Neuropsychology

Neuropsychology is the applied scientific discipline that studies the structure and function of the brain related to specific psychological processes and overt behaviors. The term neuropsychology has been applied to lesion studies in humans and animals. It has also been applied to efforts to record electrical activity from individual cells (or groups of cells) in higher primates (including some studies of human patients).

It is scientific in its approach and shares an information processing view of the mind with cognitive psychology and cognitive science.

It is one of the more eclectic of the psychological disciplines, overlapping at times with areas such as neuroscience, philosophy (particularly philosophy of mind), neurology, psychiatry and computer science (particularly by making use of artificial neural networks).

In practice neuropsychologists tend to work in academia (involved in basic or clinical research), clinical settings (involved in assessing or treating patients with neuropsychological problems – see clinical neuropsychology), forensic settings (often assessing people for legal reasons or court cases or working with offenders, or appearing in court as expert witness) or industry (often as consultants where neuropsychological knowledge is applied to product design or in the management of pharmaceutical clinical-trials research for drugs that might have a potential impact on CNS functioning).

Approaches

Experimental neuropsychology is an approach which uses methods from experimental psychology to uncover the relationship between the nervous system and cognitive function. The majority of work involves studying healthy humans in a laboratory setting, although a minority of researchers may conduct animal experiments. Human work in this area often takes advantage of specific features of our nervous system (for example that visual information presented to a specific visual field is preferentially processed by the cortical hemisphere on the opposite side) to make links between neuroanatomy and psychological function.

Clinical neuropsychology is the application of neuropsychological knowledge to the assessment (see neuropsychological test and neuropsychological assessment), management and rehabilitation of people who have suffered illness or injury (particularly to the brain) which has caused neurocognitive problems. In particular they bring a psychological viewpoint to treatment, to understand how such illness and injury may affect and be affected by psychological factors. Clinical neuropsychologists typically work in hospital settings in an interdisciplinary medical team, although private practice work is not unknown.

Cognitive neuropsychology is a relatively new development and has emerged as a distillation of the complementary approaches of both experimental and clinical neuropsychology. It seeks to understand the mind and brain by studying people who have suffered brain injury or neurological illness. One model of neuropsychological functioning is known as functional localization. This is based on the principle that if a specific cognitive problem can be found after an injury to a specific area of the brain, it is possible that this part of the brain is in some way involved. However, there may be reason to believe that the link between mental functions and neural regions is not so simple. An alternative model of the link between mind and brain, such as parallel processing, may have more explanatory power for the workings and dysfunction of the human brain. Yet another approach investigates how the pattern of errors produced by brain-damaged individuals can constrain our understanding of mental representations and processes without reference to the underlying neural structure. A more recent but related approach is cognitive neuropsychiatry which seeks to understand the normal function of mind and brain by studying psychiatric or mental illness.

Connectionism is the use of artificial neural networks to model specific cognitive processes using what are considered to be simplified but plausible models of how neurons operate. Once trained to perform a specific cognitive task these networks are often damaged or 'lesioned' to simulate brain injury or impairment in an attempt to understand and compare the results to the effects of brain injury in humans.

Functional neuroimaging uses specific neuroimaging technologies to take readings from the brain, usually when a person is doing a particular task, in an attempt to understand how the activation of particular brain areas is related to the task. In particular, the growth of methodologies to employ cognitive testing within established functional magnetic resonance imaging (fMRI) techniques to study brain-behavior relations is having a notable influence on neuropsychological research.

In practice these approaches are not mutually exclusive and most neuropsychologists select the best approach or approaches for the task to be completed.

Methods and tools

• The use of standardized neuropsychological tests. These tasks have been designed so the performance on the task can be linked to specific neurocognitive processes. These tests are typically standardized, meaning that they have been administered to a specific group(s) of individuals before being used in individual clinical cases. The data resulting from standardization are known as normative data. After these data have been collected and analyzed, they are used as the comparative standard against which individual performances can be compared. Examples of neuropsychological tests include: the Wechsler Adult Memory Scale (WMS), the Wechsler Adult Intelligence Scale (WAIS), and the Wechsler Intelligence Scale for Children (WISC). Other tests include the Halstead-Reitan Neuropsychological Battery, the Boston Naming Test, the Wisconsin Card Sorting Test, the Benton Visual Retention Test, and the Controlled Oral Word Association. (The Woodcock Johnson and the Nelson-Denny are not neuropsychological tests per se. They are psycho-educational batteries of tests used to measure an individual's intra-disciplinary strengths and weakness in specific academic areas (writing, reading and arithmetic)).

• The use of brain scans to investigate the structure or function of the brain is common, either as simply a way of better assessing brain injury with high resolution pictures, or by examining the relative activations of different brain areas. Such technologies may include fMRI (functional Magnetic Resonance Imaging) and PET (Positron Emission Tomography), which yields data related to functioning, as well as MRI (Magnetic Resonance Imaging) and CAT (or CT) (Computed Axial Tomography), which yields structural data.

• The use of electrophysiological measures designed to measure the activation of the brain by measuring the electrical or magnetic field produced by the nervous system. This may include EEG (Electroencephalography) or MEG (Magneto-encephalography).

• The use of designed experimental tasks, often controlled by computer and typically measuring reaction time and accuracy on a particular tasks thought to be related to a specific neurocognitive process. An example of this is the Cambridge Neuropsychological Test Automated Battery (CANTAB).