Neuropsychological Assessment: Past and Future

Abstract

Neuropsychological assessment tools are the staple of our field. The development of standardized metrics sensitive to brain-behavior relationships has shaped the neuropsychological questions we can ask, our understanding of discrete brain functions, and has informed the detection and treatment of neurological disorders. We identify key turning points and innovations in neuropsychological assessment over the past 40-50 years that highlight how the tools used in common practice today came to be. Also selected for emphasis are several exciting lines of research and novel approaches that are underway to further probe and characterize brain functions to enhance diagnostic and treatment outcomes. We provide a brief historical review of different clinical neuropsychological assessment approaches (Lurian, Flexible and Fixed Batteries, Boston Process Approach) and critical developments that have influenced their interpretation (normative standards, cultural considerations, longitudinal change, common metric batteries, and translational assessment constructs). Lastly, we discuss growing trends in assessment including technological advances, efforts to integrate neuropsychology across disciplines (e.g., primary care), and changes in neuropsychological assessment infrastructure. Neuropsychological assessment has undergone massive growth in the past several decades. Nonetheless, there remain many unanswered questions and future challenges to better support measurement tools and translate assessment findings into meaningful recommendations and treatments. As technology and our understanding of brain function advance, efforts to support infrastructure for both traditional and novel assessment approaches and integration of complementary brain assessment tools from other disciplines will be integral to inform brain health treatments and promote the growth of our field. (JINS, 2017, 23, 778-790)

Long‐term cognitive and neuropsychiatric outcomes in patients with anti‐NMDAR encephalitis

“…Some limitations of the present study should be acknowledged. First, the cognitive rating scale (scores: 0‐4) and MoCA used in this study are only comparatively rough methods and could be insensitive to the some specific abnormalities . Hence, other neuropsychological tools would be necessary to detect multiple domains of cognitive impairment.…”

Gambling and Social Cognition: a Systematic Review

“…Table 1 defines several SC functions, presents measures that may be used to assess them in a clinical context, while highlighting those corresponding to neuropsychological tasks. The primary objectives of neuropsychological tasks are to "(i) detect neurological dysfunction and guide differential diagnosis, (ii) characterize changes in cognitive strengths and weaknesses over time, and (iii) guide recommendations regarding everyday life ant treatment planning" [43]. Thus, those tasks are objective measures of cognitive performances and can be opposed to PRO (patientreported outcomes) that are "direct subjective assessment by the patient of elements of their health" [44].…”

Action observation combined with gait training to improve gait and cognition in elderly with mild cognitive impairment A randomized controlled trial

“…The increased scores found in the CT and GT groups may relate to the ability of learning and remembering contents of the test. 33 Another issue may have been due to the active lifestyle of the participants. Preserved physical activity in daily life is a protective factor for cognitive decline through the enhancement of angiogenesis, neurogenesis and the anti-inflammatory environment in the brain.…”