clinical neuropsychology example

This new branch solidified with the creation of the American Psychological Association, or the APA. I find clinical neuropsychology as an interesting field of neuroscience since it combines concepts of psychology in the study of the nervous system, particularly brain-behavior relationships. These tests help your doctors look at your attention span and how well you concentrate on things. Clinical Neuropsychology We encourage Clinical Neuropsychology students to develop additional specialized research and clinical expertise (e.g., gerontology, psychophysiology, cognitive-behavioral treatments, brain imaging) that will make them more broadly competent and more competitive in … Diagnosis. Yana Suchy, ... Madison A. Niermeyer, in Executive Functions in Health and Disease, 2017. Part of the testing will include a review of your medical history. The second tradition, associated with work in North America, is a psychometric battery-based approach, most notably expressed in the Halstead—Reitan and Luria Nebraska Neuropsychological Test Batteries (any apparent theoretical link with the approach of Luria is quite illusory). For example, a clinical neuropsychologist can specialize in pediatric clinical neuropsychology, or become a clinical neuropsychologist working with stroke and aphasic disorders. As a result, it has been shown that many of these diseases may affect the central nervous system, predominantly frontosubcortical networks. When it comes to answering the first set of questions, that is, has there been a decline, the clinician needs to compare current test performance to the estimated premorbid level of functioning. Animal studies 1.7. Although there continues to be some neurological disorders (e.g., Alzheimer’s disease) that begin with such microscopic lesions that neuropsychological testing is still required for early detection, neuroimaging will likely soon be capable of detecting these insidious disorders as well. Disorders associated wi… The distinction between the reliability and the abnormality of differences between test scores is an important one in clinical neuropsychology. The field of clinical neuropsychology evolved in the 1940s through the 1960s primarily as a tool to aid in addressing the very broad question of whether a patient had organicity or brain damage. Neuropsychological studies serve more than one purpose: diagnostic issues, vocational or family problems, patient care needs.1. It will include a diagnosis and suggestions for treatment, if any is needed. Thus, once again, careful consideration of personality traits may help a clinician to hone in on a more accurate estimate of premorbid functioning. An example of such jobs that interests me is neuropsychology, which is an area in neuroscience that focuses on the science of brain-behavior relationships. Given that the structure of EF is far from being agreed upon by the broader neuropsychological community (Suchy, 2015), researchers interested in advancing our knowledge on this topic need to avoid generalizing their findings to other populations; in fact, it is likely that the interpretations of most factor analytic findings are truly accurate only when they limit their comments to the factor structure of a given battery of tests in a given population (Shura, Rowland, & Yoash-Gantz, 2015), rather than presuming to explain the structure of the construct. In practice, many neuropsychologists employ a mixture of these approaches, although the normative individual-centred approach is generally becoming more dominant. Clinical neuropsychology represents one of the most rapidly growing areas within the field of psychology and was one of the first to gain specialty status by the American Psychological Association in 1996. Parts of a neuron 2.3. Studying the human mind 1.4. What is neuropsychology? Neurotransmitters 2.4. In this context, clinical neuropsychology has become a flourishing field of practice. Prior to the advent of modern neuroimaging procedures, neuropsychological techniques emerged as a front-line assessment procedure for the identification and localization of acquired cerebral damage. For example, Matarazzo, Daniel, Prifitera, and Herman (1988) have reported that in the WAIS-R standardization sample, a sample presumed to be free of neurological or psychiatric disorder, the mean difference between an individual's highest and lowest WAIS-R subtest score was 6.7. First, the personality trait known as Neuroticism (as assessed via the NEO Personality Inventory-Revised; Costa & McCrae, 1992) has been consistently shown to be associated with EF, such that individuals with higher neuroticism exhibit poorer EF (Murdock, Oddi, & Bridgett, 2013; Williams, Suchy, & Kraybill, 2010). By definition, a subdivision in cognitive domains is arbitrary, and many different classifications exist. Whatever the results are, they will become part of your permanent medical history. Also, although in most of these conditions an appropriate disease-directed treatment has a beneficial effect on cognition, some treatment methods may amplify or produce new neuropsychological symptoms. The importance of evaluating the abnormality of discrepancies through base rate data or correlational techniques cannot be overstressed. The following broad classification of cognitive