Among the best known neurosciences is clinical neuropsychology , which is, fundamentally, the discipline in charge of understanding the functioning of the nervous system and how its affectation, especially at the cerebral level, implies symptoms.

This branch of knowledge is relatively new, although in the last two centuries it has contributed greatly to understanding how our brain works, especially when it is affected by some kind of injury or other problem.

Let’s learn more about clinical neuropsychology and what it does.

What is clinical neuropsychology?

Clinical neuropsychology is a branch of psychology that studies the relationships between the brain and behavior in the clinical context of disorders .

Based on this knowledge, the professionals of this discipline, which are the clinical neuropsychologists, are able to define a diagnosis from what is observed in the patient, in addition to establishing a treatment to improve their standard of living.

Clinical neuropsychology is a psychological branch that requires a high degree of specialization from those who work in it . Clinical neuropsychologists have a profound knowledge of the brain and its functions, as well as the ability to relate the symptoms that the patient manifests with the affectation of one or another area of his or her brain. In this way, those who specialize in this area of knowledge know what the causes and consequences of a neuropathology manifested in the patient are.

Although patients who come to these types of professionals usually suffer some kind of brain injury caused by some kind of impact or disease that damages the nerve cells, there are also those who come due to some kind of infection, tumor or other medical condition that involves psychological symptoms and alteration in their cognitive abilities, emotions and behavior in general.

This is a very scientific branch, which has been developing its theoretical and practical corpus through empirical and evidence-based research, in addition to making use of reliable tools such as neuroimaging, questionnaire batteries and diagnostic methods specific to medicine . Neuropsychology combines knowledge from neuroanatomy, neurobiology, neuropathology and psychopharmacology.

What are your areas of research and intervention?

What distinguishes a clinical neuropsychologist from a clinical psychologist is the degree of knowledge he or she has about the brain, in addition to the brain disorders and how they manifest themselves in the person in the form of psychopathology.

In neuropsychology it is fundamental to know how to use various questionnaires , such as the Stroop test, the MMPI and WAIS among others. Thus, through their interpretation, the neuropsychologist can know the degree of cognitive impairment of the patient, seeing their deficits in learning, memory, attention, reading and writing, problem solving and decision making.

Patients who come to this type of professional can suffer all types of problems at the encephalic level , being the object of study and intervention the symptoms caused by head trauma, cerebrovascular accidents, brain turmoil, epilepsy, dementia, serious mental disorder, developmental problems, autism… Due to this, clinical neuropsychology is present in places such as hospitals, especially in the area of neurology and rehabilitation, as well as psychiatry.

Historical background

Although the term “clinical neuropsychology” was first coined in 1913 by Sir William Osler, the truth is that one could say that its history predates the 20th century.

Although defining it as part of this discipline would perhaps be a mistake, the truth is that the primitive trepanations, performed during the Neolithic period, could be considered as the first techniques remotely related to clinical neuropsychology.

It has been assumed that these practices, which consisted of opening a hole in a person’s skull, were intended to make the ‘bad spirits’, which caused the affected person’s atypical behaviour, leave his or her head. Thus, it could be said that this practice was based on the belief that psychopathology had a brain base and that it could be dealt with by means of a surgical intervention in the brain.

However, the clearest and most solid roots of modern clinical neuropsychology can be found in the 19th century, when many European doctors argued that there should be a relationship between the dysfunctional brain and the syndromes that their patients manifested.

Many were the great figures of that century and the following one who contributed to the development of this science. John Hughlings Jackson was the first to hypothesize that cognitive processes take place in parts of the brain and this was confirmed by the findings of Paul Broca and Karl Wernicke through their findings in language problems and affected brain areas.

Others, more from the perspective of statistics and methodology, such as Francis Galton and Karl Pearson, helped to establish research in psychology as we know it today and, therefore, also in neuropsychology.

As for the tools used by neuropsychologists, the important task of Alfred Binet and Theodore Simon, who jointly developed the Binet-Simon intelligence scale, should not be omitted, setting the precedent for the creation of the cognitive evaluation batteries.

However, as has happened with medicine and pharmacology, it is the misfortunes that have advanced clinical neuropsychology. The outbreak of the First and Second World Wars, in addition to the Korean and Vietnamese wars, caused thousands of badly wounded soldiers, many of them with brain damage due to physical trauma, gunshot wounds or bleeding . Based on their symptoms and the area of injury, it was possible to obtain extensive information about which areas of the brain are responsible for certain functions.

Objectives

Fundamentally, the task of the clinical neuropsychologist can be summarized in four main objectives.

1. Diagnosis

Through the use of questionnaire batteries, observation of pathological behaviour and the use of neuroimaging techniques, the neuropsychologist can establish a diagnosis for the patient . Thus, it is possible to know whether the person’s atypical behaviour is due to a real lesion, a brain tumour or haemorrhage or, on the contrary, the cause is rather psychiatric.

Also, based on the type of behavior that the patient manifests, it is possible to assume, both with and without the use of neuroimaging, in which area of the brain the damage has occurred.

In this phase, various aspects are evaluated, such as the cognitive abilities of the affected person , as well as his/her capacity to react to environmental stimuli.

2. Patient care

Once the diagnosis is established, it becomes necessary to see how best to care for the patient to avoid impairing his or her abilities .

The care of the patient does not only involve professionals, but also the affected person’s environment must be educated to be a source of support in their recovery

The relative sensitivity of the questionnaires used in this field and their proven accuracy allow to determine the care required by the patient and to avoid their deterioration , or at least to delay it.

Depending on the severity of the patient, it will be necessary to follow up and administer various tests over time, with the intention of observing how the patient is progressing.

3. Treatment

The main treatment option for patients who have suffered a neurological injury is basically the rehabilitation and recovery, to the extent possible, of cognitive deficits .

If possible, and the intervention involves more benefits than risks, surgery, performed by a neurosurgeon, may be another option. However, it is normal to opt for less invasive techniques , establishing a treatment plan to achieve an increase in your daily performance and promote an increase in your well-being.

4. Research

Clinical neuropsychology is not just about diagnosing and treating patients. It also, as part of the science that it is, seeks to expand its knowledge through scientific research. In this way, it manages to improve its treatment and diagnostic capacity , developing new questionnaires and techniques that allow the improvement of the affected capacities in patients.

Since the brain is perhaps the most mysterious organ in the entire human body, it is constantly deepening its functioning and establishing the areas behind specific symptoms.

Bibliographic references:

  • Antonio, P. P. (2010). Introduction to Neuropsychology. Madrid: McGraw-Hill.
  • Broks, P. (2003). Into the Silent Land: Travels in Neuropsychology. Atlantic Monthly Press.
  • Davis, Andrew, ed. Handbook of Pediatric Neuropsychology. New York: Springer Publishing.