Patients
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| Specialty Clinics | Neuropsychological Evaluation FAQ |
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Movement Disorder Specialty Clinics
Services
- Neuropsychological evaluation for Parkinson’s disease and other movement disorders.
- A monthly botulinum toxin clinic specializing in the treatment of cervical dystonia (spasmodic torticollis), blepharospasm, hemifacial spasm, cranial dystonia, focal limb dystonia, writer’s cramp, and drooling.
- Genetic counseling for patients with movement disorders and their families.
- Bimonthly comprehensive movement disorders team meetings where we discuss individual treatment care plans for our patients.
- Outreach services to teach doctors and the public about the latest research on movement disorders and help support groups for people with movement disorders.
- Autonomic testing – a series of tests that help doctors understand how well a patient’s nervous system is working.
Neuropsychological Evaluation FAQ
So, your doctor has referred you to UNC Neurology, Movement Disorders for a Neuropsychological Evaluation. What does that mean and what does it involved? Check out the most Frequently Asked Questions below to learn more!
What is neuropsychology?Neuropsychology is the study of the relationship between the brain and a person’s behavior.
Neuropsychologists study how the brain works and how it affects our behavior. They look at what happens when the brain gets sick or injured, like in Parkinson’s disease. They test people to see how their thinking and actions have changed. Some neuropsychologists also help people learn to live with these changes and get better.
A neuropsychological evaluation is a test to see how a patient’s brain is working. The test usually involves an interview with a physicians and are usually completed with paper and pencil. Some sections of the test may be self-reports, meaning that they are completed by the patients with help from a medical technician. However, most of the tests require a neuropsychologist or trained, skilled psychometrist to give the test.
Neuropsychological tests are standardized, meaning that they are always given the same way to everyone. To find the score of a test, the patient’s responses are compared to a healthy individual of a similar demographic background (i.e., similar age, education, gender, and/or ethnic background). By comparing the test scores, a neuropsychologist can determine if the patient’s brain is working as well as it should.
Neuropsychological evaluations test a patient’s brain in a number of areas, including:
- Intelligence (how smart a person is)
- Executive functions (Executive function is like the brain’s manager. It helps us plan, organize, and focus on tasks.)
- Attention
- Memory
- Language
- Perception (the way our brain interprets the information we get from our sense)
- Sensorimotor functions (the things in our bodies that involve both sensing and moving like fine motor skills, balance, and coordination)
- Motivation
- Mood state and emotion
- Quality of life
- Personality styles (the way a person think, feels, and behaves)
The areas addressed in a patient’s evaluation are determined by the referral (what the referring doctor and patient wants to know), patient’s complaints and symptoms, and observations made during the interview and test taking time.
A complete evaluation generally takes between 2 – 5 hours to finish, but can take up to 8 hours, depending on the complexity of the issues to be addressed by the evaluation and the patient’s condition (for example, if the patient is tired, confused, or moving slowly).
Occasionally, it is necessary to complete the evaluation over two or more sessions. In general, the clinician attempts to help the patient do their best on the test.
Neuropsychological evaluation finds patterns of strengths and weakness in a patients brain functions and behaviors. For patients with Parkinson’s disease or other problems with movement, understanding their strengths and weaknesses, and their patterns, can help them manage them in the following ways:
- Helps the doctors find out what is causing a patient’s problems. For example, are the problems caused by a movement disorder, like Parkinson’s disease, or something else like depression?
- Helps doctors decide if a brain surgery called deep brain stimulation is a good option for a person. It can also help to see if the surgery has helped or hurt the person’s thinking and behavior.
- Helps doctors track how the person is doing over time. Doctors can see if the patient is getting better or worse, and if their treatment is working (e.g. medications or DBS).
- Helps to see what the patient might need help with in their daily life, like managing money. It also helps to figure out what kind of treatment might help them, like therapy or medication.
These are not tests that one can study for, but there are several things that one can do to facilitate the evaluation:
- The patient should bring a current list of ALL medications and doses (because medicines may change frequently for some patients, it is important to make sure the list is up to date)
- If the patient has difficulty providing information about their medical history, it is helpful for a family member or friend to accompany them (for at least part of the clinical interview).
- It is helpful if the patient can provide records of previous neurodiagnostic testing (e.g., brain scans such as CT or MRI scans) and/or results from previous neuropsychological evaluations if completed at another hospital or institution.
It is the goal of the neuropsychologist to get the best possible picture of the patient’s current functioning. Several things can interfere with the test like:
- Excessively tired or fatigued or has sudden, unexpected “sleep attacks”;
- Not motivated to put forth their best effort;
- Very emotionally distraught or has a severe psychiatric condition;
- Under the influence of medications or illicit substances which interfere with cognitive functioning;
- Experiencing frequent changes in the ability to move.
Patients should let the examiner know if they anticipate that any of these issues are likely to interfere with the evaluation.
It is important to get a good night’s rest before evaluation. Patients who live far away might consider spending the evening prior to the evaluation at a local hotel or with friends or family rather than getting up and driving or flying most of the night to get to the appointment. Patients are encouraged not to consume any alcohol 24 hours prior to the evaluation. If taking sleep medicine, patients should check with their doctor whether it might affect test performance the next day.
Patients should not worry about whether they will “pass” the tests. The tests cannot be passed or failed; instead they describe how well a person performs relative to peers.