Neuropsychology for Movement Disorders

Movement disorders, such as Parkinson’s disease, dystonia, essential tremor, and tics, can affect more than just how you move. They can also affect your thinking, mood, and behavior. This is where neuropsychology can help.

Neuropsychology is a branch of psychology that looks at how nervous system conditions, including movement disorders, affect the way you think and behave. At Mount Sinai, our expert, Christina A. Palmese, PhD, ABPP-CN, will perform an extensive assessment of your ability to think, learn, and understand. She will develop a treatment plan to improve cognitive abilities such as attention and memory. We also use this report to consider whether you are a good candidate for surgeries such as deep brain stimulation (DBS) and focused ultrasound treatments.

The Assessment: What to Expect

We use interactive brain games and mental exercises to see how you think. As we look at your strengths and weaknesses, we take into consideration the normal aging process. Most appointments last two to three hours and include an interview and testing. During the interview, we will ask about a variety of topics, including:

• Symptoms you are experiencing
• Your medical history
• Medications you are taking

We may also want to speak with your partner or other close family or friends to learn what they think about your emotional and cognitive challenges.

We will also ask you to perform some brain games with a paper and pencil. These tests are specific to your condition. They take into consideration the effect that tremor or other motor symptoms might have on your ability to do certain things. They will assess a variety of areas, including:

• Memory
• Attention
• Communication skills

We will look at your strengths and weaknesses. This information becomes a baseline so we can see if and how your symptoms change over time.

Every brain game we use during the exam is short. The longest lasts about five minutes; the shortest takes about 30 seconds. This means we can take as many breaks as you need. Some of the activities will be easy, while others will be more complex. The important thing is to try your best. Most patients find the tests interesting. We offer both in-office visits and video consultations. We can usually complete the whole assessment in one visit.

Our expert will work with the other members of your medical team as they develop a treatment plan. The plan might include medication, rehabilitation therapy, or surgery.

Getting the Results

We will meet with you two weeks after the initial appointment to discuss the results of the exam and how they will affect your treatment. You may want to bring close family and friends so they can hear about your assessment and treatment and ask questions.

Preparation for the Appointment

You don’t need to do much to prepare. Bring your eyeglasses or hearing aids if you use them. Try to rest and relax before your evaluation.  If you are scheduled for a video visit, you will need to connect on a computer, iPad, or cell phone.

Deep Brain Stimulation

Deep brain stimulation (DBS) uses electrical impulse to control symptoms caused by certain movement, neurologic, and psychiatric disorders. If you are considering DBS as part of your treatment plan, you may meet with our neuropsychologist. This expert will not determine whether the treatment is appropriate. Rather, they will collect information to help your medical team with the following:

• Identify any risks or benefits to the procedure
• Understand your cognitive and psychological prognosis after DBS
• Assess your support system to recuperate from the procedure

Training Programs

The Clinical Neuropsychology Externship at the Mount Sinai Neuroscience Center provides doctoral students with comprehensive training in neuropsychological assessment and interdisciplinary care for patients with movement and memory disorders.