Are BPI and BPII suicide attempters distinct neuropsychologically?

It is not clear if bipolar disorder I (BPI) and bipolar disorder II (BPII) represent the same disorder on a continuum of severity or two distinct syndromes. Neuropsychological functioning is a means of understanding similarities and differences between diagnostic groups. OBJECTIVE: To compare the neuropsychological functioning of depressed suicide attempters with BPI or BPII and healthy controls. METHODS: Fifty-one individuals with bipolar disorder (BPI n=32, BPII n=19) and a history of suicide attempt were compared with 58 healthy controls with respect to neuropsychological functioning in the following domains: motor functioning, psychomotor performance, attention, memory, working memory, impulsiveness and language fluency. RESULTS: Participants with BPI and BPII performed significantly more poorly than healthy controls on tests of Digit Symbol Test of psychomotor functioning, the N Back Test of working memory and the Go-No-Go Test of impulsiveness. Participants with BPI were significantly worse than controls but not those with BPII on the Test of Verbal Fluency. Participants with BPII performed significantly worse than either controls or those with BPI on the Simple Reaction Time Motor Test and the Stroop Test of attention. CONCLUSION: While participants with both BPI and BPII performed more poorly than healthy controls, individuals with BPII also performed more poorly than those with BPI on some tests suggesting that they may have a unique syndrome. The findings have implications for assessment and treatment in bipolar disorder.     

Texas Mexican American adult normative studies: Normative data for commonly used clinical neuropsychological measures for English- and Spanish-speakers

This study aimed to provide normative references for Mexican Americans on neuropsychological measures of cognitive functioning. Data were analyzed from a total of 797 Mexican-Americans recruited across three Texas-based studies with approximately one-half of the participants tested in Spanish. Normative tables include: MMSE, AMNART, WMS-III (Logical Memory I, II; Visual Reproduction I, II; Digit Span), CERAD, RAVLT, Exit25, CLOX 1 & 2, Trail Making Test- A&B, BNT, COWA, and Animal Naming. The norms were stratified by education then age. Normative references were generated for Texas-based Mexican Americans and data may be limited to the population sampled.     

Effects of diffuse axonal injury on speed of information processing following severe traumatic brain injury

To test the hypothesis that slowed information processing in traumatic brain injury is related to diffuse axonal injury (DAI), the authors compared 10 patients with predominant DAI (diffuse group) and minimal DAI (mixed injury group) on the Symbol Digit Modalities Test, simple and choice reaction time, Trail Making Tests A and B, and the Stroop Neuropsychological Screening Test. The diffuse group was slower than the mixed injury and control groups on basic speed of processing tasks. This difference was not apparent on complex speeded tasks once basic speed of processing was controlled for. The diffuse group's slower speed of processing was not accounted for by differences in injury severity, age, or time postinjury. The diffuse group showed greater recovery over time.     

Discriminating between simulated malingering and closed head injury on the Wechsler memory scale-revised

We tested the hypothesis that malingering is distinguished by poorer performance on recognition relative to recall tasks by evaluating the ability of discriminant functions to distinguish between 89 subjects simulating malingering and 44 subjects with a history of closed head injury (CHI) on the Wechsler Memory Scale - Revised (WMS-R). Functions with good accuracy in discriminating between simulated malingerers and controls in prior studies did not have adequate specificity when applied to the CHI group. A newly derived discriminant function achieved overall classification accuracy of 79% for the malingering versus CHI groups on cross-validation, with 79% sensitivity (true positives for malingering) and 80% specificity (true negatives for closed head injured). A complex performance pattern on seven WMS-R subtests distinguished malingering subjects from those with CHI, but did not support the recognition versus recall hypothesis. The malingering pattern involved: (a) power performance on two relatively (but inconspicuously) easy tasks dependent on immediate recall (Visual Reproduction I and Visual Memory Span); (b) better performance on two relatively (but inconspicuously) easy tasks dependent on immediate recall (Visual Paired Associates I and Digit Span); (c) poorer performance on two relatively difficult delayed tasks (Logical Memory II and Visual Paired Associates II); and (d) better performance on another difficult task involving delayed recall (Visual Reproduction II).     

