The human brain has been (and remains) a mystery. Throughout the 19th and 20th centuries, based on paradigmatic cases within different disciplines that today make up neuroscience, the inseparable relationship between our cognitive processes – such as attention, perception, thinking, memory or language – and certain areas of our brain.
Such was the case of patient Phineas Gage, who suffered an injury to the prefrontal cortex of the brain (specifically, the orbitofrontal area) due to being impaled by an iron bar while working on the railroad. This patient’s behavior and personality changed drastically after suffering damage to that specific area of ​​the brain; He began to behave in an aggressive, uninhibited and socially inappropriate manner, very different from the quiet and responsible man he used to be. Thanks to cases like this, it was discovered that human executive functions were linked to the prefrontal cortex and not to other brain areas, since, in Phineas Gage, other functions such as memory were practically intact.
However, it is not necessary to have suffered an injury for there to be a structural impairment in certain areas of the brain that has a negative impact on a person’s cognitive and behavioral abilities. Mental health disorders often cause biological dysfunctions: thanks to neuroimaging, such as those obtained in positron emission tomography, it is possible to observe how neuronal activity in the brain is reduced in pathologies such as depression.
On the other hand, these alterations also manifest themselves in neuropsychological deficits, both in cognitive processes and in emotional and personality changes. This is where it comes into play. neuropsychological evaluation as a process of exploring cognitive processes that could be altered, whether due to a brain injury, a psychiatric disorder or other factors such as aging. In this article we will develop what general forms of neuropsychological evaluation exist and how these demonstrate the functioning of a person’s cognitive processes.
First of all, we must know that neuropsychological evaluation involves a process that seeks to access information of interest through the application of a series of procedures that seek to measure a psychological function. When carrying out the evaluation, It is known in advance that a particular psychological function is linked to a certain brain area or circuit. Neuropsychological evaluation has been key in the research area in recent decades, but in recent years it seems to have shifted towards the clinical area.
In this sense, its fundamental objective is to find which psychological processes are altered and how they are regulated by the different brain areas and then focus squarely on the treatment needs of the affected people. This shows the relevance of neuropsychological rehabilitation programs as a therapeutic resource, increasingly necessary in any interdisciplinary team.
The psychological processes that are evaluated
People may have a dysfunction in any human higher psychological function , while all of them have their neurobiological correlate in the central nervous system that could be altered. The psychological processes that are evaluated are very varied; including the study of general intellectual performance, learning ability, memory, perceptual and motor skills, language, communication, reasoning, attention, speed of information processing and problem solving.
The techniques used in psychological evaluation
It is important to be able to differentiate that psychological techniques and tests (or tests) are not the same as neuropsychological evaluation. Evaluation is a general process that attempts to formulate and test a hypothesis , data is collected and an attempt is made to reach a solution that benefits the person evaluated. On the other hand, psychological tests are only part of that process, and serve as a means of collecting information by evaluating certain specific variables. For example, the Wechsler Scale serves to gather information about the memory variable but not attention.
Having pointed this out, J. Tirapu Ustárroz, a Spanish clinical neuropsychologist, groups neuropsychological tests into different general categories. Recovering them is useful to know the generalities about how information is collected in a neuropsychological evaluation in order to investigate cognitive processes.
They consist of a set of varied questions that are linked to a certain number of cognitive variables, such as orientation, attention and concentration, learning, memory or language. Its application is easy and requires little time. In general, after answering all the questions, These scales yield a total score that establishes a dividing line between normal and pathological. However, a limitation of these scales is that they are sometimes very nonspecific or general.
General neuropsychological batteries
Neuropsychological assessment batteries are sets of elements that seek to detect and classify the existence of damage to the brain. General batteries usually measure most cognitive functions, not just one, and must be able to discriminate the subprocesses that make up each function. For example, they must differentiate working memory from long-term memory; or selective attention of sustained attention and divided attention.
Specific neuropsychological evaluation tests
Specific tests for neuropsychological examination seek to collect detailed information on the main cognitive functions, since mMany patients with injuries could present several alterations simultaneously and it is necessary to distinguish which functions are affected, to what degree of severity they are affected, and which ones operate correctly. It is important to know what abilities patients preserve in order to be able to use them to their advantage when planning the rehabilitation program.
In short, neuropsychological evaluation allows professionals to investigate the connection between brain modifications or lesions and cognitive processes with the aim of subsequently specifying treatments that can help the person recover after an injury, aging, or balance. the neurobiological effects of a psychiatric disorder.
