MemoryPersonality Change

Should You Visit A Neuropsychologist?


Your brain is a complex system that controls your body, guides your thinking, and filters emotional responses. Because infratentorial superficial siderosis (iSS) causes progressive neural dysfunction, it’s natural to be concerned about how a person’s thoughts, feelings, and cognitive function may eventually become affected. If you or someone close to you begins to notice changes in mood, memory, problem-solving, or behavior, it may be time to visit a neuropsychologist.

What Is A Neuropsychologist

Neuropsychologists are licensed psychologists who specialize in brain function. They focus not only on the brain-behavior relationships of cognitive function: thinking, memory, language skills, and attention but also how brain injuries or damage affect your emotions and behavior.

Your visit will likely start with questionnaires filled out by you and someone familiar with your day-to-day activities. After the responses are reviewed and compared, you will continue into a clinical interview. Your neuropsychologist will ask various questions designed to help them decide what testing is appropriate for you. If you give your permission, they will also interview someone who can provide an outsider’s point of view about your daily life. Often those closest to us are the first to notice when something is not quite right.

Task Activity Mapping of the Cerebellum Source: Xavier Guell et al./eLife 2018 (Creative Commons)
Task Activity Mapping of the Cerebellum
Source: Xavier Guell et al./eLife 2018 (Creative Commons)

What To Expect

Testing may take anywhere from two to six hours, with rest breaks between segments. Depending on what your interview reveals, you may be tested on your motor, cognitive, and perceptual skills. The Montreal Cognitive Assessment (MoCA), Mini-Mental State Examination (MMSE), or the Saint Louis University Mental Status Examination (SLUMS) are used to evaluate cognition. Manipulative tasks will test motor skills, puzzles, or drawing for spatial awareness, problem-solving, speaking, listening, and memory exercises. This testing is different than an MRI series in that it helps determine how well your brain is functioning.

Interpreting The Findings

Cranial Nerve Mapping of the Cerebellum Source: Xavier Guell et al./eLife 2018 (Creative Commons)
Cranial Nerve Mapping of the Cerebellum
Source: Xavier Guell et al./eLife 2018 (Creative Commons)

People spend a lot of time lying flat while they’re sleeping, so the cerebellum often attracts a large amount of hemosiderin. In addition to motor function, it’s essential to realize the cerebellum’s role in memory and cognition. Studies have mapped the areas of task activity controlled by the cerebellum and how neural damage results in a mix of problems. In addition to issues originating with the cerebellum, some SS patients will also experience oxidative stress-induced neural damage in the supratentorial regions of the brain. Thus, a patient can have siderosis in both the infratentorial and supratentorial areas of the brain.

If your testing shows motor skills or language deficiencies, your doctor may arrange speech, rehabilitation services, and occupational or physical therapy referrals. In addition, help with adapting your home will make your daily living activities less stressful.

Even though your cerebellum is less than 10% of your brain volume, it is home to 80% of your brain’s neurons

Dementia Is Rare

Dementia is defined as a grouping of symptoms affecting memory, thinking, and social behavior enough to interfere with daily functioning. Signs include personality changes, depression, anxiety, inappropriate behavior, paranoia, agitation, hallucinations, and decreased verbal fluency. Patients will show difficulty finding words, reasoning and problem-solving, handling complex tasks, planning, organizing, coordination, motor functions, confusion, and disorientation.

While an impaired ability to recall newly learned information, mood or personality changes, or difficulty with simple executive functions such as making plans or keeping thoughts in proper sequence is expected in the later stages of SS, dementia is rare. Statistically, only a very low percentage of those diagnosed with infratentorial superficial siderosis will ever progress into true dementia.

Don’t Ignore The Signs

If you are experiencing simple memory problems or something more serious, it’s essential to have a baseline neuropsychological test result recorded in your medical record. These early scores will help your physician determine if you’re holding steady or additional testing needs to be revisited at a future date. Stress, anxiety, and depression are just as dangerous as loss of neural function.

Argyropoulos, G.P.D., van Dun, K., Adamaszek, M. et al. The Cerebellar Cognitive Affective/Schmahmann Syndrome: a Task Force Paper. Cerebellum 19, 102–125 (2020).

Xavier Guell, Jeremy D. Schmahmann, John D.E. Gabrieli, Satrajit S. Ghosh. “Functional Gradients of the Cerebellum.” Life, August 14, 2018 DOI: 10.7554/eLife.36652

Xavier Guell, John Gabrieli, and Jeremy Schmahmann. “Triple Representation of Language, Working Memory, Social and Emotion Processing in the Cerebellum: Convergent Evidence from Task and Seed-Based Resting-State fMRI Analyses in a Single Large Cohort.” NeuroImage (First published online: February 2, 2018 ) DOI: 10.1016/j.neuroimage.2018.01.082

Jeremy D. Schmahmann and Janet C. Sherman. “The Cerebellar Cognitive Affective Syndrome.” Brain: A Journal of Neurology (1998) DOI: 10.1093/brain/121.4.561

Jeremy D. Schmahmann. “Dysmetria of Thought: Clinical Consequences of Cerebellar Dysfunction on Cognition and Affect.” Trends in Cognitive Sciences (1998) DOI: 10.1016/S1364-6613(98)01218-2

Updated: 08/26/2019­

Updated: 10/07/2021

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Rori Daniel

Living With Superficial Siderosis began as a way to keep family and acquaintances updated after my husband Gary was diagnosed with Superficial siderosis in 2014. In 2019, became a partner in the Superficial Siderosis Research Alliance. Together our alliance has expanded into research, advocacy, and patient education. Rori Daniel, Editor,

One Comment

  1. I’m looking for help with my symptoms. I have superficial siderosis. I’m looking for someone close to Va. 

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