The role of neuropsychology in the care of patients with functional neurological symptom disorder.

OBJECTIVE: Functional neurological symptom disorder (FNSD) is a neuropsychiatric condition characterized by signs/symptoms associated with brain network dysfunction. FNSDs are common and are associated with high healthcare costs. FNSDs are relevant to neuropsychologists, as they frequently present with chronic neuropsychiatric symptoms, subjective cognitive concerns, and/or low neuropsychological test scores, with associated disability and reduced quality of life. However, neuropsychologists in some settings are not involved in care of patients with FNSDs. This review summarizes relevant FNSD literature with a focus on the role of neuropsychologists. METHODS: A brief review of the literature is provided with respect to epidemiology, public health impact, symptomatology, pathophysiology, and treatment. RESULTS: Two primary areas of focus for this review are the following: (1) increasing neuropsychologists' training in FNSDs, and (2) increasing neuropsychologists' role in assessment and treatment of FNSD patients. CONCLUSIONS: Patients with FNSD would benefit from increased involvement of neuropsychologists in their care.

Reduced Subjective Cognitive Concerns With Neurobehavioral Therapy in Functional Seizures and Traumatic Brain Injury.

OBJECTIVE: Functional seizures are common among people with traumatic brain injury (TBI). Subjective cognitive concerns refer to a person's own perception of problems with cognitive functioning in everyday life. The authors investigated the presence and correlates of subjective cognitive concerns and the response to neurobehavioral therapy among adults with TBI and functional seizures (TBI+FS group). METHODS: In this observational study, participants in the TBI+FS group (N=47) completed a 12-session neurobehavioral therapy protocol for seizures, while participants in the comparison group (TBI without seizures) (N=50) received usual treatment. Subjective cognitive concerns, objective cognition, mental health, and quality of life were assessed before and after treatment. Data collection occurred from 2018 to 2022. RESULTS: Baseline subjective cognitive concerns were reported for 37 (79%) participants in the TBI+FS group and 20 (40%) participants in the comparison group. In a multivariable regression model in the TBI+FS group, baseline global mental health (ß=-0.97) and obsessive-compulsive symptoms (ß=-1.01) were associated with subjective cognitive concerns at baseline. The TBI+FS group had fewer subjective cognitive concerns after treatment (η2=0.09), whereas the TBI comparison group showed a nonsignificant increase in subjective cognitive concerns. CONCLUSIONS: Subjective cognitive concerns are common among people with TBI and functional seizures and may be related to general mental health and obsessive-compulsive symptoms. Evidence-based neurobehavioral therapy for functional seizures is a reasonable treatment option to address such concerns in this population, although additional studies in culturally diverse samples are needed. In addition, people with functional seizures would likely benefit from rehabilitation specifically targeted toward cognitive functioning.

Rates of Cognitive and Functional Impairments in Older Adults Residing in a Continuing Care Senior Housing Community.

OBJECTIVE: The current cross-sectional study examined cognition and performance-based functional abilities in a continuing care senior housing community (CCSHC) that is comparable to other CCSHCs in the US with respect to residents' demographic characteristics. METHOD: Participants were 110 older adult residents of the independent living unit. We assessed sociodemographics, mental health, neurocognitive functioning, and functional capacity. RESULTS: Compared to normative samples, participants performed at or above expectations in terms of premorbid functioning, attention span and working memory, processing speed, timed set-shifting, inhibitory control, and confrontation naming. They performed below expectation in verbal fluency and verbal and visual learning and memory, with impairment rates [31.4% (>1 SD below the mean) and 18.49% (>1.5 SD below the mean)] well above the general population (16% and 7%, respectively). Within the cognitive test battery, two tests of delayed memory were most predictive of a global deficit score. Most cognitive test scores correlated with performance-based functional capacity. CONCLUSIONS: Overall, results suggest that a subset of older adults in the independent living sector of CCSHCs are cognitively and functionally impaired and are at risk for future dementia. Results also argue for the inclusion of memory tests in abbreviated screening batteries in this population. We suggest that CCSHCs implement regular cognitive screening procedures to identify and triage those older adults who could benefit from interventions and, potentially, a transition to a higher level of care.

Initial Psychometric Properties of 7 NeuroUX Remote Ecological Momentary Cognitive Tests Among People With Bipolar Disorder: Validation Study.

