New video series by Mark Solms now available for viewing Introduction to Clinical Neuropsychology:
The Neuropsychological Examination
Just published on our website: a series of seminars delivered by Professor Mark Solms as part of the first year module of the Masters-level programme in Clinical Neuropsychology at the University of Cape Town, South Africa. The programme is taught from the perspective of the hypothetico-deductive approach to clinical assessment, as opposed to the psychometric approach.
Video 1 is available to all viewers. Membership in the International Neuropsychoanalysis Society is required to view the rest of the series.
To see the list of videos and begin watching, click here:Video 1: General Principles of the Hypothetico-Deductive Approach
There are two major and distinct approaches to neurocognitive assessment within the field of neuropsychology: the hypothetico-deductive approach and the psychometric approach. This video contrasts these two approaches and emphasizes and outlines the reasons why the hypothetico-decutive approach is favoured in this context. The hypothetico-deductive approach requires an understanding of the neuroanatomical correlates of normal mental functions and how these relate to the specific deficits (symptoms and signs) that are observed in patients. In contrast, the psychometric approach (or normative) approach is concerned with the measurement of cognitive deficits (i.e. quantifying degrees of deviation from the norm) and utilises standardised test scores derived from normally distributed populations.
Video 2: Functional Neuroanatomy
In order to practise clinical neuropsychology competently, a good understanding of the brain’s anatomy and physiology is required. One needs to know the neuroanatomical correlates of neurocognitive functions so that these can be understood in relation to the symptoms and signs observed in patients. This second video in the series provides an overview of relevant functional neuroanatomy. Historical classifications of how neuropsychological disorders were organized according to brain structures and functions are covered in the first part of the video. The second part describes modern accounts of how the brain works from the subcortical, visceral, endogenous and metabolic aspects of a living organism rather than the cortical perceptual periphery.
Video 3: The Examination of Language
This video covers the classification and assessment of the aphasias (disorders of language). This is the first area of neurocognitive functioning covered during this series of seminars because the field of neuropsychology began with the exploration of the language disorders. The clinical features of each language-based syndrome (e.g. Wernicke’s aphasia and Broca’s aphasia) are outlined, with descriptions of the qualitative features of each one.
Video 4: The Examination of Higher Visual Perception
This video outlines the key diagnostic features of the visual agnosias and related disorders of perception through the visual modality. These disorders are contextualized from the point of view of Lissauer’s classical classification schema. They are also explained in terms of their associated lesions and pathologies. The video also describes how disorders of high visual perception are assessed, along with the tests that can be used to assess them.
Video 5: The Examination of Skilled Motor Movements
This video covers the classification of the apraxias, which is taught in relation to the classical German schema, Lichtheim’s house, and the work of Hugo Liepmann. In addition to this historical perspective, the various disorders of skilled movement are identified and described on the basis of their characteristic and distinguishing clinical features.
Video 6: The Examination of Other Symbolic Functions
Other symbolic functions are those quasi-spatial functions that are impaired in Gerstmann syndrome and Balint’s syndrome. This video identifies and describes the individual component symptoms of both of these respective syndromes in detail.
Video 7: The Examination of Memory
Memory represents a very broad topic within the field of neuropsychology. This video contrasts the various type of amnesias. Hippocampal amnesia, diencephalic amnesia, frontal ‘amnesia’, short-term memory impairment, working memory impairment, and transient global amnesia (TGA) are all covered. Psychogenic (or hysterical) amnesia is also discussed. The video provides clinical descriptions of each type of memory problem and the lesions and pathologies associated with them are identified. Confabulation and other key symptoms are also explained.
Video 8: The Examination of Spatial Cognition
This video provides an overview of the functions of the right hemisphere of the brain, including its role in emotionality and spatiality. It outlines the various clinical presentations that are classified under the heading of spatial cognition and the right hemisphere syndrome. The teaching focuses on how to recognize and understand these presentations. The three components of the right hemisphere syndrome are all outlined in detail. These are disordered spatial cognition (disordered perception and construction), a disorder of spatial attention (a unilateral disorder of spatial attention called neglect, hemi-neglect or unilateral spatial neglect), and anosagnosia (unawareness of deficit).
Video 9: The Examination of Executive Functions
The frontal lobes and their associated executive functions represent a broad and complex topic within neuropsychology. Part of the complexity is that with executive functioning, the emphasis falls on the psychological and the examination of the mind (a person, a personality, an individual). These features are difficult to assess and are unique to each individual. This video outlines some key general principles pertaining to the frontal lobes and teaches the viewer about their functional and anatomical divisions.
Video 10: The Examination of Non-Localised Syndromes
It is vitally important to consider the non-localised syndromes when working with patients with brain injuries. These are the syndromes where no structural, localising disease picture is present, yet where neurocognitive functioning is nevertheless impaired. Such syndromes include acute confusional states (delirium) and post-traumatic amnesia. This video highlights the clinical contexts where non-localised syndromes may present, and case illustrations are
/rovided in order to highlight potential pitfalls that may arise if the presence of such syndromes is not taken into account.
Video 11: Preliminaries of Assessment
This final video in the series takes the viewer through the essential skills and tasks involved in the neuropsychological assessment of patients in the clinical setting. It contrasts the hypothetico-deductive method of assessment with the psychometric approach. Other key topics covered include hypothesis formation, taking a proper history, appraising oneself with the various medical records and tests (such as written records, scans, and referral letters), and conducting a clinical assessment using a range of neurocognitive tests. Here, the order in which tests are administered, and the test selection process, are both discussed.
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