Abstracts Presented at the Twenty-Third Annual Meeting of the International Neuropsychological Society February 8–11, 1995 Seattle, Washington

1995 Journal of the International Neuropsychological Society  
Seattle, Washington WEDNESDAY EVENING, FEBRUARY 8, 1995 Poster Session 1 TIN, TOXIC EXPOSURE, ASSESSMENT, MALINGERING S. RASKIN & C. MATEER. Neuropsychological Aspects of Mild Traumatic Brain Injury. 148 individuals with MTBI were administered a battery' of tests measuring attention, memory, and executive functions. Factor analyses revealed specific aspects of these cognitive processes being measured. The attention measures loaded on factors for auditory' mental control, auditory sustained
more » ... tion, and visual attention. The memory measures loaded on a factor for verbal recall, and one for visual recall. The executive functions measures loaded on a factor for abstract thinking, speeded set-shifting, and planning. These factors arc used to discuss aspects of MTBI and those measures that are likely to be most useful in evaluating these patients. R.C. MARTIN, W.I). GOUVIER, & J. HAVES. The Effects of Gender and Mild Head Injury Within a College Student Population on a Measure of Verbal Learning and Memory. Research has highlighted the need for investigation of potential learning and memory difficulties within college populations having experienced mild head injury (MHI). The present study examined performance on the Rey Auditory Verbal Learning Test in a sample of MHI students, healthy students, and a clinical sample of MHI patients. Significant effects were found for presence of MHI and gender. MHI patients performed worse than either student group on the 1st learning trial indicating relative attentional problems. Analysis of learning trials 2-5 revealed effect for gender with females performing consistently better across trials than males. No significant group or gender effects were found for immediate or delayed recall. However, measures of proactive and retroactive interference demonstrated differential gender and group effects. These findings and their implications for MHI college populations will be discussed. J.R. O'JILE, L.M. RYAN, J. PARKS-LEW, W.I). GOUVIER, B. BETZ, A. GROVES, R.C. COON, & M.L. TRETTER. Psychosocial and Behavioral Factors Associated With Mild Head Injury' in a College Sample. Psychosocial factors affect both the incidence and the outcome of head injury. In the present study, psychosocial and behavioral factors associated with mild head injury were investigated in a college sample. Measures of psychological and emotional functioning (MMPI), post concussion symptoms, risk taking attitudes and behaviors, and driving performance were administered to 66 head injured subjects and 151 controls. Differences were found between groups on MMPI scales (Hy, Hs, Sc, MAC, and ORG) although mean scores for both groups were within normal limits. Analysis of risk taking revealed that head injured subjects engaged in more risk taking behaviors. Post concussion symptoms (PCS) were significantly correlated with Hy, Hs, and ORG scales for both groups, while PCS were significantly correlated with Pt ("worry") for head injured subjects only. J. DYWAN, R. RODEN, & T. MURPHY. Orbllorrontal Symptoms are Predicted by Mild Head Injury Among Normal Adolescents. We asked 199 grade 10 high school students to complete the Brock Adaptive Functioning Questionnaire (BAFQ) along with information about family, health, and school achievement. The BAFQ have been designed to measure 12 areas of function that have been theoretically associated with frontal lobe processes. Students* scores on the 12 scales were submitted to a factor analysis which yielded 2 factors. The first appeared to capture variance usually associated with orbitofrontal processes while the second represented items usually associated with dorsolateral processes. Grade point average was most reliably predicted by the orbitofrontal factor. The best predictor of the orbitofrontal factor was self-reported head injury (incidence = 38%). The constellation of behaviours that made up the orbitofrontal factor were characterized best by high levels of arousal and dyscontrol. We propose that mild head injury may contribute to what we see as normal variation of young adolescent populations. Functional Assessment Following Traumatic Brain Injury: Correlations of the DRS, FIM, and MRI. This study examines the relationship between quantitative magnetic resonance (MR) imaging and functional outcome using the Disability Rating Scale (DRS), Functional Independence Measure (FIM), and Glasgow Coma Scale. Twenty-three subjects with existing FIM scores and MR data were rated in a retrospective fashion using the DRS at hospital admission and discharge. Analysis found inter-correlations between all functional measures, and significant relationships with certain brain structures. The left temporal horn of the lateral ventricle had the most significant correlations with functional measures. These results increase the possibility of accurately predicting functional recovery using ncuroimaging together with rating scales. 