Cognitive and motor improvement after retesting in normal-pressure hydrocephalus: a real change or merely a learning effect?

2010 ◽  
Vol 112 (2) ◽  
pp. 399-409 ◽  
Author(s):  
Elisabeth Solana ◽  
Maria Antonia Poca ◽  
Juan Sahuquillo ◽  
Bessy Benejam ◽  
Carme Junqué ◽  
...  
Keyword(s):  
Neuropsychological Tests ◽  
Motor Performance ◽  
Learning Effect ◽  
Performance Test ◽  
Walking Speed ◽  
Normal Pressure ◽  
Trail Making Test ◽  
Real Change ◽  
Trail Making ◽  
Motor Tests

Object The test-retest method is commonly used in the management of patients with normal-pressure hydrocephalus (NPH). One of the most widely used techniques in the diagnosis of this condition is evaluation of the patient's response to CSF evacuation by lumbar puncture (a so-called tap test or spinal tap). However, interpretation of improved results in subsequent evaluations is controversial because higher scores could reflect a real change in specific abilities or could be simply the result of a learning effect. Methods To determine the effect of testing-retesting in patients with NPH, the authors analyzed changes documented on 5 neuropsychological tests (the Toulouse-Pieron, Trail Making Test A, Grooved Pegboard, Word Fluency, and Bingley Memory tests) and several motor ability scales (motor performance test, length of step, and walking speed tests) in a series of 32 patients with NPH who underwent the same battery on 4 consecutive days. The same tests were also applied in 30 healthy volunteers. In both groups, the authors used the generalized least-squares regression method with random effects to test for learning effects. To evaluate possible differences in response depending on the degree of cognitive impairment at baseline, the results were adjusted by using the Mini-Mental State Examination scores of patients and controls when these scores were significant in the model. Results In patients with NPH there were no statistically significant differences in any of the neuropsychological or motor tests performed over the 4 consecutive days, except in the results of the Toulouse-Pieron test, which were significantly improved on Day 3. In contrast, healthy volunteers had statistically significant improvement in the results of the Toulouse-Pieron test, Trail Making Test A, and Grooved Pegboard test but not in the remaining neuropsychological tests. Patients in the healthy volunteer group also exhibited statistically significant improvement in the motor performance test but not in step length or walking speed. Conclusions No learning effect was found in patients with NPH on any of the neuropsychological or motor tests. Clinical improvement after retesting in these patients reflects real changes, and this strategy can therefore be used in both the diagnosis and evaluation of surgical outcomes.

scholarly journals Applicability of the Test of Variables of Attention – T.O.V.A in Brazilian adults

2018 ◽  
Vol 12 (4) ◽  
pp. 394-401 ◽  
Author(s):  
Cláudia M. Memória ◽  
Henrique C.S. Muela ◽  
Natália C. Moraes ◽  
Valéria A. Costa-Hong ◽  
Michel F. Machado ◽  
...  
Keyword(s):  
Performance Test ◽  
Digit Span ◽  
Screening Tests ◽  
Trail Making Test ◽  
Digit Symbol ◽  
Cognitive Screening ◽  
Or Education ◽  
Attentional Processes ◽  
Trail Making ◽  
State Examination

ABSTRACT The functioning of attention is complex, a primordial function in several cognitive processes and of great interest to neuropsychology. The Test of Variables of Attention (T.O.V.A) is a continuous computerized performance test that evaluates some attention components such as response time to a stimulus and errors due to inattention and impulsivity. Objective: 1) To evaluate the applicability of T.O.V.A in Brazilian adults; 2) To analyze the differences in performance between genders, age ranges, and levels of education; 3) To examine the association between T.O.V.A variables and other attention and cognitive screening tests. Methods: The T.O.V.A was applied to 63 healthy adults (24 to 78 years of age) who also underwent the Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Digit Span and Digit Symbol (Wechsler Intelligence Scale for Adults – WAIS-III) and the Trail Making Test. Results: the T.O.V.A was little influenced by age or education, but was influenced by gender. The correlations between some T.O.V.A variables and the Digit Symbol and Trail Making test were weak (r-values between 0.2 and 0.4), but significant (p<0.05). There was no correlation with the Digit Span test. Conclusion: The T.O.V.A showed good applicability and proved adequate for evaluating attentional processes in adults.

scholarly journals Age-Related Differences in Neuropsychological Testing Among High School Athletes