Factor analysis of the WMS-R and the WAIS.

A principal components factor analysis of the Wechsler Memory Scale-Revised (WMS-R) and Wechsler Adult Intelligence Scale (WAIS) was performed on 133 patients referred for neuropsychological assessment al a university medical center. Six factors were selected according to the Scree test, percentage of variance extracted, and the meaningfulness of the factors. The factors were labelled as follows: Perceptual Organization, Verbal Comprehension, Attention/Concentration, Complex Verbal Memory, Verbal Paired-Associate Memory, and Visual Paired Associate Memory. The Figurai Memory and Visual Reproduction I & II failed to emerge as a factor separate from the Performance subtests of the WAIS. Two verbal memory factors were found apart from the Verbal subtests of the WAIS.     

Neuropsychological profile of a large kindred with familial Alzheimer's disease caused by the E280A single presenilin-1 mutation.

It was hypothesized that subjective memory complaints represent the earliest sign of dementia in carriers of the presenilin-1 (PS1) mutation. A total of 122 subjects (44 males, 78 females) were included in this study. Forty of them were positive for the mutation in the PS1 gene (mutation positive, MP) whereas 82 showed negative results (mutation negative, MN). Subjects were active, functionally normal, even though some of them complained of memory difficulties. Two groups of neuropsychological instruments were administered: (a) The Consortium to Establish a Registry for Alzheimer's Disease (CERAD) neuropsychological test battery (Morris et al., 1989), and (b) some additional neuropsychological tests (Raven Test, Wechsler Memory Scale, Rey-Osterrieth Complex Figure, Boston Naming Test, Naming of Categories, Boston Diagnostic Aphasia Examination, Memory of Three Phrases, Knopman Test, Digit Symbol, and Visual "A" Cancellation Test). Performance in both groups was quite similar. In a secondary analysis, the MP group was subdivided into two subgroups: without and with memory complaints. When comparing both subgroups, a better performance in the first subgroup was found throughout the different subtests. Statistically significant differences were observed in the following test scores: Mini-Mental State Examination, Naming Test (Low Frequency), Memory of Words Test, Recall of Drawings, Wechsler Memory Scale (Logical Memory, Associative Learning, and Total Score), Rey-Osterrieth Complex Figure (Immediate Recall Condition), Boston Diagnostic Aphasia Examination (Complex Ideational Material Subtest), Memory of Three Phrases Test, Serial Verbal Learning (maximum score and Delayed Recall), Knopman Test (First Trial, Second Trial, and Recall after 5 Minutes), Digit Symbol, and Visual "A" Cancellation Test (Additions). Results supported the hypothesis that memory complaints represent the earliest symptom of familial Alzheimer's disease. In addition to the memory difficulties, other minor cognitive impairments were also found, particularly, mild anomia, concentration difficulties and defects in the understanding of complex verbal material.     

Serial neuropsychological assessment with the National Institute of Mental Health (NIMH) AIDS Abbreviated Neuropsychological Battery.

The effect of repeated administration of the (NIMH) AIDS Abbreviated Neuropsychological Battery was evaluated in a group of "at risk" individuals who served as control subjects in a larger research project. Subjects' performance across five assessment points was evaluated by repeated measures analysis. Statistically significant trends were obtained on the California Verbal Learning Test, the Paced Auditory Serial Addition Task, and the State scale of the State-Trait Anxiety Inventory. No discernable trends were detected on the Vocabulary subtest of the Wechsler Adult Intelligence Scale-Revised, total time or errors on the Visual Search Task, the Hamilton Depression Rating Scale, or the Trait scale of the State-Trait Anxiety Inventory. The implications of these findings in both clinical and research settings are discussed.     

First-Last Names and the Grocery List Selective Reminding Test: two computerized measures of everyday verbal learning.

Data are presented on two computerized tests of everyday verbal learning: Paired associate learning of First-Last Names (FLN), and the Grocery List Selective Reminding Test (GLSRT). MANOVA and multiple regression analyses demonstrated that performance on FLN and GLSRT was most strongly related to age, with significant secondary associations found for gender, with females performing better than males. Additional factor analysis of FLN and GLSRT supported the construct validity of these measures by demonstrating significant associations of performance with traditional newopsychological measures of memory and related functions, including the Paired Associate Learning and Logical Memory subtests from the Wechsler Memory Scale, the Benton Visual Retention Test, and WAIS Digit Symbol.     

