Neurocognitive Assessment

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Presentation transcript:

Neurocognitive Assessment ד"ר יהושע נאמן שנה"ל 2014-15

Current Conceptualizations of Cognitive Function Lateral Specialization for Content Left Hemisphere: Verbal Content Right Hemisphere: Visual-Spatial Content Lateral Specialization for Processing Style Left Hemisphere: Serial and Analytic Style Right Hemisphere: Global and Syncretic Style

Current Conceptualizations of Cognitive Function Cortical Localization Applicable to a few functions Point versus general localization Network Appropriate for most others Broadly applicable even to generally localized functions

Current Conceptualizations of Cognitive Function Highly Localized Functions Sensory Perception (Somatosensory Cortex) Basic Motor Control (Primary Motor Cortex) Language Comprehension (Wernicke’s Area) Motor Speech (Broca’s Area) Prosody

Current Conceptualizations of Brain Function Networks Attention & Concentration Language ( L frontal & parietal lobes, thalamus, basal ganglia, cerebellum) Visual-Spatial Processing (R temporal & parietal lodes) Learning & Memory (entorhinal cortex, dentate gyri, hippocampi: new learning) Executive Functions (frontal lobes, temporal lobes, basal ganglia, cerebellum)

Minimally Adequate Neurocognitive Assessment Orientation Attention & Concentration Language Functions Visual-Spatial Functions Praxis Learning & Memory Executive Functions

MMSE and its Advantages Brief Repeatable Widely accepted Easily-administered Norms for virtually all populations

MMSE and its Shortcomings 10 of 30 points are in orientation domain Poor measurement of strategic functions such as attention and comprehension; reading and writing; object naming; praxis; and verbal short-term memory No measurement of strategic functions such as verbal fluency, executive functions

Addenbrooke’s Cognitive Examination (ACE) ‘Mini-Mental Plus’ - 100 points ~20 minutes to administer Hebrew version Major shortcoming: insufficient attention to executive functions

Addenbrooke’s Cognitive Examination (ACE) Mathuranath PS, Nestor PJ, Berrios GE, Rakowicz W & Hodges JR. (2000). A brief cognitive test battery to differentiate Alzheimer’s disease & fronto-temporal dementia. Neurology 55:1613-1620. Newman JP. (2005) Brief cognitive assessment in Hebrew: Addenbrooke’s Cognitive Examination. Israel Medical Association Journal 7:451-7.

Addenbrooke’s Cognitive Examination (ACE) For assessment of executive functions, consider adding the Frontal Assessment Battery Dubois B, Slachevsky A, Litvan I & Pillon B. The FAB: A frontal assessment battery at bedside. Neurology 2000;55:1621-26.

Addenbrooke’s Cognitive Examination (ACE) Hebrew version URL address: www.angelfire.com/il/neuropsy/ACE-Hebrew.zip English version URL address: www.angelfire.com/il/neuropsy/ACE-English.doc

Thank you.