Showing papers in "Clinical Neuropsychologist in 2007"
TL;DR: Clinicians and researchers are acquainted with the unique and beneficial characteristics of fNIRS by reviewing its relative merits and limitations vis-à-vis other brain-imaging technologies such as functional magnetic resonance imaging (fMRI).
Abstract: Functional near-infrared spectroscopy (fNIRS) is an emerging functional neuroimaging technology offering a relatively non-invasive, safe, portable, and low-cost method of indirect and direct monitoring of brain activity. Most exciting is its potential to allow more ecologically valid investigations that can translate laboratory work into more realistic everyday settings and clinical environments. Our aim is to acquaint clinicians and researchers with the unique and beneficial characteristics of fNIRS by reviewing its relative merits and limitations vis-a-vis other brain-imaging technologies such as functional magnetic resonance imaging (fMRI). We review cross-validation work between fMRI and fNIRS, and discuss possible reservations about its deployment in clinical research and practice. Finally, because there is no comprehensive review of applications of fNIRS to brain disorders, we also review findings from the few studies utilizing fNIRS to investigate neurocognitive processes associated with neurologic...
375 citations
TL;DR: The results suggested that PAF NF improved cognitive processing speed and executive function, but that it had no clear effect on memory, suggesting that the PAFNF protocol is a promising technique for improving selected cognitive functions.
Abstract: Neurofeedback (NF) is an electroencephalographic (EEG) biofeedback technique for training individuals to alter their brain activity via operant conditioning. Research has shown that NF helps reduce symptoms of several neurological and psychiatric disorders, with ongoing research currently investigating applications to other disorders and to the enhancement of non-disordered cognition. The present article briefly reviews the fundamentals and current status of NF therapy and research and illustrates the basic approach with an interim report on a pilot study aimed at developing a new NF protocol for improving cognitive function in the elderly. EEG peak alpha frequency (PAF) has been shown to correlate positively with cognitive performance and to correlate negatively with age after childhood. The present pilot study used a double-blind controlled design to investigate whether training older individuals to increase PAF would result in improved cognitive performance. The results suggested that PAF NF improved cognitive processing speed and executive function, but that it had no clear effect on memory. In sum, the results suggest that the PAF NF protocol is a promising technique for improving selected cognitive functions.
288 citations
TL;DR: The BRIEF-P is sensitive to symptoms of ADHD, but appears to measure different elements of EF than those tapped by performance-based measures, and patterns of correlations were not significantly different than those between the BRI EF-P and non-EF measures.
Abstract: The Behavior Rating Inventory of Executive Function-Preschool Version (BRIEF-P; Gioia, Espy, & Isquith, 2003) was developed to assess executive function (EF) behaviors in children aged 2 to 5 years. We compared parent ratings of 25 preschool children with ADHD to 25 age-, sex-, and SES-matched controls from the BRIEF-P standardization sample. Children with ADHD were rated significantly higher than controls (p < .01) on all five primary scales (Inhibit, Shift, Emotional Control, Working Memory, Plan/Organize), and on all four indices (Inhibitory Self Control, Flexibility, Emerging Metacognition, General Executive Composite). The largest effect size was on the Working Memory scale. All five BRIEF-P clinical scales were significantly intercorrelated in the control group, and seven of ten scale intercorrelations were significant in the ADHD group. Within the ADHD group, the BRIEF-P Index scores were significantly correlated with ratings on the Conners' Parent Rating Scale, but only moderately correlated with ...
167 citations
TL;DR: Results suggest rates of neuropsychological NRB and malingering in criminal forensic settings are higher than in civil forensic settings.
Abstract: Several studies reveal the prevalence of negative response bias (NRB) in civil forensic settings, but little NRB base rate information is available for criminal forensic neuropsychological settings. We reviewed the published literature on neuropsychological NRB in the civil setting. We then present data from 105 criminal defendants serially referred for neuropsychological assessment to determine the prevalence of NRB. The rate of NRB using one positive indicator was 89.5%. The rate was 70.5% when using two or more positive indicators and 53.3% for three or more indicators. Based on the Slick, Sherman, and Iverson (1999) classification for malingered neurocognitive dysfunction (MND), 19% were Valid, 26.7% were Possible MND, 32.4% were Probable MND, and 21.9% were Definite MND. The combined rate of probable and definite MND was 54.3%. Results suggest rates of neuropsychological NRB and malingering in criminal forensic settings are higher than in civil forensic settings.