Feasibility of the neuropsychological spectrum in prediction of outcome following head injury

This study provided further substantiation of the neuropsychological spectrum conceptualization (Templer, Campodonico, Trent, Spencer, & Hartlage, to appear; Templer, Spencer, & Hartlage, 1993; Templer, Campodonico, Trent, & Spencer, 1991). Two hundred and two traumatic brain injury patients were administered the Wechsler Adult Intelligence Scale-Revised, the Luria-Nebraska Neuropsychological Battery, the Wisconsin Card Sorting Test, the Booklet Category Test, and Trails A and B. The correlations between neuropsychological and intellectual tests were significantly lower than the correlations within intelligence tests and within neuropsychological tests. Neuropsychological tests predicted outcome better than intelligence tests. This was interpreted in terms of outcome for severely brain-damaged patients being more dependent upon basic neuropsychological functioning than on abstract thinking ability. © 1996 John Wiley & Sons, Inc.     

Analysis of “task-positive” and “task-negative” functional networks during the performance of the Symbol Digit Modalities Test in patients at presentation with clinically isolated syndrome suggestive of multiple sclerosis

An abnormal pattern of brain activations has been shown in patients with multiple sclerosis during the performance of several cognitive tasks. The aim of this study is to investigate abnormalities of the patterns of activation/deactivation in the functional networks related to “task-positive” and “task-negative” events during the execution of the Symbol Digit Modalities Test (SDMT) in patients with clinically isolated syndromes (CIS) and preserved cognitive abilities. Eighteen CIS patients within 3 months from their first clinical attack and 15 healthy controls (HC) underwent neuropsychological assessment and performed an adapted functional magnetic resonance imaging (fMRI) version of the SDMT. “Task-positive” responses to task execution and “task-negative” activity of the default mode network were compared between groups. A regression analysis was performed to investigate the correlation between fMRI results and T2 lesion load (T2 LL) and brain atrophy. Neuropsychological performance did not differ between groups. Compared to HC, CIS patients exhibited an enhanced deactivation of the “task-negative” network at the level of the posterior cingulate cortex, whereas no differences between groups were found when the patterns of “task-positive” events were compared. A regression analysis detected a correlation (p < 0.001,r ranging from 0.62 to 0.73) between T2 LL and “task-positive” activations of areas that are part of the attention network, comprising the anterior cingulate gyrus, left prefrontal gyrus and inferior parietal lobe. No correlation was found between patterns of functional modifications and brain atrophy. CIS patients experience an enhanced pattern of brain deactivations during cognitive performances, which might contribute to their normal neuropsychological status.     

Latent structure of the Test of Everyday Attention in a non-clinical Chinese sample.

The validity and clinical viability of Posner and Petersen's (1999) 3-factor model of attention was tested through a confirmatory factor analysis of attentional performance (Test of Everyday Attention [Robertson, I. H., Ward, T., Ridgeway, V., & Nimmo-Smith, I. (1996). The structure of normal human attention: The Test of Everyday Attention. Journal of the International Neuropsychological Society, 2, 525-534]) in a sample of 133 Chinese participants. This study served both as a cross-cultural replication of the clinical implementation of this leading theoretical model of attention, and as a more stringent test of the validity of the hypothesized attentional processes underlying human cognitive control. The results support the validity of a 3-factor model of attention consistent with that proposed by Posner and Petersen (selective attention, sustained attention, and attentional switching/control), and demonstrate that clinical assessment of neuroanatomically-distinct attentional processes using simulated real life activities is possible.     

The Integrated Visual and Auditory Continuous Performance Test as a neuropsychological measure.

