Behavioral and Cognitive Neurology

Neurology and psychiatry are two disciplines of medicine that are concerned with the function and dysfunction of the brain. The traditional distinction between the two disciplines has been that neurology concerns itself with structural diseases of the brain while psychiatry covers mental diseases for with there is no structural, physical cause. Most neurological disorders can be seen on an X-ray or MRI whether it be stroke or multiple sclerosis. Psychiatric disorders, on the other hand, do not show changes on these studies.

 

 

These traditional definitions have been shifting, however, as neuroscientists learn more about the brain. The border between neurology and psychiatry is becoming more blurry. It seems that some psychiatric disorders actually do have structural causes. This is especially true in disorders of learning and memory. Alzheimer's disease, for example, is caused by microscopic collections of amyloid plaques and neurofibrillary tangles. The discipline of cognitive neurology has evolved in between the two fields. A cognitive neurologist studies and treats neurological diseases that involve human thought, emotion, and memory.

 

Cognition is the term used to describe the process by which the mind perceives, remembers, and makes decisions or judgments. Human cognitive powers are the most powerful among all of the species on the planet. Unfortunately, when one is afflicted with a cognitive disorder, the ability to function in polite human society becomes difficult or impossible.

 

One reason that cognitive and behavioral neurology evolved as a medical specialty is that a wide array of neurological disorders and diseases display a problem with cognition. While the cognitive deficits seen in Alzheimer’s disease are perhaps the simplest example of what a cognitive neurologist would treat, there are a number of others. For example Parkinson’s and Huntington’s diseases have a cognitive component among their many symptoms. Even patients that have experienced a large stroke or many small strokes may display behavioral difficulties. Also, it is not uncommon for people that have sustained head trauma to need the expertise of a cognitive neurologist.

 

Cognitive neurology combines knowledge from several different disciplines from neurology, psychiatry, and neuroscience. Cognitive and behavioral neurology uses both radiological tests and neuropsychological interview to arrive at very precise diagnoses and to track treatment. Cognitive neurologists must have a command of neuroanatomy (the structure of the brain) but also the way in which different parts contribute to thinking, feeling, memory, and behavior. Treatment may include one or more neurological or psychiatric medications, behavioral therapy or focused teaching techniques.

 

One of the newer treatment options for cognitive neurology patients that is currently an area of active research is the use of stem cells. Since many of the diseases in cognitive and behavioral neurology involve neurodegenerative diseases (cells of the brain called neurons die or are dysfunctional), it has been theorized that stem cells could be implanted in the brain to restore the diseased cells. It is the hope that the implanted neural stem cells would mature into fully functional neurons and take the place of diseased cells. The cognitive neurologist would then prescribe a treatment plan to retrain the patient in tasks of cognition. This treatment is not yet available but is certainly an intriguing option for the future.

 

Cognitive neurology spans the increasingly murky distinction between neurology and psychiatry. It aims to treat disorders of one of the most important human capacities: human cognition.