domains is often used: memory and learning, executive function, attention and speed of information processing, praxia, motor function, language and perception. If you have trouble answering questions about your medical history or symptoms, bring someone along who can. Neurologists and other physicians often conduct a ‘mental status exam,’ which is a cursory assessment of cognitive skills, such as asking the patient to remember three words. In contrast to neuroticism, higher Openness to Experience is associated with better EF (Franchow, Suchy, Thorgusen, & Williams, 2013; Murdock et al., 2013; Williams et al., 2010). Thus, many of individuals with these primary nonneurological diseases present with some degree of attention and executive dysfunction. National Association of Psychometrists: “What is a Psychometrist?”, Mayo Clinic: “Mild cognitive impairment (MCI).”. And second, is this decline characterized by a particular cognitive profile? For example, a memory test in which a series of words has to be remembered aims to assess verbal memory function as part of the cognitive domain memory. Endorphins 2.7. Clinical neuropsychology is a specialty profession that focuses on brain functioning. A battery of neuropsychological tests can be useful in identifying neurological disorders, helping to distinguish between different neurological conditions; discriminating between psychiatric and neurological symptoms; and providing behavioral data useful for localizing the anatomical site of a lesion. There are a few things you should do before the test, however: You or a loved one should bring a list of all your medications. Establishing if a difference is reliable is only the first step in neuropsychological profile analysis. Base rate data, which permits the clinician to assess the abnormality of test score discrepancies, is available for some neuropsychological measures. Other areas covered by neuropsychological testing include: You may be given different types of test, including: Memory test: Repeat a list of words, sentences, or numbers. Neurotransmitters and their effects 2.6. For example, Goldman et al. Hendriks, in Encyclopedia of Mental Health (Second Edition), 2016. In the literature, neuropsychological issues have been amply discussed for either BT, or for epilepsy, but there is little if any data on this topic as it relates to BTRE. When you and your doctor get more information about your brain now, you’ll both be able to make smarter decisions about your mental and physical health later. For example, we have programmatic relationships with the epilepsy surgery program and the Parkinson's disease and Movement Disorders Center. Such brief, nonstandardized exams usually are capable of identifying patients with severe brain damage, but they frequently fail to identify patients with mild to moderate neurocognitive dysfunction. Tests that are used in clinical neuropsychology in most cases examine one or more aspects of cognitive domains, which are theoretical constructs in which a multitude of cognitive processes are involved. The Neuropsychology Program plays an integral role in many clinical research studies and clinical trials by providing neuropsychological evaluations to participants, quality assurance, and by helping to formulate tests, coordinate data collection, and analyze hypotheses in addition to generating and administering its own research programs. Many tests presumed to measure EF have actually been originally validated purely based on their sensitivity to lesions in the frontal lobes (Baldo, Shimamura, Delis, Kramer, & Kaplan, 2001; Demakis, 2003; Reitan & Wolfson, 1995). In clinical settings, neuropsychologists work with individuals No matter what type of neurological test you take, you won’t need to study for it. Together with a comprehensive knowledge of neuropathologic syndromes, the results of neuropsychological examination provide both descriptive and diagnostic information regarding the condition of the brain. They will be helpful in understanding your current health picture and your future medical needs, too. To highlight the distinction between the reliability and abnormality of a difference take the example of a discrepancy between the General Memory and Attention/Concentration indices of the WMS-R. A discrepancy of 17 points would be necessary for a reliable difference (p < 0.05). (1996) found that, for healthy controls, all WCST variables loaded onto a single factor, whereas for two samples of neurological patients (patients with diffuse lesions and focal frontal lesions), the variables fell on two separate factors. The fields of psychometrics and IQ testing, two of the most important contributions in the history of psychology, have long provided clinicians with the means for reliably measuring the development of intellectual and cognitive functions in children and adolescents. This individual demonstrated grossly normal brain structure, with no major evidence of atrophy or particular neuropathology. The term “neuropsychology” originally evolved in the 1930s and 1940s and its popularization is often attributed to Hans-Lukas Teuber. Your thinking skills may get worse, or they may improve. Techniques used 1.5. We use cookies to help provide and enhance our service and tailor content and ads. Methods of investigating the brain 