2009 ◽  
Vol 44 (4) ◽  
pp. 405-409 ◽  
Author(s):  
Tamerah N. Hunt ◽  
Michael S. Ferrara
Keyword(s):  
High School ◽  
Test Scores ◽  
Neuropsychological Tests ◽  
Neuropsychological Test ◽  
Trail Making Test ◽  
High School Athletes ◽  
Neuropsychological Test Battery ◽  
9Th Grade ◽  
Trail Making ◽  
Baseline Testing

Abstract Clinicians have questioned the need to obtain annual baseline neuropsychological tests in high school athletes. If no difference among academic grades exists, annual baseline testing may not be necessary.Context: To examine differences at baseline testing on pencil-and-paper neuropsychological tests among grade levels in high school athletes.Objective: Cross-sectional, between-groups design.Design: Schools participating in a Georgia high school athletics association.Setting: High school football players (n  =  198) in the 9th through 12th grades, with a mean age of 15.78 ± 1.16 years.Patients or Other Participants: Participants were divided into 4 groups by grade and were administered a symptom checklist and brief neuropsychological test battery. Grade level served as the independent variable. Symptom and individual test scores within the neuropsychological test battery served as dependent variables.Main Outcome Measure(s): Differences were noted among grades on the Trail Making Test A (F3,194  =  3.23, P  =  .024, η2  =  0.048), Trail Making Test B (F3,194  =  3.93, P  =  .009, η2  =  0.057), Symbol Digit Modalities Test (F3,194  =  4.38, P  =  .005, η2  =  0.064), dominant tap (F3,194  =  3.14, P  =  .026, η2  =  0.046), and nondominant tap (F3,194  =  4.902, P  =  .003, η2  =  0.070). Using the Bonferroni correction (P ≤ .00625), we found differences between the 9th grade and 11th and 12th grades.Results: Baseline neuropsychological test scores in high school athletes improved as a function of age, with differences between the 9th grade and 11th and 12th grades. Because the differences were driven by 9th-grade test scores, baseline testing should be completed, at minimum, upon entrance into 9th and 10th grades; however, annual testing is still recommended until additional research is conducted.Conclusions:

scholarly journals Regression Based Prediction of Minimental State Examination Score Using the Tablet Based Trail Making Test

2020 ◽  
Author(s):  
Kouki Kubo ◽  
Seiji Hama ◽  
Akira Furui ◽  
Tomohiko Mizuguchi ◽  
Akiko Yanagawa ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Neuropsychological Tests ◽  
Mini Mental State Examination ◽  
Stepwise Multiple Regression ◽  
Trail Making Test ◽  
Prediction Ability ◽  
Paper Version ◽  
Trail Making ◽  
State Examination ◽  
Completion Times

Abstract Trail making test (TMT) is one of the most extensively used neuropsychological tests. In this study, we examined the equivalence between the iPad version of TMT part A (iTMT-A) and the paper version of TMT part A (pTMT-A), and predicted the cognitive function with various data extracted from repeated TMT-A. Forty-two patients who performed five repeated TMT-A (1st–3rd: iTMT-A, 4th: pTMT-A, 5th: inverse version of iTMT-A) and Mini-Mental State Examination (MMSE) were included. The Kruskal–Wallis one-way analysis of variance revealed no statistical differences between the completion times of iTMT-A and pTMT-A. Factors contributing to the MMSE prediction were selected by stepwise multiple regression analysis and Bland–Altman plots. Then, the prediction abilities of the three models—multiple linear, partial least squares (PLS), and neural network regression—were compared. When using the completion time, the linear regression model with the 1st–5th results exhibited the highest prediction ability. However, when the move time and dwell time were used, the multiple linear and PLS regression models using the 1st and 2nd iTMT-A data exhibited the highest prediction ability. Compared with pTMT-A, iTMT-A extracted a large amount of data with fewer repetitions, and the prediction accuracy of cognitive function was improved.

