Neurocognitive Testing

Setting the Baseline

With our comprehensive battery of neurocognitive testing, we can measure your memory, attention, processing speed, and executive function.  We then compare it with results from other people your age.  You will be able to see what parts of your brain are stronger than others and which parts can use some training. 

Cognitive testing is completed three times during the program for baseline, midline, and final assessments.  Our testing protocol utilizes scientifically validated, objective, and reliable computerized neuropsychological tests to evaluate your cognitive status with regard to a various mental processes like simple motor performance, attention, memory, and executive function.  Questionnaires are given to complete the holistic assessment of your overall mental health, lifestyle choices, and sleeping habits.

The following psychological tests are administered to assess cognitive functioning:

Montreal Cognitive Assessment – Basic:

  • Brief cognitive screening tool for Mild Cognitive Impairment that tests Executive Function, Immediate Recall, Fluency, Orientation, Calculation, Abstraction, Delayed Recall, Visuoperception, Naming, and Attention.
  • Scored by giving one point for each correct answer and if the score is <30 then 1 point is added if patient’s education is < 4 years and 1 point is added if patient is illiterate. 30 is the maximum score possible.
  • Interpreted as: 26-30 = No cognitive impairment, 19-25 = Mild cognitive impairment, 18 and below = Severe cognitive impairment. If a patient scores lower than 17, we do not administer the CNS

CNS Vital Signs Test

This a non-invasive clinical procedure to efficiently and objectively assess a broad spectrum of brain function performance or domains under challenge (cognition stress test) and 50+ computerized clinical and quality rating instruments. The specific sections of the test are as follows:

Verbal Memory Test:

  • The VBM test measures how well a person can recognize, remember, and retrieve words.
  • Indicative of the patient’s ability to remember a scheduled test, an appointment, take medications, attend class, etc.
  • Measured by displaying 15 words one at a time for the patient to remember both immediately and delayed and scores the correct hits and correct passes when those 15 words are mixed in with other words.

Visual Memory Test:

  • The VIM measures how well a person can recognize, remember, and retrieve figures.
  • Indicative of the patient’s ability to remember graphic instructions, navigate, operate machines, recall images, remember a calendar of events etc.
  • Measured by displaying 15 symbols one at a time for the patient to remember both immediately and delayed and scores the correct hits and correct passes when those 15 symbols are mixed in with other symbols.

Finger Tapping Test:

  • Tests for motor and fine motor speed.
  • Indicative of patient’s ability to perform motor skills and dexterity through cognitive functions, use of precision instruments or tools, performing mental and physical coordination i.e., driving a car, playing a musical instrument etc.
  • Measured by running 3 trials per hand of patients tapping the space bar as fast as they can for 10 seconds and scores the right taps average and left taps average.

Symbol Digit Coding:

  • Measures speed of processing and draws upon several cognitive processes simultaneously such as visual scanning, perception, memory and motor speed functions.
  • Indicative of patient’s ability to recognize and respond/react with accuracy and detail in different situations i.e., fitness-to-drive, occupation issues, possible danger/risk signs or issues.
  • Measured by showing an answer grid with symbols that match up with numbers 2-9 and a test grid, which has the symbols and blanks where the corresponding numbers are typed in. Patients match the symbol with its number and fill in the Test Grid. Scores the amount of correct answers over the duration of 2 minutes.

Stroop Test:

  • Measures reaction time and higher executive functioning such as inhibition/disinhibition, mental flexibility and directed attention.
  • Indicative of patient’s ability to react to a simple and increasingly complex direction set as well as response to a variety of stimuli over lengthy periods of time quickly and accurately, i.e., driving a car, attending to conversation, tracking and responding to a simple set of instructions, self-regulation, behavior control etc.
  • Measured in three parts. Part one: patients press the space bar as soon as a word is displayed on the screen and scores the number of correct responses and errors. Part two: patients press the space bar only when the color of the word matches the name of the word and scores the number of correct responses and errors. Part three: patients press the space bar only when the color of the word does not match the name of the word and scores the number of correct responses and errors.

Shifting Attention Test:

  • Measures how well an individual can shift between information sets, and manage multiple tasks simultaneously.
  • Indicative of patient’s ability to switch tasks, make decisions, multitask, track and respond to set of instructions, etc.
  • Measured by having patients match the color or shape of an object that changes every two seconds, to two shapes that are constant throughout the test. Scores number of correct responses and errors.

Continuous Performance Test:

  • The CPT measures sustained attention, vigilance, and choice reaction time.
  • Indicative of patient’s ability to track and respond to a single defined stimulus over lengthy periods of time while performing vigilance and response inhibition quickly and accurately to a simple task, i.e, self-regulation and simple attention control.
  • Measured by letters of the alphabet appearing on the screen one at a time for 5 minutes and having patients press the space bar only when the letter ‘B’ appears on the screen and scores the number of correct responses and errors.

Four Part Continuous Performance Test:

  • The FPCPT test is a four-part test that measures a subject’s working memory and sustained attention.
  • Indicative of patient’s ability to focus and complete a task or activity, sequence action, and focus during complex thought as well as to carry out short-term memory tasks that support decision making, problem solving, planning, and execution. Enables “right-now” responses.
  • Measured in four parts. Part one: patient presses the space bar as soon as a shape is displayed on the screen. Part two: patient only presses the space bar when an object of a particular color and shape is displayed on the screen. Part three: patient only presses the space bar when two objects of the same color and same shape are displayed in a row. Part 4: patient only presses the space bar when two objects of the same color and same shape are separated by another object. For each of these parts, the shapes are displayed one at a time and scores the number of correct responses and errors.

Qualitative Clinical Interview Questionnaires:

Epworth Sleepiness Scale:

  • Subjective measure of daytime sleepiness in eight different situations.
  • Scored as: No chance of dozing = 0, Slight chance of dozing = 1, Moderate chance of dozing = 2, High chance of dozing = 3
  • Interpreted as: 0-7 = Unlikely that the patient is abnormally sleepy, 8-9 = Patient has an average amount of daytime sleepiness, 10-15 = Patient may be excessively sleepy depending on the situation and may want to consider seeking medical attention, 16-24 = Patient is excessively sleepy and should consider seeking medical attention.

Pittsburgh Insomnia Rating Scale:

  • Assesses level of insomnia in the previous 7 days and nights.
  • Scored as: Not bothered at all = 0, Slightly bothered = 1, Moderately bothered = 2, Severely bothered = 3
  • Interpreted as: Minimum score = 0 (excellent sleep quality), Maximum score = 60 (very poor sleep quality)

Beck Anxiety Scale:

  • Assesses level of anxiety in the past month with how much they were bothered by 21 symptoms
  • Scored as: Not at all = 0, Mildly but didn’t bother me much = 1, Moderately- it wasn’t pleasant at times = 2, Severely- it bothered me a lot = 3
  • Interpreted as: 0-21 = Low anxiety, 22-35 = Moderate anxiety, 36 and above = Potentially concerning levels of anxiety

Beck Depression Scale: