What is neuropsychology and what does it treat?
Without a doubt, one of the scientific fields that has been growing and evolving the most in recent years is related to neurosciences: neuropsychology, neurology, neurophysiology, neuroeducation, etc. The 90s are known as the “decade of the brain,” as the revolution in neuroimaging techniques spurred great advances in the study of the brain. Thus, these techniques marked a before and after, which is why it is considered that, despite all areas covered by neurosciences still being very young, they have a promising future in both research and clinical settings.
Neuropsychology is one of the specialties of psychology, blending knowledge from different branches such as: psychology, psychiatry, neurology, and neurophysiology. By integrating knowledge from all these neurosciences, it studies and understands the relationship between the central nervous system with all its structures and neural networks, and the cognitive, behavioral, and emotional manifestations of human beings.
Furthermore, neuropsychology covers different areas such as research, teaching, and clinical practice. In the latter, the fields of intervention can be summarized as follows:
- Neurodevelopmental disorders (attention deficit/hyperactivity disorder (ADHD), learning disorders (dyslexia, dysgraphia, dyscalculia), etc.)
- Acquired brain injury (traumatic brain injuries, tumors, strokes, infections, etc.)
- Cognitive impairment and dementias (mild cognitive impairment, Alzheimer’s Disease, frontotemporal dementia, Lewy body dementia, etc.)
Therefore, it intervenes in child, adult, and aging populations, performing assessment, diagnosis, and intervention for each case.
How does a neuropsychologist work?
The neuropsychologist, as explained in the previous section, intervenes in various neurological disorders, following this scheme:
- First, a clinical interview is conducted with the patient and/or their family, where data from their medical history is collected and an anamnesis is performed. This includes questions such as: the reason for consultation, the symptoms observed by the patient themselves or their family, personal and family history, pathologies and treatments, etc.
- After the initial interview, a neuropsychological evaluation is carried out using tests and batteries that assess different cognitive functions (attention, processing speed, executive functions, memory, language, praxias, gnosias), behavior, and emotion. Based on the results, a cognitive profile will emerge, leading to a syndromic diagnosis (amnesic syndrome, aphasic syndrome, dysexecutive syndrome, etc.) and, depending on the pathology, with the combination of these syndromes and behavioral and emotional symptoms, a differential diagnosis will be reached (e.g., Alzheimer’s Disease, ADHD, etc.)
- Finally, an intervention plan is carried out, in which, depending on the pathology, an attempt will be made to rehabilitate, compensate for, or substitute cognitive functions where difficulties are present (attentional, linguistic deficits, etc.). For example, in a patient who has suffered a stroke, cognitive functions will be rehabilitated with the aim of returning them to normal functioning, and where rehabilitation cannot eliminate the deficit, compensation or substitution will be used through external aids, guidelines, etc., so that the patient can be as functional as possible in their daily life. The principle on which neuropsychological rehabilitation is based is neuronal plasticity, defined by the World Health Organization (WHO) as “the capacity of the cells that make up the nervous system to reconstitute themselves anatomically and functionally after certain pathologies, diseases, or even traumas.”
Therefore, the neuropsychologist breaks down the brain into small pieces (these being the aforementioned cognitive functions) and assesses which pieces do not fit well to make a diagnosis and intervention, and then reassembles them as best as possible, thus restoring maximum possible functionality to the patient.
Reflections: Understanding the Brain to Understand Cognition, Behavior, and Emotion
It is important to understand how the brain works to better comprehend what is happening to our child with ADHD, our father who has suffered a stroke, or our grandmother who suffers from some type of dementia.
Is my child lazy or do they have attentional and executive function difficulties?; Is my child ill-mannered or do they have a frontal lobe dysfunction that prevents behavioral inhibition and self-regulation?; Is my father a “dirty old man” or does he have problems with sexual disinhibition due to behavioral variant frontotemporal dementia?; Do I get angry with my grandmother because she doesn’t “know” how to put on a blouse, or do I understand that she has dressing apraxia?