141 citations
TL;DR: The results indicated that VR memory testing accurately distinguished the TBI group from controls and there was a significant relationship between the VR Office and a standard neuropsychological measure of memory, suggesting the construct validity of the task.
Abstract: It has been suggested that virtual reality may provide a medium for producing neuropsychological measures with greater ecological validity. The present study examined the usefulness of virtual reality (VR) to assess learning and memory in individuals with traumatic brain injury (TBI). A total of 20 TBI participants were compared with 20 healthy controls on their ability to learn and recall 16 target items presented within a VR-based generic office environment. The results indicated that VR memory testing accurately distinguished the TBI group from controls. Additionally, non-memory-impaired TBI participants acquired targets at the same rate as HC participants. Finally, there was a significant relationship between the VR Office and a standard neuropsychological measure of memory, suggesting the construct validity of the task. These findings suggest that the VR Office provides a viable medium for measuring learning and memory. The present results provide preliminary support for the ecological validity of the VR Office, which ultimately can improve assessment of real-world functioning following TBI.
130 citations
TL;DR: The EI appears to be useful for detecting insufficient effort on a screening battery for the Repeatable Battery for the Assessment of Neuropsychological Status.
Abstract: The present study aimed to develop an internal validity indicator for a brief general purpose screening battery, the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Two subtests of the RBANS were predicted to be relatively resilient to cognitive dysfunction on the basis of previous research. An Effort Index (EI) was created by combining them via a scaling system. The frequency of EI scores was first examined in a heterogenous clinical sample. A subsequent validation study showed good discriminability. In conclusion, the EI appears to be useful for detecting insufficient effort on a screening battery.
128 citations
TL;DR: It is asserted that fNIRS may be particularly beneficial to neurorehabilitation of cognitive disabilities, and future applications are suggested.
Abstract: Functional Near-Infrared Spectroscopy (fNIRS) is a neuroimaging technique that utilizes light in the near-infrared spectrum (between 700 and 1000 nm) to detect hemodynamic changes within the cortex when sensory, motor, or cognitive activation occurs. FNIRS principles have been used to study brain oxygenation for several decades, but have more recently been applied to study cognitive processes. This paper provides a description of basic fNIRS techniques, and provides a review of the rehabilitation-related literature. The authors discuss strengths and weaknesses of this technique, assert that fNIRS may be particularly beneficial to neurorehabilitation of cognitive disabilities, and suggest future applications.
98 citations
TL;DR: Results suggest that TOMM Trial 1 demonstrates high diagnostic accuracy and is a viable option for screening insufficient effort, and the need for more comprehensive SVT assessment in most clinical and forensic situation is discussed.
Abstract: The identification of insufficient effort is critical to neuropsychological evaluation, and several existing instruments assess effort on neuropsychological tasks. Yet instruments designed to detect insufficient effort are underutilized in standard neuropsychological assessments, perhaps in part because they typically require significant administration time and are, therefore, not ideally suited to screening contexts. The Test of Memory Malingering (TOMM) is a commonly administered, well-validated symptom validity test. This study evaluates the utility of TOMM Trial 1 as a relatively brief screening measure of insufficient effort. Results suggest that TOMM Trial 1 demonstrates high diagnostic accuracy and is a viable option for screening insufficient effort. Diagnostic accuracy estimates are presented for a range of base rates. The need for more comprehensive SVT assessment in most clinical and forensic situation is discussed.
86 citations
TL;DR: Significantly poorer mean BNT scores and increasing variability were found with successively older age groups and with lower educational levels even after stratification on the demographic variables.
Abstract: The effects of age, education, and gender on visual confrontation naming using the 60-item Boston Naming Test (BNT) were studied in 1111 "normal" elderly (ages 50-101) and 61 younger adults (ages 20-49). Significantly poorer mean BNT scores and increasing variability (measured in standard deviations) were found with successively older age groups and with lower educational levels even after stratification on the demographic variables. There was a non-significant trend for males to score slightly higher than females. Age declines on the BNT were considerably greater for this cross-sectional data than for the longitudinal data we previously reported.
