My neuropsychological test results

I just got back from getting the results from my neuropsychological eval.

These are the items that were not average:

Attention and Processing Speed -
mental arithmetic - high avg
selective visual attention & processing speed - low avg

Executive Functioning -
processing speed, visual scanning & sequencing requiring mental flexibility - moderately impaired
inhibition of automatic responses - above avg

Motor Functioning -
gross motor speed - moderately to severely impaired in right hand & mildly to moderately impaired in left.
fine motor speed & dexterity - moderately impaired on right side & mildly to moderately impaired on left.

Language Functioning -
expressive vocab and fund knowledge - above avg
confrontation naming - mildly to moderately impaired
both phonemic & semantic verbal fluency - mildly impaired

Visuospatial Functioning -
judge angles of lines in space, block construction, & ability to analyze & synthesize abstract visual stimuli - above avg

Learning and Memory -
immediate to delayed recall of structured verbal info in the form of short stories - high avg
retention - above avg
non-verbal memory - mildly to moderately impaired

I was kind of disappointed with the results. But - it is what it is. I thought for my baseline I would have been higher, but the whole reason that I had the test, was because I was noticing cognitive problems.

Thanks,
Kelly

[jensequitur]

Yup, they found that I had some mild impairment, and my IQ had dropped about 30 points.  

[ccorina]

Kelly - wow that seems like a lot of info.  How long did the test take?  

Jensequitur - OH MY!  30 points?  That sounds like alot.  I feel so dumb these days, I'd be scared to take a test and find out how low I was.  Does 30 points feel like alot to you?  Do you notice the difference?  I mean, I can tell that I'm not thinking as fast, and I can never think of words, but I'm scared of being unable to be me.  

But I guess it probably sneaks up on you so you dont' notice it.

Corina

[kelly97]

I wish I would have had this test when I was my old "normal."  I know that this cannot really be my baseline per se.  I really can't believe some of the deficits/impairments, especially since I've only been DXd for maybe about 6 mos. I knew I was having issues, but I thought I would have been higher.

The test took about 5 1/2 hrs. It was from 9am - 3pm with a half hour lunch.

[Sparkysarah]

Wow that must have been an exhausting assessment but at least you have had it done and although this is your "baseline" and you are aware that things have changed recently, it has been done and is on record.

At the end of the day, seeing the word mild or moderate impairment just reinforces what you have as you stated known for a while..but it is just seeing it written down and acknowledged by the test conducted by a professional that has obviously hit home with you.  It does not change anything and who you are as a person, so try not to let it get you down and see it as an explanation of why you may sometimes find cognition a bit slow. I know that my cognition has slowed in last year and I find it hard to concentrate with background talking and noise. In Uk I don't think they offer these sort of tests so for me it is just having awareness..but it hard to explain to family and friends and can make one feel vulnerable and just more aware of this chronic condition.

Keep positive and thanks for sharing this information with us.

Love Sarah x

[kelly97]

Sarah, I've always noticed, in all your posts, you are able to take a step back and help explain things a bit more to the people on here.  Thank you.  You're right; I had already noticed the changes, now it's just on paper - nothing has changed regarding that. I'll try not to let it get me down.

I do wonder now if my neuro is going to talk to me at all about it, or if it will just be stuffed in with all of my other records. I'm not sure how that works. Too bad they don't offer tests like this for you in the UK.

[kelly97]

Hey Jen, when they did yours did they note bilateral motor impairment?  I've looked around on the internet, and the only thing I'm finding that comes up for that is stroke. Although, the doctor who gave me the results said it's to be expected with MS. I think it's weird that I don't see anything about it online.

[jensequitur]

Hey, Corina - I could definitely tell something was off.  I had that total brain fog.  Thinking was so hard, and I was having a hard time tracking what was going on.  I just couldn't seem to shake the fog, no matter what I did.  My psychologist recommended Aricept, so I gave it a try.  It really seemed to cut through the gray fluffy stuff and help me remember what I was doing from one moment to the next.

Right now I'm doing a lot better.  After I started feeling more like myself, I stopped taking the Aricept.

Kelly - MS disease activity usually attacks one side or the other, not both - when you see bilateral motor impairment, it's usually because of stroke.  But that doesn't mean that your impairment is a stroke - it just means that it's bilateral.

[COBOB]

Since some PwMS have spinal lesions, the possibility of bilateral symptoms/signs is much higher. The left and right anterior and posterior horns of the spinal cord are very close together, and it doesn't take a very large lesion to effect both anterior columns or posterior columns,  I think this is why some of the people on the forum with spinal lesions seem to have such profound symptoms.

The chances of symmetrical brain lesions in the supratentorial brain are pretty slim.  Now lesions in the brainstem, cerebellum and  midbrain could also cause bilateral symptoms/signs.

Bob

[kelly97]

I guess since I have lesions in my spine, that would cover that. The lesion in my t-spine is 4mm x 3.0cm.  I also have a lesion in my middle cerebral peduncle. I haven't been able to figure out, yet, if that's in my brain or brainstem, or somewhere inbetween.

[jensequitur]

It looks like it's the bit of descending brain that turns into the brainstem.  I have lesions in my spine as well, and lesions in the pons and medulla.

[COBOB]

I suspect that you mean the middle cerebellar peduncle.  It is the middle node of the cerebellum that extends downward into the pons.  It is considered part of the brainstem.  You could also get bilateral symptoms in this area.  

If you are looking for a great neuro-anatomy site, I use:  http://www.neuroanatomy.wisc.edu/


Bob

[supermum_ms]

I nearly had a cow when the neuro-psych told me my test results, i'd averaged out to fit into the normal IQ range. The big deal, was that I'm identified highly gifted, born into a family of highly/profoundly gifted people. Dropping 30-45 IQ points should of set off alarm bells but unfortunately they dont seem to recognise 'normal' IQ as an indication that there is a problem, well it is for ME! lol.

