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Methodological Concerns in Traumatic Brain Injury
Published in Mark R. Lovell, Ruben J. Echemendia, Jeffrey T. Barth, Michael W. Collins, Traumatic Brain Injury in Sports, 2020
Stephen N. Macciocchi, Jeffrey T. Barth
In most studies, concussion is inferred from the presence of unconsciousness and/or posttraumatic confusion and typically validated by neuropsychological tests and symptoms. Unfortunately, neuropsychological tests and symptom checklists are prone to instrumentation problems. Consequently, selection and application of dependent measures is a concern in all investigations of concussion. On a positive note, neuropsychological tests are readily available and easily administered, but despite the availability and ease of administration, several problems associated with test application deserve mention. First, neuropsychological tests have variable reliability. Tests used in some studies are clearly more reliable than others (see Table 16.2). False positive or false negative findings can be the result of employing tests with low test-retest reliability. As such, investigators must balance theoretical and practical concerns. For example, the Trail Making Test (TMT) is widely used in clinical settings as well as research investigations of concussive injuries (Collins, Grindall, & Lovell et al., 1999; Macciocchi et al., 1996; Matser et al., 1999), but the TMT is known to have test-retest reliability in the questionable range in some studies (.50 –.60) and documented practice effects in others (Spreen & Strauss, 1998). Consequently, investigators should carefully consider the reliability of all instruments selected for studies.
Structural and Functional Aspects of Brain Damage
Published in Giuseppe Mancia, Guido Grassi, Konstantinos P. Tsioufis, Anna F. Dominiczak, Enrico Agabiti Rosei, Manual of Hypertension of the European Society of Hypertension, 2019
Cristina Sierra, Miguel Camafort, Antonio Coca
Functional and structural abnormalities due to hypertension may be detected in neurologically asymptomatic individuals by computerized tomography (CT), magnetic resonance imaging (MRI), transcranial Doppler (TCD) ultrasound, positron emission tomography (PET) and single-photon emission computed tomography (SPECT) (4). Neuropsychological tests may also provide useful information. However, availability and cost considerations do not allow the widespread use of MRI in the search for asymptomatic structural organ damage in middle-aged and elderly hypertensives. Likewise, availability, cost and radiation hazards are disadvantages of techniques investigating hemodynamic abnormalities (PET, SPECT). TCD could be useful in investigating cerebral hemodynamics in hypertensive individuals, although there are not sufficient longitudinal studies to assess its predictive value.
The Use of Tests and Instruments in the Evaluation of Patients With Dementia
Published in Zaven S. Khachaturian, Teresa S. Radebaugh, Alzheimer’s Disease, 2019
Neuropsychological test results can be more or less useful depending upon the question that is being asked and the characteristics of the test itself. Several tests have been shown to be useful in evaluating patients with suspected AD, but clinicians will probably use only one or two tests with which they are quite familiar. To compare a patient’s score with published normative data or to assess change over time accurately requires that the test have a high degree of reliability. Many of the tests used most commonly to evaluate patients with AD, including the tests described above, have been shown to have a high degree of inter-rater and test-retest reliability. Assuming that these tests are given according to the published instructions, it should be possible to compare a patient’s data with published norms and to conclude that measured changes over time actually reflect changes in the patient’s cognitive state.
Association between myasthenia gravis and cognitive disorders: a PRISMA-compliant meta-analysis
Published in International Journal of Neuroscience, 2023
Xiaoling Zhou, Shugang Cao, Jinyi Hou, Tiantian Gui, Feng Zhu, Qun Xue
Neuropsychological tests were defined by objectively assessing a recognized cognitive domain. We identified nine cognitive domain categories, including sixteen neuropsychological examinations: Global cognitive function: Mini-Mental State Examination (MMSE)Language: Boston naming test (BNT)Attention: Digit forward, digit backwardVisuospatial function: Trail Making Test A (TMTA), Trail Making Test B (TMTB)Information processing: Symbol Digit Modalities Test (SDMT), Paced Auditory Serial Addition Test (PASAT)Verbal learning and memory: verbal immediate recall memory, verbal delayed recall memoryVisual learning and memory: visual immediate recall memory, visual delayed recall memoryExecutive function: Stroop Colour Word Test (time), Stroop Colour Word TestResponse fluency: Letter fluency, semantic fluency.
Association between plasma trimethylamine-N-oxide and cognitive impairment in patients with transient ischemic attack
Published in Neurological Research, 2023
Lufeng Wang, Xiaopeng Zhan, Li Jiang, Guangyu Xu, Yiwen Bao, Junlang Wang, Shaohua Qv, Jie Yang, Dongya Huang
The inclusion criteria were as follows: (i) age ≥18, (ii) diagnosed with TIA within 7 days after onset and no definite infarction on diffusion-weighted magnetic resonance imaging (MRI) during the entire period of follow-up, (iii) complete data about neuropsychological test results 3 months after onset, and (iv) data available for other variables of interest. The exclusion criteria were as follows: (i) participants with a history of stroke events, cerebral hemorrhage, traumatic brain injury, or psychiatric disorders known to affect cognitive function, (ii) diagnosed with cognitive decline before the onset of the current TIA (Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) was applied to help screen the preexisting cognitive decline in the Chinese elderly and scoring 3.4 or more was considered preexisting cognitive decline), and (iii) patients with difficulties in hearing, speaking and comprehension could not complete the neuropsychological tests.
Executive Dysfunction, Psychiatric Symptoms, and Behavioral Dysregulation in Preschoolers: Preliminary Findings in a Clinical Sample
Published in Evidence-Based Practice in Child and Adolescent Mental Health, 2023
Sarah E. Martin, Brian C. Kavanaugh, Claudia Paszek, Mia DeMarco, Lauren R. Mernick, John R. Boekamp
Moreover, because there is no modal neurocognitive profile associated with ADHD and other early emerging psychopathology, identification of each child’s neurocognitive strengths and weaknesses is critical to optimizing clinical care and outcomes. Neuropsychological evaluation is an established, evidence-based clinical service that is known to improve access to appropriate treatments and subsequently improve clinical symptoms. However most commonly utilized neuropsychological tests continue to be administered via multi-hour, in-person, paper-and-pencil methods requiring high assessor qualifications. Further, the waitlists for neuropsychological evaluations are a substantial barrier to care. Brief, computerized neurocognitive measures – such as the NIH Toolbox – are critical to more efficiently identifying neurocognitive deficits in child psychiatry patients. This is the first study to our knowledge that examined the feasibility and potential utility of the NIH Toolbox with very young children in an intensive psychiatric treatment setting. Results suggest the Toolbox holds promise for use with children presenting with significant psychiatric symptoms and clinical needs, with the potential to inform case conceptualization (e.g., by identifying neurocognitive deficits that exacerbate clinical symptoms and behavioral impairment), as well as treatment planning (e.g., by offering insight into neurocognitive processes that may serve as mediators, moderators, or targets for intervention).