121 https://www.cambridge.org/core/terms. https://doi.This study examined the neurobehavioral outcome of moderate to severe head injury as reported by the patients themselves and their significant others, and the consistency between their views, at 6 months post-injury. Our findings revealed that both patients and their significant others reported problems in many areas, although the severity of these neurobehavioral changes was rated as mild. Compared to their significant others' views, patients reported more difficulty in the area of cognitive functioning. There was no difference between patient and significant other ratings in the other areas assessed. Correlational analyses revealed moderate agreement between patient and significant other ratings of cognitive and somatic problems, and less agreement in other areas. Implications of these findings for evaluating head-injury outcome will be discussed. S.M. DOSS. Impaired Self Awareness of Personality Traits in People with Frontal System Dysfunction Due to Traumatic Brain Injury. This study examined the Unawareness Phenomenon in people with frontal system dysfunction due to traumatic brain injury (TBI) by investigating decreased self-awareness of personality traits. Twenty experimental subjects with TBI and their spouses, and 20 matched control subjects and their spouses were asked to complete a sorting task of 60 personality traits and a rating scale instrument, the PCRS. Subjects and their spouses evaluated each other on the two instruments. TBI subjects' were hypothesized to show evidence of less self-awareness than control subjects on the sorting task and 8 targeted questions of the PCRS; and TBI subjects' would show evidence of decreased self-awareness of "Bad Intellectual" and "Bad Social" dependent variables on the sorting task. Evidence of impaired self-awareness of personality traits was found on the sorting task, particularly for the "Bad Intellectual" and "Bad Social" dependent variables. Evidence of impaired self-awareness was also found on 2 PCRS questions with intact awareness on 6 of the PCRS targeted questions. sured by a self-report measure. The results suggest a relationship between impairments of impulse control and propensity for marital violence. B.K. CHRISTENSEN, T.P. ROSS, R.S. KOTASEK, M. ROSEN-THAL, & R.R. HENRY. Factor Structure of the Beck Depression Inventory in a Sample of Persons With Traumatic Brain Injury. The factor structure of the Beck Depression Inventory (BDI) was investigated in a sample of persons with traumatic brain injury (TBI). One hundred and seventy persons receiving comprehensive TBI rehabilitation served as subjects. Principal components analysis, with varimax rotation, produced a 5 factor solution. These factors were labeled: (I) symptoms of major depression, (2) symptoms of TBI, (3) hopelessness/anhedonia, (4) negative self-appraisal, and (5) cognitive distortions. Cumulatively, these 5 factors accounted for 55.6% of the sample variance. The current factor structure is incongruous both with Beck's proposed 3 factor solution, and factor solutions from other populations. These results indicate that the underlying dimensionality of depression in TBI may differ significantly from that of other populations. Clinical and research implications are discussed. J.W. THIGPEN, W. BURNS, J. ELLERY, & R. LEVITT. Discrimination Between Normal Subjects and Patients With Moderate to Severe Closed Head Injury on the Denman Neuropsychology Memory Scale. 40 patients with CHI were found to have an average of 30 points lower mean score on the DNMS full scale memory quotient, verbal memory quotient, and nonverbal memory quotient than did 42 normal subjects. Percentage of correct classifications of subjects into normal and brain damaged groups using the DNMS full scale memory quotient was approximately 80T0 with or without analyses using education or full scale IQ as a covariate. A priori clusters of subtcsts on the DNMS which showed the most accurate classification of subjects into the two groups were those which contained delayed recall tasks. Results were interpreted to provide evidence for the discriminative validity of the DNMS with closed head injury. The present study compared a group of capital offender {N = 32) to incarcerated violent criminals (N = 68) and nonviolent criminals (Af=37) on several neuropsychological measures. These groups were matched on age, education, race, and gender. Multivariate analyses revealed significant differences between the capital offenders group and the violent group on the Category Test, with the former more violent sample committing a higher number of errors. The capital group also was more impaired than the nonviolent group on the Category Test and Trails B. In contrast, group comparisons of performance on WAIS-R Vocabulary and Block Design subtcsts and Rey Complex Figure (Copy and Delay) were not significant. These results suggest that as the degree of violence increases, more significant neurocognitive impairment emerges. Relevance