79 citations
TL;DR: The goals of this article are to acquaint the reader with both established and newer methods for imaging and quantifying white matter anatomy and pathology; and to review recent findings on white matter pathology in aging and dementia.
Abstract: Clinical neuroscientists have focused increasing attention on white matter connections in the brain and on the effects of aging and disease on these connections. Recent advances in magnetic resonance imaging (MRI) analysis have given researchers new tools for quantifying and visualizing white matter to better relate white matter structure and function. The goals of this article are (a) to acquaint the reader with both established and newer methods for imaging and quantifying white matter anatomy and pathology; and (b) to review recent findings on white matter pathology in aging and dementia. Computer-assisted quantification appears to offer better statistical power than visual rating scales for detecting these relationships. New MR modalities such as diffusion imaging can detect white matter abnormalities not shown with conventional acquisition sequences. These newer techniques hold promise for early detection of disease and for delineating functional connections between brain areas.
77 citations
TL;DR: Despite relatively high levels of self-reported depression, chronic pain, and disability, not a single patient failed the TOMM, and in this study, the TOMm was not affected by chronicPain, depression, or both.
Abstract: Neuropsychologists routinely give effort tests, such as the Test of Memory Malingering (TOMM). When a person fails one of these tests, the clinician must try to determine whether the poor performance was due to suboptimal effort or to chronic pain, depression, or other problems. Participants were 54 community-dwelling patients who met American College of Rheumatology criteria for fibromyalgia (FM). In addition to the TOMM, they completed the Beck Depression Inventory-Second Edition, Multidimensional Pain Inventory-Version 1, Oswestry Disability Index-2.0, British Columbia Cognitive Complaints Inventory, and the Fibromyalgia Impact Questionnaire. The majority endorsed at least mild levels of depressive symptoms (72%), and 22% endorsed "severe" levels of depression. The average scores on the TOMM were 48.8 (SD = 1.9, range = 40-50) for Trial 1, 49.8 (SD = 0.5, range = 48-50) for Trial 2, and 49.6 (SD = 0.9, range = 45-50) for Retention. Despite relatively high levels of self-reported depression, chronic pain, and disability, not a single patient failed the TOMM. In this study, the TOMM was not affected by chronic pain, depression, or both.
TL;DR: The Random shape cancellation test, Star cancellation, and two line bisection tasks appeared to be the most sensitive tests of visuospatial neglect.
Abstract: The multidimensional nature of the neglect syndrome constitutes a challenge for clinical assessments. This study evaluates the sensitivity of different clinical measures to detect neglect and explores ways to evaluate the diversity of the syndrome in a clinical sample. An extensive battery of tests was used to examine aspects of visuospatial, representational, and personal neglect. A total of 31 normal control participants and 34 patients with right hemisphere stroke were examined 16.8 days post-stroke, on average. Of the patients, 24 showed neglect in at least one task. The Random shape cancellation test, Star cancellation, and two line bisection tasks appeared to be the most sensitive tests of visuospatial neglect. Personal neglect and neglect in far space occurred only together with extrapersonal neglect. Besides near space, other spatial aspects of neglect are important to consider in clinical assessments, but standardized methods are needed. In this patient group a minimum of 10 tests were needed to cover various aspects of detection, dissociations, and severity of neglect. A multifactorial approach in clinical testing of neglect is recommended.
TL;DR: All aspects of the DBS procedure that can result in mood, cognitive, and behavioral effects and what role(s) the neuropsychologist should play in screening and follow-up are reviewed.
Abstract: Deep brain stimulation (DBS) now plays an important role in the treatment of Parkinson's disease, tremor, and dystonia. DBS may also have a role in the treatment of other disorders such as obsessive-compulsive disorder, Tourette's syndrome, and depression. The neuropsychologist plays a crucial role in patient selection, follow-up, and management of intra-operative and post-operative effects (Pillon, 2002; Saint-Cyr & Trepanier, 2000). There is now emerging evidence that DBS can induce mood, cognitive, and behavioral changes. These changes can have dramatic effects on patient outcome. There have been methodological problems with many of the studies of DBS on mood, cognition, and behavior. The neuropsychologist needs to be aware of these issues when following up patients, and constructing future studies. Additionally, this article will review all aspects of the DBS procedure that can result in mood, cognitive, and behavioral effects and what role(s) the neuropsychologist should play in screening and follow-up.
