Formal Neuropsychological Assessment Research Articles

Diagnostic profiles at a Center for Memory Disturbances

The Memory Disturbances Center is a multidisciplinary team devoted to the study and treatment of patients with memory problems. To report the clinical features of patients consulting to this center. Retrospective review of the clinical records of the first 100 patients consulting in the center. The age of consulting patients ranged from 17 to 93 years and 57 were female. The most common diagnoses were Alzheimer disease, depressive pseudo dementia, mild cognitive impairment, vascular dementia and adult attention deficit disorder. A formal neuropsychological assessment was performed in 60% and 20% entered a cognitive stimulation program. Although Alzheimer disease is the most common cause of memory disorders in the adult, concealed depression and attention deficit disorders are also common. A multidisciplinary approach allows a better diagnosis and treatment.

Perfiles diagnósticos y epidemiológicos en una Unidad de Memoria

The Memory Disturbances Center is a multidisciplinary team devoted to the study and treatment of patients with memory problems.To report the clinical features of patients consulting to this center.Retrospective review of the clinical records of the first 100 patients consulting in the center.The age of consulting patients ranged from 17 to 93 years and 57 were female. The most common diagnoses were Alzheimer disease, depressive pseudo dementia, mild cognitive impairment, vascular dementia and adult attention deficit disorder. A formal neuropsychological assessment was performed in 60% and 20% entered a cognitive stimulation program.Although Alzheimer disease is the most common cause of memory disorders in the adult, concealed depression and attention deficit disorders are also common. A multidisciplinary approach allows a better diagnosis and treatment.

Specialist neuropsychological assessment procedures for children and adolescents

This paper provides an introduction to specialist developmental neuropsychological assessment for clinical or research purposes. In particular, the review considers how to identify groups likely to require specialist neuropsychological testing. Furthermore, it discusses measurement issues, such as the non-specific abilities that are utilized in the course of various assessments. These abilities are not the target functions; but children's capacity in such abilities may confound the test results; and as such it is important to be aware of these hidden test requirements. A variety of published tests and measures are described in detailed tables (including target function, reference population and test age range). Also the paper considers issues relating to individual brain functions such as implicit versus explicit memory, expressive and receptive language, sustained and selective attention, spatial and motor skills. It raises the notion that there is a lack of specificity in the executative function (EF) concept – which is particularly important as EF functions are implicated in so many neurodevelopmental disorders. Finally, the paper highlights the difficulties in capturing social cognition with formal neuropsychological assessment.

Individual differences in latent neuropsychological abilities at addictions treatment entry.

The latent structure of neuropsychological abilities and risk factors for impairment were examined in 197 persons entering addictions treatment. Confirmatory factor analysis yielded 4 factors: Executive, Memory, Verbal, and Processing Speed. The measurement model was consistent with evidence that neuropsychological test performance is factorially complex and supported by multiple brain regions. Path analyses showed that risk factors explained 34%-57% of the true variance in abilities. Age, education, and medical status had the most generalized and robust associations with abilities. Drug use disorder diagnoses, childhood behavior problems, familial alcoholism, and psychopathology were also significantly related to specific latent abilities. Knowledge of neuropsychological impairment may be clinically useful, and selected risk factors may help treatment providers decide which clients should receive formal neuropsychological assessment.

Reversible delayed leukoencephalopathy following intravenous heroin overdose

We present serial neuropsychological, magnetic resonance (MR) imaging and EEG changes in a case of widespread CNS myelinopathy due to intravenous heroin overdose complicated by a period of prolonged unconsciousness. Following recovery from the acute ove rdose, the subject had the delayed onset of akinetic mutism with urinary incontinence. Sequential formal neuro-psychological assessments over 9 months showed evolution from severe global cerebral dysfunction to moderate disturbance of frontal lobe functi on. Almost complete resolution of diffuse white matter signal changes, accompanied by the development of a degree of volume loss, was evident on serial MR imaging overthe same period, and generalized arrhythmic delta-range slowingon the EEG evolved int o a near normal pattern.

Chronic Neuropsychological and Neurological Impairment Following Acute Exposure to a Solvent Mixture of Toluene and Methyl Ethyl Ketone (MEK)

A 38 year-old laborer experienced solvent intoxication during each of two spray paintings of a dump truck and other heavy equipment in an enclosed, unventilated garage. The paint base consisted primarily of toluene and methyl ethyl ketone. Nausea, headaches, dizziness, respiratory difficulty and other symptoms began after exposures. Over the next several days he developed impaired concentration, memory loss and cerebellar signs including an intention tremor, gait ataxia and dysarthria. MRI of the brain and EGG early in the work-up were normal, although later MRIs demonstrated fluid collection over the left parietal area. Examination by a toxicologist and neurologist revealed likely toxic encephalopathy with dementia and cerebellar ataxia. Three formal neuropsychological assessments over 2 1/2 years quantified cognitive, motor and behavioral changes. Despite similar findings in chronic exposure to these solvents, lasting sequelae following acute exposure have not been widely reported.

The effect of long‐term physostigmine administration in Alzheimer's disease

We assessed the effect of chronic long-term physostigmine in 20 patients with probable Alzheimer's disease. Initially, all patients went through a dose-finding phase and a double-blind crossover period, and were subsequently classified as physostigmine responders or nonresponders based on an a priori classification system. We then offered all patients long-term treatment with physostigmine regardless of their initial classification. Results revealed that responders spent significantly (p less than 0.0005) longer time periods on drug (36.1 +/- 4.6 months) than nonresponders (10.8 +/- 3.2). During a 2nd crossover period, 18 months into treatment, responders still demonstrated behavioral improvement, as assessed with the Sandoz Clinical Assessment-Geriatric Scale, whereas there were no behavioral changes observed in nonresponders. There were no effects on formal neuropsychological assessment. The results suggest that a subgroup of Alzheimer's patients benefits from long-term physostigmine therapy.

Epilepsy presenting as memory disturbances.

Six patients presented with severe adult-onset memory deficit that was subsequently diagnosed as complex partial epilepsy. In three cases acute amnestic episodes also occurred. The seizures were characterized by short losses of contact and oral automatisms. Interictal EEG showed temporal abnormalities of varying degrees. Formal neuropsychological assessment revealed dissociation between the subjective complaint and the test performances that showed a selective impairment in a few long-term verbal memory tests. These patients present a characteristic clinical picture of memory disturbance as the prominent feature of partial seizures.