By  Barbara Colacchia (MD)

 In the early 1970s the first complete review of test that could be used to evaluate brain damage, clinical neuropsychology was practiced by a few clinicians who mostly performed assessments with a few tests dewsigned for making neuropsycological evaluations plus many more developed for other purpouses and varying degrees of applicability to neuropsycological issues.

Experimental/theoretical neuropsycology was, in many ways, more advantaged as the basic outlines of the brain’s structure-function relationships had been described or hypothesized.

With increasing developments in neuropsycology, the number of research reports, case studies, scientific rewiews and theoretical proposal escalated, which made the task of preparing a thorough update onerous but not yet virtually impossible.

Clinical neuropsychology is an applied science concerned with the behavioural expression of brain dysfunction. Its rapid evolution in recent years reflects a growing sensitivity among clinicians to the pratical problems of identification, assessment, care and treatment of brain damaged patients.

The need for screening and diagnosis of brain injured and behaviourally disturbed servicemen during wartime and for their rehabilitation afrterwards created the first large-scale demands for neuropsychology programs.

The practice of neuropsychology calls for flexibility, curiosity and inventiveness even for the most routine work. But even the routine work of the neuropsychologist holds the promise of new insights into the workings of the brain and the excitement of discovery.

Neuropsychological assessment can be useful in disciminating between psychiatric and neurological symptoms, in identifying a possible neurological disorder in a non psychiatric patient, in helping to distinguish between different neurological conditions and in providing behavioural data for localizing the site- or at least the emisphere side- of a lesion.

However, accurate diagnosis, including localization of a lesion, is most often achived by means of the neurologist’s examinaton and laboratory tools. Neuropsychology’s diagnostic role, which predominated in its early years, has diminished as its contributions to patient care and treatment and to understanding behavioural phenomena and brain function have grown.

More than any other advance in techniques for the diagnosis and localization of pathological conditions of the brain, computerized tomography (CT scan) and more recently developed magnetic resonance imaging (MRI) have reduced the instances in which neuropsychological assessment, along with most other older diagnostic procedures, may make a definitive contribution to the diagnostic process.

 References:

Muriel Deutsch Lezak Neuropsychological assessment 3° Ed  Oxford University Press 1995 New York