Neuropsychological Assessment – II

We previously mentioned screening tests/short dementia batteries and behavior inventories/mood tests, some of the neuropsychological tests administered in our country. In this article, we will talk about tests that assess cognitive (concerning cognizance) functions classified as the third group.

The tests assessing the cognitive functions are grouped under the following titles:

• Attention/Perseverance/Interference and Resistance/Attention Maintenance Tests
• Memory Tests
• Visual Spatial Function Tests
• Language Tests
• Executive Function Tests (Reasoning, Abstraction, Planning, Sorting)
• Calculation/Arithmetical Tests
• Spatial Distribution of Attention
• Apraxia Tests

Attention Tests are divided into two groups: those measuring simple attention and complex attention. In simple attention tests, (WAIS-R Digit Span Subtest and WMS-R Digit Span Subtest) patients are expected to repeat the numbers they are told in a straight or reverse order. Therefore, verbal performance and overall intelligence are evaluated. Complex attention tests (WMS-R Mental Control Subtest, Verbal Fluency Test, Stroop Test, Trail Making Test, Wisconsin Card Sorting Test), however, measure the functions of maintaining the attention for a specific period of time, showing perseverance, coping with external stimulants, suppressing an unwanted answer, maintaining categories and changing categories.

Memory Tests assess the processes of acquisition, processing, codification of the information, transmission of the information to the long-term memory, storage and consolidation of the same in the memory, and screening, recalling and recognition of the information for remembering. They are divided into two groups: verbal (Öktem Verbal Memory Processes Test and California Verbal Learning Test) and non-verbal (Camden Pictorial Recognition Memory Test, WMS-R Visual Production Subtest and Rey Complex Figure Test).

Ökten Verbal Memory Processes Test

WMS-R Visual Production Subtest

Visual Spatial Function Tests (Hooper Visual Organization Test, Line Orientation Test, Face Recognition Test, WAIS-R Block Design Subtest and Figure Copying Test) are administered to distinguish the adults with brain damage.

Hooper Visual Organization Test

WAIS-R Block Design Subtest

Language Tests (Gülhane Aphasia Test and Boston Naming Test) are administered to assess skills of spontaneous speech, understanding and repeating what is said, along with reading and writing. Particularly dementia patients are observed to have difficulties in finding words or to mistake one word for another.

Boston Naming Test

Executive Function Tests (reasoning, abstraction, planning, sorting) assess the functions of reasoning, abstraction, planning and sorting. In the case that the patient is aphasic, the Standard Progressive Matrices Test is administered instead of the Proverb Interpretation Test and WAIS-R Dual Similarities Subtest. Wisconsin Card Sorting Test, which assesses the complex attention we mentioned before, can be included under this title as it also measures the skills of abstraction, hypothesizing and mental flexibility. London Tower, Clock Drawing, Luria Sequential Drawings Test are administered while assessing the skills of planning and sorting.

Standard Progressive Matrices Test

Luria Sequential Drawings Test

Calculation/Arithmetical Tests determines whether the patient suffers from “acalculia” by means of multiplication table, knowledge of operation modes, numerical knowledge, etc. These tests are as follows: Boston Diagnostic Aphasia Examination (BDAE) Arithmetical Subtest and WAIS-R Arithmetical Subtest.

Boston Diagnostic Aphasia Examination

One of the Spatial Distribution of Attention Tests implemented the most in our country is the marking test. Right hemisphere is measured to see whether it has a disorder based on the direction the patient takes while marking.

Apraxia Tests are used to determine whether there is a deterioration in the execution of the learned intentional movements. If a patient, when asked to execute, fails to execute the movements she/he knows of in advance though she/he automatically does the same (e.g. İmitating the use of a pair of scissors, saluting like a solider, creating a circle with her/his thumb and index finger), then it can be considered that there is a deterioration in her/his left hemisphere or in both hemispheres.

It must be kept in mind that the patient is never subjected to only one test; the result of the assessment is backed by different tests.