to psycholegal issues as well as implications for future studies are discussed. V. BRUMM, A. ROSENBAUM, & R.A. COHEN. The Neuropsychology of Impulsivity and Martial Violence. This study examined neuropsychological correlates of impulsivity and propensity for violence. Most subjects were court referred marital violence offenders. Subjects were assessed on a number of standard measures of executive and attentional control, as well as specific experimental measures sensitive to impulsivity, including tasks requiring inhibition of responding for specific durations. While batterers were not impaired on most neuropsychological measures, mild impairments of impulse control were noted on certain tasks, as well as below average expressive vocabulary. Severity of neuropsychological dysfunction was also associated with pattern of marital violence and degree of impulsivity as mea- J. VILKKI & S. VIRTANEN. Decreased Past Time and Normal Present Time Judgement After Closed-Head Injury (CHI). Twenty-three subacute CHI patients and 14 controls read randomized digits at a subjective one per second rate during predetermined intervals and estimated the total duration of each interval immediately afterwards. The past time estimates of CHI patients were shorter than those of controls especially on the longest (80 seconds) interval (p < .001). The groups did not differ on the present time estimates, i.e., the numbers of digits read during the intervals. Past time estimates were unrelated to the Mini-Mental State of the Galveston Orientation and Amnesia Test scores in the CHI group. The hypothesis that CHI causes a decrease of prospective past time estimate was confirmed, but contrary to the expectation the underestimation was not secondary to attention or memory deficits. E. VAKIL, R. SHERF, M. HOFFMAN, & M. STERN. Direct and Indirect Measures of Temporal Order and Spatial Location Memory: Control Versus CHI Subjects. In two experiments 40 CHI and 42 control subjects were tested on temporal and spatial memory under intentional and incidental retrieval conditions. A list of words was presented repeatedly (4 times in Exp. 1 and 8 times in Exp. 2) in fixed or varying order in the temporal task and in a fixed or varying spatial position in the spatial task. The number of words recalled, as well as their temporal and spatial judgments, were the direct measure of memory. The effect of consistency of order or location was the indirect measure of memory. Results suggest that the groups significantly differed on the direct but not the indirect measures. This study highlights two major points: 1) intentionality in the retrieval stage determines the effortfulness with which information is processed; 2) the more automatic the task, the better preserved it is following closedhead injury. https://www.cambridge.org/core/terms. https://doi. R.J. RIDDER & M. HISCOCK. Newly Learned Word Associates Generate a Priming Effect in Closed Head Injury Patients With Amnesia. Twenty closcd-head-injured (CHI) patients and 20 normal controls were tested on a primed lexical decision task in which the association between stimulus and target words was either old (semantic condition) or new (episodic condition). Associations between unrelated words were established in the episodic condition via paired-associate learning. The CHI group showed a significant facilitation of lexical decision-making in the episodic condition. This priming effect was comparable to that obtained in the semantic condition and equal to that of the control group. Experiment 2 confirmed that the episodic priming effect is based on the new associations rather than direct priming, i.e., merely having seen the target word during the prior paired-associate learning task. E. SHERMAN, E. STRAUSS, & F. SPELLACY. Neuropsychological Test Correlates of WAIS-R Factor Scores. The VVAIS-R factor scores of 262 head-injured adults were compared to neuropsychological tests assumed to measure similar abilities. Results suggested good construct validity for the first two factors of the threefactor solution of the WAIS-R. The Verbal Comprehension factor was associated with word retrieval and verbal memory; the Perceptual Organization factor with object perception, visual-spatial memory, visual reproduction and visual information processing. Executive functioning, as measured by the Wisconsin Card Sorting Task , was associated with both factors. Memory tests were uncorrclated with the third factor. Freedom From Distractibility (FFD) and its association with executive functioning was inconsistent. Few of the measures of attention (with the exception of Trails A and B and the Stroop Test, measures with a strong visual processing component) correlated with this factor. This fact, along with the minimal variance accounted for the the FFD within the factor solution, cautions the use of the FFD as a unitary and reliable measure of attention in brain-damaged populations. The limitations of the WAIS-R in measuring attention highlights the need for administering more specific neuropsychological measures