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Correlation of Wisconsin Card Sorting Test performance with eye tracking in schizophrenia.

The authors studied the relationship between performance on the Wisconsin Card Sorting Test and on the Trailmaking-B test and measures of smooth pursuit eye movements in 12 patients with chronic schizophrenia and 12 normal volunteers. They found that performance on the Wisconsin Card Sorting Test was significantly correlated with measures of smooth pursuit eye movements in schizophrenic patients but not in normal subjects. Trailmaking-B scores, however, were unrelated to smooth pursuit eye movements in either group.

Adult↗

Neuropsychological predictors of adaptive kitchen behavior in geriatric psychiatry inpatients.

This study examined the degree to which demographic variables, psychiatric diagnosis, depression rating, and neuropsychological test performance predict adaptive kitchen behavior in geriatric psychiatry patients and normal elderly volunteers. Amixed group of 27 participants including 8 normal volunteers and 19 geriatric psychiatry inpatients underwent psychiatric evaluation, neuropsychological testing, and a kitchen skills assessment conducted in a natural setting. Both depression and dementia were prevalent among patients. The kitchen skills assessment was abnormal in 69% of patients, compared to none of the normal volunteers. Estimated premorbid IQs, psychiatric diagnosis, and neuropsychological test scores significantly predicted the pass/fail status on the kitchen skills assessment, but there was no effect for age, education, gender, or depression. The discriminant function analysis classified 92% of cases, and the canonical correlation coefficient was .84. Of the neuropsychological tests employed in the study, two tests involving visuospatial processing and attention were retained in the discriminant function analysis. The results are consistent with previous studies that suggest that visuospatial tasks are more predictive of instrumental activities of daily living than are cognitive tasks emphasizing verbal and memory abilities. In addition, we conclude that neuropsychological test data are useful and valid for the purpose of guiding clinical judgments regarding activities of daily living in geriatric psychiatry patients.

Activities of Daily Living↗

Neuropsychological impairment among intravenous drug users in pre-AIDS stages of HIV infection.

While much of the current literature concurs that neuropsychological decline does not occur among gay men in the early stages of HIV infection, there is no comparable body of evidence with regard to seropositive intravenous drug users (IVDU). In this study, 45 seropositive (CDC groups 2, 3, and 4a) IVDU in recovery and 55 seronegative IVDU in recovery were given a complete battery of neuropsychological tests measuring attention, language, visual-motor, memory, and conceptual skills. The groups were not significantly different in age, incidence of childhood and adult head injury, types of drugs used, length of use of cocaine, crack, amphetamines and hallucinogens, overdose history, and length of time in recovery. In addition, groups were statistically corrected for education level and length of heroin use. Results indicate that the seropositive participants scored significantly lower on measures of divided attention, visual short-term memory, graphomotor speed and accuracy, auditory language shortterm memory and abstract concept formation. Further analyses revealed that 18% of participants with Persistent Generalized Lymphadenopathy (CDC group III) and 27% of those with constitutional disease (CDC group IVa) were neuropsychologically impaired, as their performance was two standard deviations or more below the normative mean on two or more measures. These results are similar to the reported performance of gay men with full-blown AIDS in a number of studies. It is hypothesized that because of premorbid neurological insult, the toxic effects of drug abuse on brain tissue, and the immunosuppressive effects of the drugs, subcortical brain cells of IVDU are more vulnerable to the invasion of HIV, and neurological deterioration may occur at earlier stages of HIV Spectrum Disease in IVDU than in gay men.

Adolescent↗

Neuropsychological evaluation of patients with inoperable non-small cell lung cancer treated with combination chemotherapy or radiotherapy.

Neuropsychological tests were used to evaluate possible central nervous system dysfunction in patients treated with chemotherapy. Ninety-five patients with non-small cell lung cancer limited disease were randomized to either radiotherapy (2.8 Gy x 15) or combination chemotherapy with cisplatin and etoposide. In order to evaluate cognitive functions three neuropsychological tests were applied: Trail Making, Benton Visual Retention Test and Verbal Learning. Changes in the patients' test scores before and after treatment were compared. The chemotherapy patients showed reduced performance on some of the neuropsychological tests compared to the radiotherapy group. This indicates a treatment related effect on the central nervous system, possibly caused by the combination chemotherapy.

Adult↗

Dose-related cognitive deficits among floor layers with previous heavy exposure to solvents.