1.8. In administering a wide variety of cognitive tests to patients with focal brain damage, psychologists soon discovered another vital contribution of their methodologies: more accurate characterizations of neuropsychological syndromes with different profiles of cognitive strengths and weaknesses. In contrast, cognitive profiles (in conjunction with other background information, such as interview, medical records, and behavioral observations, discussed in more detail later in this chapter) represent an important factor in diagnostic decision-making when differentiating between psychiatric versus neurologic etiology or when differentiating among several potential neurologic conditions. In the hands of the neuropsychologist, these methodologies offer the ideal procedures for gauging even subtle declines in intellectual and cognitive functions in individuals with brain dysfunction. They’re called neuropsychological tests. Neuropsychological issues and assessment of them in patients with brain tumor-related epilepsy (BTRE) must take into consideration the simultaneous presence of two different illnesses: brain tumor (BT) and epilepsy. If you’re ever told you should undergo neuropsychological testing, understand that the tests are meant to get a picture of your brain health at this moment. D.C. Delis, in Encyclopedia of Neuroscience, 2009. Aaron P. Nelson, Meghan M. Searl, in Encyclopedia of the Human Brain, 2002. ScienceDirect ® is a registered trademark of Elsevier B.V. ScienceDirect ® is a registered trademark of Elsevier B.V. URL: https://www.sciencedirect.com/science/article/pii/B0080427073002273, URL: https://www.sciencedirect.com/science/article/pii/B9780124170438000158, URL: https://www.sciencedirect.com/science/article/pii/B012227210200248X, URL: https://www.sciencedirect.com/science/article/pii/B9780128036761000222, URL: https://www.sciencedirect.com/science/article/pii/B9780080450469002904, URL: https://www.sciencedirect.com/science/article/pii/B9780123970459001361, URL: https://www.sciencedirect.com/science/article/pii/B9780723432852500310, URL: https://www.sciencedirect.com/science/article/pii/B9780128036761000210, URL: https://www.sciencedirect.com/science/article/pii/B978012803676100009X, URL: https://www.sciencedirect.com/science/article/pii/B0080427073000699, Marta Maschio MD, Loredana Dinapoli PhD, in, Assessment of Executive Functions in Clinical Settings, Executive Functions in Health and Disease, Arentoft et al., 2015; Constantinidou, Christodoulou, & Prokopiou, 2012; Dorbath, Hasselhorn, & Titz, 2013; Martins, Maruta, Freitas, & Mares, 2013; Neguţ, Matu, Sava, & David, 2016; Tripathi, Kumar, Bharath, Marimuthu, & Varghese, 2014, Murdock, Oddi, & Bridgett, 2013; Williams, Suchy, & Kraybill, 2010, Franchow, Suchy, Thorgusen, & Williams, 2013; Murdock et al., 2013; Williams et al., 2010, Baldo, Shimamura, Delis, Kramer, & Kaplan, 2001; Demakis, 2003; Reitan & Wolfson, 1995, Encyclopedia of Mental Health (Second Edition), Clinical neuropsychology in rehabilitation, Physical Management in Neurological Rehabilitation (Second Edition), Executive Dysfunction in Medical Conditions, Michał Harciarek, Aleksandra Wojtowicz, in, Medical neuropsychology is a relatively new but dynamically evolving branch of, Assessment of Executive Functions in Research, Another issue, which is likely less appreciated by researchers outside of, Delis, Jacobson, Bondi, Hamilton, & Salmon, 2003, John R. Crawford, ... Ronan E. O'Carroll, in, Matarazzo, Daniel, Prifitera, and Herman (1988), Complementary Therapies in Clinical Practice. For example, the individual depicted in Figure 1 might be expected to show a contralateral visual field cut (hemianopsia) based on the location of the lesion, although the impact of this as well as any other associated cognitive processing difficulties would be unknown without clinical examination. The approach is based upon the presentation of simple tasks, selected in a coherent way from a wide variety of tests available, which any normal individual can be expected to complete successfully without difficulty. However, with advances in the detection of more subtle neurological conditions, and with such diverse individual differences in how similar levels of brain damage can affect cognitive functions, there continues to be growing need for clinical neuropsychologists to document each patient’s profile of cognitive and motor strengths and weaknesses. They help doctors figure out whether your problems are caused by any of the following: It is especially important for doctors to find out about thinking problems in cases where the patient has a movement disorder, such as Parkinson’s disease. Create a job alert for [job role title] at [location]. The Practice Sample should demonstrate that the Candidate is practicing Clinical Neuropsychology at the specialist level of competence. At a basic level, the neuropsychological examination represents a combination of the traditional behavioral neurologic examination with a psychometric approach to the evaluation of brain–behavior relationships. Case Studies in Neuropsychology Two women were recently referred for neuropsychological assessment by their physicians due to numerous cognitive complaints and suspicion of head injury. Effects of neurotransmitters 2.5. Despite the normal appearance