BACKGROUND: As smartphone technology has become nearly ubiquitous, there is a growing body of literature suggesting that ecological momentary cognitive testing (EMCT) offers advantages over traditional pen-and-paper psychological assessment. We introduce a newly developed platform for the self-administration of cognitive tests in ecologically valid ways. OBJECTIVE: The aim of this study is to develop a Health Insurance Portability and Accountability Act-compliant EMCT smartphone-based platform for the frequent and repeated testing of cognitive abilities in everyday life. This study examines the psychometric properties of 7 mobile cognitive tests covering domains of processing speed, visual working memory, recognition memory, and response inhibition within our platform among persons with and without bipolar disorder (BD). Ultimately, if shown to have adequate psychometric properties, EMCTs may be useful in research on BD and other neurological and psychiatric illnesses. METHODS: A total of 45 persons with BD and 21 demographically comparable healthy volunteer participants (aged 18-65 years) completed smartphone-based EMCTs 3 times daily for 14 days. Each EMCT session lasted approximately 1.5 minutes. Only 2 to 3 tests were administered in any given session, no test was administered more than once per day, and alternate test versions were administered in each session. RESULTS: The mean adherence to the EMCT protocol was 69.7% (SD 20.5%), resulting in 3965 valid and complete tests across the full sample. Participants were significantly more likely to miss tests on later versus earlier study days. Adherence did not differ by diagnostic status, suggesting that BD does not interfere with EMCT participation. In most tests, age and education were related to EMCT performance in expected directions. The average performances on most EMCTs were moderately to strongly correlated with the National Institutes of Health Toolbox Cognition Battery. Practice effects were observed in 5 tests, with significant differences in practice effects by BD status in 3 tests. CONCLUSIONS: Although additional reliability and validity data are needed, this study provides initial psychometric support for EMCTs in the assessment of cognitive performance in real-world contexts in BD.

Physical and Mental Health Characteristics of 2,962 Adults With Subjective Cognitive Complaints.

We investigated subjective cognitive complaints (SCCs), as well as physical and mental health factors, in adults and older adults. U.S. residents (N = 2,962) were recruited via the Amazon Mechanical Turk platform and completed a 90-item survey. Overall, 493/1930 (25.5%) of younger adults and 278/1032 (26.9%) of older adults endorsed SCCs. Analyses revealed worse physical and mental health characteristics in the SCC+ compared to the SCC- group, with primarily medium (Cohen's d = 0.50) to large (0.80) effect sizes. Age did not moderate relationships between SCCs and physical/mental health. Results suggest that SCCs are associated with a diverse set of negative health characteristics such as poor sleep and high body mass index, and lower levels of positive factors, including happiness and wisdom. Effect sizes of psychological correlates were at least as large as those of physical correlates, indicating that mental health is critical to consider when evaluating SCCs.

REM Sleep Behavior Disorder in Parkinson's Disease: Effects on Cognitive, Psychiatric, and Functional outcomes.

OBJECTIVE: Rapid eye movement sleep behavior disorder (RBD) affects 33-46% of patients with Parkinson's disease (PD) and may be a risk factor for neuropsychological and functional deficits. However, the role of RBD on neuropsychological functioning in PD has yet to be fully determined. We, therefore, examined differences in neurocognitive performance, functional capacity, and psychiatric symptoms among nondemented PD patients with probable RBD (PD/pRBD+) and without (PD/pRBD-), and healthy comparison participants (HC). METHODS: Totally, 172 participants (58 PD/pRBD+; 65 PD/pRBD-; 49 HC) completed an RBD sleep questionnaire, psychiatric/clinical questionnaires, performance-based and self-reported functional capacity measures, and underwent a comprehensive neuropsychological battery assessing attention/working memory, language, visuospatial function, verbal and visual learning and memory, and executive function. RESULTS: Controlling for psychiatric symptom severity, the PD/pRBD+ group had poorer executive functioning and learning performance than the PD/pRBD- group and poorer neuropsychological functioning across all individual cognitive domains than the HCs. In contrast, PD/pRBD- patients had significantly lower scores than HCs only in the language domain. Moreover, PD/pRBD+ patients demonstrated significantly poorer medication management skills compared to HCs. Both PD groups reported greater depressive and anxiety severity compared to HCs; PD/pRBD+ group also endorsed greater severity of apathy compared to HCs. CONCLUSIONS: The presence of pRBD is associated with poorer neuropsychological functioning in PD such that PD patients with pRBD have poorer cognitive, functional, and emotional outcomes compared to HC participants and/or PD patients without pRBD. Our findings underscore the importance of RBD assessment for improved detection and treatment of neuropsychological deficits (e.g., targeted cognitive interventions).