of attention in the assessment of clinical populations. M.C. WILDE, C. BOAKE, & M. SHERER. A Reevaluation or Memory Deficit Subtypes in Closed Head Injury Using the California Verbal Learning Test. The California Verbal Learning Test (CVLT) protocols of 57 severe CHI subjects were grouped according to the method of Crosson et al. (1989) in order to evaluate the existence of memory deficit subtypes. The distribution of subjects falling into groupings representing impaired and normal performance on the two recognition measures differed significantly from that obtained by Crosson ct al. (1989). As predicted, group comparisons disclosed that the encoding deficit group showed poorer performance on the List A learning trials and displayed a greater number of free and cued recall intrusions. Contrary to prediction, the encoding group did not show a relatively greater recency effect or a greater improvement in recall when given semantic cues and a semantic encoding strategy. The results arc discussed within the context of characterizing memory deficits in CHI using process memory scores. M.C. WILDE, C. BOAKE, & M. SHERER. WAIS-R Broken Configuration Errors in Nonpenetrating Traumatic Brain Injury. Final broken configuration errors on the WAIS-R Block Design subtest were studied in 3 groups of 45 moderate and severe nonpenetrating traumatically brain injured (TBI) patients. The mean percentage of final broken configurations was compared in two groups of patients who had undergone unilateral craniotomy (left and right) and a group with diffuse brain CT scan findings but no history of neurosurgery. The mean percentage of final broken configuration errors on designs with and without clear internal edge features was also compared. Patients with right craniotomies produced more final broken configurations than those with left craniotomies and diffuse injury. The left craniotomy group did not differ significantly from the diffusely injured group. There was a non-significant trend for more broken configuration errors to occur on designs without clear internal edge features. The Utility of the Dementia Version of the California Verbal Learning Test (CVLT-D) in a Traumatic Brain Injury Population. The Dementia Version of the CVLT (CVLT-D), is a 9 word list learning task identical in administration procedure and indices to the 16 word CVLT, and may be an appropriate instrument for impaired patients with diminished processing capacities. However, there are no controlled studies validating the CVLT-D's sensitivity in detecting impairment while fulfilling its purpose of adjusting to the reduced processing levels of more impaired patients. For validation purposes, the CVLT-D performance of twenty patients suffering traumatic brain injury (TBI) of varying severity was compared with twenty age and education matched normal controls. Statistical analysis was organized according to the five factor structure of the CVLT (general verbal learning, response discrimination, learning strategy, proactive effect, and serial position effect). Significant between-groups differences occurred across all five factors covering learning/memory capacity and information processing. It is concluded the CVLT-D is appropriate in its information processing demands with TBI patients without losing its sensitivity to cerebral dysfunction. K.P. REEDER, M. ROSENTHAL, P.A. LICHTENBERG, & D. WOOD. Impact of Age on Functional Outcome Following Traumatic Brain Injury. This multi-center investigation evaluated the effect of age on recovery of functioning as measured by Functional Independence Measure (FIM) and Disability Rating Scale (DRS) scores during acute rehabilitation in the national model systems project. One hundred and sixty-five subjects matched on injury severity, as measured by Glasgow Coma Scale, were divided equally into three age groups with the following ranges: 16-34, 35-49, and 50-86. A Multivariate and four univariate ANOVAs were conducted to test the effect of age on functioning. Results showed age accounted for approximately 6To and 2% of the variance in FIM and DRS scores, respectively. Hence, these data suggest age has little impact on functional status at admission or discharge from rehabilitation programs, despite multiple studies demonstrating increased morbidity and mortality. R. OTTO, C. LEAVELL, J. ROSENBAUM, II. BROADBENT, & II. LEAVELL. Early Rate of Cognitive Recovery and Outcome in Traumatic Brain Injury. This study investigated the relationship between rate of improvement on neuropsychological (NP) measures early in TBI recovery and patient status at six months post-injury as measured by the same NP measures and by independent global ratings of functioning. Thirty-five moderately to severely injured patients were evaluated at three points in their recovery. Early recovery in simple attention showed the strongest relationship with later NP outcome, followed by retention of learned declarative material. Only one NP change score was predictive of later global functional outcome, this again being a measure of simple attention. It