In the qualitative approach, it is a complement to the evaluation, it contributes to data that are not observable through standardized tests, to confirm or question the quantitative data.

Malloy-Diniz (2008) points out that the main reasons for requesting a neuropsychological assessment are:

1. Diagnostic assistance: diagnostic questions generally seek to know what the patient’s problem would be and how it presents itself. This implies that a differential diagnosis is made between conditions that have very similar manifestations or that are likely to be confused.

2. Prognosis: with the diagnosis made, it is desired to establish the course of evolution and the impact that the disorder will have in the long term. This type of prediction has to do with the pathology itself or underlying condition of the disease or disorder (when there is a lesion, with the place, size and side on which it is located and, in this case, the distant effects that they cause).

3. Treatment orientation: by establishing the relationship between behavior and brain substrate or pathology, the neuropsychological assessment not only delimits areas of dysfunction, but also establishes the hierarchies and dynamics of the disorders under study. Such a design can contribute to the choice or changes in drug or other treatments.

4. Rehabilitation planning aid: the neuropsychological assessment establishes what the cognitive strengths and weaknesses are, thus providing a kind of map to guide which functions should be reinforced or replaced by others.

5. Selection of patients for special techniques: the detailed analysis of functions allows separating subgroups of patients with the same pathology, enabling a specific screening of patients for a procedure or drug treatment.

6. Expertise: aiding decision-making that legal professionals need to make in a given legal matter.

Fachel & Camey considers that, due to the different factors that interfere in the evaluation process, the diagnosis elaborated only in quantitative data easily leads to error. Hence the importance of the interdisciplinarity of neurosciences as well as the use of varied instruments by the neuropsychologist. (apud Alcantâra; Ferreira 2000, p.3)

In 2004, the Federal Council of Psychology recognized Neuropsychology as a Psychology specialty (Resolution CFP Nº 002/2004).

According to the CFP, there are 3 fields of action that are fundamental in the profession of Neuropsychologist:

1. Diagnosis – Through the use of standardized instruments (tests, batteries, scales) for the evaluation of cognitive functions, the Neuropsychologist will investigate the performance of skills such as attention, perception, language, reasoning, abstraction, memory, learning, academic skills, processing of information, visuoconstruction, affection, motor and executive functions. This diagnosis aims to be able to collect clinical data to help understand the extent of losses and explore the intact points that each pathology causes in the central nervous system of each patient. Based on this Neuropsychological assessment, it is possible to establish types of intervention, particular and specific rehabilitation for individuals and/or groups of patients with acquired or non-acquired disorders, genetic or not, primarily Neurological or secondarily to other disorders (Psychiatric).

2. Treatment (Rehabilitation) – With the diagnosis in hand, it is possible to carry out the necessary interventions with the patients, so that they can improve, compensate, work around or adapt to the difficulties. These interventions can be in the scope of cognitive functioning, that is, in the direct work with the cognitive functions (memory, language, attention, etc.) or with a much more ecological work, in the environment where the patient lives, with their relatives, to act as co-participants in the rehabilitation process; together with multidisciplinary teams and academic and professional institutions, promoting cooperation in the insertion or re-insertion of such individuals in the community when possible, or even in individual and family adaptation when the changes in the patient’s capabilities are more permanent or long-term.

3. Research – Research in Neuropsychology involves the study of different areas, such as the study of cognitions, emotions, personality and behavior, focusing on the relationship between these aspects and brain functioning. For such research, the use of Neuropsychological tests is a resource used, in order to have a parameter of the patient’s performance in the certain functions that are being researched. Currently, the use of specific drugs to stimulate or inhibit certain functions has been frequently used to observe the behavior and cognitive functioning of subjects in given situations. Another technique that has contributed a lot in the Neurosciences and with great specificity in Neuropsychology is the use of functional neuroimaging by Magnetic Resonance Imaging (fMRI) and functional positron emission tomography (PET-CT) that allow mapping certain areas related to specific activities, such as example recall of word lists during the exam. Therefore, it is clear that Neuropsychology is an emerging field of work and research, both for Psychology and for the Neurosciences, advancing and contributing in a unique way to the understanding of the way we think and act in the world.

Tests, as evaluation instruments, inform the subject’s performance only at the exact moment of their application. In view of this, the neuropsychologist must consider that, if the assessment involves different stages and is carried out at different times, it is essential to pay attention to the individual’s qualitative changes, such as the use of drugs, the performance of psychological and/or speech therapy treatment and any other type of disruptive event during the current week. (WINOGRAD; JESUS; UEHARA, 2012)

BIBLIOGRAPHIC REFERENCES

AMBRÓZIO, C.; RIECHI, ​​T.; BRITES M.; JAMUS, D.; PETRI, C.; ROSE, T; FAJARDO, D. Neuropsychology theory and practice. Available at: < http://www.proec.ufpr.br/enec2005/download/pdf/SA%DADE/PDF%20SAUDE/45%20-%20NEUROPSICOLOGIA%20TEORIA%20E%20PR%C1TICA%20-%20rev. pdf>. Accessed on: Oct 21, 2012.

FEDERAL COUNCIL OF PSYCHOLOGY. Resolution 02/2004. Available at: < http://www.crp.org.br/legislacao/resolucoes/federais/2004/resolucao2004_2.pdf>. Accessed on: Oct 20, 2012.
LURIA, AR Fundamentals of Neuropsychology. (1981). Sao Paulo: EDUSP.
KRISTENSEN, CH; ALMEIDA, RMM; GOMES, WB (2001). Historical Development and Methodological Foundations of Cognitive Neuropsychology. Psychology: Reflection and Criticism, 14(2), p. 259-274.

MALLOY-DINIZ , LF . Neuropsychological assessment – ​​Porto Alegre: Artmed. 2010. 432p.

PONTES, Livia Maria Martins; HUBNER, Maria Martha Costa. Neuropsychological rehabilitation from the perspective of behavioral psychology. Rev. psychiatrist. clín., São Paulo, v. 35, no. 1, 2008 . Available at: . access on 24 Oct. 2012

VENTURA, Dora Fix. A Portrait of the Area of ​​Neuroscience and Behavior in Brazil Psychology. University of São Paulo: Theory and Research 2010, Vol. 26 no. special, pp. 123-129

ALCANTARA, Joseane; FERREIRA, Sandra de Fatica Barboza. CONTRIBUTIONS OF NEUROPSYCHOLOGICAL ASSESSMENT FOR THE COMPLEMENTARY DIAGNOSIS OF SYNDROMIC CONDITIONS: A CASE STUDY. 2010.

Winograd, Monah; Jesus, Milena Vasconcelos Martins de; Uehara, Emmy. Qualitative aspects in the practice of neuropsychological assessment.Ciências & Cognição 2012; Vol 17 (2):…