Applied Neuropsychology

Craniopharyngiomas are rare brain tumors within the area of the craniopharyngeal duct. They are often diagnosed in children and young people and can be associated with significant cognitive impairments such as memory and executive problems. This single-case report describes a brief investigation into the effectiveness of goal management training for dysexecutive problems following the removal and treatment of a craniopharyngioma in a young woman. In contrast to previous laboratory-based studies, we exploited naturally occurring distractions within the patient's work environment as periodic alerts to facilitate goal management. Following a 2-month intervention, the patient reported improvements in her ability to focus attention at work and performed significantly better on neuropsychological tests requiring organized behavior posttraining relative to pretraining. Thus, the exploitation of naturally occurring external distractions as periodic alerts to facilitate goal management can be an effective and easy-to-adopt cognitive rehabilitation strategy for dysexecutive problems associated with craniopharyngioma.

Claudia Metzler-Baddeley

Roy W. Jones

Brief Communication: Cognitive Rehabilitation of Executive Functioning in a Case of Craniopharyngioma

简报：一例颅咽管瘤患者的执行功能认知康复

Sensory and motor functions are good markers of neurocognitive decline due to their proximity and hierarchical relationship to high-order processes. The current study investigated if patients with Alzheimer's disease (AD) differed from a healthy control group in two tactile perceptual processes: astereognosis and agraphesthesia. Analyses were also conducted to see if these tactile processes were predictive of higher-order cognitive functioning. Twenty-eight patients with AD (mean age = 75.86) were compared to 28 healthy control subjects (mean age = 76.38) and were administered the Dean-Woodcock Sensory Motor Battery and the Woodcock-Johnson Psychoeducational Battery-Revised. Results suggest the patients with AD demonstrated significantly higher levels of tactile disturbance and astereognosis while agraphesthesia was able to predict a substantial portion of the variance in 3/7 cognitive tests and 4/7 cognitive tests, respectively. This included measures of fluid reasoning, visual processing, crystallized language, short-term memory, and auditory processing. These results suggest that astereognosis and agraphesthesia may be good markers of the extent of cognitive impairment in AD and should be included in neuropsychological evaluations due to their functional importance.

Andrew S. Davis

Anna Mazur-Mosiewicz

Raymond S. Dean

The Presence and Predictive Value of Astereognosis and Agraphesthesia in Patients with Alzheimer's Disease

阿尔茨海默病患者中实体觉缺失和触觉失认的存在及其预测价值

Abstract Assessing cognitive change during a single visit requires the comparison of estimated premorbid abilities and current neuropsychological functioning. Although premorbid intellect has been widely examined, estimating premorbid memory abilities has received less attention. The current study used demographic variables and an estimate of premorbid intellect to predict premorbid memory abilities in a sample of 95 community-dwelling, cognitively intact older adults. These prediction formulas were then applied to a sample of 74 individuals with amnestic Mild Cognitive Impairment to look for discrepancies between premorbid and current memory abilities. Despite minimal differences between premorbid and current memory abilities in the intact sample, large and statistically significant differences were observed in the impaired sample. Although validation in larger samples is needed, the current estimates of premorbid memory abilities may aid clinicians in determining change across time. Key words: assessmentlearning and memorypredicting cognition ACKNOWLEDGEMENTS The project described was supported by research grants (R03 AG025850–01; K23 AG028417–01A2) from the National Institutes on Aging. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute on Aging or the National Institutes of Health. Notes Note. All scores are age-corrected standard scores based on the test manuals. WRAT-3 = Wide Range Achievement Test–3; BVMT-R = Brief Visuospatial Memory Test–Revised; HVLT-R = Hopkins Verbal Learning Test–Revised; MCI = Mild Cognitive Impairment. Note. Age is years old. Education is number of years completed. Gender is coded as male = 0 and female = 1. BVMT-R = Brief Visuospatial Memory Test–Revised; HVLT-R = Hopkins Verbal Learning Test–Revised; WRAT-3 = Wide Range Achievement Test–3.

