Biomedical subjects
Publications and source records attributed to C J Golden.
Relationships between regional cerebral blood flow (rCBF) and the Luria-Nebraska Neuropsychological Battery (LNNB) were examined utilizing 15 adolescent psychiatric inpatients. Significant correlations were obtained between the gray matter measure on the rCBF and those scales on the LNNB more related to nonverbal function.
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An earlier study by the authors had demonstrated neuropsychological impairment among 66 clinically stable patients suffering from chronic obstructive pulmonary disease (COPD), and had found that the deficits were directly associated with the amount of oxygen available to body tissue. We were able to follow 62 of the patients for three years when retrospective analyses were performed to determine the relationship of the neuropsychological test scores with the patients' three-year survival status. Patients who survived had scored significantly (p less than 0.01) higher on the neuropsychological tests than those who had died. Individual analyses of variance indicated that the significant relationship between the neuropsychological tests and survival status was attributable primarily to the Benton Visual Motor Retention Test and the digit symbol subtest of the Wechsler Adult Intelligence Scale. The latter test had, in the earlier study, shown the strongest relationship with partial pressure of oxygen and with a pulmonary function test. These findings suggest that certain neuropsychological tests may reflect both the progress of COPD and three-year survival probability among the patients.
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The paper examined the relationship between the scales of the Luria Nebraska Neuropsychological Battery and measures of cerebral blood flow in a sample of 51 chronic schizophrenic patients without a history of brain damage. Of 88 correlations between the two sets of data, 22 were significant at the .05 level. The measurement of left anterior gray flow were particularly predictive of LNNB scores, although all correlations were at a moderate level, ranging from -.24 to -.38. The data are consistent with the hypothesis that neuropsychological testing performance in schizophrenics is related to brain function rather than merely reflecting deficits due to anxiety or other psychiatric features which have been hypothesized to invalidate neuropsychological assessment in this population. The data are also consistent with the notion that schizophrenia is more likely associated with left-anterior functioning, and that gray-matter measures in rCBF are effective predictors of neuropsychological performance.
In a recent article, T. V. Akhutina and L. S. Tsvetkova (1983, Brain and Cognition 2, 129-134) presented an analysis of the Luria-Nebraska Neuropsychological Battery. Along with their generally positive review, they raised questions regarding the importance of the qualitative aspects of patients' performance in the interpretation of the battery. We agree with the authors that any interpretation of the battery which does not consider qualitative performance can limit the power and applicability of the battery. The procedures of item analysis and qualitative analysis are discussed as essential to a comprehensive interpretation of the battery. Also discussed are comments on additional scaling for the battery and the development of a standardized qualitative scoring system.
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Previous studies found changes in regional cerebral blood flow (rCBF) patterns related to both age and various cognitive tasks. However, no study has yet demonstrated a relationship between rCBF and performance on the Luria-Nebraska Neuropsychological Battery (LNNB) in an elderly group. Seventy-nine elderly volunteers (56-88 years old), both healthy and demented, underwent the 133xenon inhalation rCBF procedure and were given the LNNB. The decrements in the gray-matter blood flow paralleled decrements in performance on the LNNB. Using partial correlations, a significant proportion of shared variance was observed between gray-matter blood flow and the LNNB scales. However, there was much less of a relationship between white-matter blood flow and performance on the LNNB. This study suggests that even within a restricted age sample rCBF is related in a global way to neuropsychological functioning.
Two new clinical summary scales have been developed for the Luria-Nebraska Neuropsychological Battery. The scales were constructed in a derivation/ crossvalidation design with a sample of 459 mixed brain impaired patients and 135 non-brain impaired persons. Preliminary evidence suggests that the Profile Elevation scale and the Impairment scale are psychometrically viable, produce additional information to what is offered by the current clinical summary scales, and deserve further investigation. Interpretations are suggested for the two new scales and supported by two neurosurgical case examples. The scales are also expected to offer the possibility of quick screening devices.
Rules have been developed to facilitate global interpretive discriminations from the summary profile of the Luria-Nebraska Neuropsychological Battery (LNNB). Two such rules focus on the number of scales above an individual critical level and the range between highest and lowest summary scale t-score. Neither of the criteria have been observed for their relationships with either demographic or treatment variables (e.g., length of hospitalization, type of medication, etc.). The LNNB protocols and demographic and treatment data of 1037 persons were included in this study. The sample included not only brain impaired persons, but also schizophrenic subjects and both medical patients and nonhospitalized normal subjects. A series of analyses indicated that, though the number of scales above critical level and the range may be used in global interpretation of the LNNB profile, the effect of both demographic and treatment variables ought to be taken into account when making an interpretation with an individual patient. More conservative estimates of classification accuracy are reported and several cautions are recommended when applying these decision rules to schizophrenics.
