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Paul Foster, PhD

Paul Foster, PhD

Neurology Specialists

615-867-8090

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Dr. Foster graduated from Kennesaw State University with a B.S. in Psychology in 1993 and graduated summa cum laude in 1994 with a B.S. in Public and Social Services.  He earned a Master of Science degree in Clinical Psychology from Georgia Southern University in 1996.  Dr. Foster completed his Ph.D. in Clinical Psychology, specializing in neuropsychology, from Virginia Tech in 2004.  He completed an internship in neuropsychology at the University of North Carolina at Chapel Hill School of Medicine.  After graduating with his Ph.D. he completed a two-year post-doctoral fellowship in behavioral neurology and neuropsychology from the University of Florida.  He is presently an Associate Professor in the Psychology Department at Middle Tennessee State University, a position he has held since 2007.  Further, he is a Licensed Psychologist with Health Service Provider designation and has had a private practice as a Clinical Neuropsychologist in the Department of Neurology at Murfreesboro Medical Clinic since 2008.  He also still holds a courtesy appointment as a Research Assistant Professor at the University of Florida.  Dr. Foster has over 50 publications in peer-reviewed journals and over 70 presentations at professional conferences at the regional, national, and international levels.

His clinical practice at MMC focuses on examining brain-behavior relationships and in particular assessing for the presence of neurodegenerative diseases.  These neurodegenerative diseases include Alzheimer’s disease, vascular dementia, Parkinson’s disease, among others.  However, he also evaluates patients with a variety of other neurological and psychological problems, including strokes, head injuries, epilepsy, and mood disorders.  The purpose of the neuropsychological evaluations is to assess for the presence of memory and cognitive problems and to help ascertain the reasons the patient may be experiencing these problems.  Treatment recommendations are then provided based on the results of the evaluation.  

Many individuals and/or their families feel that they are experiencing problems with memory loss.  However, although many individual may feel that they are experiencing memory problems this does not necessarily mean that they are in fact suffering from memory loss.  A neuropsychological evaluation is the only objective method that may be used to determine whether the patient is experiencing memory and/or cognitive problems.  Given the presence of memory problems, there are many reasons that an individual may be experiencing problems with memory.  Many of these causes are very treatable and with treatment the patient may experience an improvement in memory.  Depression, sleep loss or sleeping problems, stress, vitamin deficiencies, and thyroid problems are among those disorders that may be associated with memory problems and that are quite treatable.  The results of the neuropsychological evaluation, in combination with the patient’s history, may help to determine whether any of these conditions are causing memory and cognitive problems.  The results of the evaluation may also indicate that the patient is experiencing a neurodegenerative disease or dementia.  There are many different forms of dementia, of which Alzheimer’s disease and vascular dementia are the most common.  A brain biopsy is the only method of diagnosing many types of dementia with certainty.  This fact places greater importance on neuropsychological evaluations as a diagnostic tool in determining whether a patient has a neurodegenerative disease.  Many patients may be experiencing a condition known as Mild Cognitive Impairment.  These individuals are experiencing more mild problems with memory and do not meet the full criteria for a diagnosis of dementia.  However, individuals with Mild Cognitive Impairment are at increased risk for developing dementia later in life, with research indicating that as many as one-third of these patients will eventually develop a dementia.  The results of a neuropsychological evaluation may be used to help identify those with Mild Cognitive Impairment and who are at this increased risk for developing a dementia.  Treatment may then be initiated earlier, possibly prolonging the onset of dementia.  

As an Associate Professor at MTSU he teaches courses in Human Neuropsychology, Clinical Neuropsychology, Psychopharmacology, Research Methods, and Learning Theories.  Dr. Foster also has an active program of research, with much of this research focusing on neurodegenerative diseases.  The majority of his research in this area has focused on Alzheimer’s disease, vascular dementia, and Parkinson’s disease.  Specific research projects that are currently ongoing include examining spreading activation in memory networks in Alzheimer’s and Parkinson’s diseases as well as vascular dementia and mild cognitive impairment.  Spreading activation refers to the process whereby activation of a specific memory may spread to associated memories.  His recent findings have found that Alzheimer’s disease is associated with increased spreading activation in some memory networks (lexical-based) but reduced spreading activation in other networks (semantic-based).  His research has also found that increased spreading activation is associated with increased recall for lists of words, thus, as spreading activation increases memory also improves.  Further, a class of medications known as acetylcholinesterase inhibitors (such as Aricept and Exelon) are often given to dementia patients to treat their memory problems.  However, Dr. Foster’s research indicates that these medications are associated with reduced spreading activation.  Thus, whereas these medications may help to increase memory, likely through improved attention, they also have a negative impact from the reduced spreading activation that they create.  

Dr. Foster has also conducted extensive research in Parkinson’s disease.  Much of this research has focused on examining the differences in memory and behavior in patients whose motor symptoms begin at the left or right side.  His research has found that patients whose symptoms begin at the right experience greater problems with emotional functioning (depression and anxiety) as the disease progresses.  Patients with left onset of motor symptoms are more likely to experience problems with working memory when they also have problems with depression and anxiety than patients with right onset of symptoms.  Many patients with Parkinson’s disease go on to develop a dementia, although this form of dementia is different than that of Alzheimer’s disease.  A neuropsychological evaluation may help to identify those Parkinson’s disease patients who are at increased risk of developing dementia.

PATIENT CARE EMPHASIS
Dr. Foster uses a flexible battery approach to neuropsychological assessments, having a core battery of tests that most patients receive, and then administering other assessments to test hypotheses that arise from the core tests and to answer referral-specific questions. His patient focus includes late adolescent, adult, and geriatric patients. He has extensive experience in conducting neuropsychological assessments for patients with degenerative diseases, such as Alzheimer’s and Parkinson’s diseases. Additionally, he has experience with a number of disorders, including traumatic brain injury, concussion, epilepsy, tumors, strokes, mild cognitive impairment, ADHD, and learning disabilities.

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