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Traumatic Brain Injury and Post Concussion Syndrome For traumatic brain injury (TBI) and post concussion syndrome (PCS). |
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10-06-2014, 02:46 PM | #1 | ||
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I've got my neuropsych evaluation tomorrow, and am a little nervous to find out how I'll do, and how the test itself will affect me. Any advice from veterans of the test? Do they give you short breaks?
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26 year-old PhD student in evolutionary biology, slipped on ice in Feb 2014 while clipping my fingernails and walking to save time (dumbest reason for PCS ever?). Initially just had headaches and didn't feel quite right, but a minor head bump 5 days later started a downward spiral of anxiety, depression, insomnia and fatigue. Had trouble concentrating on reading/looking at screens April 2014 - did exertion test, passed, started exercising and doing more, but didn't feel much better. May 2014 - Went on backpacking trip OK'd by doctor, trip itself went fine, but felt worse a few days after getting back, more difficulty concentrating, worse headaches. June 2014 - Bumped head on ceiling walking slowly down stairs, no immediate symptoms, but caused worsening headahces, more difficulty concentrating and looking at screens. Have not felt as good as I did before this since this bump. December 2014 - after feeling relatively better I went xc skiing and fell but didn't hit my head (something my psychologist who specializes in brain injuries told me he hoped would happen so I saw it was OK), felt worse Feb 2015 - back in grad school, light teaching load and some research, nowhere close to operating at my full capacity. Still have constant headaches, difficulty reading/looking at screens, mild anxiety and depression, and just not feeling like my normal sharp self. Trying, but struggling, to believe that I'll get back to my old self, or at least get close. |
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10-06-2014, 03:27 PM | #2 | ||
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Don't worry about breaks. If you get fatigued, it will show up. Your fatigue issues are an important part of the test. The NPA is not an indicator of your value as a person. It is to quantify your current capabilities and dysfunctions.
If it exhausts you causing you to sleep tomorrow, that is to be expected. There is no need for preparation. In fact, preparing for it can skew the results.
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Mark in Idaho "Be still and know that I am God" Psalm 46:10 |
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10-06-2014, 03:51 PM | #3 | ||
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Thanks for the reply, the only "preparation" I've done is lumosity games, which I've been doing for a while off and on. I haven't really prepared, but I would have thought that doing some kind of preparation (maybe lots of lumosity games or something, or more regular practice) would be good, as it would distinguish between lower than expected scores showing up because my brain is injured, or simply because I'm not as sharp from disuse for the past 7 months.
I know I shouldn't approach this as a test I have to pass, and I think I'm doing OK at taking that approach, but I've always been anxious about (and bad at) standardized tests...
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26 year-old PhD student in evolutionary biology, slipped on ice in Feb 2014 while clipping my fingernails and walking to save time (dumbest reason for PCS ever?). Initially just had headaches and didn't feel quite right, but a minor head bump 5 days later started a downward spiral of anxiety, depression, insomnia and fatigue. Had trouble concentrating on reading/looking at screens April 2014 - did exertion test, passed, started exercising and doing more, but didn't feel much better. May 2014 - Went on backpacking trip OK'd by doctor, trip itself went fine, but felt worse a few days after getting back, more difficulty concentrating, worse headaches. June 2014 - Bumped head on ceiling walking slowly down stairs, no immediate symptoms, but caused worsening headahces, more difficulty concentrating and looking at screens. Have not felt as good as I did before this since this bump. December 2014 - after feeling relatively better I went xc skiing and fell but didn't hit my head (something my psychologist who specializes in brain injuries told me he hoped would happen so I saw it was OK), felt worse Feb 2015 - back in grad school, light teaching load and some research, nowhere close to operating at my full capacity. Still have constant headaches, difficulty reading/looking at screens, mild anxiety and depression, and just not feeling like my normal sharp self. Trying, but struggling, to believe that I'll get back to my old self, or at least get close. |
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10-06-2014, 04:09 PM | #4 | ||
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Legendary
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You said "I haven't really prepared, but I would have thought that doing some kind of preparation (maybe lots of lumosity games or something, or more regular practice) would be good, as it would distinguish between lower than expected scores showing up because my brain is injured, or simply because I'm not as sharp from disuse for the past 7 months."
This does not make sense. Trying to prepare will only make the scores confusing. The tests have been researched, often over decades, to quantify problems. None of them have been normalized for the changes that may be due to Lumosity or other brain training. Plus, Lumosity and such create a familiarity with the activities used to gauge brain function. This 'learning how to do the task' interferes with the scoring. I have had three plus NPA's. I have learned how to do some of the tasks better than I would have done them without prior experience. The Trail Making Test is worthless for me. I have learned work-arounds so I can do it quite fast. Without these work-arounds, my scores were much different.
