Wednesday, 30 November 2011


brain-with-cogs.jpg For the clinical neuropsychologist (or those in training) a dinner party can be an interesting experience. When the talk inevitably turns to “what do you do” neuropsychologists need to be prepared for the fact that most people a. have never heard of neuropsychology; b. don’t understand what neuropsychologists do; and c. (the best bit) usually want to know more.

So what is clinical neuropsychology?

Clinical neuropsychology is a specialisation within the field of psychology which involves the assessment, diagnosis and treatment of psychological disorders associated with conditions affecting the brain.

Clinical neuropsychologists conduct evidence-based neuropsychological assessments to develop a profile of an individual’s cognitive strengths and weakness. This neuropsychological profile helps to identify the root causes(s) of presenting problems and informs treatment programs.

There are a number of reasons why clinical neuropsychology is not a widely known or understood specialisation. One important reason relates to the complexity of the brain. Our current understanding of how the brain works has been informed by centuries of research. Clinical neuropsychology has evolved along with important developments in our understanding of brain structure and function and this will no doubt continue as we deepen our understanding of this complex organ.

A brief history of our evolving understanding of the brain

Written records about the brain and nervous system have been found as early as 1700 B.C. However, it was not until the 17th century A.D. that serious investigations about the brain and its functions were undertaken, and not until the 20th century that scientists began to fully appreciate the relationship between structure and function. Some key developments were:
  • Rene Descartes introduced the concept of the relationship between the mind and the body, coining his famous phrase “I think, therefore I am”.
  • Thomas Willis published his ‘Anatomy of the Brain’. One of his most important contributions was a discussion of cerebral circulation.
  • Franz Josef Gall founded the science of Phrenology, which involved studying the topography of a skull as an indicator of brain anatomy. He introduced the concept of the brain being composed of various sections, each of which he proposed was responsible for a psychological trait.
  • While his ideas were later largely discredited, the idea of linking brain structure to function was an important development, leading to the theory of localisation.
  • Neurologists Paul Broca (and later Carl Wernicke) used this theory, together with investigations of brain damaged people, to determine that there were two distinct yet related areas of the brain responsible for language production and language comprehension.
  • Hans Berger developed the first electroencephalograph (EEG), a device for recording the electrical activity in the brain.
  • Procedures such as Lobotomies and Electro-shock Therapy, while controversial, helped advance understanding of the relationship between brain structure and function and the outcomes of damage to certain brain regions.
  • In 1953 patient HM, who went on to become one of the most important patients in the history of brain research, underwent a bilateral medial temporal lobe resection to treat medication-resistant epilepsy. As a result, HM became densely amnesic and was largely unable to form new memories.
  • HM participated in hundreds of research studies and helped advance our understanding of memory, learning
  • brain-with-lobes.jpgand their relationship with brain structure and other cognitive functions.
  • A key finding was the importance of the role of a brain structure called the hippocampus in forming new memories.
  • Experiments on epilepsy patients who had the two halves (hemispheres) of their brain surgically separated advanced our understanding of lateralisation.
  • In the 1970’s and 1980’s scanning and imaging devices such as CT and MRI allowed for detailed mapping of the brain’s structure.
  • Advances in brain imaging technology have improved understanding of brain structure and techniques such as functional MRI have enhanced understanding of the relationship between structure and function.
  • The aging population and increasing prevalence of dementia has resulted in an explosion of research in the field. Neuropsychology is critical for the diagnosis and management of dementia.

How we use our knowledge to help you

Understanding how the brain functions is just one of the many skills that clinical neuropsychologists need to master. Our knowledge of brain anatomy informs our clinical assessments, allowing us to provide informed diagnoses and to draw conclusions about functional implications and rehabilitation techniques for a wide range of conditions affecting the brain, from learning disorders to dementia.

Contact us today to find out more about how our neuropsychological services can help you.
And please feel free to use this information to impress your friends at your next dinner party!
Images courtesy of google images

1 comment:

  1. Hi MD,
    really enjoyed reading this post, particularly enjoyed the section on "brief history of our evolving understanding of the brain".

    Oh by the way, my friends are particularly impressed that I can even pronounce "neuropsychology" correctly!

    Keep em coming!

    Respectfully yours,