Halstead-Reitan Neuropsychological Battery Research Articles

Neuropsychological, Learning and Developmental Characteristics of the Low Vision Child

This study was conducted to provide a comprehensive profile of the low vision child in the areas of cognitive, psychomotor, academic and neuropsychological development. The case-study method was employed to study 50 children on 143 variables using the Halstead-Reitan Neuropsychological Battery, the Stephens Piagetian Battery of Reasoning Assessments and standardized achievement tests. Results of the study indicated that the sample of low-vision children was characterized by significant delays in cognitive and psychomotor development and academic achievement. Thirty-two subjects or 65 percent of the total sample were classifiable as either brain-damaged or learning disabled by the application of the Selz and Reitan Rules Analysis (1980) and the Halstead Impairment Index to the neuropsychological data.

Moderate head injury: completing the clinical spectrum of brain trauma.

We have divided head injury into three categories based on the Glasgow Coma Scale (GCS) (severe, 3-8; moderate, 9-12; and minor, 13-15). In a previous report, we described significant disability after minor head injury. The present report describes 199 patients with moderate head injury, 159 of whom underwent follow-up examinations at 3 months. In contrast to patients with minor head injury, half as many were students (17%) and twice as many were intoxicated (53%). Seventy-five patients were studied with computed tomographic (CT) scanning; 30% of the scans were negative and 31% showed a space-occupying mass. As reported by Gennarelli et al. in patients with severe head injuries, those with moderate head injury and subdural hematoma had a very poor outcome: 65% died or were severely disabled and none made a good recovery as measured by the Glasgow Outcome Scale. At 3 months, 38% of the moderate head injury patients had made a good recovery compared with 75% of the minor head injury patients. Within the good recovery category, however, there was much disability (headache, 93%; memory difficulties, 90%; difficulties with activities of daily living, 87%), and only 7% of the patients were asymptomatic. The Halstead-Reitan Neuropsychological Battery in an unselected subset (n = 32) showed significant deficits on all test measures. Sixty-six per cent of the patients previously employed had not returned to work, compared to 33% of the minor head injury patients. The major predictors of unemployment after minor head injury were premorbid characteristics (age, education, and socio-economic status). In contrast, all predictors in moderate head injury were measures of the severity of injury (length of coma, CT diagnosis, GCS on discharge). We conclude that: (a) moderate head injury, not described previously in the literature, results in mortality and substantial morbidity intermediate between those of severe and minor head injury; (b) unlike minor head injury, the principal predictors of outcome after moderate head injury are measures of the severity of injury; and (c) more attention should be directed to patients with moderate head injury than to those with the most severe injuries, in whom brain damage is probably irreversible and all forms of management have demonstrated little success.

Correlations between the Luria-Nebraska and the Halstead-Reitan Neuropsychological Batteries: Effects of partialing out education and postmorbid intelligence.

Correlations between the Luria-Nebraska and the Halstead-Reitan Neuropsychological Batteries: Effects of partialing out education and postmorbid intelligence.

Correlations between the Luria-Nebraska and the Halstead-Reitan Neuropsychological Batteries: effects of partialing out education and postmorbid intelligence.

Correlations between the Luria-Nebraska and the Halstead-Reitan Neuropsychological Batteries: effects of partialing out education and postmorbid intelligence.

Deficits of Ideokinetic Praxis in Chronic Schizophrenics on a Modified Version of the Luria-Nebraska Motor Scale

One disturbance of motility in schizophrenia is the blocking of voluntary action, or ambitendency. Although the traditional explanation for this disorder is psychological, the documentation of psychomotor slowing in the literature suggests the possibility of a neurologic pathogenesis. It was hypothesized that disconnection between the ideatory and motor components of a voluntary action described as ambitendency is similar to the ideokinetic apraxia of disease of the left frontal cortex. It was also hypothesized that because of this presumed anatomical locus, manifestation of ideokinetic apraxia in schizophrenia would be correlated with corticomotor slowing of the dominant hand. To test these hypotheses, a modified version of the Motor Scale of the Luria-Nebraska Neuropsychological Examination and the Finger Tapping Test of the Halstead-Reitan Neuropsychological Battery were administered to 10 chronic undifferentiated schizophrenics, 10 paranoid schizophrenics, 10 patients with major depressive disorders, 10 patients with mixed personality disorders, and 10 normals. Both chronic schizophrenics and major depressives demonstrated a significant frequency of ideokinetic apraxia in comparison with the other groups. Age was found to correlate positively with ideokinetic apraxia in the depressives, suggesting that such symptoms may be an artifact of the aging process in these subjects. Ideokinetic apraxia was correlated with slowing of the dominant hand in the chronic schizophrenics, suggesting a neurologic rather than a psychologic basis for their blocking of voluntary action. No group demonstrated a significant incidence of ideational apraxia.

“Optimal” Lateralization on the Tapping Test

The present study was designed to test the general "imbalance" hypothesis in regard to the Tapping Test, a motor measure of finger-oscillation speed from the Halstead-Reitan neuropsychological battery. The study was prompted by a recent spate of reports linking cerebral lateralization to a variety of conditions. It was hypothesized that it would be possible to determine an "optimal," midrange of lateralization, to be identified by faster tapping speeds. As hypothesized, those offenders with "moderate" laterality achieved faster speeds than those with "extreme" laterality ("extreme" defined as either less or more laterality than for the moderates). The same range appeared optimal over several demographic groups. A second goal of the present study was to pursue hints from a previous study that had suggested a lateralization measure might prove to be free of some unwanted variations by demographics. As hypothesized, the lateralization measure appeared free of variations according to age, sex, and handedness. Applications and future directions were suggested.

