The University of Kentucky Neurocognitive Diagnostic Service is a comprehensive diagnostic clinic offering both pediatric (age 5 and older) and adult services. This service is an integral component of the Neurology & Neurosurgery departments at UK HealthCare.
The University of Kentucky also has the only National Institute of Aging-Alzheimer's Disease Center in the region. Our neuropsychologists are closely affiliated with this institution and serve as Principal Investigators and consultants on NIH-NIA grants, investigating methods of Alzheimer's prevention and improving the assessment and early detection of cognitive disorders.
As part of a comprehensive diagnostic service, the UK neurocognitive diagnostic service offers neurocognitive/neuropsychological evaluations that may be helpful in diagnosing deficits due to causes such as dementia and other neurodegenerative disorders, movement disorders, toxic exposure, epilepsy, cancer, stroke, multiple sclerosis, head injury, sports-related concussion and post-concussional disorder, depression and anxiety, and other chronic health conditions.
The neurocognitive diagnostic service is also a critical component of:
- UK's National Association of Epilepsy Centers (NAEC) Level 4 Epilepsy Center
- UK multidisciplinary movement disorders program
- UK Spinal Cord and Brain Injury Research Center (SCoBIRC)
- UK multidisciplinary concussion program
- The stroke program, which has the Gold Plus status from the American Heart Association and American Stroke Association.
As part of a comprehensive diagnostic service, the UK neurocognitive diagnostic service offers neurocognitive/neuropsychological evaluations that may be helpful in diagnosing deficits due to causes such as:
- Dementia and other neurodegenerative disorders
- Movement disorders
- Toxic exposure
- Multiple sclerosis
- Head injury
- Sports-related concussion and post-concussional disorder
- Depression and anxiety
- Other chronic health conditions
Our neuropsychologists serve as attending faculty in many programs within the neurology department including:
Services provided to these programs include (but are not limited to):
- Comprehensive cognitive and behavioral assessments of pediatric, adolescent, adult and geriatric outpatients and inpatients.
- Memory assessments.
- Specialty outpatient procedures, including memory and language testing during the ISAP/Wada procedure for epilepsy surgery.
- Cognitive testing prior to and following deep brain stimulation (DBS).
- Assessments of children, adolescents and adults with concussions and other head injuries due to sports, motor vehicle accidents and falls.
- Post-stroke evaluation of cognitive status.
- Cognitive testing for acute and long-term follow-up care for cancer.
Neurocognitive testing, also known as neuropsychological testing, is a comprehensive evaluation of the patient's cognitive status by specific neurologic domains, i.e., memory, attention, problem solving, language, visuospatial, processing speed motor, and emotion. Testing is mainly comprised of paper and pencil tasks and/or computerized tasks, done in a one-on-one setting. It is physically non-invasive.
Assessing brain function
As the brain controls specific neurologic domains, cognitive skills are often affected by many different types of brain-related health conditions. Accordingly, it is important for physicians and other health care providers to carefully assess the patient's relationship among brain, thought, behavior and mood. Neurocognitive/neuropsychological testing helps to clarify this picture, especially in the context of one's daily living or development.
When is referral from your doctor appropriate?
Referrals are typically made to diagnose or rule out diseases of the brain. This information also helps to describe the identified condition's impact on the patient's daily functioning. Examples include traumatic brain injury, epilepsy, Parkinson's disease, multiple sclerosis, brain tumor, stroke, Alzheimer's disease and other types of dementia. The information gathered during this assessment will go to your doctor, and he or she will use this information to make decisions regarding your health care.
Some conditions, such as Alzheimer's disease and multiple sclerosis, cause patients to experience memory and thinking difficulties over time. If these types of conditions are diagnosed or suspected, a baseline evaluation with follow-up (usually yearly) may be useful in interpreting possible changes in one's disease condition.
Neurocognitive or neuropsychological testing is also beneficial in tracking progress for patients undergoing rehabilitation and/or to evaluate how effective a certain treatment is for them. Neurocognitive or neuropsychological testing can help in planning educational and vocational programs as well. They can also assist in disability determination or for forensic (medical-legal) uses.
When should I think about having a neurocognitive evaluation?
Difficulties that might indicate the need for an evaluation include:
- Memory loss
- Difficulty communicating (getting the right words out and/or understanding others)
- Attention and concentration problems
- Difficulty planning and organizing
- Changes in spatial skills or visual perception
- Difficulty reading or writing
- Disturbed thinking or confusion
- Increased impulsivity
- Slowed thinking speed
Talk to your doctor if you have any symptoms mentioned above.
