Ax for Cognitive and Higher Cortical Function.pdf
- 1. ASSESSMENT ON COGNITIVE AND HIGHER CORTICAL FUNCTIONS DISEASE DISEASE DISEASE
- 2. What is cognitive function? Cognitive function is a broad term that refers to mental processes involved in the acquisition of knowledge, manipulation of information, and reasoning. (Kiely, K.M. , 2014) INTRODUCTION INTRODUCTION
- 3. What is higher cortical function? Higher cortical function refers to the cognitive processes and abilities that are localized in the cerebral cortices of the brain. INTRODUCTION INTRODUCTION
- 4. Relationship of cognitive and higher cortical function They are closely related concepts, often overlapping in their definitions and applications. They are not entirely distinct, can be differentiated based on their scope and complexity. INTRODUCTION INTRODUCTION
- 5. COGNITIVE executive Judgement COGNITIVE and higher cortical FUNCTIONS ATTENTION MEMORY LANGUAGE PERCEPTION COGNITIVE Orientation praxis Social cognition
- 6. table of contents Attention Memory Language Perception Executive Social cognitive 01 03 04 05 06 07 CONTENTS CONTENTS Screening test 02
- 7. Screening test Used to identify potential cognitive functions impairment. screening test
- 8. Cognitive screening test moca mmse Mini-Mental State Examination A quick screening test to detect moderate to severe conditions Montreal Cognitive Assessment Commonly used for detecting mild cognitive impairment. ABOUT ABOUT ABOUT ABOUT
- 9. Comparison between MOCa and MMSe moca mmse purpose A rapid screening instrument for mild cognitive dysfunction Screen for cognitive impairment, especially moderate to severe conditions targetedgoup People with subjective cognitive For older, community dwelling, hospitalized and institutionalized adults scoring and interpretation 11 questions 30 points <=23: cognitive impaitment 30 points <26: cognitive impairment
- 10. Comparison between MOCa and MMSe COGNITIVEDOMAIN MOCA MMSE Visuospatial/Executive • Trail Making (alternating sequence) • Cube copy • Clock drawing Pentagon copy Naming Name 3 animals (e.g., lion, rhino, camel) Name 2 objects (e.g., pencil, watch) Memory • 5-word learning task with delayed recall • Cue recall option 3-word immediate and delayed recall Attention • Digit span (forward and backward) • Vigilance (tapping at a target letter) • Serial subtraction (subtracting 7s) • Serial 7s • Spell "WORLD" backward
- 11. Comparison between MOCa and MMSe COGNITIVEDOMAIN MOCA MMSE Language • Sentence repetition • Verbal fluency (e.g., words beginning with F) • Follow 3-step command • Read and obey a written command • Write a sentence Abstraction Explain similarities between two objects (e.g., train and bicycle) Not assessed Orientation Date, month, year, day, place, and city Date, month, year, day, season, place, and season
- 12. Comparison between MOCa and MMSe moca mmse strengths • Higher sensitivity for detecting Mild Cognitive Impairment (MCI) and early Alzheimer's disease. • Assesses a broader range of cognitive domains, including executive functions and visuospatial abilities. • More effective in identifying subtle cognitive deficits. • Widely used and well-known tool in clinical settings. • Quick and easy to administer, typically taking about 10 minutes. • Effective for assessing moderate to severe cognitive impairment.
- 13. Comparison between MOCa and MMSe moca mmse Limitations • May be more challenging for individuals with lower education levels, potentially leading to false positives. • Slightly longer administration time compared to MMSE. • Requires training to administer and interpret correctly. • Less sensitive in detecting early cognitive changes, such as MCI. • May exhibit a ceiling effect, failing to detect subtle deficits in high-functioning individuals. • Limited assessment of certain cognitive domains, like executive functions.
- 14. attention 01. The capacity to focus on specific stimuli or tasks, sustaining concentration ocer time, and managing distraction. attention attention attention
- 15. TYPES OF ATTENTION ALTERNATING attention The ability to change focus attention between two or more stimuli. Sustained attention The ability to attend to a stimulus or activity over a long period of time. Divided attention The ability to attend different stimuli or attention at the same time. selective attention The ability to attend to a specific stimulus or activity in the presence of other distracting stimuli. ATTENTION ATTENTION
- 16. ATTENTION IMPAIRMENT SIGNS DISEASES COMMON CAUSES assessment • Digit Span Test • Trail Making Test Part A • Easily distracted • Poor concentration • Trouble multitasking • ADHD • Delirium • Traumatic Brain Injury (TBI) • Dementia • Frontal lobe damage • Neurotransmitter imbalance • Sleep deprivation
- 17. Trial making test (TMT) Purpose: To evaluate visual scanning, processing speed, attention, and cognitive flexibility (especially in shifting between tasks). Targeted Group: Used in adults and older populations, commonly for those suspected of executive dysfunction (e.g., stroke, traumatic brain injury, dementia). Components: Part A: Assesses visual scanning and psychomotor speed (connecting numbers in sequence). Part B: Assesses cognitive flexibility and set-shifting (alternating between numbers and letters). Timing Needed: 5 minutes Scoring and Interpretation: Scored by measuring the total time to complete each part (with errors noted and potentially corrected) and by counting errors (e.g., sequencing mistakes). Longer completion times or increased errors suggest deficits in attention, speed, or executive function. Norms are usually age- and education-adjusted. Assessments
- 18. Trial making test (TMT) Scoring and Interpretation: Part A: Completion time under 40 seconds: Generally within normal limits. Completion time over 78 seconds: May indicate cognitive impairment. Part B: Completion time under 90 seconds: Typically normal. Completion time over 273 seconds: Suggests significant impairment. Assessments
- 19. MEMORY 02. The ability to store, retain, and recall information. It is essential for learning and adapting to new situations. MEMORY MEMORY MEMORY
- 20. Types of MEMORY Sensory memory Very brief storage of sensory information Short-term memory (Working memory) Holds a small amount of information (about 7 items) for a short duration (20-30 secs) Long-term memory The ability to attend different stimuli or attention at the same time. memory Explicit memory implicit memory Episodic Memory (personal experience) Semantic Memory (facts and general knowledge) Procedural Memory (Skills or habits) Iconic memory echoic memory For visual input For auditory input
- 21. memory IMPAIRMENT SIGNS DISEASES COMMON CAUSES assessments • Wechsler Memory Scale • Rey Auditory Verbal Learning Test (RAVLT) • Forgetting recent events • Repeating questions • Getting lost in conversation • Alzheimer’s disease • Amnesia • Korsakoff’s syndrome • Hippocampal damage • Thiamine (B1) deficiency • Alcohol abuse • Brain injury
- 22. Rivermead memory test (RMT) Purpose: Designed to assess everyday memory functions, focusing on memory for everyday events and tasks. Targeted Group: Commonly used with patients who have sustained brain injuries, strokes, or suffer from dementia; applicable for both adults and older adults. Components: Assesses multiple memory domains, including immediate recall, delayed recall, recognition, and prospective memory (remembering to do things in the future). Timing Needed: 30 to 45 minutes to administer. Scoring and Interpretation: Consists of 14 subtests, each scored individually. Raw scores are converted to scaled scores (Mean = 10, SD = 3). A General Memory Index (GMI) is derived from the sum of scaled scores. Assessments
- 23. Rivermead memory test (RMT) Scoring and Interpretation: GMI Categories: • 130 and above: Superior memory function. • 110–129: Above average. • 90–109: Average. • 70–89: Below average • .69 and below: Impaired memory function. Scores help identify specific memory deficits and track changes over time. Assessments