The Integrated Visual and Auditory (IVA) Continuous Performance Test (CPT) and Neuropsychological Impairment Scale (NIS) were completed by adults diagnosed with mild traumatic brain injury (mTBI), adults diagnosed with attention deficit hyperactivity disorder (ADHD), and controls. On the IVA CPT, the mTBI and ADHD groups performed significantly lower on the full and secondary scales for attention and response accuracy. For individual scales, the mTBI and ADHD groups showed lower performance on measures of reaction time, inattention, impulsivity, and variability of RT. The mTBI and ADHD groups showed similar patterns of performance on the IVA. On the NIS, the mTBI and ADHD groups reported more neuropsychological symptoms than the control group, and the mTBI group reported more neuropsychological symptoms than the ADHD group. The results are discussed in regard to changes in cognitive processing and sustained attention in individuals diagnosed with mTBI and ADHD.     

The intermediate visual and auditory continuous performance test as a neuropsychological measure.

The Intermediate Visual and Auditory (IVA) Continuous Performance Test (CPT) and Neuropsychological Impairment Scale (NIS) were completed with adults diagnosed with mild traumatic brain injury (mTBI), adults diagnosed with Attention Deficit Hyperactivity Disorder (ADHD), and controls. On the IVACPT, the mTBI and ADHD groups performed significantly lower on the full and secondary scales for attention and response accuracy. For individual scales, the mTBI and ADHD groups showed lower performance on measures of reaction time, inattention, impulsivity, and variability of RT. The mTBI and ADHD groups showed similar patterns of performance on the IVA. On the NIS, the mTBI and ADHD groups reported more neuropsychological symptoms than the control group and the mTBI group reported more neuropsychological symptoms than the ADHD group. The results are discussed in regard to changes in cognitive processing and sustained attention in individuals diagnosed with mTBI and ADHD.     

Application of Choynowski's Memory Scale in assessment of patients with dementia

Introduction

Neuropsychological assessment of patients with dementia necessitates the use of varied memory tasks designed to measure different memory processes, including information memorization, retention and retrieval. A valid memory battery should be demonstrated to discriminate between demented and non-demented subjects and its scores should be related to the degree of intellectual impairment. The objective of this study was to evaluate the potential usefulness of Choynowski''s Memory Scale in assessment of patients with dementia.

Material and methods

Thirty-two patients with dementia and 64 age- and gender- matched healthy controls took part in the study. All participants were examined by means of Choynowski''s Memory Scale, and the patients were additionally assessed by the Mini Mental State Examination and Clock Drawing Test (CDT).

Results

All subtests of Choynowski''s Memory Scale were found to highly significantly (p ≤ 0.001) discriminate between patients with dementia and healthy controls. Except for Digit Span, all other subtests of Choynowski''s battery were highly correlated with the global mental status as assessed by MMSE with correlation coefficients ranging from 0.59 to 0.81. Most subtests of Choynowski''s Memory Scale were also moderately or highly correlated with performance on the CDT, and the correlations coefficients between the total score on Memory Scale and the CDT were r = 0.66 and r = 0.61 (p ≤ 0.001) for the free recall drawing and copying, respectively.

Conclusions

Choynowski''s Memory Scale showed high discriminative properties and strong associations with the degree of intellectual impairment in dementia. The results encourage the use of this battery in clinical settings.     

Association of angiotensin-converting enzyme functional gene I/D polymorphism with amnestic mild cognitive impairment

The relationship between angiotensin-converting enzyme (ACE) gene insertion/deletion (I/D) polymorphism and serum ACE activity, as well as amnestic mild cognitive impairment (aMCI), was investigated. The study recruited 90 aMCI patients and 90 matched healthy controls. All subjects underwent an extensive assessment of cognitive function. The ACE gene I/D genotype was determined by polymerase chain reaction. Serum ACE activity was measured using a spectrophotometric technique. The scores obtained by the aMCI patients on the neuropsychological tests were significantly lower than those of the control subjects (all p < 0.01). The genotype (χ² = 11.510) and allele (χ² = 6.945) frequencies of the ACE gene were significantly different between the aMCI and the control groups (all p < 0.01). The DD genotype (23%) and D-allele (57%) frequencies in the aMCI patients were higher than those in the controls (16% vs. 43%). ACE genotype was correlated with delayed recall in Auditory Verbal Memory Test, delayed recall in Complex Figure Test, Category Fluency Test, and Symbol Digit Modalities Test in all subjects, in which the carriers of the DD and DI genotypes obtained lower scores than those of the II genotype (p < 0.05). A significant difference in the serum ACE level was observed among the three genotypes (DD > DI > II) in both the aMCI and the control groups (all p < 0.01). D-allele may be a genetic risk factor for the development of aMCI to Alzheimer's disease. A high serum ACE level possibly plays an important role in the incidence of aMCI.     