TL;DR: Assessment practices of neuropsychologists with regard to their utilization of instruments designed with ecological concerns in mind are surveyed, and results indicated that approximately one-third of respondents reported use of ecologically oriented instruments (EOIs), and these instruments were generally utilized with much less frequency than traditional measures.
Abstract: The ecological validity of neuropsychological instruments has become an important topic in recent decades, as neuropsychologists are asked to address real-world outcomes with increasing frequency. Although novel instruments that tap skills required for everyday functioning have been developed, it is unclear whether these instruments are migrating from research laboratories into the applied settings of clinical neuropsychologists. The current study surveyed assessment practices of neuropsychologists with regard to their utilization of instruments designed with ecological concerns in mind. Respondents included 747 North American, doctorate-level psychologists (40% usable response rate) affiliated with Division 40 of the American Psychological Association, National Academy of Neuropsychology, or the International Neuropsychological Society. Results indicated that approximately one-third of respondents reported use of ecologically oriented instruments (EOIs), and these instruments were generally utilized with...
TL;DR: A unique view of SWB among individuals with MS in the absence of acute exacerbation of the illness is presented, indicating that a substantial proportion of patients experienced diminished SWB and that disease characteristics such as duration and severity have differential relationships to SWB outcomes.
Abstract: Neuropsychological and psychosocial predictors of subjective well-being (SWB) were examined among 74 persons with multiple sclerosis (MS). The multidimensional construct of SWB was assessed by self-report measures of acute psychological distress, global life satisfaction, and health-related quality of life (HRQoL). Objective disease-related indices were obtained from medical records and neuropsychological testing. Unawareness of deficit, a frequent aspect of executive function impairments in MS, was measured as the discrepancy between patient self-report of functional abilities and a caregiver's report of the patient's abilities. Results indicate that a substantial proportion of patients experienced diminished SWB and that disease characteristics such as duration and severity have differential relationships to SWB outcomes. Multiple regression analyses indicated that, in the context of a combined predictive model, social support and unawareness of deficit provided unique information in predicting all thre...
TL;DR: Results showed that the CVM suppressed their IQ scores to approximate closely the level of MR participants, suggesting that new cutting scores will likely need to be validated to detect feigned MR using current malingering instruments.
Abstract: A recent Supreme Court decision—Atkins v. Virginia, 536 U.S. 304 (2002)—prohibiting the execution of mentally retarded (MR) defendants may have raised the attractiveness of feigning this condition in the criminal justice system. Unfortunately, very few published studies have addressed the detection of feigned MR. The present report compared results from tests of intelligence, psychiatric feigning, and neurocognitive faking in a group of 26 mild MR participants (MR) and 25 demographically matched community volunteers asked to feign MR (CVM). Results showed that the CVM suppressed their IQ scores to approximate closely the level of MR participants. WAIS-III and psychiatric malingering measures were relatively ineffective at discriminating feigned from genuine MR. Although neurocognitive malingering tests were more accurate, their reduced specificity in MR participants was of potential concern. Revised cutting scores, set to maintain a Specificity rate of about .95 in MR clients, were identified, although th...
TL;DR: The data suggest that a participant's performance on the MCST may be based essentially on two parameters: categorizing efficiency (orategorizing efficiency plus), measuring the participant's ability to categorize, and perseverative errors (or percent perseverativeerrors), measuring his or her difficulty in shifting, both considered typical executive functions.
Abstract: According to Nelson's (1976) criteria, the MCST (MWCST) is a simplification of the Wisconsin Card Sorting Test (WCST). As the MCST is particularly suitable for children, the aim of this study was to establish the normative data presently lacking for that group. The MCST was administered to 1126 normal children aged 4 to 13 years. Scoring was based on all the classical parameters, according to existing criteria, plus two new ones that we propose (“categorizing efficiency” and “categorizing efficiency plus”). Strong correlation (or inverse correlation) with age is found for most parameters, including all criteria used for perseverative responses. This does not occur for “failure to maintain set,” calculated according to the usual criteria. “Categorizing efficiency” and “categorizing efficiency plus” avoid the ceiling effect occurring at higher ages in the parameter categories. The MCST may be used in children 4 years of age and above. Most, but not all, of its parameters show regular improvement with age, d...
