The regulation of cognitive functions, i.e. information processing functions and behaviour, is based on the activity of extensive, constantly changing neural networks.
A neuropsychological disorder means a change in an individual's cognitive performance, i.e. information processing, behaviour and emotion regulation.
The nature of the disturbance depends on where in the regulatory network the damage or weakness in brain function is situated.
Neuropsychological disturbances may appear as changes varying in severity, be transient or stable in a certain restricted function or wide in scope, covering several cognitive functional areas.
Various degrees of dysfunction in skills that were already learned, not resulting from factors such as decline in visual acuity, impaired motor control or limited education
Reading and writing difficulties often appear in association with other verbal disorders (such as aphasia) but they may also be associated with nonverbal neuropsychological symptoms.
In addition, they may appear as what are called primary specific learning disorders.
Disorders of visual perception
Visual agnosia
Difficulty recognizing and interpreting visual information
May appear as a general disturbance in observing objects or be restricted to the observation of certain objects, such as faces, letters or colours.
Disorders of spatial perception
Difficulty in (relative) spatial perception
May appear as difficulty in
determination of position, estimation of direction and distance
perceiving the environment.
Visuoconstructive disorders
Difficulty in combining parts into an entity, which requires several cognitive functions, such as spatial perception, planning skills / executive functions and motor functions.
May appear as a result of several different disturbances in cognitive function and disturbances in several brain areas.
Disorders of voluntary movements, apraxia
Apraxia is a disorder of voluntary movement not explained by difficulties in motor or sensory functions or problems associated with the general cognitive state.
The most common disorder is apraxia of the arms or facial area.
Appear in areas such as the use of objects and production of movements/postures.
Memory problems are among the most common cognitive symptoms in neurological patients.
Memory function may be disturbed by many reasons, including non-neurological ones.
Memory consists of many partial systems working together in parallel. Memory processing proceeds in stages.
Memory may be lost specifically in various parts of the memory system or at various stages of the memory process.
The type and severity of the memory disorder depend on what area of the brain is damaged.
Memory disorders may vary from slight problems with memorizing to considerable disturbance of episodic memory.
Amnesic syndrome represents extensive anterograde loss of episodic memory that may be either partial or complete, transient or permanent, stable or progressive.
Disorders of attention
Attention depends on many factors, such as alertness, motivation, mood, legal and illegal drugs, strain, age and skill level.
Disorders of attention are common in patients with neurological diseases and injuries.
They may become manifest in the direction, maintenance or sharing of attention or in selective attention.
Stimulus neglect
Difficulty noticing and reacting to stimuli in the field of function and perception opposite to the brain damage
More common in patients with lesions in the right hemisphere
Most common in the area of visual perception (visual neglect)
May also affect the perception of auditory (auditory neglect) or tactile (tactile neglect) stimuli.
In addition, there may be personal neglect of one's own body.
The symptoms often include other neuropsychological disturbances, such as visual memory problems, visuospatial or visuoconstructive problems or deficient awareness of symptoms or executive functions.
Disorders of executive functions
Executive functions are processes connecting single events in information processing into complex, target-oriented action, and flexible regulation and change of such action depending on the circumstances and feedback.
The anterior frontal lobe with its subcortical pathway connections is essential.
Disorders of executive functions may appear in the areas of
initiative and motivation
control of behaviour
controlling information processing.
Disorders of executive functions emerge more clearly in unusual and new situations than in routine tasks, and they may affect other cognitive functions secondarily.
Damage to the left hemisphere
In right-handed individuals and in many left-handed ones, the left hemisphere of the brain is dominant.
Disorders of verbal function
Difficulties in speech production, repetition or reception
Disorders of verbal conceptional skills
Difficulties in conceptual thinking
Difficulties in naming
Disorders of reading, writing and arithmetic
Difficulties in verbal memory
Difficulties in voluntary control of the arms, or apraxia
Difficulties in visuoconstructive functions
Damage to the right hemisphere
Difficulties in visual perception
Visuoconstructive difficulties
Difficulties in spatial perception
Neglect of the left perception field
Difficulties in visual attention
Difficulties in non-verbal memory
Deficient awareness of symptoms
Changes in emotions
Damage to posterior brain regions
Disorders of visual perception
Difficulties in pattern recognition, or agnosia
Memory disorders
Damage to frontal brain regions
Disorders of executive functions
Disorders of information processing
Behavioural control
Initiative and motivation
Difficulties in regulating attention
Disorders of working memory
Changes to emotions and personality
Diseases often accompanied by neuropsychological symptoms
Cerebrovascular disorders
Brain trauma
Progressive brain diseases
MS
Parkinson's disease
Brain tumours
Epilepsy
Inflammatory brain diseases
States of anoxia
Substance use disorders
Psychiatric diseases
Cardiac diseases
Sleep disorders
Neuropsychological examination
May be indicated
to make a differential diagnosis
to describe the patient's performance with regard to his/her situation and needs
Assessment of working ability and performance capacity
Assessment and planning related to the prerequisites and need for rehabilitation
Vocational or educational planning
to address special issues.
Assessment of driving ability
Assessment of legal competency
Assessment of cognitive functions, i.e. functions related to information processing, any changes to them and preserved functions.
Variation in performance in examinations does not always indicate any disorder in brain function.
Assessment of factors affecting mental performance, such as mood or fatigue.
Neuropsychological examination is based on the available history, an interview, observation, and qualitative and normative interpretation of examination and assessment results.
Usually done on referral by the patient's physician.
Neuropsychological rehabilitation
Part of medical rehabilitation, based on neuropsychological examination
Aims at decreasing any harm from changes to information processing, behaviour and emotion regulation due to the brain injury.
May form a part of multidisciplinary rehabilitation or be the only form of rehabilitation required.
Always based on a comprehensive neuropsychological examination and provided by a neuropsychologist.
May be provided as individual rehabilitation, brief neuropsychological guidance or neuropsychological group rehabilitation, and be carried out in a rehabilitation institution or in an outpatient clinic.
Neuropsychological rehabilitation includes various methods of cognitive rehabilitation, psychoeducation and mental and psychosocial support, depending on the time from diagnosis, the neuropsychological symptoms and the patient's overall situation.
In neuropsychological rehabilitation, electronic services and applications of technology, such as neuropsychological online rehabilitation as well as telerehabilitation, may be used.
New, developing possibilities are offered by methods based on virtual technology as well.