Study of Independent Living Residents of a Continuing Care Senior Housing Community: Sociodemographic and Clinical Associations of Cognitive, Physical, and Mental Health.

OBJECTIVE: To examine associations of sociodemographic and clinical factors with cognitive, physical, and mental health among independent living older adults in a continuing care senior housing community (CCSHC). METHODS: This was a cross-sectional study at the independent living sector of a CCSHC in San Diego County, California. Participants included English-speaking adults aged 65-95 years, of which two-thirds were women. Of the 112 subjects recruited, 104 completed basic study assessments. The authors computed composite measures of cognitive, physical, and mental health. The authors also assessed relevant clinical correlates including psychosocial factors such as resilience, loneliness, wisdom, and social support. RESULTS: The CCSHC residents were similar to a randomly selected community-based sample of older adults on most standardized clinical measures. In the CCSHC, physical health correlated with both cognitive function and mental health, but there was no significant correlation between cognitive and mental health. Cognitive function was significantly associated with physical mobility, satisfaction with life, and wisdom, whereas physical health was associated with age, self-rated physical functioning, mental well-being, and resilience. Mental health was significantly associated with income, optimism, self-compassion, loneliness, and sleep disturbances. CONCLUSION: Different psychosocial factors are significantly associated with cognitive, physical, and mental health. Longitudinal studies of diverse samples of older adults are necessary to determine risk factors and protective factors for specific domains of health. With rapidly growing numbers of older adults who require healthcare as well as supportive housing, CCSHCs will become increasingly important sites for studying and promoting the health of older adults.

The Factor Structure of the Boston Diagnostic Aphasia Examination, Third Edition.

OBJECTIVE: The Boston Diagnostic Aphasia Examination (BDAE) is one of the most commonly used aphasia batteries. The newest edition has undergone significant revisions since its original publication in 1972, but existing evidence for its validity is lacking. We examined the construct validity of BDAE-3 and identified the factor structure of this battery. METHOD: A total of 355 people with aphasia of various types and severity completed neuropsychological evaluations to assess their patterns of language impairment. A principal component analysis with varimax rotation was conducted to examine the components of BDAE-3 subtests. RESULTS: Five components accounting for over 70% of the BDAE-3 total variance were found. The five language factors identified were auditory comprehension/ideomotor praxis, naming and reading, articulation-repetition, grammatical comprehension, and phonological processing. CONCLUSIONS: Our results show that the BDAE-3 demonstrates good construct validity, and certain language functions remain primary, distinct language domains (i.e., receptive vs. expressive language) across severities of aphasia. Overall, our findings inform clinical practice by outlining the inherent structure of language abilities in people with aphasia. Clinicians can utilize the findings to select core BDAE-3 tests that are most representative of their respective functions, thereby reducing the total testing time while preserving diagnostic sensitivity. (JINS, 2019, 25, 772-776).

Comparing the Mini-Mental State Examination and the modified Mini-Mental State Examination in the detection of mild cognitive impairment in older adults.

ABSTRACTObjectives:To show enhanced psychometric properties and clinical utility of the modified Mini-Mental State Examination (3MS) compared to the Mini-Mental State Examination (MMSE) in mild cognitive impairment (MCI). DESIGN: Psychometric and clinical comparison of the 3MS and MMSE. SETTING: Neuropsychological clinic in the northeastern USA. PARTICIPANTS: Older adults referred for cognitive concerns, 87 of whom were cognitively intact (CI) and 206 of whom were diagnosed with MCI. MEASUREMENTS: The MMSE, the 3MS, and comprehensive neuropsychological evaluations. RESULTS: Both instruments were significant predictors of diagnostic outcome (CI or MCI), with comparable odds ratios, but the 3MS explained more variance and showed improved classification accuracies relative to the MMSE. The 3MS also demonstrated greater receiver operating characteristic area under the curve values (0.85, SE = 0.02) compared to the MMSE (0.74, SE = 0.03). Scoring lower than 95/100 on the 3MS suggested MCI, while scoring lower than 28/30 on the MMSE suggested MCI. Additionally, compared to the MMSE, the 3MS shared more variance with neuropsychological composite scores in Language and Memory domains but not in Attention, Visuospatial, and Executive domains. Finally, 65.5% MCI patients were classified as impaired (scoring ≤1 SD below the mean) using 3MS normative data, compared to only 11.7% of patients who were classified as impaired using MMSE normative data. CONCLUSIONS: Broadly speaking, our data strongly favor the widespread substitution of the MMSE with the 3MS in older adults with concerns for cognitive decline.