may be that early rapid recover)' of attentional functions holds special significance for overall cognitive and functional outcome. W.M. HIGH, JR., C. BOAKE, L.I). LEHMKUHL, C. IVANHOE, S. YABLON, & C.N. NEWTON. Comparison or Ncurobehavioral Outcome Following Gun Shot Wounds and Blunt Trauma in a Rehabilitation Setting. Over a six year period, 489 patients were entered into the TBI Model System National Database; 36 sustained gun shot wounds (GSWs) while 453 sustained blunt trauma (BT). Twenty-one (58fo) of the GSWs and 310 (6S«To) of the blunt trauma group were able to undergo neuropsychological testing before discharge. Subjects underwent neuropsychological testing after obtaining normal scores on the GOAT on two https://www.cambridge.org/core/terms. https://doi. consecutive days. For the patients with neuropsychological testing, the GSW group was significantly younger than the BT group. There were no differences between the groups on educational level. There were no differences between the groups on lowest GCS score, duration of impaired consciousness, or PTA. However, a significantly greater proportion of the GSWs had abnormal pupillary findings compared to persons sustaining BT. Length of stay was also approximately 38^0 longer for the GSW group, but failed to reach statistical significance. Functional Impairment (FAM) was similar on admission to the rehabilitation hospital or service whereas the GSW group was significantly more impaired at discharge. No significant difference was observed on the DRS on admission or discharge although the GSW group tended to be more disabled. On the neuropsychological tests, the GSW group performed significantly more poorly on COWA, digit span backward. Symbol Digits Modalities Test (written), and Block Design. The total score on the NRS was not significantly different for the two groups. However, clinician ratings of conceptual disorganization, disinhibition, guilt feelings, memory deficit, agitation, inaccurate self-appraisal, excitement, and poor planning were worse for the blunt trauma group. performance is associated with older ages of exposure, but not older children may suggest a threshold effect for age of exposure. K. WOODS, J. RUFFER, J. MOLLMAN, K. JUDY, & C. ARM-STRONG. The University of Pennsylvania Longitudinal Project on the Effects of Radiotherapy: Early-and Late-Delayed Effects on Cognition. This is a replication and extension of our previous report on the sensitivity of neuropsychological tests for identifying the effects of radiotherapy (XRT). Subjects included twenty patients (mean age = 35.4) who had undergone biopsy or resection of a low-grade primary brain tumor. Intrasubject, repeat measure analyses at 1.5 months post XRT (12 cases) revealed decrement only in long term memory retrieval, followed by a rebound. One year post baseline (nine cases) there were no decrements in memory, and significant improvement in processing speed occurred. At two years (six cases) improvement continued in central processing speed, though decrement in one measure of long-term memory reemerged. At three years, (four cases) central processing speed continued to improve, and memory scores continued to decline although significance was not reached. A.M. SANDER, W.M. HIGH, & L.D. LEHMKUHL. The Relationship of Blood Alcohol Levels to Neurological/Neuropsj chological Outcome Following Traumatic Brain Injury. The present study investigated the effect of alcohol blood levels at the time of injury upon outcome in patients who had sustained traumatic brain injuries. Subjects were 503 patients tested at 4 different rehabilitation centers which are part of a multi-center study of recovery from traumatic brain injury. The outcome measures used included length of time taken to follow commands, duration of posttraumatic amnesia, scores on a neuropsychological test battery, and scores on the Disability Rating Scale (DRS) at both admission and discharge from a rehabilitation hospital. The results revealed that, once the effects of injury severity, age, and education were accounted for, alcohol blood level at the time of injury accounted for a significant proportion of the variance in DRS admission and discharge scores, as well as in scores on a test of verbal learning (Rey Auditory Verbal Learning Test). The effect of blood alcohol levels on the remainder of the outcome variables was not significant. Implications for future research will be discussed. . Anoxia may result in cognitive deficits as well as neuropathological changes. We have recently seen a case of a patient who suffered a severe anoxic episode, who has made a remarkable recovery. A neuropsychological test battery was administered and quantitative analysis of MRI scans were carried out. W.R. does not exhibit residual cognitive deficits and there are no major morphologic abnormalities despite a severe anoxic injury. There is a slight enlargement of the ventricle to brain ratio which may be an indication of ventricular dilation. The size to the temporal horns are within normal limits, which suggest that there is