Performance on the Neurobehavioral Evaluation System (NES) has been demonstrated to be affected by exposure to a variety of neurotoxicants. However, the relation of NES subtests to CNS function has not yet been documented in patients diagnosed with neurologic disorders known to implicate specific brain substrates. A validation study of the NES2 was carried out in patients with multiple sclerosis (MS) and Parkinson's disease (PD), disorders exhibiting neuropathology at loci (white matter in MS, basal ganglia in PD) believed to be the sites of action of several known neurotoxicants. The results indicated that performance on certain NES2 subtests was affected in expected ways in both types of patients. However, performance on many more subtests was impaired, relative to controls, in MS than in PD. The relative insensitivity to PD suggests that expansion and refinement of the battery are required if it is to serve well in detecting the effects of toxicants in subjects without frank physical symptoms. These are the goals of a new version of the instrument currently under development (NES3).

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A comparison of NES2 and traditional neuropsychological tests in a neurologic patient sample.

The Neurobehavioral Evaluation System (NES), a computer-assisted battery of behavioral tests, has been widely used to detect central nervous system dysfunction in occupational and environmental settings and has recently been adapted for testing of neurological patients. The purpose of the present study was to assess the relationship between NES tasks and the traditional neuropsychological tests from which many of the NES tests were developed. For this purpose, comparisons were made between scores on NES tests and traditional neuropsychological tests designed to measure functioning in the same cognitive domains in a sample of patients with idiopathic Parkinson's disease (PD). As has been found in prior studies with normal subjects, correlations between traditional and NES2 tests varied from low to moderate. Correlations tended to be low when the modality of stimulus presentation or responses was different in the NES tests from the traditional tasks (e.g., verbal rather than visual) or when divergent and highly specific cognitive functions were being measured by the tests.

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The archetype of death and renewal in "I never promised you a rose garden".

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