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Mark in Idaho "Be still and know that I am God" Psalm 46:10 |
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10-06-2014, 05:34 PM | #5 | ||
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I think my point makes at least some sense, although I'm not sure of how they normalize these scores. My understanding is that these tests measure cognitive deficits - I can think of two causes of poor performance relative to my normal baseline, 1 - my brain is injured, and 2 - I'm simply out of practice in working my brain on all cylinders.
I imagine lots of people who take this test have been out of practice in using their brains for months, and this could, to some extent, account for lower scores. My thinking was that brain training games might make the score a more accurate reflection of deficits due to injury, because it somewhat controls for deficits due to disuse.
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26 year-old PhD student in evolutionary biology, slipped on ice in Feb 2014 while clipping my fingernails and walking to save time (dumbest reason for PCS ever?). Initially just had headaches and didn't feel quite right, but a minor head bump 5 days later started a downward spiral of anxiety, depression, insomnia and fatigue. Had trouble concentrating on reading/looking at screens April 2014 - did exertion test, passed, started exercising and doing more, but didn't feel much better. May 2014 - Went on backpacking trip OK'd by doctor, trip itself went fine, but felt worse a few days after getting back, more difficulty concentrating, worse headaches. June 2014 - Bumped head on ceiling walking slowly down stairs, no immediate symptoms, but caused worsening headahces, more difficulty concentrating and looking at screens. Have not felt as good as I did before this since this bump. December 2014 - after feeling relatively better I went xc skiing and fell but didn't hit my head (something my psychologist who specializes in brain injuries told me he hoped would happen so I saw it was OK), felt worse Feb 2015 - back in grad school, light teaching load and some research, nowhere close to operating at my full capacity. Still have constant headaches, difficulty reading/looking at screens, mild anxiety and depression, and just not feeling like my normal sharp self. Trying, but struggling, to believe that I'll get back to my old self, or at least get close. |
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10-06-2014, 06:05 PM | #6 | ||
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Meh. I finished cognitive therapy and did lumosity games about a week or two before mine. Some tests in my battery were so similar in nature that my NP discounted them. Be forthcoming with the np as well.
As Mark says, theres no pass or fail and it has years worth of data. They dont know what your baseline is, and neither do you for that matter. You will categorized by education age race and gender. Relax, its stressful at times, but its worth it. Especially with an invisible injury like ours. |
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"Thanks for this!" says: | Laupala (10-06-2014) |
10-06-2014, 06:38 PM | #7 | ||
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Legendary
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I don't think there is a substantial decline due to disuse unless that disuse is due to being in a coma. The tests are not geared to high levels of performance where 'academic or cognitive laziness' would show up.
Plus, if one lost memory skills due to an injury but then learned new ways to access memory with brain training, the skills lost to injury may not show up. I believe that much of the improvements achieved from using Lumosity and other brain training programs are not due to neuro-plasticity developing new pathways. In my experience, most brain training is developing or strengthening under-developed skills that were always present but not adequately utilized. The observation skills, discretionary skills, focus skills, and many others have just been under-utilized. As I said, I learned how to do the Trail Making Test after doing it multiple times. If I did not use my work-arounds, I would do much worse. It would be interesting to see what kinds of improvements are quantifiable by an NPA after doing a Lumosity training program. The studies released do not get into much detail.
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Mark in Idaho "Be still and know that I am God" Psalm 46:10 |
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"Thanks for this!" says: | Laupala (10-06-2014) |
10-07-2014, 06:32 PM | #8 | ||
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Thanks again for the responses, I survived it! I'm not feeling too bad now either, although I usually feel overdoing it a few days after whatever I overdid, so I guess we'll see. Not sure how I did, the administrator said I did better than anyone she's ever seen (she was fairly young) on the number memory tests, but I had some trouble with the short story verbal memory tests. I guess it's useless to think about it now before I get the results back in two weeks.
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26 year-old PhD student in evolutionary biology, slipped on ice in Feb 2014 while clipping my fingernails and walking to save time (dumbest reason for PCS ever?). Initially just had headaches and didn't feel quite right, but a minor head bump 5 days later started a downward spiral of anxiety, depression, insomnia and fatigue. Had trouble concentrating on reading/looking at screens April 2014 - did exertion test, passed, started exercising and doing more, but didn't feel much better. May 2014 - Went on backpacking trip OK'd by doctor, trip itself went fine, but felt worse a few days after getting back, more difficulty concentrating, worse headaches. June 2014 - Bumped head on ceiling walking slowly down stairs, no immediate symptoms, but caused worsening headahces, more difficulty concentrating and looking at screens. Have not felt as good as I did before this since this bump. December 2014 - after feeling relatively better I went xc skiing and fell but didn't hit my head (something my psychologist who specializes in brain injuries told me he hoped would happen so I saw it was OK), felt worse Feb 2015 - back in grad school, light teaching load and some research, nowhere close to operating at my full capacity. Still have constant headaches, difficulty reading/looking at screens, mild anxiety and depression, and just not feeling like my normal sharp self. Trying, but struggling, to believe that I'll get back to my old self, or at least get close. |
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