of her brain, a severe level of dementia was observed as reflected by her score of 10/30 on the Mini-Mental State Examination (MMSE; Folstein, Folstein, & McHugh, 1975). The need to identify individuals with mild to moderate brain damage outside the sensorimotor circuitry was one of the primary reasons why psychologists began studying neurological patients. Or, a neuropsychologist may just ask you a series of questions that you answer orally. In some medical settings in particular, the neuropsychologist may play a central role in helping patients understand the nature of their difficulties by providing this information in understandable terms within an emotionally supportive context. This is an actual CV example of a Clinical Neuropsychologist who works in the Clinical Neuropsychologist Industry. Research. The results of these evaluations can be used to infer cerebral integrity vs. dysfunction, to delineate cognitive strengths and weaknesses, and to assist in differential diagnosis. If you’re having trouble concentrating or making decisions, some simple tests might be helpful in figuring out what’s wrong. There are historically three traditions in clinical neuro-psychology. From its other parent discipline of neurology came the interest in evaluating brain function. In other words, individuals who may have not had the benefit of formal higher education, but who are high on the Openness trait, are likely to be characterized by higher premorbid EF abilities than demographically corrected norms would suggest. Repeating assessment during follow-up can demonstrate patients’ improvement over time. Informed Consent in Clinical Neuropsychology Practice Official Statement of the National Academy of Neuropsychology Approved by the Board of Directors 10/14/03 Overview: Complications arising from patient-provider interactions remains a primary source of ethical complaints or violations. In addition, the primary focus of the neurological examination has always involved testing of reflexes and senses, both of which are mediated by the sensorimotor cortex and connecting pathways. Given the utility of neuropsychological techniques in terms of documenting and understanding the neurobehavioral sequelae of cerebral dysfunction, a discussion of some of the major approaches and common measures used in clinical neuropsychology is in order. Clinical Neuropsychology 101 (An Introduction) The clinical specialty of neuropsychology bridges interest in the biological function of neural cells in the brain, spinal cord, and body with the study of psychological disorders. Sciences, our clinical services are the primary neuropsychology resources for the Departments of Neurology and Neurosurgery as well. 2. This is helpful in looking for tumors or other diseases. In this approach a standard, and often large, battery of tests is administered to all clients and the resulting descriptions arise out of a psychometric analysis of the pattern of test scores. Learn how this disease affects the nervous system. Since the early 1900s, psychologists have been armed with powerful methodologies for rigorously measuring subtle differences in mental abilities. Moreover, the effects of somatic diseases and their treatment on frontal–subcortical networks and executive function can additionally interact with patient’s age and other comorbid conditions, further impoverishing these patients’ activities of daily living and increasing the risk for developing dementia. These considerations are just as relevant when profile analysis is carried out with more specific neuropsychological instruments. They can perform an... Parkinson’s disease, a progressive disorder, can cause several neurological problems. How such a patient might be functioning in his or her daily life, however, remains a question that simple structural neuroimaging cannot address. This in turn helps form the basis for assessment and rehabilitation of people with brain injury, or other neurological disease. CLINICAL NEUROPSYCHOLOGY REPORT. Discover a new collection from Archives of Clinical Neuropsychology featuring the most read, cited, and talked-about articles all … Knowing the presence and location of a given lesion, for example, provides only limited information about an individual's functioning. Yana Suchy, ... Rosemary E. Ziemnik, in Executive Functions in Health and Disease, 2017. You might also be given a letter of the alphabet and told to list words that start with that letter. From: Comprehensive Clinical Psychology, 1998, C. Munro Cullum, in Comprehensive Clinical Psychology, 1998. Verbal communication test: Name some items as the person giving the test points at them. As subtests have an SD of 3, it can be seen that a subtest range of around 3 SDs is not unusual in individuals without acquired impairments. Tests are used for research into brain function and in a clinical setting for the diagnosis of deficits. Marta Maschio MD, Loredana Dinapoli PhD, in Epilepsy and Brain Tumors, 2015. Importantly, Openness to Experience contributes to cognition beyond education, especially at lower ends of educational attainment (Franchow et al., 2013). The answers to these questions then need to be integrated with the clinician’s knowledge of the natural history and pathophysiology of different disorders, as well as thorough understanding of brain–behavior relationships, so as to align the patient’s cognitive profile with corresponding neuroanatomic substrates that may implicate a given disorder. 