Like Jen, I too knew something was off, each episode seem to be more brutal but in truth i would find every excuse to explain the signs away. That was until I couldn't name my mum, husband or children, my excuses of being just tired stopped. I had completely lost all 'nouns' and only nouns, Huston we have a problem. I was doing a pretty good job of keeping this to my self, everyone was already freaked out because i was stuttering and slurring and I was walking like a string puppet to boot. Being verball gifted probably made my cognitive issues really stand out to them anyway, though I was thinking I could still hide it lol

An odd question "whats the name of the white stuff I put in my coffee?" I finally addmitted I just couldn't find the name of anything, describe it, explain it, not a problem, just naming it was. There was only one thing to explain it as far as I was concerned - something had damaged specific areas of my brain, the language centre of my brain and my movement control panel were obviously fried, I just didn't know what else was damaged.

Getting tested just confirmed what I already knew, still dropping around 3 deviations was upsetting, getting told 'normal' didn't indicate a problem was like a red rag to a bull, realising if I'd been tested during an episode i'd have drop below normal didn't sit well with me at all. Understanding that i'm still 'ALL' there but my cognitive skills are less than ideal when they are affected by my physical output is simply priceless!

Cheers........JJ      

[kelly97]

JJ, I felt the same way as you when they told me that my overall intellectual functioning was average.  All I could do is just sit there and smile at him when he was telling me these things, while inside, I was thinking, "OMG!"
I've never been "average."  I was in the gifted & talented program and in advanced placement classes in school. And I graduated with highest honors with my Bachelor's degree.  I think they may not understand how profound that is - to be told that, intellectually, you're average.  

Thanks for the website Bob.

[ccorina]

Kelly...I think people don't understand at all.  My IQ was 140 (was - no idea what it could be now!).  

I was talking to my husband about this thread and my fear of losing 30 points or more!  He just laughed and said then you'd be like the rest of us.  

I'm already starting to see the results of being so-called normal.  I read over my papers I'm writing and there will be stuff in there that I have no idea where it came from!  Makes absolutely no sense, grammatically or otherwise.  I also got a "C" on a paper the other day and my husband just laughed.  I've NEVER got a C in my life.  I don't know how I'm going to make it through my degree.

I wish people/docs would understand that it's not NORMAL for YOU, you can't judge people by one set of norms.  

Corina

[meg321]

Hi Kelly,

Thanks for sharing this with us, I didnt get thru a lot of it...I can never read too much at a time and understand it.    I cannot even put how this feels into words, maybe because I can't find the words..it is so frustrating and I feel so dumb.  My friends just say I have always been a dumb blonde and they can't see a difference.  

But there is a huge difference....

I would love to have that test to see the results.

meg

[supermum_ms]

The thing to remember is not what you averaged out too but the individual components that make up the whole, the components or subsets do specifically indicate your cognitive issues. It is those subsets that the neuro-psychologist should be taking notice of eg. Attention and Processing Speed -

Mental retardationarithmetic - high avg
resourcesvisualVisual acuity testattention & processing speed - low avg

If they are not looking at what the subsets are indicating then together these findings become meaningless, they cancel each other out, high takes away the low and your left with average. From my perspective it tells me that you dont have a problem with processing or attention when working with concrete data. Your working memory kicks in and your able to hold onto the data with out distraction or a slowing down.

Visual attention & processing on the other hand tells me that you have a problem with non concrete data. The brain is slowed down whilst its interpreting firstly what the eyes see, secondly eliminating irrelevant visuals, then thirdly finding the correct working memory in order for you to complete the task. Its telling me that your visual input is affecting your processing speed and working memory.      

If you analyse each subset to understand there mean, breaking it down to what specific issues your having, then add support and work on each specific area, you will help tap into the brains unique plasticity. Somethings will improve and others wont but still your acceptance and how you deal with it, will in the end be helpful to you.

Cheers........JJ    

[kelly97]

Thanks Meg, Corina, and JJ.

I was thinking the same thing about my highs and lows, cancelling each other out, and then I'm left with average, which doesn't tell the whole picture.  My visual attention is what got me the free ticket from my neuro to take this neuropsych eval  (metaphorically).

Corina, at least your trying with school. I think, for myself, it would be too frustrating to do anymore.  

[sllowe]

Hey Kelly,

Good for you for getting through it. Don't let it get you down girl :)

-Shell

[jensequitur]

Hey, folks - I know it's depressing to see that you're testing lower than you used to.  But it's possible to regain that cognitive function.  Four years ago, I couldn't talk straight to save my life.  I was having such cognitive problems that I figured I'd be on disability in a little while, because I was having such a hard time functioning.

Today I'm much better.  I have different problems - my legs are weak and feel odd, so it's difficult to walk normally.  But if I had the choice of trading cognitive function for legs... well, I'll take it.

Three years ago, I decided I would learn how to play the upright bass.  Of all the things I could have wanted to do!  Playing bass means I have to learn bass clef (already know treble, so I had to retrain my brain.)  I have to make my left hand stronger.  My right hand has to be able to strike the string at the right time, and rhymically.  There's lots of stuff that I have to learn, and in so many different areas.  

Learning is more difficult than it used to be.  I stick the stuff in any which way, and when it falls out I stick it back in.  Use different learning techniques - say it out loud, write it down, and especially write down the information you just learned without referring to the old notes.  It is possible to learn - you just have to use new techniques.

I hear that music helps your corpus callosum to grow, because it uses both sides of your brain.  I have a lesion in the corpus callosum - probably since 2006.