no hippocampal atrophy. W.R. exhibited normal memory performance and does not appear to have hippocampal morphologic changes which arc commonly associated with anoxia. C. JORDAN, E. SHAPIRO, A. KUNIN, & D. ZELINSKV. The Effects of Lead Overburden on Neuropsychological Performance: A Pilot Study. The relationship between lead level, duration of exposure, age of exposure and neuropsychological performance was studied in 55 children over age 2. Children with higher lead levels had lower Wechsler IQs. Severity of lead burden was also related to attention as demonstrated by poorer performance of high lead children on ratings of attentiveness and on tests dependent on attention (PPVT-R and KABC Magic Windows). Duration of exposure did not correlate with performance. A correlation between age of exposure and IQ in younger children, such that poorer M.-E. MEADOWS & R.W. BUTLER. The Neuropsychological Effects of Cranial Irradiation in Adult Brain Tumor Patients. The cognitive effects of cranial irradiation (CRT) have not been well documented in adult brain tumor survivors. An analysis of patients who had tumors resected prior to neuropsychological testing was conducted. Patients either received CRT (n = 21) or did not receive CRT (n = 13) as part of their treatment. A backward stepwisc regression analysis was conducted using the neuropsychological test scores as the dependent variables and tumor location, time since tumor resection, age, socioeconomic status, type of tumor, and CRT as the independent variables. CRT significantly predicted performance on tests of perceptual interference, learning, and attention. Impairment, however, was not global and group differences were significant only for two conditions of the Stroop. CRT may not be highly detrimental to cognition within the first two years post-irradiation. M. WELSH, G. HUMES, & N. COOKSON. Disk-Transfer Task Intercorrelations: The Tower of Hanoi and the Tower of London. Two disk-transfer tasks. Tower of Hanoi and Tower of London, are presumed to measure executive functions such as planning and working memory. Both have been used as putative assessments of frontal lobe function. In this study, we administered both tasks to 61 normal adult subjects to test the assumption that the two tasks arc measuring the same cognitive processes, despite differences in task structure, administration, and demands (e.g., number of moves required, timed vs. untimed). The results revealed low to moderate significant correlations between performances on the two tasks. The strongest association was between the more complex 4-disk TOH and the TOL (r = .40). Subjects also found the TOL to be an easier task than the TOH. The strength of the intercorrelations suggest that TOL performance explains only 10-16^0 of the variance in TOH performance. Thus, the common assumption that the two tasks are isomorphic must be reevaluated. (N = 160) . The temporal stability (Mean interval = 37.5 days; N = 44) was poor for the TOH (r = .41) and TOL (r = .44), but adequate for the M-PMT (r = .71). The association between these three measures and other executive tests ranged from r= .17 t o r = .50. Principal component analysis of an executive test battery resulted in a three factor solution, with the M-PMT, TOH, WCST and Trails B loading on a "sclf-regulation/planning factor." This study supports the usefulness of the M-PMT, but at present, the TOH and TOL procedures need refinement. T.P. ROSS. The Reliability and Validity of the Tower of Hanoi, Tower of London, and a Modified Portcus Maze Test. The stability and concurrent validity of the Tower of Hanoi (TOH), Tower of London (TOL), and a Modified Portcus Maze Test (M-PMT) was examined in a college sample https://www.cambridge.org/core/terms. https://doi.Working memory (WM) is the on-line processing and manipulation of information to accomplish future problem solving goals. It has been proposed that this cognitive process is mediated by the prefrontal cortex. It also has been assumed that disk-transfer tasks (e.g.. Tower of Hanoi & Tower of London) tap working memory skills. This assumption was tested in a study of 61 normal adults who were administered the following measures: Tower of Hanoi, Tower of London, Sequential Memory (nonverbal WM), Sentence Span (verbal WM), Wechsler Story Memory (short-and long-term memory). The two disk-transfer tasks significantly correlated at a low to moderate level with the Sequential Memory test, but not with Sentence Span. Surprisingly, the two WM tests did not intercorrelate, and instead Sentence Span correlated with short-and long-term memory. Nonverbal WM explained only 10-16T0 of the variance in disk-transfer performance, suggesting that other cognitive processes are likely involved. fer on some, but not all, of the factors. The Q-Score holds promise as a brief and useful metric for both clinical and research purposes. , 1981) . This study compared four commonly used methods utilizing data from forty consecutive clinic patients. Comparisons (paired t-tests) were made between the following: average of