Neuropsychologist, Brain Detective

As a neuropsychologist, I’m often asked, “What is it you do, exactly?” or more commonly, “What IS neuropsychology?”

One way to think about it is like detective work – a neuropsychologist is like a sleuth solving cases. Cases of the brain, that is.

When something goes wrong in the brain, it can cause quite baffling or bewildering symptoms. Simply put, the brain is complex!  To me, figuring out those complexities is endlessly fascinating, which is one of the reasons I became a neuropsychologist.

The Remarkable Brain

I’ve always been intrigued by the brain and how it works. Did you know…

• The brain is the control center for all our actions and thoughts, from basic movements to advanced skills.
• It is estimated that each brain contains 86 billion neurons, or brain cells.
• The human brain doesn’t reach maturity until approximately age 25.
• It is our only organ packed in layers of protective cushioning and bony armor.

Many mysteries about the brain remain unanswered, though researchers are discovering more each day. As a neuropsychologist, each patient I assess presents me with an opportunity to discover new insights into the brain.

Brain Changes

Despite our bodies’ best-laid brain protection plans – meninges, protective fluid, the skull – our brains are still susceptible to injury and disease.

An injury or disease involving the brain can hinder its ability to function properly. More often than not, symptoms occur spanning multiple areas of functioning, such as:

• Cognition
• Emotion
• Sensation
• Motor/movement

Symptoms can massively vary from person to person. They aren’t always apparent on the outside, unlike other physical injuries (e.g., a broken arm). Nonetheless, “invisible” symptoms are very much felt by the individual experiencing them.

What Can Be Done?

Neuropsychology is concerned with how the brain is functioning and how it influences a person’s cognition and behavior. We are psychologists with extensive training in functional neuroanatomy, neurological disorders, and other conditions that involve the brain and the rest of the nervous system.

A neuropsychologist can help identify:

• If there’s brain dysfunction
• What may be causing an individual’s cognitive symptoms
• The degree to which cognition is affected
• What can be done about it
• Response to interventions

Diagnosing the cause and extent of problems in the brain is a complex process. It can be difficult to accurately pinpoint a specific disease process, predict someone’s recovery from an injury, or choose the most appropriate interventions to treat brain-based conditions.

Solving The Mystery

Back to the concept of neuropsychology as detective work- it’s true in many ways. Each case presents a unique mystery to be explicated.

A neuropsychologist works through proven steps to address each unique case.

• Gathering evidence:
  • A neuropsychologist begins to collect evidence from the time of referral. What are the patient’s symptoms, relevant medical history, observations, etc?
• Identifying Leads:
  • The neuropsychologist uses all the collected information to make hypotheses about what might be going on inside the patient’s brain.
• Testing hypotheses:
  • The neuropsychologist explores hypotheses through the neuropsychological evaluation, administering a set of cognitive tests.
  • The patient’s performance across these tests reveals more clues.
• Interpreting results:
  • The neuropsychologist can detect what disease or combination of factors best account for the patient’s symptom by interpreting test performance in view of normative samples and/or expected abilities, as well as the patient’s unique history.

 The Conclusions

Neuropsychologists are detectives in a way, but they’re also psychologists. That means their deductive process doesn’t end once a diagnosis is reached or ruled out!

After integrating all the clues, the neuropsychologist helps guide what to do next. This may include referrals to other specialists, treatments, and other recommendations to help resolve, reduce, or compensate for their difficulties.

Neuropsychologists help treat individuals who have suffered a brain injury, whatever the cause. They also help the individual and loved ones navigate the unpredictable, often uncertain journey that follows. This is done by coordinating their care, collaborating with other providers, and following up to ensure treatment recommendations are meeting the patient’s needs.

Who Should See A Neuropsychologist?

When individuals experience cognitive changes- such as significant forgetfulness, decline in communication, disorientation- without obvious explanation, a neuropsychological evaluation can help identify the problem.

Neuropsychological evaluations can also track cognition over time, such as in recovery from injury, assessing effects of a medical treatment, or if there’s concern about a neurodegenerative disease.

As a neuropsychologist, I typically evaluate:

• Neurologic conditions
  • Hydrocephalus, multiple sclerosis, epilepsy (seizures), brain tumors, encephalitis, cerebrovascular disease, stroke, known or suspected dementia
• Neurodevelopmental disorders
  • Learning disorders, ADHD
• Effects & recovery after brain injury
  • Traumatic brain injury (TBI)
  • Acquired injury due to anoxia, toxin exposure, electrical injury
• Cognitive symptoms in the context of complex medical problems
  • Autoimmune disease, certain genetic disorders, sleep-related problems, chronic heart or respiratory problems
• Individuals who had prior neuropsychological testing and are seeking a second opinion after unsuccessful interventions

If you have a case for me, I’m here to help you solve it. Call (212) 335-2100 to chat with me or schedule an appointment.

Dr. Amanda Hahn-Ketter

Dr. Amanda Hahn-Ketter is a licensed psychologist with specialized training in neuropsychology. She has expertise in assessment, diagnosis, and treatment planning for individuals with known or suspected brain dysfunction. She also provides cognitive rehabilitation to help individuals compensate for and cope with cognitive difficulties.