The authors used tests of attention and memory, which are sensitive to the influence of aging, to explore possible adverse effects on cognitive functioning following past heavy exposure to solvent-based glues, with special reference to dose-effect relationships and interactions with the aging process. The study included 41 floor layers and 40 carpenters (referents) who participated in a longitudinal follow-up assessment. The authors assessed cognitive functioning with the following tests: trail-making, color words, and word recall. Higher cumulative exposure was associated with poorer test performance that was related to concept shifting, episodic memory, and speed of congruent and incongruent color naming. The magnitude of the decrements in memory tasks was equivalent to about 20 yr of age-related decline. Dose-effect relationships were seen mainly for contact adhesives, and there was partial evidence for an interaction between exposure and aging.

Adult↗

Effects of visual acuity and visual motor speed and dexterity on cognitive test performance.

This study examined the hypothesis that near visual acuity and visual motor speed and dexterity contribute significantly to performance on cognitive tests that place a premium on these functions. Near visual acuity for both eyes, Finger Tapping Test - average taps with dominant hand, and Grooved Pegboard Test - dominant hand time, served as the independent variables. The dependent variables were Trail Making Test-Part B and the Performance subtests of the Wechsler Adult Intelligence Scale. Results indicated that while visual acuity was significantly correlated with all six test variables, it did not contribute to the regression model as well as Pegboard time or Tapping speed. Pegboard time and Tapping speed contributed to the regression model, but in different ways depending upon which test was examined.

Journal Article↗

Neuropsychological differences between young and old schizophrenics with and without associated neurological dysfunction.

Age differences among 134 schizophrenics with associated neurological dysfunction, 160 schizophrenics without such dysfunction, 285 nonschizophrenics with neurological dysfunction and 240 patient controls on the Halstead-Reitan neuropsychological Test Battery (HRB) were examined by splitting subjects at their median ages and performing two way analyses of variance for each HRB component test with diagnosis and age category as the independent variables. In the case of the schizophrenics with neurological dysfunction, significant interactions were found for several subtests of the Wechsler Adult Intelligence Scale (WAIS), and for the Speech Perception, Trail Making and Aphasia Screening Test. In the case of the neurologically intact subgroup, significant interactions were only found for the WAIS Comprehension subtest and Part B of the Trail Making Test. Only WAIS Comprehension produced a significant interaction in the nonschizophrenic group with neurological dysfunction. It was concluded that age differences in neurologically intact schizophrenics were generally comparable to those found in the controls, but that was less the case for the neurologically impaired schizophrenics. Furthermore, this pattern of findings is unlikely to be based upon the presence of associated neurological dysfunction alone, but probably reflects the particularly detrimental effect of compounding schizophrenia with neurological dysfunction.

Adult↗

Attention deficit hyperactivity disorder and the frontal lobe syndrome.

The usefulness of frontal lobe (FL) dysfunction as a conceptual model for Attention Deficit Hyperactivity Disorder (ADHD) was investigated. Twenty-four ADHD and 24 normal control (NC) children were tested using two batteries of tasks. The first was sensitive to FL deficits in motor control and problem solving skills. The second consisted of memory tasks sensitive to temporal lobe dysfunction. ADHD children differed significantly from NCs on measures of FL function, but not on tests of temporal lobe functions. Where norms were available for normal children on the same FL tests, ADHDs performed like 6- to 7-year-olds, despite their mean age of 10 years and minimum age of 8 years. The differential performance of ADHDs on tasks sensitive to FL and temporal lobe dysfunction supports the hypothesis that ADHD deficits are analogous to FL dysfunction and demonstrates that the children's deficits do not reflect generalized cognitive impairment.

Attention Deficit Disorder with Hyperactivity↗

Definite malingered neurocognitive dysfunction in moderate/severe traumatic brain injury.

There has been disagreement in the literature about whether persons with documented neuropathology can be diagnosed as malingering. To address this question, we present three moderate severe traumatic brain injury patients who were evaluated in the context of litigation who met the Slick, Sherman, and Iverson (1999) criteria for a diagnosis of "Definite Malingered Neurocognitive Dysfunction." Each performed significantly below-chance on at least one forced-choice symptom validity test, thereby demonstrating a deliberate attempt to appear impaired. These cases represent the first definitive evidence of an intentional effort to appear impaired in the context of documented moderate/severe traumatic brain injury.