- 24. Rivermead memory test (RMT) ● Includes prospective memory items; targets everyday memory problems ● Quick and easy to administer ● Identifies a patient’s strengths and weaknesses of memory ● Norm-based ● Designed to administer several times (with alternate changes) so changes in memory can be detected ● Patients must have cognitive abilities in order to perform test ● This test was published in 1985; not current (other new editions of test have been published). ● Because test is older, articles supporting its validity and reliability not find. ● High cost
- 25. EXECUTIVE 03. High-level cognitive processes that enable goal-directed behavior, problem-solving and adaptation to new situations. MEMORY EXECUTIVE EXECUTIVE
- 26. executive Working memory The ability to hold and manipulate information in your mind over short periods. Cognitive flexibility The ability to shift your thinking and adapt to new demands or perspectives. Inhibitory control The ability to control impulses, focus attention, and regulate emotions or actions. executive executive
- 27. executive IMPAIRMENT SIGNS DISEASES COMMON CAUSES assessments • Wisconsin Card Sorting Test • Stroop Color and Word Test • Trail Making Test Part B • Poor organization • Impulsivity • Difficulty adapting to change • ADHD • Parkinson’s disease • Schizophrenia • Frontal lobe syndrome • Prefrontal cortex damage • Stroke • Dopamine imbalance
- 28. Winsconsin Card Sorting TEST (WCST) Purpose: Assesses executive functions such as abstract reasoning, cognitive flexibility, and the ability to modify behavior in response to changing environmental contingencies. Targeted Group: Typically administered to adults; useful in patients with frontal lobe damage, schizophrenia, or other conditions affecting executive functioning. Components: Requires sorting cards according to unknown rules that change during the test. It examines concept formation, set shifting, and error monitoring (perseverative versus non-perseverative errors). Timing Needed: 12 to 20 minutes, depending on the individual’s performance. Scoring and Interpretation: Scoring includes the number of categories achieved, total errors, and particularly perseverative errors (continued use of a previously correct sorting rule). A high number of perseverative errors indicates difficulty in cognitive flexibility and may suggest frontal lobe dysfunction. Assessments
- 29. Winsconsin Card Sorting TEST (WCST) Assessments
- 30. LANGUAGE 04. A complex cognitive process that involves understanding, processing and producing speech, reading, and writing LANGUAGE LANGUAGE LANGUAGE
- 31. language Understanding spoken and written language Expressive language Speaking and writing. Receptive language naming Retrieving and producing words. fluency Generating words smoothly and rapidly. language language
- 32. language IMPAIRMENT SIGNS DISEASES COMMON CAUSES assessments • Boston Naming Test • Western Aphasia Battery • Word-finding difficulty • Misuse of grammar • Poor comprehension • Aphasia • Frontotemporal dementia • Stroke (left hemisphere) • Neurodegeneration
- 33. Verbal fluency test Purpose: Assesses executive function (including cognitive flexibility and self-monitoring) as well as language abilities, specifically lexical retrieval and verbal production. Targeted Group: Commonly used with adults, particularly in neuropsychological evaluations for dementia, stroke, schizophrenia. Components: • Phonemic Fluency: Generate as many words as possible beginning with a specific letter (e.g., “F”, “A”, “S”) in 60 seconds. • Semantic Fluency: Generate words belonging to a specific category (e.g., animals, fruits) in 60 seconds. Timing Needed: Each subtest is timed for 60 seconds. Scoring and Interpretation: Total Score: The number of correct, non-redundant words produced in the allotted time. Lower word counts: May suggest difficulties with lexical access, executive dysfunction, or language impairments. Performance is interpreted based on age and education norms. Assessments
- 34. PERCEPTION 05. The process of interpreting sensory information from the environment. PERCEPTION PERCEPTION PERCEPTION
- 35. perception Interpreting touch sensations. Visual perception Recognizing and interpreting visual stimuli. Auditory perception Processing sounds. Tactile awareness Spatial awareness Understanding the position of objects in space. perception perception