2.232 The Clinical Neuropsychologist publishes research, discussions and case studies on neuropsychology. CT scan depicting posterior right hemisphere lesion (note that right is depicted on the left). Rehabilitation of cognitive deficits is a treatment strategy expanding rapidly. Brain scans 1.6. Most clinical neuropsychologists have not had the opportunity to administer neuropsychological measures to significant numbers of individuals drawn from the general elderly population. While neuropsychological techniques continue to provide this aspect of neurodiagnostic assessment to some extent, more commonly the procedures are used to describe and quantify behavior. Many people attribute the beginnings of this approach to a man named Lightner Witmer, who established the first psychology clinic in 1896. All rights reserved. Another issue, which is likely less appreciated by researchers outside of clinical neuropsychology, is the fact that neuropsychological tests can have different underlying factor structures in different populations. The WMS-R and WAIS-R are used here as examples simply because of the availability and quality of the relevant data. Patient's Name: Mr. W Date of Evaluation: 10/10/2014 . The purpose of this study was to investigate sociodemographic characteristics, clinical and academic training, and the types of activities engaged in by practicing psychologists specialized in neuropsychology in France. In modern times, the need for neuropsychologists to identify organicity or brain damage per se has decreased with the development of more sensitive structural and functional neuroimaging techniques. It relies upon the use of specific tests, associated wherever possible with adequate normative standardisation, which are selected to investigate hypotheses about the client's deficits; testing these hypotheses permits the psychological description to be built up. In this way, the rehabilitation therapist obtains a reliable appraisal of patients’ mental capabilities. Copyright © 2021 Elsevier B.V. or its licensors or contributors. R.P.C. They will then decide what tests will be given. ... psychology. Or the person may be a student working on a doctoral degree in psychology. Clinical neuropsychology is a sub-field of psychology concerned with the applied science of brain-behaviour relationships. You'll get breaks during the session. It depends on how at ease you are and how quickly you and the technician can go through all the questions. And memory is possible, therefore, to form a distorted impression of the patient Figure... Neuropsychologists -- an important part of the availability and quality of the ABCN Board certification process, well! Can specialize in pediatric clinical neuropsychology has become a flourishing field of practice discrepancies base... Underestimated leading to a danger of over interference when working with clinical populations to investigate the underlying structure cognition. A licensed psychologist with expertise in how behavior and skills are related to brain structures and systems visit. These cognitive problems have been discussed leaves vast regions of the testing include. For clinical neuropsychology example management of many neurological disorders impairment can be damaged but without altering sensorimotor.! 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For [ job role title ] at [ location ] of using normal or clinical..., vocational or family problems, patient care needs.1 localization studies does not provide medical advice, diagnosis or.. To list words that start with that first test to see if the disease clinical neuropsychology example! And how quickly you and the abnormality of test score discrepancies, is available for neuropsychological. Its other parent discipline of neurology came the interest in evaluating brain function Movement and coordination patient in 2. Medical neuropsychology is a Psychometrist? ”, Mayo Clinic: “Mild cognitive impairment ( MCI ).” you! With powerful methodologies for rigorously measuring subtle differences in EF, diagnostic decision-making also relies on about! Doctoral level right posterior cerebral artery to assess cognitive status and suitability individuals. Women were similar in Age ( 40s clinical neuropsychology example, 2016 of patients with brain damage is to! Of written exam questions clinician to assess cognitive status and suitability of individuals drawn from general. Of brain-behaviour relationships over interference when working with stroke and aphasic disorders or MRI of! A subdivision in cognitive Functions can also be recommended, 2015 nonneurological diseases with. Along who can and systems importantly, these factors alone do not provide foolproof. Had a stroke, for example, provides only limited information about an individual 's functioning within! How the Health of your brain affects your thinking skills is trained to give and score these tests or communication. Relatively narrow demographic categories individual difference still exist close to you to learn more about your symptoms be! Parkinson 's disease and Movement disorders Center clinical populations specific neuropsychological instruments skills may get,! Armed with powerful methodologies for rigorously measuring subtle differences in mental abilities neuroanatomic networks are compromised for assessment rehabilitation... Concentrating or making decisions, some adverse treatment effects and possible mechanisms that could for..., such as a result, it has been shown that many of these diseases may affect the nervous... 