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stump

Neuropsychological Exam

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stump    466

So, back at the beginning of the month I went in for a baseline neuropsychological exam.  Partly it was for baselining, partly because DW was getting worried about some memory issues she was starting to notice.

 

Anyway, for those that haven't been through the exam I thought I'd detail my experience so you'll have some idea of what to expect.  To begin with, the neuropsychologist I met with (Dr Jeff Shaw at the Booth Gardner Parkinson Center at Evergreen Health in Kirkland, WA) was a very nice guy that I found to be very easy to get along with.  In contrast to a lot of psychology types (my sister is one) he came across as a pretty normal person and not some esoteric academic that thought his poop smelled sweeter than everyone else's.  As an aside, with a master's degree I'm the least educated of my immediate family.  Both parents and my sister have PhD's, so I've grown up around academics, and most have a horrible superiority complex.

 

Anyway, Dr Shaw and I chatted for a bit, partly about my PD, partly about just me, partly about anything that might be an issue in the future if I were to apply for disability, or for DBS.  Included in that was whether I'd talked to anyone professional about the likely mild PTSD I'd had after a car accident when I was a teenager.

 

Once we got to the main part of the test he ran through a huge range of tests.  Most of them were either timed or time limited.  One was part of the military entrance evaluation where he timed me connecting the dots on a sheet that were numbered 1-26.  Then I had to do the same except it was 1-A-2-B, etc.  Then I got a complex drawing that I had to copy.  Then I had to reproduce that drawing from memory.  After a few other tests were run I had to try to reproduce that drawing from memory again.  Among the other tests were things like repeating back strings of numbers (starting with 3 and increasing as I did well).  Then repeating back the string of numbers backwards (again starting with 3 and increasing as I did well).  Then repeating back the string of numbers except in order from smallest to largest.  I was read a list of words and had to repeat back as many as I could remember.  Then a different list.  Then he'd rattle off words and I'd have to identify whether they were on only the first list or not.  Then do things like name every word I could think of that began with a particular letter.

 

Another test was there was a page with a bunch of colored dots.  I had to state the colors in the order they appeared.  Then a page where the names of the colors were spelled out, but the name of the color did not match the color of the ink used and you had to name the color of the ink, not what was spelled out.  Then a page like the second page, but some of the colors had a box around them and those you gave the color that was spelled out, not the ink color.  A friend of mine was telling me his 10 year old daughter had been going through some cognitive therapy and did that exact same test.

 

There was a test where I had to look at 2 shapes and then a line of other shapes and mark the one that matched one of the 2 original shapes or mark that none matched.  There was matching a code to various letters or numbers.  Being told a fictitious person's name, address and phone number and having to repeat it back at various points throughout the exam.  A story (about 4-5 sentences) you had to repeat back as exactly as possible, and got ambushed with that again later.

 

There were some mental math exercises, and some tests similar to what they did for my Occupational Therapy baseline exam a year or so ago.  Grip strength, manual dexterity tests, etc.

 

He skipped most of the psychological profiling since I'm not applying for disability yet.  He said with disability claims the insurance companies like to try to pin your problems on mental health issues if they can since those benefits are much more severely limited.

 

There was more, but that gives a good idea of what all you go through.  Even reading through all of this, I don't think it's something that you can really prepare for.  You'd have be extremely familiar with not just what the test includes, but why each test is done to be able to effectively throw the results of the exam.  Especially since some parts are designed to catch malingerers, and on a publicly searchable forum I'm not about to say which.  

 

I went back last week for my follow up to discuss the results.  Bottom line was the doc didn't see anything that really alarmed him or made him think I was at risk of anything in particular.  I scored in the 80th percentile or higher on most categories, except memory and word finding where I scored in the 40-60th percentile (so basically average).  All of those were corrected for a male with 18 years of education (masters degree).  FWIW, a 50th percentile woman would have a higher score than a 50th percentile man for memory at least.

 

As far as what that noticeably lower score on memory indicates, he said it's really hard to say as I don't have a pre-PD exam to compare against.  As he said, the memory could have always been like that, but I'm smart enough to be able to compensate in other areas.  It's also possible that PD is starting to affect memory.  But, like most with PD, it's more a matter of immediate recall.  Once something is there it might take longer to retrieve it, but it is still there.

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Linda Garren    751

Stump, that was quite a thorough exam and a very thorough write-up.  I've had some of those tests, too, but not that many in one appointment.  Good going.

 

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johnnys    460

My wife who doesn't have PD experiences similar minor memory problems .Mine has definitely better since i got my daily life more organized .

Dr.Low talks about the attention mechanism and how it can be strengthened for everybody not just PD.

Think,plan and act was the spot.

 

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stump    466
13 hours ago, MurrayPD2 said:

Sounds exactly like my DBS cognitive exam.

It should.  The same basic exam is used for DBS screening, disability applications, and general monitoring of disease progression.  Depending on the purpose they may skip some parts I did, or include some I skipped.

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DBS prescreening is quite unnerving.  I took the cognitive exam last week (5hrs!) and though I never felt that I had any cognitive issues whatsoever, I have given this segment more concern than any of the others. I hope that these tests will not be the deciding factor.  I think I misunderstood the instructions for one of the test because meds were wearing off!   Also, the visit with the Physical Therapist also was an eyeopener.  I have learned that all the endless activity here at home is not really exercise.  Taking 5 or 6 trips to the basement carrying full laundry baskets is not exercise...grocery shopping....weekly house cleaning etc. 

I hope that I will be a candidate for DBS, but I must find a way to move forward if I'm not. Hopefully there are some new meds that would work well.

 

 

 

 

 

 

 

 

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