Health Outcomes in Individuals with Problem and Pathological Gambling: An Analysis of the 2014 North Carolina Behavioral Risk Factor Survey System (BRFSS).

Problem and pathological gambling refers to subclinical and clinical levels of maladaptive gambling, respectively, and is associated with specific sociodemographic characteristics as well as a number of poor health outcomes. We examined such demographic, physical health, mental health, and health-related behaviors in a sample of 7045 low-risk gamblers and 244 problem/pathological gamblers. Participants completed the 2014 North Carolina Behavioral Risk Factor Surveillance System telephone survey. Using the National Opinion Research Center's Diagnostic Screen for Gambling Disorders-CLiP, participants were categorized as either "problem/pathological gamblers" or "low-risk gamblers." Problem/pathological gamblers were younger, more likely to be male, of ethnic minority status, unmarried, and of lower education than low-risk gamblers. No physical health variables differentiated the groups but problem/pathological gamblers reported experiencing significantly more adverse childhood experiences and engaging in significantly more tobacco and alcohol use compared to low-risk gamblers. Moreover, gender moderated relationships between gambling group and several of the alcohol use variables such that male problem/pathological gamblers exhibited greater alcohol use behavior than male low-risk gamblers but no such relationship was present in females. Overall, this study expands the current knowledgebase on disordered gambling and highlights the need to assess disordered gambling in public health samples. Clinical implications are discussed.

Seizure-related variables are predictive of attention and memory in children with epilepsy.

Children with epilepsy (CWE) are at greater risk for cognitive deficits and behavioral difficulties than are typically developing healthy children, and particular epileptic symptoms and treatments may contribute to this risk. The current study examined the relationships between four seizure-related variables and attention and memory functioning in a sample of 207 CWE (ages 6-16) using both neurocognitive and parent/teacher-report measures. Sociodemographic, medical, and neuropsychological data were collected from patients' medical charts in a retrospective fashion. Hierarchical multiple regressions were performed with sociodemographic variables (age, gender, race) entered as step one and seizure-related variables (number of anti-epileptic drugs [AEDs], EEG laterality, EEG lobe of focus, lifetime seizure duration) entered as step two. Results indicated that seizure-related variables were consistently predictive of poor cognitive performances above and beyond sociodemographic variables, although only minimally predictive of parent/teacher-reports. A longer duration of seizure burden and greater number of AEDs were robust predictors of performances on most cognitive measures. These findings indicate that CWE with long lifetime seizure durations and multiple AEDs are at risk for inefficiencies in attention and memory. Knowledge of this risk will allow treating providers greater accuracy and precision when planning medical treatment and making recommendations to families.

Multivariable Prediction of Return to Work at 6-Month Follow-Up in Patients With Mild to Moderate Acute Stroke.

OBJECTIVE: To investigate predictors of return to work (RTW) in a poststroke sample. DESIGN: Retrospective investigation of archival data from an inception cohort; acute care records and 6-month follow-up telephone interview data were obtained for analysis. SETTING: The Brain Recovery Core, a collaborative interinstitutional endeavor among an academic medical center, an acute care hospital, and a rehabilitation center. PARTICIPANTS: Data from patients with stroke from the Brain Recovery Core (N=298). Excluded cases included those with nontraditional and/or nonpaid job status, no National Institute of Health Stroke Scale (NIHSS) score, and an NIHSS score >16. Our final sample included 244 individuals (age range, 25-87y). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Sociodemographic variables, stroke severity (NIHSS), and physical and neurocognitive measures. RESULTS: Adding predictor variables to our logistic regression model increased accuracy by approximately 18%. Greater independence in the FIM sit-to-stand movement predicted improved RTW rates (odds ratio [OR], 1.8; 95% confidence interval [CI], 1.0-3.1), whereas nonwhite race (OR, 2.52; 95% CI, 1.16-5.47) and greater impairment on the NIHSS (OR, .88; 95% CI, .77-.99) predicted attenuated RTW rates. CONCLUSIONS: Valid measures of stroke severity and a clinician-rated sit-to-stand movement have utility in the acute prediction of later RTW in patients with mild to moderate stroke. Given the complexity of the RTW construct and the acute measurement of these variables, we believe that our findings can be used to inform clinical decisions and appropriately tailor rehabilitative strategies that improve quality of life for stroke survivors.