Persons who had been arrested for sexual assault were administered the Luria-Nebraska Neuropsychological Battery and the results compared to a group of normal controls. The sexual assaulters performed significantly worse on 7 of the 14 scales of the battery. The data were then broken down into three groups: (1) those who had forcibly assaulted postpubescent victims, (2) those subjects who had sexually molested a prepubescent child, and (3) normal controls. A discriminant analysis correctly classified 68% of the subjects on the basis of their neuropsychological performance alone.
Measurements of intrahemispheric and bilateral regional cerebral blood flow (CBF) for gray and white matter were compared in 29 schizophrenic patients and 22 normal controls, using the xenon Xe 133 inhalation method. Results showed significantly lower CBF values for all brain regions in the schizophrenic group, and post hoc comparisons showed relatively greater reduced gray-matter CBF values in the anterior areas of the brain. There was also a left-hemisphere frontal loss similar to that reported previously, although it was in the context of a generalized loss in anterior functioning. Interhemispheric comparison within both groups showed no differences between homologous regions for gray matter, and greater white-matter CBF values in the right hemisphere than in the left hemisphere. The findings support a hypothesis of a bilateral anterior deficit in schizophrenia.
Previous studies have shown that large doses of a urinary alkalinizing agent reduced cigarette consumption spontaneously among smokers. After establishing a safe daily dose of an alkalinizing agent, sodium bicarbonate, its effect upon smoking cessation rates among 72 enrollees in a smoking cessation program was studied. In the first study, we determined that sodium bicarbonate (3900 mg per day) significantly increased urinary pH (from 6.0 to 6.7) and lowered titratable acidity. Ascorbic acid (1500 mg per day) had no effect of pH or acidity. In a second study, a group given sodium bicarbonate surpassed a placebo control group (who were given 1500 mg per day ascorbic acid) in total daily cigarette reduction after 5 weeks and in week-to-week smoking reduction. The groups did not, however, differ in the number who achieved total abstinence.
The present study was an attempt to investigate hypotheses about the interrelationship of brain dysfunction and symptoms of schizophrenia using the Brief Psychiatric Rating Scale (BPRS) and a measure of cerebral ventricular size. The ventricular brain ratio (VBR) was correlated with admission and discharge scores on the BPRS in 46 schizophrenic patients. A significant relationship was found between VBR and discharge BPRS scores. In general, the results were partially supportive of relationships found between neuropsychological data and the BPRS in a previous study, but shed little light on the relationships between brain damage and negative and positive symptoms. Limitations of using the BPRS, as well as possible sampling variations, are discussed.
Major depression accompanied by psychosis may be a separate nosological entity from nonpsychotic depression. Investigators have noted behavioral and biochemical differences in psychotic and nonpsychotic patients, as well as differences in response to treatment. A previous study using computed tomography (CT) found enlargement of the lateral cerebral ventricles in patients with manic-depressive illness with psychotic symptoms. The present study examined CT scans of patients with major affective illness that was accompanied by hallucinations, delusions, or both. The ventricles of the depressed group were significantly larger than those of a group of normal controls.
The relationship between scores on the PPVT-R and Luria-Nebraska Neuropsychological Battery for Children was examined utilizing 86 normal children, including 55 females and 31 males from middle-class families. Correlation coefficients were computed between the standard scores obtained on the PPVT-R and the T scores from the summary scales on the Luria-Nebraska. Significant relationships were predicted between the PPVT-R and the Receptive scale on the Luria-Nebraska. Significant but small correlations were found between the PPVT-R and this scale as well as the Intelligence, Visual, Arithmetic, Memory scales on the Luria-Nebraska.
This study validates the use of a shortened version of the booklet form of the Category Test developed by DeFillipis, McCampbell and Rogers (1979). In a sample of 85 subjects the estimated total score (using the Calsyn, O'Leary and Chaney (1980) regression equation) correlated 0.93 with the actual total error score. It was also found that the estimated score could reliably predict who would exceed the cutoff of 51 errors on the entire test with an overall accuracy of 86%. The results support the use of a brief booklet version of the Category Test.
A number of studies have reported effects of age and education on neuropsychological test performance, finding these effects to different degrees on different tasks. The present study examines effects of age and education on Luria-Nebraska Neuropsychological Battery performance. Forty normal, 38 schizophrenic, and 38 nonpsychotic psychiatric subjects and 40 brain-damaged subjects in groups matched for age, education and sex were tested. Performance on each Luria-Nebraska scale was correlated with age and education in each diagnostic group and correlations were also calculated using scores adjusted for the age and education of individual subjects. Normal subjects showed significant education effects on all scales, with age-declines on "fluid" but not on "crystallized" functions. Schizophrenics showed education effects only on "crystallized" academic skills and showed age declines consistently on sensory functions. The brain-damaged and nonpsychotic psychiatric groups generally showed little age or education effect on test performance. The significance of these findings and methodological issues are discussed.