Complete Guide to Neuropsychology

Neuropsychology examines how brain structures and networks give rise to cognition, emotion, and behaviour. It sits at the crossroads of experimental psychology, clinical assessment, and the neurosciences, translating discoveries about the nervous system into tools for diagnosis, rehabilitation, and basic research.

Classical era – Broca & Wernicke link focal lesions to speech ⇄ language.

20th century – Lashley’s lesion studies, Luria’s systemic approach, and Penfield’s cortical stimulation refine localisation.

Neuroimaging revolution – CT → MRI → fMRI/DTI provide in vivo structure‑function mapping.

Digital & network era – Connectomics and AI enable millimetre‑scale wiring diagrams and predictive models of behaviour. :contentReference[oaicite:0]{index=0}

Frontal lobes – executive control, working memory, social cognition.

Temporal lobes – declarative memory, language comprehension, emotion (amygdala).

Parietal lobes – spatial attention, praxis, numeracy.

Occipital lobes – primary & higher‑order vision.

Subcortex – hippocampus (memory consolidation), basal ganglia (procedural learning), thalamus (relay), cerebellum (timing & coordination), brainstem (arousal).

White‑matter tracts – arcuate fasciculus (language), uncinate (emotion ↔ memory), corpus callosum (inter‑hemispheric integration).

Attention & Processing Speed – sustained, selective, divided; vigilance tasks, Trail‑Making A.

Executive Function – planning, inhibition, set‑shifting; Stroop, WCST, verbal fluency.

Memory – working, semantic, episodic; tests: Digit Span, RAVLT, WMS-IV.

Language – naming, fluency, comprehension; Boston Naming Test, Token Test.

Visuospatial & Construction – Rey‑Osterrieth Complex Figure, Block Design.

Motor & Praxis – finger tapping, grooved pegboard, apraxia batteries.

Social & Affective Cognition – emotion recognition, theory‑of‑mind tasks.

• Neuropsychological Tests  – fixed (Halstead–Reitan) or flexible batteries; computerised tools (CogState, CNS Vital Signs).
• Neuroimaging  – structural MRI, fMRI, PET, SPECT, DTI; MEG & EEG for millisecond‑scale dynamics; fNIRS for bedside cortical activity.
• Modulation  – TMS, tDCS, focused ultrasound to test causality.
Computational Modelling  – reinforcement‑learning & Bayesian models link algorithmic mechanisms to clinical phenotypes.
• Machine Learning / AI now classifies cognitive profiles and predicts conversion to dementia from brief digital tasks. :contentReference[oaicite:1]{index=1}

1. Referral Question & Background – medical, psychiatric, developmental, educational history.
2. Hypothesis Formation – target domains & likely syndromes.
3. Test Selection – evidence‑based, culturally appropriate (see INS translation guidelines). :contentReference[oaicite:2]{index=2}
4. Administration – standardised instructions, behaviour observation.
5. Scoring & Norms – age, sex, education, culture, language.
6. Interpretation – pattern analysis, differential diagnosis, integration with imaging/labs.
7. Feedback & Report – clear, functional recommendations for patient, family, and referring team. Up‑to‑date ethical considerations highlighted in recent StatPearls review. :contentReference[oaicite:3]{index=3}

• Traumatic Brain Injury (TBI) – diffuse attention / processing‑speed slowing; frontal‑executive deficits.
• Stroke – focal deficits (e.g., aphasia, neglect) based on vascular territory.
• Dementias – Alzheimer’s (amnestic profile), frontotemporal dementia (social + executive), Lewy bodies (visuospatial & attention).
• Movement Disorders – Parkinson’s (bradyphrenia, fronto‑striatal), Huntington’s (procedural learning).
• Epilepsy – temporal‑lobe epilepsy (verbal or visual memory).
• Psychiatric – schizophrenia (working memory & executive network dysconnectivity), ADHD (inhibitory control).
• Developmental – autism spectrum, learning disorders; sensitive periods and neuroplastic compensations.

Restorative training (attention process training, working‑memory drills), compensatory strategies (external aids, environmental modification), and psychosocial education are combined in individualised programmes. Telerehabilitation platforms now extend access to rural areas and allow continuous monitoring.

Digital & Remote Neuropsychology – secure video‑based testing expands reach; remote assessments boost inclusion in clinical trials. :contentReference[oaicite:4]{index=4}

AI‑augmented Scoring & Prediction – ensemble models flag subtle cognitive change years before clinical onset of disease. :contentReference[oaicite:5]{index=5}

Connectomics – higher‑order network metrics improve decoding of tasks and individual identification. :contentReference[oaicite:6]{index=6}

Theory‑Driven & Bayesian Assessment – calls for replacing atheoretical test batteries with computational hypotheses. :contentReference[oaicite:7]{index=7}

Cultural Adaptation & Translation – 2023 INS guidelines provide step‑by‑step process for multilingual and multicultural norms. :contentReference[oaicite:8]{index=8}

Key principles: informed consent, data privacy, test security, fair access, awareness of bias in norms, interdisciplinary collaboration, and continual professional development (e.g., NAN Annual Conference, Austin 2024). :contentReference[oaicite:9]{index=9}

South African practitioners must integrate multilingual batteries, consider educational disparities, and reference region‑specific norms (e.g., SA‑MoCA). Adaptation follows the INS International Test Commission framework for translation, validation, and local norming. :contentReference[oaicite:10]{index=10}

Texts: Lezak et al. – Neuropsychological Assessment; Strauss & Spreen – Compendium of Neuropsychological Tests; Banich & Compton – Cognitive Neuroscience.

Journals: Neuropsychologia, Journal of Clinical Neuropsychology, Frontiers in Psychology (Neuropsychology).

Societies: International Neuropsychological Society (INS), National Academy of Neuropsychology (NAN), South African Clinical Neuropsychology Interest Group.

Study Strategies – spaced repetition for test names/metrics; concept‑maps linking brain regions to syndromes; active recall of diagnostic criteria; practise articulating mechanism → deficit → intervention chains aloud.