Kevin Duff

Predicting Premorbid Memory Functioning in Older Adults

预测老年人的前病态记忆功能

The Neuropsychological Assessment Battery (NAB; Stern & White, 2003 Stern , R. A. , & White , T. ( 2003 ). Neuropsychological Assessment Battery . Lutz , FL : Psychological Assessment Resources . [Google Scholar]) is a comprehensive test battery that assesses five cognitive domains (Attention, Language, Memory, Spatial, and Executive Functions). The purpose of the current descriptive study was to present data on the index and primary test scores from the five main NAB cognitive modules in a sample of patients with moderate-to-severe traumatic brain injury (TBI) admitted to a residential postacute rehabilitation program. Twenty patients were administered all five main NAB modules upon recommendation from the NAB Screening module. The sample performed significantly worse than normal on tests that assess selective and divided attention, psychomotor speed, verbal memory, and cognitive flexibility. The largest proportion of patients performing below an established impairment cutoff (10th percentile) occurred on the Numbers and Letters, List Learning, Story Learning, Daily Living Memory, and Categories Tests. Significant performance decrements were not observed on any indices or tests from the Language or Spatial cognitive domain modules. The pattern of performance on the NAB demonstrated by the current sample is consistent with the neuropsychological profile observed in postacute patients with moderate-to-severe TBI without focal deficits (e.g., aphasia), demonstrating its relative sensitivity in this patient population. A comparison between the current study sample and a related clinical sample from the NAB standardization data is discussed.

Dennis J. Zgaljardic

Richard O. Temple

Neuropsychological Assessment Battery (NAB): Performance in a Sample of Patients with Moderate-to-Severe Traumatic Brain Injury

神经心理学评估量表（NAB）：中度至重度创伤性脑损伤患者的样本表现

Abstract The Wisconsin Card Sorting Test (WCST) is among the most frequently administered neuropsychological tests. It is assumed that successful completion of this test requires engagement of executive functions (EF). One of the most common origins of EF impairments is ischemic stroke. The present study intends to evaluate the diagnostic use of the WCST as a measure of these impairments in poststroke patients. Forty-four patients (8 women and 36 men) who had recent unilateral stroke (22 left hemisphere, 22 right hemisphere) participated in the study. The overall accuracy of the WCST in classifying stroke survivors as having executive disorders was poor. Nevertheless, statistical analysis revealed its negative predictive power to be greater than positive predictive power (i.e., normal scores on the WCST reliably indicated the absence of executive disorders in 8 or more out of 10). Performance on the WCST is clearly influenced by severity of the executive disorders. Namely, patients with severe impairment of EF (as measured by go/no-go, fluency, and other EF tests) performed more poorly on the WCST than patients with lesser impairment or those with no impairment at all, the latter group's results being indistinguishable. In addition, this study highlights a three-factor solution to the WCST, which accounted for 90.3% of the variance. The scores that most strongly loaded on Factors 1 to 3 were, in order: percentage of conceptual-level responses, number of trials to complete the first category, and failures to maintain the set of responses. Finally, an analysis using multivariate analysis of variance, with the anterior versus posterior site and left versus right side of the lesion as independent variables, revealed a relatively weak effect of lesion location on the WCST performance. In particular, with respect to all test scores, there is only one significant interaction between the site and side of lesion was obtained (F (1,24) = 4.12; p < .05; i.e., the number of categories achieved was significantly smaller after damage to the frontal lobe on the left than on the right side, whereas the laterality effect was not significant after nonfrontal lesions). In conclusion, to ascertain the cerebral substrates of poststroke executive dysfunction, there is a need to apply more accurate tests than the WCST. The study highlights the importance of a multicomponent approach to executive functioning in stroke patients. Key words: controlexecutive functionstrokeWCST ACKNOWLEDGEMENTS This work was supported by the University of Gdańsk grant number BW/7400-5-0060-8 to the authors. The authors are grateful to Dr. Dariusz Gąsecki from the Department of Neurology at the Medical University of Gdańsk, Poland, for his help with the anatomical analysis and assistance with the subject recruitment for this study. Notes Note. WCST = Wisconsin Card Sorting Test. Values in the second and third columns from the left refer to the number of patients in each subgroup. Two values marked "a" or "b" superscript were used to calculate probabilities presented in columns on the right — PPP (Positive Predictive Power), NPP (Negative Predictive Power), and CCR (overall correct classification rates indicating average percentage of patients diagnosed correctly as having "impaired" or "normal" executive functions), according to the formulas: PPP = (valuea/24) × 100; NPP = (valueb/20) × 100; CCR = [(valuea + valueb)/44] × 100. Note. WCST = Wisconsin Card Sorting Test. Differences between means marked "a" superscript and means marked "b" superscript are significant at p < .05. Note. WCST = Wisconsin Card Sorting Test. Values marked "a" superscript indicate a statistically significant (≥.5) loading for this variable. Note. LH = left hemisphere; RH = right hemisphere; DLT = dorsal lateral; MDL = medial; ORB = orbital; PA = parietal; TE = temporal; OC = occipital.