Cognitive performance in functional seizures compared with epilepsy and healthy controls: a systematic review and meta analysis.

BACKGROUND: Cognition is a core component of functional seizures, but the literature on cognition in this disorder has been heterogeneous, with no clear unifying profile emerging from individual studies. The aim of this study was to do a systematic review and meta-analysis of cognitive performance in adults with functional seizures compared with epilepsy (including left temporal lobe epilepsy) and compared with healthy non-seizure cohorts. METHODS: In this systematic review and meta-analysis, starting Feb 6, 2023, replicated and updated on Oct 31, 2023, a medical librarian searched MEDLINE, Embase, PsycINFO, and Web of Science. Inclusion criteria were full reports documenting raw or standardised cognitive test data in adults with functional seizures compared with adults with epilepsy, prospectively recruited healthy comparisons, or published norms. Grey literature was retained and there were no language or date restrictions. We excluded studies only reporting on mixed functional seizures and epilepsy, or mixed functional neurological samples, with no pure functional seizures group. Risk of bias was evaluated using a modified version of the Newcastle-Ottawa Scale. People with lived experiences were not involved in the design or execution of this study. This study is registered as CRD42023392385 in PROSPERO. FINDINGS: Of 3834 records initially identified, 84 articles were retained, including 8654 participants (functional seizures 4193, epilepsy 3638, and healthy comparisons 823). Mean age was 36 years (SD 12) for functional seizures, 36 years (12) for epilepsy, and 34 years (10) for healthy comparisons, and the proportion of women per group was 72% (range 18-100) for functional seizures, 59% (range 15-100) for epilepsy, and 69% (range 34-100) for healthy comparisons. Data on race or ethnicity were rarely reported in the individual studies. Risk of bias was moderate. Cognitive performance was better in people with functional seizures than those with epilepsy (Hedges' g=0·17 [95% CI 0·10-0·25)], p<0·0001), with moderate-to-high heterogeneity (Q[56]=128·91, p=0·0001, I2=57%). The functional seizures group performed better than the epilepsy group on global cognition and intelligence quotient (g=0·15 [0·02-0·28], p=0·022) and language (g=0·28 [0·14-0·43], p=0·0001), but not other cognitive domains. A larger effect was noted in language tests when comparing functional seizures with left temporal lobe epilepsy (k=5; g=0·51 [0·10 to 0·91], p=0·015). The functional seizures group underperformed relative to healthy comparisons (g=-0·61 [-0·78 to -0·44], p<0·0001), with significant differences in all cognitive domains. Meta regressions examining effects of multiple covariates on global cognition were not significant. INTERPRETATION: Patients with functional seizures have widespread cognitive impairments that are likely to be clinically meaningful on the basis of moderate effect sizes in multiple domains. These deficits might be slightly less severe than those seen in many patients with epilepsy but nevertheless argue for consideration of clinical assessment and treatment. FUNDING: Department of Veterans Affairs, Veterans Health Administration.

Examining associations between concussion history, subjectively experienced memory problems, and general health factors in older men.

OBJECTIVE: Examine associations between subjective memory complaints (SMCs), concussion history, and cognitive, psychological, and physical health in older men from the general population. METHOD: Participants were 504 men aged 50-79 who were recruited using an online labor market. Participants completed a survey assessing demographics, medication history, concussion history, recent memory problems, and additional aspects of recent cognitive, mental, and physical health. RESULTS: Men with a lifetime history of ≥3 concussions also reported a lifetime history of being prescribed medication for anxiety (46.8%), depression (43.5%), chronic pain (79.0%), and high blood pressure (66.1%). When asked about symptoms experienced over the past year and the past week, they endorsed higher rates of cognitive and mental health problems, migraines, and difficulties with sleep and fatigue. The multivariable logistic regression model for predicting mild or greater memory problems was significant, χ2(8) = 168.97, p < .001. In unadjusted analyses, significant predictors, in order of magnitude (strongest to weakest), were fatigue (odds ratio [OR] = 3.21), back or neck pain (OR = 2.28), migraines (OR = 2.11), anxiety (OR = 2.07), depression (OR = 2.04), difficulty sleeping (OR = 1.98), and concussion history (OR = 1.49). In the multivariable model, only back or neck pain (OR = 1.51, p = .004) and fatigue (OR = 1.99, p = .004) were significant predictors. CONCLUSIONS: A personal history of multiple concussions was associated with perceived memory problems, but to a lesser degree than fatigue, back or neck pain, and migraines.