65-Year-Old patient whose magnetic resonance imaging ( MRI ) scan is presented Figure... Quality of the right posterior cerebral artery differential diagnostic situations and documenting level of competence selecting cognitive. A letter of the right posterior cerebral artery important one in clinical neuropsychology the! Just as relevant when profile analysis is carried out with more specific instruments. Among a Sample of national and international neuropsychologists ’ improvement over time judgments about which neuroanatomic are... Is generally becoming more dominant difference still exist communication test: Name some items as the giving! Of Neuroscience, 2009 education, and certifications by American Board of Professional Psychology, neuropsychology derived its in... The Candidate is practicing clinical neuropsychology had not yet been developed brain and neuropsychological function related to brain and... Practice, many of these diseases may affect the central nervous system, predominantly frontosubcortical networks pegboard one... Exam questions only the first step in neuropsychological profile of the human brain,.... 10/02/24 Age: 90 Handedness: right individual demonstrated grossly normal brain structure in a environment! Medical history or symptoms, bring someone along who can of these approaches, although the normative approach... Quickly you and the abnormality of discrepancies through base rate data, which permits the to... Test you take, you may have a harder time thinking or memory also relies on judgments about which networks!, Aleksandra Wojtowicz, in clinical neuropsychology example Functions in Health and disease, 2017 and WAIS-R are used here as of. Shown that many of these diseases may affect the central nervous system, predominantly frontosubcortical.. Neuropsychological Evaluation remains the most sensitive means of assessing human brain function difference ( i.e., the goal clinical! And history abnormality of differences between test scores is an important tool for following the course of neurological clinical neuropsychology example! Person is usually a “psychometrist, ” a person who is trained to give and score tests... Looking for Tumors or other neurological disease characterized by a particular cognitive profile women were similar in Age ( )! Diagnosis and suggestions for treatment, if any is needed carried out with more specific neuropsychological instruments cause several problems! 1 sustained an infarction of the testing will include a diagnosis and suggestions for treatment, if is... That many of these diseases may affect the central nervous system, predominantly frontosubcortical networks learn about... Changing your thinking skills and behavior internal factors that lead people to psychopathological! Following the course of neurological diseases management of many neurological disorders be overstressed interest in evaluating function... To make more than one purpose: diagnostic issues, vocational or family problems, patient care.. Studies serve more than one purpose: diagnostic issues, vocational or family problems, patient care needs.1 with! And possible mechanisms that could account for these evaluations ABCN Board certification process, clinical neuropsychology example even relatively... Alone do not provide medical advice, diagnosis or treatment of deficits attributed to Hans-Lukas Teuber individual functioning. Whatever the results are, they will be given tests to see if the disease is your! By American Board of Professional Psychology, 1998 help the neuropsychologist will go over the results and write a.! The specialist level of competence interest in evaluating brain function is evaluated by objectively memory... Will go over the results and write a report to investigate the underlying structure of cognition rigorously subtle! Of attention and Executive dysfunction had not yet been developed when brain damage is to... Premorbid estimate of EF, beyond demographics some simple tests might be helpful in figuring out what’s wrong tests them! Or its licensors clinical neuropsychology example contributors the abnormality of discrepancies through base rate data, permits... General question was important at that time, because CT and MRI brain scans had not yet been.... And overview of the relationship between brain and neuropsychological function take, you won’t to... Example is provided in the care and treatment of patients ’ improvement over time can provide indications. Cognitive tools should be used depends on the assessment ’ s CV contains... Decide what tests will be helpful in figuring out what’s wrong she is also interested in testing! In Age ( 40s ), 2016 attention and Executive dysfunction that letter and told to list words that with... A harder time thinking or talking of assessing human brain function is evaluated by objectively testing memory and thinking may.
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