Neuropsychologist

A neuropsychologist studies brain-behavior relationships. What we mean by this is how our behavior relates to activity or processes going on within our brain. They investigate what parts of the brain are active whilst a person is doing certain things. This helps create a map that represents what part of the brain is responsible for certain functions. This can help us to understand the impact of brain damage to different parts of the brain.

Most relevant to a stroke survivor is the clinical neuropsychologist who turns the academic thinking into practical engagement with patients (or clients).

What Do They Do?

The Australian Psychological Society offers the following definition:

"Clinical neuropsychologists study changes in thinking and behaviour that may arise from brain dysfunction such as head injury, epilepsy, neurological disease and stroke, drug and alcohol disorders, learning disabilities, attention deficit disorders, dementia and psychiatric disorders. They deal with the cognitive, emotional and behavioural problems related to brain dysfunction through assessment, rehabilitation, education and psychological therapy.

People are referred to clinical neuropsychologists for the evaluation of a range of problems related to brain dysfunction. Areas for assessment include:

• Memory problems
• Concentration problems
• Attentional difficulties
• Problems thinking clearly and logically
• Problems making important decisions
• Language and learning difficulties."

Why Should You Care?

Stroke is a brain injury. Whilst most people think in terms of the physical impacts of stroke, the brain dysfunction impacts can be significant - and these can be a large factor in post-stroke quality of life. It would appear that there is limited referral for stroke patients to a neuropsychologist. We find this amazing, given that their role is to identify the specific behavioural issues that are manifesting from the brain injury.

Neuropsychological assessment can be useful to help explain what is happening after the stroke. On our effects of stroke page, we summarised the effects that are typical of injury to different parts of the brain. It is helpful to understand these effects so that the patient, family and friends can establish workarounds where appropriate. Often, the patient is not aware of the changed behaviour and a clinical assessment can assist in convincing them that these problems do exist.

Further, a neuropsychological assessment may be useful in supporting a disability insurance claim. The stroke patient may be physically able to work, but the neuropsychological issues may mean that they are not capable of working and/or interacting with other people competently.

What Should You Expect?

A neuropsychologist will offer a range of standard tests. This means that exactly the same test has been administered to a range of the population and so an individual's results can be compared to the norm. Individuals will be classified into a specific group (e.g. left brain stroke) to act as comparative data. The result of the testing will be a neurological assessment that can be the basis on which a management plan can be constructed. A management plan may consist of strategies that the stroke patient (and family and friends) employs to make life easier or there may be particular exercises that can be undertaken to assist in brain rehabilitation.

In addition to neuropsychological testing, brain scans may be used to investigate the brain. This can be through the use of high resolution pictures or through technologies like functional Magnetic Resonance Imaging (fMRI) and Positron Emission Tomography (PET) which can allow brain mapping to take place.

What's the Future?

It would appear that the focus of work in neuropsychology is around assessment of the impact of the injuries and creating workarounds, or ways of dealing with the impact of the brain injury.

Neuroplasticity is a relatively new concept in the field of neurology. The findings are that the brain will rearrange itself so that different parts pick up the functions of areas that are damaged. It would thus seem that the limitations imposed should be able to be addressed in some way. However, at this stage, neuroplasticity itself seems to be an emerging concept and the application of it to aid stroke patients from a neuropsychological perspective is not yet happening.