During your visit, you will meet with the neuropsychologist. The doctor will ask about your medical history and the specific concerns that brought you to this clinic. The doctor will often spend additional time talking to your spouse, parent, child or other family members who accompany you. You will spend the majority of your appointment working with a psychometrist, who will do the testing with you.
You may be asked to answer questions, read, write or draw. You may also complete measures that will help the doctor understand how your illness or injury affects your mood, personality or coping skills. During the tests, your family members or friends will be asked to wait in the lobby area.
Unlike the tests you have taken in school, neurocognitive tests do not give you a “pass” or “fail” grade. We will simply ask that you do your best on all of the tests that are presented to you. This will allow us to gather accurate results that best represent how you function in your daily life. Information gathered from these tests helps your doctor know your individual strengths and weaknesses, and provide recommendations for your future care.
Once testing is complete, the neuropsychologist will examine the results. If there has been previous testing, those scores will be compared to the new results. The neuropsychologist will generate a report interpreting the findings and provide conclusions. As authorized by the patient, the report will be sent to the doctor who referred you within one to three weeks for full evaluation or quicker for a test specific to a certain disease. Feedback details for the patient may be arranged prior to leaving the appointment for the assessment date.
If you have any questions, please call the UK Neurocognitive Diagnostic Service at 859-323-5661.
Your appointment can last from two to five hours, depending on the questions asked by your doctor and the nature of the tests required as determined by the neuropsychologist. To be prepared for a visit of this length:
- Dress in comfortable clothes and get a good night's rest before your appointment.
- Take any medicine as you normally do each day.
- Bring any necessary medicines with you, so you will be able to take them at the normal times.
- Bring glasses for reading and hearing aids if you normally wear them.
- Meals and snacks are available in our deli and cafeteria, but feel free to bring these with you if you feel you might get hungry during the day.
- Be sure to eat any meals before your scheduled appointment.
- If you have a family member or friend who is familiar with your condition or current problems, please bring them with you. They may be able to provide valuable information while you meet with the doctor to discuss your condition or current problems.
- For minors, a parent or legal guardian must accompany the minor for the appointment.
During the testing, your family member or friends will be asked to leave the exam room. This is so that you will not be distracted during testing. Your full concentration is very important to your performance.
To ensure as many people as possible are allowed appointments, it is very important that patients inform the clinic if they are unable to keep their scheduled appointment. It is also very important to check with your insurance carrier about coverage. Contact your insurance provider and ask if your policy covers neurocognitive/neuropsychological testing. If the insurance company requires a referral, you will need to contact the referring doctor and have him or her send this form to your insurance company.
A clinical neuropsychologist is a professional psychologist trained in the science of brain-behavior relationships. The clinical neuropsychologist specializes in the application of assessment and intervention principles based on the scientific study of human behavior across the lifespan as it relates to normal and abnormal functioning of the central nervous system. (Source: The Houston Conference on Specialty Education and Training in Clinical Neuropsychology)
A psychometrist is trained in administering and scoring tests and instruments that examine thinking abilities. UK psychometrists hold a master's degree and are licensed by the commonwealth of Kentucky. They work under the supervision of the neuropsychologist. It is the responsibility of the psychometrist to guide the patient through the examination. In order to ensure accurate results, the psychometrist will encourage the patient to do his or her best on all tests. Be assured that the psychometrist will do his or her best to provide for your comfort while you are at the Kentucky Neuroscience Institute.
The referring doctor can fax, mail, or use the online referral form for a consultation request. A referral/consultation request should include:
- Patient background and history in the context of neurological concern(s), and contact information ◦Specific concerns related to your patient's neurological health and cognitive ability
- Any specific questions regarding your patient's neurocognition
- Any questions pertaining to guardianship of the patient if necessary
- Any questions pertaining to capacity/competency of the patient if necessary
Please note that pre-certification for insurance must be obtained by the referring provider.
If the patient and/or doctor are outside the UK HealthCare system or the patient is being referred from UK Psychiatry, please send reports and records relevant to the patient's health as available. Our team will triage referrals once all the information is received. The patient or patient's guardian will be contacted within one week to schedule an appointment. No special forms need to be filled out. Depending on referral issues, a half-day is reserved for each patient, so the number of appointments is limited.