Course Title: Plenary D: The Quest for Precision: Neuropsychological Evaluations for Epilepsy Surgery in India (Shah)

Credit Hours: 1

Instructor(s) Urvashi Shah

Urvashi Shah, PhD Department of Neurology, King Edward Memorial Hospital, Mumbai
Plenary D: The Quest for Precision: Neuropsychological Evaluations for Epilepsy Surgery in India
Abstract & Learning Objectives: Neuropsychology is poised at a critical juncture in the era of evidence and precision based medicine. The goal of precision medicine is to tailor treatments for the benefit of the individual and develop accurate evaluation tools. Neuropsychological testing still uses the time tested, paper-pencil tools and stringent psychometrics for valid and reliable assessments. However, the precision of these tools is currently being challenged. In a high technology era, the reliability of paper-pencil tools is being critically examined and the validity of standard tools in evaluating diverse populations is being questioned. Do we need a paradigm shift in how we evaluate? Should we shift to computerized testing and review our tools and methods for tailored evaluations of diverse populations? In epilepsy there is impact on cognition, mood and behaviors due to a complex interplay between damaged neuroanatomical substrates, aberrant physiological processes, medication side effects and psychosocial stigma. Neuropsychological assessments form an integral part of epilepsy surgery evaluations. There are definitive questions posed to a neuropsychologist regarding seizure focus, impact on cognition and outcome predictions, needing accurate tools and precise data. Ensuring fair evaluations using tools developed in the west, in heterogeneous, multicultural, multilingual India, is a challenge, and the ability of low education groups to engage in computer based testing is unclear. This lecture reviews a two-decade journey of seeking precision in evaluating and managing challenges encountered in assessment of a low- income group. It underscores the need to work together for precise evaluations by harmonizing research from across the world. Upon conclusion of this course, learners will be able to:
  • Describe neuropsychological evaluations in epilepsy surgery
  • Discuss assessment issues in low income-education groups and utility of computerized testing in a low middle-income country
Speaker Biography: Dr. Urvashi Shah works in the Department of Neurology, King Edward Memorial Hospital, Mumbai, one of the largest public hospitals in India where she set up the first neuropsychology services, the ‘Center for Neuropsychology Studies (C.N.S)’, for socioeconomically deprived populations. For her pioneering work in neuropsychology in Mumbai she was awarded the prestigious Mayor’s Achievement Award. For over twenty years, she has been an integral part of the ongoing, Comprehensive Epilepsy Care Program that has conducted over six hundred epilepsy surgeries. She has also been involved in setting up neurorehabilitation services for traumatic brain injury and has worked as a research consultant on an NIH funded, Indo-US project on ‘Cognitive Changes in the Elderly’ in Mumbai. She has vast experience of evaluating hundreds of cases from the heterogeneous, multicultural, multilingual diverse Mumbai population and has been an expert on the Indian Council of Medical Research ICMR, ‘Neurocognitive Tool Box Project- Standardized Protocols for Cognition in India’. She is on the Board of Studies in Psychology, a reviewer for various academic journals and has published in multiple peer-reviewed journals. She was invited to be a member of the Neuropsychology Task Force of the International League Against Epilepsy (ILAE) and the Scientific Committee of the World Congress for Neurorehabilitation (WCNR) in India. Dr. Shah has also presented at numerous national and international conferences, delivered national neurology orations, spoken at multiple, continuing education (CE) workshops and has conducted several public, patient and family awareness programs. She has mentored over twenty-five graduate psychology students, several of whom have gone on to obtain specialized degrees in neuropsychology from international universities. She completed a Ph.D from Bombay University in 1995 working on implicit and explicit memory systems in neurological populations.