TL;DR: The results revealed that the MEAA group outperformed the ED group on the verbal (i.e., Vocabulary and Similarities), but not the nonverbal subtests, which underscores the importance of taking cultural factors, particularly level of acculturation, into account when interpreting test scores of ED individuals.
Abstract: The objective of this study was to examine differences between fluent English-speaking ethnically diverse (ED) individuals (from Hispanic, Asian, and Middle-Eastern descent) and monolingual English-speaking Anglo-Americans (MEAA) on the Wechsler Abbreviated Scale of Intelligence (WASI). A sample of 86 (50 ED and 36 MEAA) healthy individuals participated. The results revealed that the MEAA group outperformed the ED group on the verbal (i.e., Vocabulary and Similarities), but not the nonverbal (i.e., Block Design and Matrix Reasoning) subtests. Various cultural factors such as the level of acculturation and the degree to which the English language was used correlated with verbal skills. Number of years the education was obtained outide of the US was an important predictor of verbal and some nonverbal performance in the ED group. The findings from this study underscore the importance of taking cultural factors, particularly level of acculturation, into account when interpreting test scores of ED individuals.
TL;DR: It is found significantly poorer mean BNT scores and increasing variability with successively older age groups and decreasing educational levels indicating the need for demographically stratified normative data when determining an individual's degree of impairment.
Abstract: Stratified normative data for age, education, and gender are provided for the 60-item Boston Naming Test (BNT) on 1026 older participants ages 50–95 years using overlapping age ranges. Tables are presented that convert BNT raw scores to scaled scores and percentiles. Mild dementia cases were eliminated using a comprehensive cognitive battery. In a companion paper we found significantly poorer mean BNT scores and increasing variability with successively older age groups and decreasing educational levels indicating the need for demographically stratified normative data when determining an individual's degree of impairment. These norms should be clinically useful when assessing suspected dementia cases.
TL;DR: Correlational analyses demonstrated that working memory was most strongly associated with performance-based functional ability; however, impairment in planning appeared to best predict performance- based functional decrement in simultaneous regression models.
Abstract: The manner in which executive control functioning exerts its influence on functional tasks was investigated. Sixty older adults were administered neuropsychological tasks tapping into four domains of executive control function, including working memory, planning, fluency, and flexibility. A test of performance-based functional ability also was administered. Correlational analyses demonstrated that working memory was most strongly associated with performance-based functional ability; however, impairment in planning appeared to best predict performance-based functional decrement in simultaneous regression models. Results highlight the role of planning in the maintenance of functional ability, as measured by performance-based functional measures.
TL;DR: This address to the International Neuropsychological Society membership challenges the wisdom of several common practices in contemporary neuropsychology, including the development of race-specific test norms, the indiscriminate use of Bonferroni's correction for multiple comparisons, and the conduct of “quality of life” research.
Abstract: This address to the International Neuropsychological Society membership challenges the wisdom of several common practices in contemporary neuropsychology. It is argued that, in spite of their popularity, the development of race-specific test norms, the indiscriminate use of Bonferroni's correction for multiple comparisons, and the conduct of “quality of life” research are all conceptually problematic. These practices may have untoward sociopolitical effects as well, and neuropsychologists are urged to exercise caution before embracing them.
TL;DR: Results indicated that the forced-choice portion of the CVLT-II, the V-DS difference score, and the Rarely Missed Index Test from the WMS-III might be appropriate for use with this population with passing rates of 89, 98%, and 91% respectively.
Abstract: The purpose of this study was to determine which tests of effort and motivation would be appropriate for use with patients with mental retardation when feigning of cognitive deficits is suspected. The seven measures evaluated included the WMS-III Rarely Missed Index Test, forced-choice recognition portion of the California Verbal Learning Test-II, Reliable Digit Span test, Rey 15-Item Test, Rey Dot Counting Test, the Rey 15-Item Test with Recognition Trial, and the Vocabulary (V)-Digit Span (DS) difference score. Results indicated that the forced-choice portion of the CVLT-II, the V-DS difference score, and the Rarely Missed Index Test from the WMS-III might be appropriate for use with this population with passing rates of 89%, 98%, and 91% respectively.