first five trials (method A), average of first five trails within a range of five (method B), average of ten trials (method C), average after dropping the highest and lowest scores out of ten trials (method D). A significant difference was found between method A and all other methods for the dominant hand. No differences were found between any method for the nondominant hand. These results suggest that common scoring procedures may produce dominant hand scores that are inflated in comparison to normative data obtained using a different method. M.C. DOLSKE & R.I. NAUGLE. Scoring Variations of the Finger Oscillation Test (FOT). Administration and scoring of the FOT varies across neuropsychology laboratories (Boll M. BASSO , L. BIELIAUSKAS, & B. ROPER. The PPVT as an Estimator of Premorbid Intelligence In Stroke Patients. Testing the hypothesis that vocabulary is a "hold" ability, the PPVTs efficacy as an estimator of premorbid intelligence in patients with vascular lesions was examined. Patients were categorized by Iatcrality of lesion and by degree of impairment as assessed by the Mini-Mental Status Exam. To evaluate its accuracy, PPVT scores were compared to 1Q estimates based on demographic variables (Barona ct al., 1984). The results show the PPVT IQ is unaffected by left or right hemisphere infarcts. In patients with significant cognitive impairment, the PPVT and Barona IQ scores were equivalent, suggesting the PPVT provides accurate premorbid estimates of intelligence. Since the PPVT had greater efficacy in estimating scores in extreme ranges, the findings also demonstrate an advantage of the PPVT over the Barona. Qualitative Scoring System for the Rcy-Osterrieth Complex Figure: Preliminary Validity Findings. This report provides initial validity evidence for the Boston Qualitative Scoring System for the Rcy-Ostcrricth Complex Figure (BQSS). We determined whether several qualitative aspects of the scoring system (e.g., Planning, Fragmentation, Size, Perseveration, Confabulation, Rotation, Neatness, and Asymmetry) as well as global Presence & Accuracy and Retention scores could differentiate between several patient samples. Results showed that: Copy Planning distinguished patients with right vs left hemisphere seizure focus; Delay Presence & Accuracy, Copy Perscveration, and Immediate Perseveration distinguished TBI patients from normals; and Copy Presence & Accuracy and Copy Pcrscveration distinguished demented from depressed patients. The traditional 36-point scoring system did not distinguish any of the patient groups. These results, along with previously reported reliability findings, indicate that the BQSS is a psychometrically sound, diagnostically sensitive measure of visuoconstructivc ability and visuospatial memory. F.W. BVLSMA, J.II. BOBHOLZ, D. SCHRETLEN, & D.D. COR-REA. A Brief, Reliable Approach (o Coding How Subjects Copy the Rcy-Osterrlclli Complex Figure (CFT). A brief, reliable method of scoring qualitative aspects of CFT copy performance is presentcd. The resulting "Q-Score" is based on whether structural elements arc reproduced using contiguous lines, the order in which structural elements are produced, and completion time. The scale has good internal consistency (Chronbach's Alpha -0.83) and excellent intcrratcr and scorc-rcscorc reliability (rs = .99). Compared to accuracy scores, Q-scorcs discriminate among independent clinician judgments of CFT copy organizational strategy with greater sensitivity. Factor analysis of the scale yielded 5 factors that closely resemble previous a priori groupings of structural elements. Patient groups dif-E.B. McCLURE, N.M. THOMPSON, G.A. ROGENESS, & M.J. BEYER. The Rey Figure: Evidence for Executive Dysfunction in Fragile X Females. We examined the efficacy of the Waber-Homes Rey Osterrieth Complex Figure (ROCF) scoring system in evaluating planning and organizational skill in women with Fragile X Syndrome. Nineteen FraX women (Af= 19) and a matched group of mothers with developmental^ delayed children (N = 20) were evaluated. FraX women, primarily those with full genetic mutations, produced ROCF copies that were significantly more poorly organized than those of the comparison subjects. Whereas the FraX ROCF organization scores were associated with aspects of executive functioning, relationships with spatial and motor skills were found in the comparison group. Results indicate that the Waber-Holmcs ROCF scoring system reflects varied cognitive skills in different populations, and highlight the importance of regarding executive function as a multifaceted construct. tion of a Computerized Neuropsychological Test Baiter}' in Patients With Subcorlical Lesions. The Ncurobchavioral Evaluation System (NES) is a computerized neuropsychological test battery originally designed to identify behavioral changes associated with exposure to neurotoxicants. The present study extended the validation of the NES to subcortical lesions by comparing the performance of a group of patients with idiopathic Parkinson's disease (PD), Multiple Sclerosis (MS), and normal