- 36. perception IMPAIRMENT SIGNS DISEASES COMMON CAUSES assessments • Motor-Free Visual Perception Test (MVPT) • Rey-Osterrieth Complex Figure Test • Benton Visual Retention Test (BVRT) • Visual-spatial disorientation • Agnosia (inability to recognize objects) • Parietal or occipital lobe damage • Visual agnosia • Right parietal stroke
- 37. Motor-Free Visual Perception Test (MVPT) Purpose: To assess visual perceptual abilities independent of motor skills. Targeted Group: Suitable for children and adults, particularly useful when motor impairments might confound the results. Components: • Visual Discrimination: Ability to distinguish different shapes. • Figure-Ground Discrimination: Ability to separate an object from its background. • Spatial Relationships: Understanding the positions of objects. • Visual Closure: Ability to recognize incomplete images. • Visual Memory: Recalling visual details. Timing Needed: 15 to 20 minutes Scoring and Interpretation: Total Score: Raw score based on the number of correct responses out of 36. Lower scores indicate possible deficits in visual perceptual processing, which can affect learning and daily functioning. Interpretation is based on standardized norms or standard scores. Assessments
- 38. Motor-Free Visual Perception Test (MVPT) Assessments
- 39. Social cognition 06. The ability to understand and interpret social cues, such as facial expressions, body language, and tone of voice. cognition social social
- 40. Social Perception The ability to perceive and interpret nonverbal social cues such as body language, tone of voice, and facial expressions. Social Understanding The ability to interpret others’ mental states, intentions, and emotions using both verbal and nonverbal cues. Social Decision-Making The ability to make appropriate choices in social settings based on contextual cues, norms, and expected outcomes. Social cognitive
- 41. Social cognition IMPAIRMENT SIGNS DISEASES COMMON CAUSES assessments • NEPSY-II Social Perception Battery • Reading the Mind in the Eyes Test • Faux Pas Recognition Test • Difficulty understanding sarcasm • Lack of empathy • Inappropriate behavior • Frontal/temporal lobe degeneration • Neurodevelopmental disorders • Autism Spectrum Disorder (ASD) • Schizophrenia • Frontotemporal dementia
- 42. FauxPasRecognitionTest Purpose: The test is designed to assess an individual’s ability to detect and understand social blunders (faux pas) in conversation. Targeted Group: Children, adolescents, and adults with social cognition deficits (e.g., ASD, TBI, schizophrenia). Components: The test typically involves a series of short stories that include situations where a social faux pas occurs. Key components evaluated are: Detection: Recognizing that a social misstep has occurred. Explanation: Articulating why the statement or action was inappropriate. Attribution: Understanding the emotions and intentions of the parties involved. Timing Needed: The entire test usually takes about 20–30 minutes to administer, depending on the number of stories and the depth of follow-up questions. Assessments
- 43. FauxPasRecognitionTest Scoring and Interpretation: Total Score: The test consists of a set number of stories (often 10–20). Each story is scored based on accurate detection and appropriate explanation of the faux pas. Scoring Example: Each story may be assigned 1–2 points for correctly identifying the faux pas and an additional point for a correct explanation. Hypothetical Total: For instance, if there are 15 stories with a maximum of 3 points each, the total possible score is 45. High scores = effective social cue recognition Low scores = potential issues like ASD, schizophrenia, or frontal lobe damage. Assessments
- 44. ● AUTHOR (YEAR). Title of the publication. Publisher ● AUTHOR (YEAR). Title of the publication. Publisher ● AUTHOR (YEAR). Title of the publication. Publisher ● AUTHOR (YEAR). Title of the publication. Publisher ● AUTHOR (YEAR). Title of the publication. Publisher ● AUTHOR (YEAR). Title of the publication. Publisher ● AUTHOR (YEAR). Title of the publication. Publisher REFERENCES REFERENCES REFERENCES
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