Applied Fields: Neuropsychology

Introduction

Neuropsychological assessment as a formal procedure is a relatively recent development. Its evolution has paralleled advances, in the past fifty years, in the areas of neuroscience in general, and cognitive neuroscience in particular. It has also been influenced by developments in applied clinical disciplines such as neurology, neuroradiology, rehabilitation medicine, special [Page 73]education, geriatrics, developmental psychology, etc. In this section, we review the historical trajectory of this aspect of clinical neuropsychology, and present the current state of the field.

Historical Antecedents

Neuropsychological assessment did not come of age until after the Second World War. In the second half of the 19th century, there had been a flurry of clinical studies that correlated brain structures and cognitive activity. The work of Broca, Déjerine, Jastrowitz, Korsakoff, Lichteim, Liepmann, Oppenheimer, Ribot, Wernicke, and many others in the latter part of the 19th century described the neurological substrates of disorders such as the aphasias, apraxias, amnesia, and frontal disinhibition (Walsh, 1978; Benton, 2000). However, these advances in localization of function lay dormant (except in the USSR) for over half a century. This approach regained its popularity in the 1950s and 1960s, in part as a result of the work of Brenda Milner and her colleagues in Montreal, who described the pivotal role of the hippocampus in memory (Scoville & Milner, 1957), and in part due to the work of Benton, Zangwill, Hecaen, Ajurriaguera, and Goodglass. Sperry's work and the seminal case study of a human deconnection syndrome (Geschwind & Kaplan, 1962) lent further impetus to the belief that higher cognitive functions could be componentialized and subjected to analysis via objective techniques. Interest in the pioneering 19th century studies and their potential contribution to the study of brain-behaviour relationships was revived by Norman Geschwind in Boston at approximately the same time (Geschwind, 1997).

Paradigms in Neuropsychological Assessment