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The Cognitive Behavioral Neurology Unit at Massachusetts General Hospital offers comprehensive diagnostic and treatment services to patients with disorders of the brain affecting language, memory, problem solving and other intellectual functions, as well as patients with neurological diseases affecting emotional function and behavior.
What to Expect
We accept "self-referred" patients as well as those referred by primary care physicians or specialists. At the first appointment, the patient (along with a family member or caregiver) meets with one of our physicians, who performs a physical examination and obtains details about the patient's history.
Moving forward, the physician might choose to schedule further outpatient interviews and examinations. These generally involve extensive evaluations of the patient's cognitive abilities and behavioral tendencies. When medications are prescribed, the physician explains how the medicine works, how to take it and any precautions to keep in mind.
Where appropriate, we refer patients to another department within Mass General for further evaluation (e.g. psychology, psychiatry, neurosurgery, medicine, speech pathology). In these cases, we often comanage the patient's care with that department or the primary care physician.
Cognitive behavioral diseases and disorders can greatly compromise various high-level functions, such as the ability to work or take part in family life. As a result, we strongly encourage family members to get as involved as possible in caring for the patient. For long-term conditions, we work closely with families, helping them understand problems and manage care throughout the process.
Fast, Accurate Diagnoses
Patients who come to our unit are often in the early stages of a disease. They and their family know something is wrong, but they are not sure exactly what. This is understandable, as cognitive behavioral conditions can be notoriously difficult to diagnose.
Our unit has the expertise to quickly diagnose conditions with considerable specificity. Three key reasons:
Managing Symptoms and Manifestations
Although it is impossible to halt the progression of many cognitive behavioral conditions, our unit has a special ability to manage the related symptoms and manifestations.
Some patients respond to medications and/or adjustments to their environment. Others benefit from our multidisciplinary approach to treatment. For example, speech pathology often plays a large role. Many of our conditions are interrelated with depression, in which case psychiatrists can help. When surgery is a viable option, we can call on the resources of our surgery department.
Our unique skill in treatment management means patients suffer from fewer of the symptoms associated with their conditions, such as agitation, pain and sleep deprivation.
Our unit diagnoses and treats patients suffering from conditions such as:
Major Contributions to Our Field
Two of our great predecessors—C. Miller Fisher, MD, and the late Raymond Adams, MD—sparked the Department of Neurology's interest in cognitive behavioral neurology. Over the years, a number of clinics that specialize in thinking and emotion disorders sprang up within the department.
In 1990 the department decided to organize these various subspecialties within one entity: the Cognitive Behavioral Neurology Unit. David Caplan, MD, PhD, a world-renowned neurologist who focuses on language disorders, was named director and continues to serve in this capacity today.
Over the past two decades, members of our unit have made major contributions to the field. For instance, Jeremy Schmahmann, MD, authored a groundbreaking article that explained the cerebellum's previously underestimated role in cognition. Thanks to his guidance, neurologists today are much more likely to consider cerebellum diseases as a possible cause of cognitive and emotional symptoms.
Members of our unit have also been at the forefront of examining both structural differences (i.e. loss of tissue) and changes in function (i.e. blood flow) in early Alzheimer's patients. These factors have become increasingly critical in enabling a quicker diagnosis of this disease.
The Cognitive Behavioral Neurology Unit is closely affiliated with the Neuropsychology Laboratory, which conducts basic and clinical investigations into the nature of cognitive disorders. As a result, patients have the opportunity to take part in a range of voluntary research projects, including neuropsychological tests of memory, improved methods of diagnosis and investigational drug studies.
We encourage interested patients to contact us for more information on research opportunities.
An adjustment disorder is defined as an emotional or behavioral reaction to an identifiable stressful event or change in a person's life that is considered maladaptive or somehow not an expected, healthy response to the event or change.
Alzheimer's disease is a progressive, neurodegenerative disease that occurs when nerve cells in the brain die, often resulting in symptoms such as impaired memory, thinking and behavior.
Aphasia is a language disorder caused by damage in a specific area of the brain that controls language expression and comprehension, and leaves a person unable to communicate effectively with others.
Conduct disorder is a behavior disorder, sometimes diagnosed in childhood, that is characterized by antisocial behaviors which violate the rights of others and age-appropriate social standards and rules.
A depressive disorder is a whole-body illness, involving the body, mood, and thoughts, and affects the way a person eats and sleeps, feels about himself or herself, and thinks about things.
Epilepsy is a neurological condition involving the brain that makes people more susceptible to having seizures.
A head injury is a broad term that describes a vast array of injuries that occur to the scalp, skull, brain, and underlying tissue and blood vessels in the head.
Panic disorder is characterized by chronic, repeated, and unexpected panic attacks - bouts of overwhelming fear of being in danger when there is no specific cause for the fear
Persons with a personality disorder display more rigid and maladaptive thinking and reacting behaviors that often disrupt their personal, professional, and social lives.
According to the American Psychiatric Association, a phobia is an uncontrollable, irrational, and persistent fear of a specific object, situation, or activity.
Post-traumatic stress disorder (PTSD) is a debilitating condition that often follows a terrifying physical or emotional event - causing the person who survived the event to have persistent, frightening thoughts and memories, or flashbacks, of the ordeal.
Schizophrenia is one of the most complex of all mental health disorders. It involves a severe, chronic, and disabling disturbance of the brain.
Stroke, also called brain attack, occurs when blood flow to the brain is disrupted.
Neurology residents, program graduates, faculty members, and the education director talk about training at Mass General Hospital and Brigham and Women’s Hospital.
Cognitive Behavioral Neurology Unit
Wang Ambulatory Care Center
Mailing Address Cognitive Behavioral Neurology UnitMailcode: WACC 8-835Massachusetts General Hospital55 Fruit StreetBoston, MA 02114
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