Adult↗

Neuropsychological function in asymptomatic HIV-1 infection: methodological issues.

There have been conflicting reports as to whether significant neuropsychological deterioration occurs in asymptomatic HIV-1 infection. Comparisons among studies have been hindered by substantial variations in sample size, statistical methods, definitions of neuropsychological abnormality, and attention to potential confounding factors. In this study, the neuropsychological performance of 44 subjects with asymptomatic HIV-1 infection and 41 seronegative (SN) controls was compared using analysis of variance models. Rates of abnormality were also determined using commonly employed impairment criteria. The seropositive (SP) subjects performed comparably to SN controls once differences in full scale IQ were taken into account. Rates of abnormality for HIV-1 SP subjects were estimated at 10%, 17.5%, and 67.5% by three different criteria, and were not significantly different from the rates of the control group. The findings indicated that both premorbid characteristics, and the validity and biases of definitions of impairment should be examined and incorporated into the interpretation of study findings.

Adult↗

The effects of normal ageing on neuropsychological functioning following traumatic brain injury.

Increasing age is associated with greater absolute neuropsychological impairment (e.g. slower processing speed, diminished memory), although it is unclear if older individuals with traumatic brain injury (TBI) show greater relative impairment than younger individuals with TBI. The current study evaluated the effects of normal ageing on TBI by using age-based normative data to calculate indices of relative decline from pre-morbid levels (expressed as z-deficit scores) for different age groups (20-39 years, 40-59 years, 60+ years). The sample included 279 individuals with TBI between the ages of 20 and 65 who were assessed in a department of rehabilitation neuropsychology laboratory over a 4-year period. Spearman correlations and ANOVAs did not show age-related differences in relative memory, attention or speed of processing abilities, although results did indicate that increasing age is associated with relatively less impairment in intelligence. The results suggest that the greater neuropsychological impairment noted in older individuals with TBI is most likely related to normal ageing. The importance of considering both absolute and relative degrees of impairment is discussed.

Achievement↗

Learning deficits in adolescents with anorexia nervosa.

Learning ability was examined in a group of female adolescents hospitalized with anorexia nervosa, and in groups of demographically similar depressed inpatients, diabetic outpatients, and healthy normal subjects. Results showed that the group of anorectic females was significantly impaired on a difficult symbol-digit paired-associate learning test, but did not differ from control subjects on measures of attention, immediate or delayed visual memory, and psychomotor ability. Whereas performance on the Symbol-Digit Learning Test was found to be independent of acute weight loss at the time of testing, a significant relationship was obtained between learning ability and duration of illness.

Adolescent↗

Withdrawal of phenobarbital and carbamazepine in epileptic patients: a preliminary neuropsychological report.

We systematically investigated the neuropsychological effects of controlled withdrawal of antiepileptic therapy with a battery of tests exploring intelligence, vigilance, attention, memory and sensori-motor performance. 16 patients without seizures for at least 2 years, 9 on therapy with phenobarbital (PB) and 7 with carbamazepine (CBZ), were examined 4 times over a period of 21 months. No significant correlation was found between drug levels and performance in the tests. The slight differences found between the PB and CBZ groups at full doses disappeared completely one year after withdrawal.

Adolescent↗

Depression and neuropsychological performance in asymptomatic HIV infection.

OBJECTIVE: The authors examined the effect of depression on neuropsychological performance in HIV-infected men. Previous studies have suggested that depression may account for the neuropsychological abnormalities observed in some patients with HIV infection, but few studies have specifically examined this question. METHOD: An extensive neuropsychological test battery was administered to 121 HIV-seropositive asymptomatic men and 42 HIV-seronegative comparison subjects. The seropositive subjects were grouped into depressed and non-depressed groups on the basis of scores on the Beck Depression Inventory, Hamilton Rating Scale for Depression, and Structured Clinical Interview for DSM-III-R. RESULTS: Statistical comparisons revealed very few measures on which the depressed seropositive subjects scored significantly worse than either of the nondepressed comparison groups. The nondepressed seropositive group differed consistently from the seronegative comparison subjects on measures of verbal memory and dexterity. CONCLUSIONS: These data indicate that the subtle neuropsychological abnormalities observed in some asymptomatic HIV-seropositive subjects cannot be attributed to depression. These data also indicate the advantages of a multifaceted approach to assessment of depression.

Adult↗