Krzysztof Jodzio

Daria Biechowska

Wisconsin Card Sorting Test as a Measure of Executive Function Impairments in Stroke Patients

威斯康星卡片分类测验在评估中风患者执行功能障碍中的应用

Abstract A repeated observation during memory assessment with the Rey Auditory Verbal Learning Test (RAVLT) is that patients who spontaneously employ a memory rehearsal strategy by repeating the word list more than once achieve better scores than patients who only repeat the word list once. This observation led to concern about the ability of the standard test procedure of RAVLT and similar tests in eliciting the best possible recall scores. The purpose of the present study was to test the hypothesis that a rehearsal recall strategy of repeating the word list more than once would result in improved scores of recall on the RAVLT. We report on differences in outcome after standard administration and after experimental administration on Immediate and Delayed Recall measures from the RAVLT of 50 patients. The experimental administration resulted in significantly improved scores for all the variables employed. Additionally, it was found that patients who failed effort screening showed significantly poorer improvement on Delayed Recall compared with those who passed the effort screening. The general clear improvement both in raw scores and T-scores demonstrates that recall performance can be significantly influenced by the strategy of the patient or by small variations in instructions by the examiner. Key words: memory assessmentRAVLTrecallrehearsal

Erik Hessen

Rehearsal Significantly Improves Immediate and Delayed Recall on the Rey Auditory Verbal Learning Test

排练显著提高雷伊听觉言语学习测试的即时和延迟回忆

In an effort to identify four-subtest Wechsler Adult Intelligence Scale-Third Edition (WAIS-III) short forms valid for estimating Full-Scale IQ (FSIQ) among individuals with traumatic brain injury (TBI), seven tetrad versions of the WAIS-III were evaluated in a convenience sample of patients referred for neuropsychological assessment (n = 176). Estimated FSIQ scores were compared to actual FSIQ scores via correlation analyses, repeated-measures analyses of variance (ANOVAs), and frequency analyses. All short form-estimated FSIQ scores correlated highly with actual scores (all rs > .91, ps < .001). Repeated-measures ANOVAs identified no significant differences between actual and short form-estimated FSIQ scores for two of the seven short forms. These same two short forms had the highest percentage of scores within ±5 points of actual FSIQ scores (75.6% and 71.6%). Thus, two tetrad versions were consistently superior to others in accuracy of estimating FSIQ; these may be helpful when time constraints or other issues necessitate use of an abbreviated battery for estimating FSIQ among individuals with TBI.

Stephanie A. Reid-Arndt

Brittany J. Allen

Laura Schopp

Validation of WAIS-III Four-Subtest Short Forms in Patients with Traumatic Brain Injury

创伤性脑损伤患者中WAIS-III四子测验简表的验证

The Clock-Drawing Test (CDT) is widely used in clinical practice for the screening of dementia. However, neural activity during real clock drawing has not been investigated due to motion artifacts. In the present study, we examined brain activity during real clock drawing using multichannel near-infrared spectroscopy (NIRS). We measured hemoglobin concentration changes in the prefrontal and temporal surface areas during clock drawing using 52-channel NIRS. Data obtained from 37 right-handed healthy volunteers were analyzed. We found significant increases in oxy-Hb in more than 96.2% of the channels (false-discovery rate corrected, p < .025). The time required for CDT performance showed a negative correlation with changes in oxy-Hb in the prefrontal region (r = -.529, p = .002). The mean value for oxy-Hb changes was higher in the left hemisphere in 20 subjects (54%) and in the right hemisphere in 17 subjects (46%). The NIRS/CDT combination is acceptable as a clinical tool, as the method has the advantages of direct measurement of cortical activation with high temporal resolution. Our results confirm the aspects of the CDT involving the frontal-lobe battery.