TL;DR: It is suggested that VSVT response latencies may supplement accuracy scores in identifying patients who are exerting suboptimal effort on cognitive measures, and measures of cognitive symptom validity only partially overlap with measures of psychopathological symptom exaggeration.
Abstract: The purpose of this study was twofold: (1) to examine the relationships among measures of cognitive symptom exaggeration (i.e., response accuracy and response latency) and (2) to examine the relationship between measures of cognitive and psychopathological symptom exaggeration. It was expected that Victoria Symptom Validity Test (VSVT) accuracy and latency measures would be significantly correlated, with invalid responders demonstrating longer response latencies. VSVT scores were also expected to correlate significantly with the Negative Impression Management (NIM) and Infrequency (INF) subscales of the Personality Assessment Inventory (PAI). VSVT and PAI data were collected from 300 patients during routine clinical neuropsychological evaluations. Results indicated that VSVT accuracy and latency measures were significantly and moderately correlated, and both types of VSVT scores were significantly, but modestly, related to NIM, but not INF. These findings suggest that VSVT response latencies may supplemen...
TL;DR: The data suggest that intentional response distortion in patients referred for non-forensic neuropsychological evaluation is rare, and performances by specific diagnosis using different classification criteria are presented.
Abstract: We retrospectively reviewed Victoria Symptom Validity Test (VSVT) in 374 patients who underwent neuropsychological assessment in an academic hospital-based practice. Patients were classified as either non-TBI clinically referred (generally patients referred from neurology, neurosurgery, or medicine), clinically referred TBI (no known external financial incentive), and non-clinical referrals (e.g., attorney-referred, Worker's Compensation). Three patients were not classified into any group and considered separately. Intentional response distortion, defined as statistically less than chance performance on hard VST items, was present in only 1/306 (0.3%) clinically referred non-TBI patients, and no clinically referred TBI patient obtained scores significantly less than chance on this measure. One additional clinically referred patient with a non-neurologic diagnosis who was subsequently found to be pursuing a disability claim also performed worse than chance. In contrast, 5/25 patients (20%) referred by atto...
TL;DR: Parents were generally satisfied with pediatric neuropsychological evaluations, although some parents indicated that the evaluations did not provide as much help as expected, and a factor analysis of the survey instrument revealed four dimensions of satisfaction: General Satisfaction, Clinician acceptance/Empathy, Provision of Help, and Facilities/Administrative Assistance.
Abstract: Satisfaction with pediatric neuropsychological evaluations was surveyed by asking parents or guardians of children who completed pediatric neuropsychological evaluations at a large children's hospital over a 2-year period to complete a 30-item rating scale. The scale included items drawn from published measures of consumer satisfaction, and incorporated a well-validated measure of general satisfaction. A total of 338 surveys were distributed, with 117 completed, for a return rate of 35%. Respondents were generally similar to non-respondents, except that respondents had a higher average level of maternal education and were more likely to have been referred for neuropsychological evaluations by sources outside the hospital. Parents were generally satisfied with pediatric neuropsychological evaluations, although some parents indicated that the evaluations did not provide as much help as expected. A factor analysis of the survey instrument revealed four dimensions of satisfaction: General Satisfaction, Clinician Acceptance/Empathy, Provision of Help, and Facilities/Administrative Assistance. Maternal education was negatively correlated with all four factors, but no other demographic, patient, or clinician variables were significantly related to satisfaction. Future studies could survey physicians and educators to provide a more complete understanding of satisfaction with pediatric neuropsychological evaluations.
TL;DR: The Brown Location Test was designed to specifically measure visual memory for location of identical objects (dots) and address limitations found in commonly employed visual memory tests and results indicate good internal and alternate form reliabilities.
