Cognitive function is a very vague term that describes various functions of the brain called higher cortical function. These include attention and concentration, speech and language, memory, executive function, spacial function and other more complex functions of the brain that define our character, temper and personality. In general, it is very difficult to evaluate all these functions in an office or laboratory setting because the brain is a very complex organ and higher cortical functions are the most complicated functions of the brain. They truly are what makes us what we are.
Computer-Based Cognitive Testing
Computer-based cognitive testing consists of a series of tests performed on a regular computer to assess various higher cortical functions, such as attention and concentration, short and long-term memory, various language functions, such as speech and comprehension, executive function and others. All the tests are given on a computer screen, similar to any home computer and the test is designed to be very easy even to people with no computer experience. It is almost like an easy video game. At Progressive Neurology, we perform one of the standardized computer-based test, called MindStreams®. The program offers several various tests that assess different cognitive functions. The physician usually selects which test is appropriate based on the patient's condition. For example, patients suspected of having attention deficit disorder will be given a different set of tests than those suspected of having Alzheimer's disease. The test can be used by children and adults and the results are provided based on the patient's age.
Cognitive testing is sometimes used to help support the suspected diagnosis of certain conditions, such as attention deficits disorder (ADD) or attention deficit hyperactivity disorder (ADHD), mild cognitive impairment (MCI) or conditions causing dementia, such as Alzheimer's disease. The test can also be very useful in monitoring treatment. For example, once a patient is diagnosed with a certain condition and treatment is started, a follow up test after several weeks may help determine if the treatment is actually working or not. If the patient performed better at the follow-up test, that would indicate that the treatment might be working. Finally, cognitive testing sometimes helps assess the progression of the disease. For example, in patients with early dementia or mild cognitive impairment, follow testing several months later or a year later may help determine if the condition is getting worse or not. If you have additional questions about cognitive testing in general, and computer-based cognitive testing specifically, please contact us by email or using the messaging system.
The traditional and most studied method is formal neuropsychological evaluation. This is usually a lengthy and detailed test that could last several hours, performed by a licensed neuropsychologist. It provides a detailed and comprehensive assessment of several cognitive functions that can serve clinicians with the diagnosis of cognitive disorders. However, neuropsychological evaluation is not indicated for everyone and frequently neurologists and other clinicians perform a much shorter version in the office, that takes anywhere between three minutes and half an hour, depending on how detailed it is. The most common test used by physicians is the mini-mental status exam (MMSE). The MMSE is very brief and provided a very rough assessment of only certain higher cortical functions. The MMSE has very limited utility and serves as a very crude initial assessment in patients suspected of having cognitive difficulties. Other longer and and more comprehensive tests can also be performed in the office by certain physicians who had special training in cognitive disorders. More recently, computer-based cognitive testing was introduced to help clinicians assess higher cortical functions in the office and provide more detailed and comprehensive assessment that simple office-based test, such as the MMSE.