Masaru Shoyama

Tomoko Nishioka

Masatoshi Okumura

Asami Kose

Tomikimi Tsuji

Satoshi Ukai

Kazuhiro Shinosaki

Brain Activity During the Clock-Drawing Test: Multichannel Near-Infrared Spectroscopy Study

时钟绘制测试期间的脑活动：多通道近红外光谱研究

The aim of this study was to track the evolution of cognitive decline in Parkinson's disease (PD) patients 1 year after baseline testing. Thirty-three PD patients, divided according to three previously determined subgroups based on their initial cognitive performance, and a healthy comparison group were reassessed after a 1-year interval. Participants were assessed in the following five domains: Executive Function, Problem Solving, Working Memory/Attention, Memory, and Visuospatial Ability. The PD groups differed on the domains of Executive Function, Problem Solving, and Working Memory, with the most severe deficits being evident for the group that had previously shown the greatest level of impairment. Increased cognitive problems were also associated with decreased functioning in activities of daily living. The most severely impaired group had evidence of global cognitive decline, possibly reflecting a stage of preclinical dementia.

Audrey McKinlay

Randolph C. Grace

Characteristic of Cognitive Decline in Parkinson's Disease: A 1-Year Follow-Up

帕金森病认知功能下降的特征：一项为期1年的随访研究

The current investigation sought to replicate and extend the findings of Green (in press Green , P. , Flaro , F. , Brockhaus , R. , & Montijo , J. ( in press ). Performance on the WMT, MSVT, & NV-MSVT in children with developmental disabilities and in adults with mild traumatic brain injury . In C. R. Reynolds & A. Horton (Eds.), Detection of malingering during head injury litigation () , 2nd ed. . New York , NY : Plenum Press . [Google Scholar]), which demonstrated superior sensitivity of the Nonverbal Medical Symptom Validity Test (NV-MSVT) relative to the Test of Memory Malingering (TOMM) in the detection of suboptimal effort during neuropsychological assessment. Nearly twice as many examinees failed the NV-MSVT than the TOMM. Profile analyses of the NV-MSVT demonstrated patterns suggestive of inconsistent effort in those who failed the NV-MSVT but passed the TOMM. A classification analysis employing the Word Memory Test and Medical Symptom Validity Test as external criteria for poor effort showed that the NV-MSVT is substantially more sensitive to poor effort than the TOMM and maintains an acceptable false-positive rate. Overall, results closely matched those of the Green (in press Green , P. , Flaro , F. , Brockhaus , R. , & Montijo , J. ( in press ). Performance on the WMT, MSVT, & NV-MSVT in children with developmental disabilities and in adults with mild traumatic brain injury . In C. R. Reynolds & A. Horton (Eds.), Detection of malingering during head injury litigation () , 2nd ed. . New York , NY : Plenum Press . [Google Scholar]) study and extend the evidence that the NV-MSVT possesses better sensitivity to poor effort than the TOMM.

Patrick Armistead-Jehle

Roger O. Gervais

Sensitivity of the Test of Memory Malingering and the Nonverbal Medical Symptom Validity Test: A Replication Study

《记忆伪装测试和非言语医学症状效度测试的敏感性：一项重复研究》

Publication Information	Publisher: Taylor and Francis Inc.，Publishing cycle: Quarterly，Journal Type: journal，Open Access Journals: No
Basic data	Year of publication: 1994，Proportion of original research papers: 0.00%，Self Citation Rate:N.A.， Gold OA Rate: 0.00%
Average review cycle	网友分享经验：>12周，或约稿
Average recruitment ratio	网友分享经验：容易

Applied Neuropsychology

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