Change in Balance and Neuropsychological Measures Post-Lumbar Drain Trial in Patients with Suspected Normal Pressure Hydrocephalus

2021 ◽  
pp. 1-6
Author(s):  
Hannah E. Wadsworth ◽  
Daniel K. Horton ◽  
Kaltra Dhima ◽  
C. Munro Cullum ◽  
Jonathan White ◽  
...  
Keyword(s):  
Normal Pressure Hydrocephalus ◽  
Digit Span ◽  
Verbal Learning ◽  
Normal Pressure ◽  
Berg Balance Scale ◽  
Trail Making Test ◽  
Clinical Change ◽  
Vp Shunt ◽  
Lumbar Drain ◽  
Trail Making

<b><i>Objective:</i></b> Ventriculoperitoneal (VP) shunting is commonly used to treat normal pressure hydrocephalus (NPH). Assessment of cognition and balance pre- and post-lumbar drain (LD) can be used to provide objective metrics which may help determine the potential benefit of VP shunting. The aim of this investigation was to determine which measures identify clinical change as a result of a LD trial and to develop recommendations for standard NPH clinical assessment procedures. <b><i>Methods:</i></b> The Berg Balance Scale (BBS) and a brief battery of commonly used neuropsychological tests pre- and post-LD (MMSE, trail making test, animal fluency, Hopkins Verbal Learning Test – Revised, and digit span) were administered to 86 patients with a diagnosis of NPH. Subjects were divided into groups based on whether or not clinical change was present, and thus, VP shunting was recommended post-LD, and predictors of group membership were examined. <b><i>Results:</i></b> Significant improvements (<i>p</i> &#x3c; 0.05) were seen on the BBS and Trail Making Part B in the VP shunt-recommended group, with no other significant changes over time in either group. Regression analyses found that VP shunt recommendation was accurately predicted for 80% of the sample using the BBS score alone, with accuracy increasing to 85% when Trails B was added. <b><i>Conclusions:</i></b> Scores from the BBS and Trails B were most likely to change in those chosen to undergo VP shunting post-LD. Given that the typical clinical presentation of NPH includes gait disturbance and cognitive impairment, it is recommended that a standard pre-/post-LD evaluation include the BBS and trail making test.

scholarly journals A-195 Emotional Factors in Performance on Halstead-Reitan/Halstead-Russell Neuropsychological Tests

2020 ◽  
Vol 35 (6) ◽  
pp. 990-990
Author(s):  
Gass C ◽  
Patten B
Keyword(s):  
Depressive Symptom ◽  
Neuropsychological Tests ◽  
Primary Care Physicians ◽  
Performance Test ◽  
Brain Disorder ◽  
Emotional Factors ◽  
Middle Range ◽  
Trail Making ◽  
Depressive Symptom Severity ◽  
And Performance

Abstract Objective Evaluate the relation between depression and performance on eight widely used tests: Revised Category Test, Trail Making Test, Part B Tactual Performance Test, TPT Memory, TPT Location, Aphasia Screening Test, Seashore Rhythm Test and Speech Perception Test. Method Participants: 116 women, 71 men referred for comprehensive neuropsychological evaluation in an outpatient memory disorders clinic as part of a broader neurodiagnostic workup for memory complaints and cognitive decline. Referral sources: neurologists (78%), primary care physicians (21%). Patients’ mean age: 59.0 (SD =13.8); education: 14.9 (SD = 2.6) years. They were screened from a larger sample (N = 214) for brain disorder or positive neurodiagnostic findings. All participants satisfied performance and symptom validity criteria. Diagnostically, 62% had mood disorders. Based on Scale D scores, 65 middle-range scorers were excluded and 122 patients were classified into High and Low Depressive Symptom groups (ns = 61). The two groups were no different on age, education, Average Impairment Rating or predicted level of intelligence (Test of Premorbid Function). Results On all eight of the neuropsychological tests, scores were compared across the two groups. There was no main effect (MANOVA) for group, F(8,98) = 1.56, p = .147. Univariate comparisons revealed a trend on TPT Location but no statistically significant effects of depression severity on any of these tests. Conclusion Results suggest that severity of depressive symptoms is unrelated to performance on these neuropsychological tests. In cooperative examinees, these tests are valid for assessing brain-based abilities independent of depressive symptom severity.

Prospective Multicenter Study for Evaluating Cognitive Disorders in Hematology-Oncology: A Pilot Study of 118 Patients

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 1309-1309
Author(s):  
Jean François Rossi ◽  
Laurence Laurier ◽  
Jean-Louis Misset ◽  
Dominique Spaeth ◽  
F. Uwer ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Neuropsychological Tests ◽  
Cognitive Disorders ◽  
Trail Making Test ◽  
Prospective Multicenter Study ◽  
Oral Fluency ◽  
Group 4 ◽  
Trail Making ◽  
Group 5 ◽  
Group 2