The relationship between intellectual ability and adult performance on the Trail Making Test and the Symbol Digit Modalities Test.

Subjects between the ages of 18 and 30 were divided in groups based on their Satz-Mogel Wechsler Adult Intelligence Scale-Revised Full Scale IQs: (a) Borderline (70 to 79); (b) Low Average (80 to 89); (c) Average (90 to 109); (d) High Average (110 to 119); (e) Superior (120 to 129). Each subject was administered the Trail Making Test (Forms A and B) and the written version of the Symbol Digit Modalities Test. A significant effect for IQ emerged. The low ability subjects were, in the main, significantly different from the higher ability subjects. No gender differences were found.     

Verbal vs. visual categories on the Wechsler memory scale - revised: How meaningful a distinction?

This study investigated whether the a priori classification of Wechsler Memory Scale-Revised (WMS-R) subtests into separate Verbal and Visual categories is warranted. Correlational and hierarchial clustering analyses found that (a) memory test performance correlated significantly with performance on subtests of Form II of the Luria-Nebraska Neuropsychological Battery (LNNB-II) that measure substrates of particular memory processes; and (b) subtests that appeared a priori to involve verbal skills clustered separately from those that appeared to involve nonverbal (visual) skills. However, the WMS-R Visual Paired Associates subtest did not cluster with the nonverbal scales as expected, and the LNNB-II Memory Scale appeared to be predominantly a test of verbal memory. Practical consequences of these findings were discussed.     

The relationship between experimental and neuropsychological measures of memory.

The current investigation sought to provide convergent and divergent validational information on both experimental and neuropsychological measures short versus long-term memory. Forty undergraduates (20 male, 20 female) were administered memory assessments from the Halstead-Reitan Neuropsychological Battery, the Luria-Nebraska Neuropsychological Test Battery, and the experimentally developed Paired Associates (Face-Name Association & Distractor tasks). Results indicated that the experimental measures of memory demonstrated a high degree of convergent and divergent validity. Both the Luria-Nebraska Memory Scale and the Halstead-Reitan correlated to long-term measures of memory. The Luria Memory Scale did not significantly correlate to short-term measures of memory. Selected subtests from the Halstead-Reitan correlated to experimentally-derived measures of short-term memory. Implications of this study are discussed and recommendations for future research is discussed.     

A comparison of the trail making test, symbol digit modalities test, and the Hooper Visual Organization Test in an inpatient substance abuse population.

Ninety inpatients from a substance abuse treatment facility each completed the Symbol Digit Modalities Test, the Trail Making Test and a novel, group-administered form of the Hooper Visual Organization Test. Patients exhibited varying degrees of impairment on all three instruments compared to available norms. The correlations among the tests were all statistically significant. The lowest inter-test correlations were obtained on the Hooper Visual Organization Test. The utility of global neuropsychological screening instruments with inpatient substance abusers' is discussed in light of these findings.     

Factor analysis of the Wechsler Memory Scale and the Warrington Recognition Memory Test.

Subjects were 156 individuals referred, for psychological and neuropsychological evaluation. The Wechsler Memory Scale (WMS) including the 12h delayed condition of Russell's revision and Warrington's Recognition Memory Test (RMT) were administered as part of each evaluation. Using scores from the RMT subtests: (1) Memory for Words and (2) Memory for Faces, and scores from the WMS subtests: (3) Logical Memory, (4) Digit Span, (5) Visual Reproduction, and (6) Associate Learning flow associate pairs only), a principal components factor analysis was carried out with an orthogonal varimax rotation yielding four factors: (1) verbal learning and memory, (2) Figurai memory, (3) Recognition memory, and (4) Attention-Concentration. Results are discussed with respect to the independent, but complementary information provided by the WMS and RMT for measurement of memory functions.