Explore This Treatment Program

Our Approach

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.

Dr. Finkelstein was VERY attentive and caring and I never felt rushed while she listened to all of my concerns after a horrific car accident. Thank you!

– Patient in the Cognitive Behavioral Neurology Unit

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 Diagnosis

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 for three key reasons:

  1. As part of an academic medical hospital, our physicians stay abreast of the latest research, diagnosis and treatment science in the wide universe of cognitive behavioral diseases and disorders. This commitment, which includes collaborating with our affiliated hospitals to create continuing medical education courses, makes us particularly adept in distinguishing between different conditions.
  2. In assessing the patient's symptoms, we work closely with other world-class specialists in geriatric neurobehavior, language disorders, neuropsychiatry and other areas across Mass General.
  3. Mass General's advanced diagnostic capabilities, including neuroradiology, provide valuable information that enhances the certainty of a diagnosis.

Managing Symptoms & 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.

About This Program

Our unit diagnoses and treats patients suffering from conditions such as:

  • Alzheimer's disease and other degenerative dementias
  • Various degenerative neurological disorders affecting walking, coordination and movement
  • Complex seizures
  • Strokes and closed-head injuries resulting in cognitive and behavioral problems
  • Aphasia and other language disorders
  • Certain memory disorders
  • Attention deficit hyperactivity disorder (ADHD) and attention deficit disorder (ADD)

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.

Research Opportunities and Clinical Trials

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.