Abstract Introduction: Cognitive impairment occurs in a subset of cancer survivors and is generally subtle. Most evidence suggests that chemotherapy may be a cause, although other factors associated with the diagnosis and treatment of cancer may contribute. Recently, recommendations for future research in evaluating cognitive disorders have been suggested though different published studies. Nevertheless, there is a need to standardize this evaluation, particularly for neuropsychological tests. The various domains to be explored include memory disorders, decrease in oral fluency, care and concentration, slowing down of information processing. The main objective of this prospective study was to assess the feasibility for evaluating cognitive disorders with neuropsychological tests in different groups of homogeneous patients. The secondary objectives were to evaluate the cognitive disorders in these groups of patients and the impact of disease and therapeutic strategies with a follow-up period of 48 weeks. Patients and Methods: 124 previously untreated patients were included by 13 centers. 5 subgroups were defined: group 1, breast cancer T1N0 treated by local radiotherapy (n=24); group 2, breast cancer T1–T2, N+ treated by adjuvant chemotherapy and radiotherapy (n=52); group 3, diffuse large B-cell lymphoma treated by chemotherapy plus rituximab (n=8); group 4 colon cancer treated by adjuvant chemotherapy (n=11); group 5, multiple myeloma treated by 4–5 cycles of VAD followed by high dose therapy and autologous transplantation (n=23). Exclusion criteria included previous cognitive disorders or neurological diseases, HIV patients, other cancers, previous vascular disease or head trauma, sleep apnea, brain metastasis, metabolic disorders or neuropsychiatric drug intake. Hetero-evaluation was performed three times by neuropsychologists, at inclusion (pre-therapeutic, except for group 5 where inclusion corresponded to the pre-transplantation period), second evaluation, (24 weeks after 1st visit (V) for groups 1–4 and 12 weeks for group 5), and 3rd evaluation (48 weeks or 24 weeks respectively for groups 1–4 or 5). Intra- and inter-comparisons were made. Neuropsychological tests were performed in similar order and included: Brown Petterson test; Grober and Buschke (16 items) test; Double work; letter, number sequence; D2 test; code test; trail-making test; Stroop test; oral fluency. Statistical analysis included Mantel Haenszel tests. Results : Mean age was 57.14 years (range 31–85), with a sex ratio F:M=5.3. Body mass index and blood pressure were not significantly different between groups. Performance status was different among groups particularly for groups 3–5. Baseline evaluation included other co-morbidities and anxiety/depression status which was slightly abnormal in 7% of the patients. Test feasibility was good for the majority of them but was dependent on the group of patients, particularly for oral fluency test (not performed in 27.3% of patients in group 4). In addition, the percentage of patients who did not have other controls (V 2 and 3) varied from one group to another, but concerned less than 24% of the patients (particularly for groups 3,4 and 5). A significant increase of the number of patients presenting an alteration at V 2 and 3 but normal at V1 was observed, particularly in the trail making test (altered in 26.2% of the patients) and Brown Petterson test altered particularly after 12 months of radiotherapy (37% of patients). The Empan test was improved at visit 3 particularly for group 2. Conclusion: This pilot prospective multicenter study allows to define and validate neuro-psychological tests for evaluating cognitive disorders and estimate the percentage of patients having impaired cognitive functions due to treatment.

Acculturation and Performance of Hispanics on Selected Halstead-Reitan Neuropsychological Tests

Assessment ◽  
1994 ◽  
Vol 1 (3) ◽  
pp. 239-248 ◽  
Author(s):  
Bill R. Arnold ◽  
Gary T. Montgomery ◽  
Irene Castañeda ◽  
Robert Longoria
Keyword(s):  
Neuropsychological Tests ◽  
Mexican American ◽  
Performance Test ◽  
Neuropsychological Test ◽  
Clinical Implications ◽  
Category Test ◽  
Halstead Category Test ◽  
Trail Making ◽  
Anglo American ◽  
And Performance

This study investigated the effect of acculturation on Halstead-Reitan neuropsychological test performances on nonimpaired Hispanics. The sample consisted of three groups of 50 subjects, representing distinct levels of acculturation: (a) Mexican-American, (b) Anglo-American, and (c) Mexican. A significant effect ( p > .05) for acculturation was found on several measures, including the Tactual Performance Test (TPT; Dominant, Nondominant, and Total), the Seashore Rhythm Test, and the Halstead Category Test. Measures not affected by acculturation were TPT Localization and Memory, Finger Tapping, and the Trail Making Test. Recommendations for further research and clinical implications of findings are discussed.

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