NEUROPSYCHOLOGY

The Brain Behaviour

Relationship
 Neuropsychology…

 Proposes a model relating brain dysfunction/damage

to observable empirically described behavioural
deficits.

 Studies revealed- results from neuropsychological

tests accurately agree with diagnosis made by
neurologists and/or psychiatrists.
 What is Brain Behaviour
Relationship?

n Behaviour is an outcome of the interaction of the brain

with the environment
(a composite of psychological processes shape behaviour).

n Chief domains of psychological processes are cognition,

emotion and volition.
 Neuropsychology will…

F Establish the existence of any cognitive

deficits related to insult/injury
F Establish the relative magnitude of this
insult/injury
F Estimate the patient’s possibility to return to
his previous life-style
F Suggest remediation programme
 Why should we assess
neuropsychological functioning?...

n It considers both what is wrong and what is right

with the patient – assets and deficits.
n It is a clinical examination of both the working
brain and dysfunctional brain.
n The behavioural deficits are explained by
underlying cognitive, emotional and volitional
deficits as well as personality changes.
Assessment Tools

n Luria-Nebraska
Neuropsychological Battery
(adult and child both)
n NIMHANS Neuropsychology
Battery – 2004.
Remediation Programme

n Rehabilitation

n Cognitive Retraining
 Philosophy of Rehabilitation

n Identified defective link in the functional

system involved can be replaced with an
intact link; thus restoring, at least to some
extent, the system as a whole (based on
Luria’s functional system theory).

for example: acoustic analysis may be replaced by tactile

analysis in the mediation of some behaviour.

Contd…
 Contd…

n Restoring the function of the impaired area and the

patient as well to some form of productive living –
providing an improved quality of life.

n Later approaches involve the identification of some

area in which the patient may be productive, despite
of having neuropsychological deficits.
 Contd…

n Plasticity of the brain (capacity to adapt to changes in the environment,

changes in the functional neural networks following practice) is the basis of
neuropsychological rehabilitation.

n Psychologically brain plasticity is conceptualized to be

mediated by the re-organization and re-establishment
of functions.
 Cognitive Retraining

n A component of neuropsychological rehabilitation.

n Refers to treatment strategies which employ
psychological methods to ameliorate
neuropsychological dysfunctions.
n A training program in which new skills are
established or the efficacy of the existing cognitive
functions is enhanced by a process of gradual
learning.
n It emphasize on the efficiency of the brain to
process task of increasing complexity level as well as
carry this out with increasing speed.
 Contd…

n The aim is to improve the functions of basic

(e.g. attention, short term memory and information
processing) to higher level skills.

n Graded practice is given using the method of

saturation cueing.
 Contd…

n The rationale is that – these are the basic

building blocks of higher level skills such as
learning, long term memory, etc.

n Improvement in the basic functions will

improve the higher level functions which
depend on the basic function.
Contd…

Utility

Improves basic function

Further improve higher level functions

Components of Cog.
Retraining

Restoring skills

Using strategies, compensatory

techniques, or "tools" to cope with
weaker areas.
 Other management
Programme
n Teaching problem solving skills.
n Improving patient’s self expression through
conventional means such as language, emotions
or gestures.
n Using psychotherapy, behavioural management
programme, psycho-education and counseling
for the patient and for the care givers as well as
an adjunct therapy.
 Application

n Neuropsychological rehabilitation is the

treatment of choice in clinical conditions such
as sequelae of head injury, infection, stroke.

n It is widely used to treat head injury related

changes in cognition, affect and personality.
 Contd…

n Specific cognitive deficits and emotional changes following

stroke are amenable for neuropsych remediation

n Preliminary studies have shown that it does yield good

results in treating the sequelae of brain infection.

n It also was used widely in different neurological,

neuropsychiatric and psychiatric illnesses.