Memory, fluid reasoning, and functional capacity in adults experiencing homelessness.

BACKGROUND AND OBJECTIVE: In individuals experiencing homelessness, determinants of functional capacity (i.e. the ability to perform activities of daily living) are poorly understood. Identifying potentially modifiable correlates of functional capacity, such as cognitive abilities, may inform treatment targets to address independence and housing stability. This study aimed to identify the strongest neuropsychological predictors of variance in functional performance in 100 adults living in a homeless shelter. METHODS: Participants completed a brief cognitive screening test, from which four composite scores were derived, as well as tests of processing speed, fluid reasoning, premorbid intellectual function, and performance-based functional capacity. We conducted a hierarchical linear regression to predict variance in functional capacity. RESULTS: Beyond the impact of education and premorbid intellectual function, better memory and fluid reasoning predicted better functional performance. CONCLUSIONS: Although our cross-sectional design does not permit causal inference, it is possible that interventions targeting memory and fluid reasoning may improve functional ability in individuals experiencing homelessness.

Improvements in Montreal Cognitive Assessment scores after neurobehavioral therapy in adults with functional (nonepileptic) seizures and traumatic brain injury.

Cognitive functioning impacts clinical symptoms, treatment response, and quality of life in adults with functional/nonepileptic seizures (FS/NES), but no study to date examines effects of behavioral FS/NES treatment on cognition in these patients. We hypothesized that there would be a reduction in cognitive symptoms in participants with FS/NES and traumatic brain injury (TBI) following neurobehavioral therapy (NBT). We also hypothesized that select seizure-related, medication, subjective cognitive, and mental health symptoms would be negatively correlated with improvements in cognitive performance after NBT. Participants were 37 adults with TBI + FS/NES and 35 adults with TBI only, recruited from medical centers in the northeastern or southeastern U.S. TBI + FS/NES participants completed a 12 session NBT intervention, and TBI without seizures participants were not treated. All participants completed pre-post assessments of cognition (Montreal Cognitive Assessment [MoCA]) and baseline sociodemographic factors and mental health symptoms. Pre-post MoCA scores increased significantly in TBI + FS/NES participants (28/37 [75.7%] improved) but not in TBI comparisons (10/35 [28.6%] improved). Language, memory, and visuospatial/executive functions, but not attention, improved over time in the TBI + FS/NES group. Gains in cognition were concentrated in those TBI + FS/NES participants with likely baseline cognitive impairments (MoCA total score <26), and 9/17 of these participants moved from the "impaired" range at baseline (<26) to the "intact" range at endpoint (≥26). Lastly, participants taking fewer medications and reporting lower subjective cognitive difficulties at baseline showed larger pre-post MoCA total score improvements. Overall, results from this study suggest the potential for positive change in cognition in FS/NES and co-occurring TBI using evidence-based psychotherapy.

Digital Methods of Delivering Education and Training in Neuropsychology.

OBJECTIVE: High quality and accessible education is crucial to secure the future of neuropsychology. Recent and ongoing advancements include the creation of a taxonomy of education and training, progress in delineating relevant competencies, and an update to the Houston Conference Guidelines. Meanwhile, there is also potential for growth in digital methods of delivering education such as podcasts, webinars, and social media platforms. This paper aims to review the evidence for these three methods and to provide recommendations for implementing them across the continuum of training in neuropsychology, from graduate school through postdoctoral fellowship and continuing education. METHOD: We reviewed the literature on podcasts, webinars, and social media platforms as educational tools that may be applied to improve learning of brain-behavior concepts and clinical skills. Specifically, we (a) introduce and describe each method, (b) discuss benefits and drawbacks, (c) review the literature on satisfaction and learning outcomes, and (d) provide suggestions for implementation in neuropsychology training programs. RESULTS: Podcasts and webinars have strong evidence for satisfaction and moderate support for improving learning outcomes, with the learning outcome literature suggesting equivalency between podcasts/webinars and traditional methods of education. Social media platforms are associated with high satisfaction, but learning outcome data are scarce. CONCLUSIONS: Evidence for podcasts and webinars is sufficient to support implementation into neuropsychology education, whereas social media platforms should be used more cautiously. We provide recommendations of select instances in which trainees and educators can use these methods to improve education in neuropsychology.