controls. Results identified differences between patient groups and normal controls, contributing the NES* validity. Specifically, PD subjects evidenced motor and visual memory deficits, while motor, attention, visuospatial, and visual memory deficits were observed in the MS patients relative to normal controls. Results also suggested that the NES may be differentially sensitive to specific cognitive changes associated with PD and MS. Thus, it may be useful in the differential diagnosis of subcortical diseases. E.M. FIELSTEIN, M.A. WILLIAMS, J.A. LA MARCIIE, & T.J. BOLL. Use of a 7-Sublcst Short Form of the WAIS-R: Errors of Estimation as a Function of IQ Level and Subtest Scatter. The present study investigated the validity of a 7-subtest short form of the WAIS-R and determined the relative contribution of IQ and subtest scatter in the production of error. Subjects were 240 patients referred for outpatient neuropsychological evaluation. The results showed that despite high validity coefficients, over 20^0 of the sample showed greater than five point discrepancies between estimated and actual Performance IQ. Level of IQ was found to be a significant predictor of error rates. The degree of subtest scatter showed a greater role in explaining error, even when the effects of IQ were partially out. The implication of this https://www.cambridge.org/core/terms. https://doi.A Factor Analytic Study With Stroke Patients. The Neurobehavioral Cognitive Status Examination is composed of 10 psychometrically distinct subscalcs. A previous study with CVA patients identified a single factor solution interpreted to be left hemisphere language/verbal. In this study, principle component factor analysis of the NCSE subscales was conducted on the total sample (N= 127) and on a more refined subset. The first three factor solution was interpreted as left hemisphere language/verbal, ability to function in one's environment, and visuospatial factors. In the second analysis, these first two factors again emerged along with a mixed factor. This failure to maintain a pure visuospatial factor is considered indicative of a deficit in visuospatial tasks on the NCSE. It was noted that the NCSE loads heavily on language and verbal functions limiting its usefulness with language impaired populations. Race and Gender Differences in Cognitive Factors: A Neuropsychological Interpretation. Data by gender and race on the KAIT for ages 11-93 were factor analyzed. The sample of 1,901 adolescents and adults, taken from the KAIT standardization sample, was divided as follows: African-Americans (133 females, 93 males), Hispanics (73 females, 67 males), and Whites (773 females, 762 males). Six principal factor analyses of the 8 KAIT subtests were conducted, two for each race (one for males, one for females). Based on previous research, discrepancies in cognitive performance in brain damaged individuals have been attributed to apparent gender and race differences. Neither Inglis and Lawson's nor McGlone's neuropsychological hypotheses about gender differences in processing information were supported. The race/gender differences found, however, have implications for assessing patients with suspected or known brain damage. Application of the Benton Tests to Hispanic Adults: A Preliminary Analysis. Nine of the tests described by Benton, Sivan, Hamsher, Varney and Spreen (1994) were given to 75 normal Hispanic adults. The distributions of scores w ere compared to those of the standardization samples of Englishspeaking subjects. Median scores were found to be nearly identical in all tests. The relative frequency of defective performances was also found to be equivalent. The influence of gender, age, and education was similar to those reported for the original standardization studies. Overall, the performance of the subjects in the two language communities w ere quite comparable. Additional data on a larger sample of Hispanic subjects are being collected in order to formulate normative standards for clinical application for this population. R.S. SCHEIBEL& C.A. MEYERS. Cognitive Dysfunction Following Surgery for Intracerebral Glioma. The relationship between cognitive function and malignancy, therapy (radiation, chemotherapy), and lesion lateralization was examined in 245 patients following surgery for a glioma. On a neuropsychological battery there was no difference between the high and low malignancy groups, but differences were found for lateralization and therapy. Scores on Digit Symbol were lowest following therapy and were not related to lesion location. In contrast, several other measures did not differ among the therapy groups but were related to lateralization. Left hemisphere lesions were associated with lower scores on verbal tests, while right hemisphere patients had lower scores on the Facial Recognition Test. These findings suggest that neuropsychological tests may be useful for distinguishing betw een the diffuse effects of therapy and the focal effects of the tumor and surgery.
doi:10.1017/s1355617700001843 fatcat:kp53pe6bgfgwtgyncaxpe3vcca