Historically the only way that neurologists were able to study the brain for any damage, dysfunction, or diseases was to either remove a piece of the brain (biopsy) from a live patient which was very high risk, or they could perform a detailed study of the brain during an autopsy which had the disadvantage of only demonstrating the severely diseased brain rather than the brain in a preliminary diseased state (Stirling, 2002). With the increased development of technology came advancements in brain structure measurements such as Computerized Tomography (CT) Scans which uses x-rays to view the brain structures, Magnetic Resonance Imaging (MRI) which shows brain structures by emitting hydrogen atoms in a magnetic field and measuring their density, Positron Emission Tomography (PET Scan) which measures active areas of the brain using radioactive isotope that reacts similarly to glucose by neurons, and Electorencephagram (EEG) which measures waveforms (Stirling, 2002).
In addition to the physical brain structure observations neuropsychological assessments are equally valuable; however, they preferably should not be conducted on the same day as visualizing techniques being that the results are considered invalid if the participant is tired (Stirling, 2002). Generally, neuropsychologists use two types of assessments which are structured or unstructured tests. Structured tests consist of a standard battery of tests that are administered with an inflexible approach such as the Halstead-Reitan Neuropsychology Test Batteries. Inflexible, or structured, tests have the advantage of being very exhaustive; however, this can be a challenge when administering a test battery to a person who may be suffering from psychopathologies such as schizophrenia (Allen, Goldstein, & Aldarondo, 1999).
Unstructured tests consist of tests that are selected by the neuropsychologist based upon symptoms reported by the patient and/or the family as well as clinical observations of particular disorders. The neuropsychologist can look at the results from specific tests such as the Lezak’s flexible battery to determine what, if any, additional tests would be beneficial. Unstructured tests could include language assessments such as the Aphasia Screening Test, achievement tests such as the Wide Range Achievement Tests, or memory and learning tests which measure logical memory, paired associated learning, or visual memory scales (Loring & Meador, 2008). If a neuropsychologist prefers this stepped approach to testing the advantages are the ability to have a tailored diagnostic assessment; however, the disadvantages are that the selection of tests could be based upon the neuropsychologist’s education background or work experience and this could result in the oversight of a valuable or needed battery of tests.
Loring, D. W. & Meador, K. J. (2008, March 17). Neuropsychology for neurologists. NLD on the Web. Retrieved from www.nldontheweb.org.
Stirling , J. (2002). Introducing neuropsychology. New York: Psychology Press.