Abstract: There are a variety of well-established neuropsychological tests that are helpful in identifying global and specific verbal memory deficits. In contrast, tests of visual memory have produced less consistent results likely due in part to confounding variables such as verbal encodability, administration difficulties, and insufficient differentiation of among types of visual memory. The Brown Location Test (BLT) was designed to specifically measure visual memory for location of identical objects (dots) and address limitations found in commonly employed visual memory tests. This paper describes the empirical basis for the BLT and reports the psychometric properties of the test. Results indicate good internal and alternate form reliabilities. Factor analysis of a brief test battery confirmed that BLT performance is generally independent of verbal memory and global intellectual abilities. BLT performance declined with age, but there was no association between performance and gender, education, or intellectual functioning. In view of the favorable psychometric properties observed during preliminary studies, additional normative and validation studies in healthy and patient populations are warranted.
TL;DR: Findings from three cases of individuals with severe brain trauma will be presented to show the influence of brain trauma on baseline cerebrovascular parameters measured by fMRI.
Abstract: There is a rapidly growing literature using fMRI technology to investigate the various forms of behavioral impairment associated with brain injury and disease. Given this, surprisingly little work has been conducted to examine the influence of neuropathophysiological processes on the fMRI signal. This paper reviews the literature examining baseline alteration in cerebrovascular parameters associated with normal aging, brain injury, and brain disease. In addition, findings from three cases of individuals with severe brain trauma will be presented to show the influence of brain trauma on baseline cerebrovascular parameters measured by fMRI. The methods used here can be implemented by other investigators to accurately isolate specific hemodynamic changes that can influence the BOLD fMRI signal.
TL;DR: Overall, both patients and significant others reported being satisfied with the interview, testing, and feedback sessions, and were more inclined to have followed recommendations regarding patient safety than coping or support.
Abstract: To assess perceptions of the neuropsychological evaluation, 349 patients and 218 significant others presenting to an academic medical center neuropsychology service were surveyed over a two year period. Thirty-seven percent of the patient surveys (n = 129) and 37% of the significant other surveys (n = 80) were returned. Overall, both patients and significant others reported being satisfied with the interview, testing, and feedback sessions. Responders were generally receptive to the recommendations made, but were more inclined to have followed recommendations regarding patient safety (63.6%) than coping or support (31.8%). Some barriers to compliance with recommendations were identified.
TL;DR: Various Barona formulae, a WTAR algorithm based on demographic data, and WRAT-3 oral reading methods of estimating premorbid ability were compared and it was found that the revised Barona formula was superior to the original formula for subjects at the upper end of ability level.
Abstract: Various Barona formulae, a WTAR algorithm based on demographic data, and WRAT-3 oral reading methods of estimating premorbid ability were compared in a diverse research sample of 119 subjects. These methods were correlated with one another and with a modified version of the Raven Standard Progressive Matrices. Descriptive data are provided to illustrate advantages and disadvantages of various methods of estimating premorbid ability when no formal intellectual testing is available. While predicting premorbid ability for individual subjects involves varying degrees of error, we found that the revised Barona formula was superior to the original formula for subjects at the upper end of ability level. When researchers have screened out learning disability and have subject samples with few individuals likely to be of superior premorbid intelligence, oral reading scores are a reasonable measure of premorbid ability. Otherwise, researchers are advised to use both demographic and oral reading methods to estimate p...
TL;DR: The SBIS scores were lowered compared to controls; in some instances this lowered performance was at a clinically relevant level and significantly better than unsuccessful brain injury simulators on select standard neuropsychological measures.
Abstract: This study provided an examination of the performance characteristics of successful brain injury simulators (SBIS). Coached (n = 56) and uncoached (n = 35) brain injury simulators received instructions to fake cognitive impairment; controls were asked to do their best. The Test of Memory Malingering (TOMM) was administered along with standard neuropsychological measures (e.g., Wisconsin Card Sorting Test). The TOMM identified 80% of uncoached and 60% of coached brain injury simulators. SBIS were participants from the brain injury simulation groups whose TOMM performance indicated adequate effort. A total of 32% of all brain injury simulators scored above the TOMM cutoff scores for adequate effort (the SBIS group). Significantly more coached than uncoached participants composed the SBIS group (76% vs. 24%, respectively). SBIS performed significantly worse than controls and significantly better than unsuccessful brain injury simulators on select standard neuropsychological measures. The SBIS scores were low...