1 ד"ר יהושע נאמן שנה"ל 2014-15 Neurocognitive Assessment.

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ד"ר יהושע נאמן

2014-15שנה"ל

Neurocognitive Assessment

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Current Conceptualizations of Cognitive Function

Lateral Specialization for ContentLeft Hemisphere: Verbal ContentRight Hemisphere: Visual-Spatial Content

Lateral Specialization for Processing Style

Left Hemisphere: Serial and Analytic StyleRight Hemisphere: Global and Syncretic

Style

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Current Conceptualizations of Cognitive Function

Cortical LocalizationApplicable to a few functionsPoint versus general localization

NetworkAppropriate for most othersBroadly applicable even to generally

localized functions

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Current Conceptualizations of Cognitive Function

Highly Localized FunctionsSensory Perception (Somatosensory Cortex)

Basic Motor Control (Primary Motor Cortex)

Language Comprehension (Wernicke’s Area)

Motor Speech (Broca’s Area)

Prosody

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Current Conceptualizations of Brain Function

NetworksAttention & ConcentrationLanguage ( L frontal & parietal lobes,

thalamus, basal ganglia, cerebellum)Visual-Spatial Processing (R temporal &

parietal lodes)Learning & Memory (entorhinal cortex,

dentate gyri, hippocampi: new learning)Executive Functions (frontal lobes,

temporal lobes, basal ganglia, cerebellum)

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Minimally AdequateNeurocognitive Assessment

OrientationAttention & ConcentrationLanguage FunctionsVisual-Spatial FunctionsPraxisLearning & MemoryExecutive Functions

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MMSE and its Advantages

BriefRepeatableWidely acceptedEasily-administeredNorms for virtually all populations

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MMSE and its Shortcomings

10 of 30 points are in orientation domainPoor measurement of strategic functions

such as attention and comprehension; reading and writing; object naming; praxis; and verbal short-term memory

No measurement of strategic functions such as verbal fluency, executive functions

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Addenbrooke’s Cognitive Examination (ACE)

‘Mini-Mental Plus’ - 100 points~20 minutes to administerHebrew versionMajor shortcoming: insufficient

attention to executive functions

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Addenbrooke’s Cognitive Examination (ACE)

Mathuranath PS, Nestor PJ, Berrios GE, Rakowicz W & Hodges JR. (2000). A brief cognitive test battery to differentiate Alzheimer’s disease & fronto-temporal dementia. Neurology 55:1613-1620.

Newman JP. (2005) Brief cognitive assessment in Hebrew: Addenbrooke’s Cognitive Examination. Israel Medical Association Journal 7:451-7.

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Addenbrooke’s Cognitive Examination (ACE)

For assessment of executive functions, consider adding the Frontal Assessment Battery

Dubois B, Slachevsky A, Litvan I & Pillon B. The FAB: A frontal assessment battery at bedside. Neurology 2000;55:1621-26.

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Addenbrooke’s Cognitive Examination (ACE)

Hebrew version URL address: www.angelfire.com/il/neuropsy/ACE-Hebrew.zip

English version URL address: www.angelfire.com/il/neuropsy/ACE-English.doc

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Thank you.