Relationship of the Halstead-Reitan Neuropsychological Battery to the Luria-Nebraska Neuropsychological Battery.

One of the major questions that has arisen in the field of neuropsychology deals with the effectiveness of the Luria-Nebraska Neuropsychological Battery as compared with the Halstead-Reitan Neuropsychological Battery, which has been recognized by many as the preeminent standardized battery. The present study compared the major 14 scores of the Halstead-Reitan battery with the 14 summary scale scores of the Luria-Nebraska battery to investigate whether the batteries could predict one another and their effectiveness in a common sample of 48 brain-damaged and 60 normal patients. Discriminant analysis found both batteries equally effective in identifying brain damage, with hit rates over 85%. A high degree of relationship (all Rs > .71, p < .05) between the Luria-Nebraska scale scores and the selected 14 scores of the Halstead-Reitan was found. The recent introduction of the Luria-Nebraska Neuropsychological Battery, an attempt at the standardization of the qualitative work of the Russian neuropsychologist A. R. Luria, has elicited considerable interest from clinicians and researchers in the field of clinical neuropsychology. One of the major questions that has arisen is the relationship between the effectiveness of the Luria-Nebraska Neuropsychological Bat

Comparative diagnostic accuracy of the Halstead-Reitan and standardized Luria-Nebraska neuropsychological batteries in a mixed psychiatric and brain-damaged population.

Comparative diagnostic accuracy of the Halstead-Reitan and standardized Luria-Nebraska neuropsychological batteries in a mixed psychiatric and brain-damaged population.

Comparative diagnostic accuracy of the Halstead-Reitan and standardized Luria-Nebraska Neuropsychological Batteries in a mixed psychiatric and brain-damaged population.

Comparative diagnostic accuracy of the Halstead-Reitan and standardized Luria-Nebraska Neuropsychological Batteries in a mixed psychiatric and brain-damaged population.

Relationship of the Halstead-Reitan Neuropsychological Battery to the Luria-Nebraska Neuropsychological Battery.

Relationship of the Halstead-Reitan Neuropsychological Battery to the Luria-Nebraska Neuropsychological Battery.

Neuropsychologic consequences of Reye syndrome

Behavioral measurement of brain function was conducted in 40 children, one or more years after their recovery of Reye syndrome. Test measures included standard indices of intelligence, school achievement, visual-motor coordination and social maturity, plus the Halstead-Reitan Neuropsychological Batteries. There was a strong correlation between the degree of impaired neuropsychologic function and clinical grade at admission, the duration of impaired consciousness, and the number of exchange transfusions required. Patients with milder disease had normal brain function and fewer school problems. Language and perceptual-motor performance significantly improved with increasing years in recovery, suggesting that some of the disturbances of brain functioning are transient. The statistical analysis indicated that there are lasting, often subtle disturbances of higher cognitive function as a result of Reye syndrome. These deficits, not always apparent on clinical examination, are clearly correlated with the extent of neurologic involvement. This quantitative assessment of neuropsychologic function is a basis for determining the "quality of survival" in Reye syndrome, and such measurements should be included in the comparative evaluation of Reye syndrome treatment programs.

Sex differences on the Halstead-Reitan neuropsychological battery and on other neuropsychological measures

Evaluated differences in performance between adult males and females with respect to Halstead's Neuropsychological Battery, additional tests employed by Reitan (Trail Making Test, Aphasia Screening Test, Perceptual Examination, dynamometer), and other neuropsychological measures (Seashore Tonal Memory Test, Logical Memory and Visual Reproduction portions of the Wechsler Memory Scale). In evaluating differences, 47 matched pairs of non-neurologic males and females were employed, as well as 47 pairs of neurologic patients. A small number of statistically significant differences were found, all of which favored males. Some of these differences occurred with respect to tasks that have very strong motor components, and these differences were shown to be related to hand size. Others pertained to tasks that have strong visual-spatial components. In general, the differences were less prominent with the neurologic than the non-neurologic samples. The question was raised as to possible over-representation of male-superior components in these tests.

Computerized Transaxial Tomographic and Neuropsychological Evaluations in Chronic Alcoholics and Heroin Abusers

Computerized transaxial tomographic (CTT) scans and the Halstead-Reitan Neuropsychological Battery were administered to 42 paid male volunteers (15 chronic alcoholics, 15 heroin abusers, and 12 matched control subjects). CTT scans revealed that only 1 of the chronic alcoholics had a ventricle/brain (V/B) index larger than normal. One unexpected finding was that the heroin abusers had significantly smaller sulci and V/B indices. Neuropsychological assessments of the alcoholics and heroin abusers revealed functional impairment in a majority of cases; the alcoholics were twice as likely as opiate abusers to show impairment.

Organic impairment in polydrug users: risk factors.

In a national collaborative study to assess the neuropsychological status of 151 polydrug users, the Halstead-Reitan Neuropsychological Battery showed deficits in 37% two to three weeks after they entered treatment and in 34% at three-month follow-up. Comparative rates for a group of psychiatric patients were 26% and 27%, and for nonpatients, 8% and 4%. Extensive and intensive use of CNS depressants and opiates correlated positively with neuropsychological deficit. Older, less-educated subjects with adverse medical or developmental histories were more likely to show polydrug-related organic impairment. Although there is some evidence that such impairment is reversible, the condition appears to be of at least intermediate duration and may be long lasting.

Neuropsychological Implications of Rhythm and Aphasia Deficits After Unilateral Left Hemisphere Injuries

The present study was designed to investigate changes in rhythm skills independent of any right hemisphere dysfunction and in relationship to verbal deficits which accompany left hemisphere injuries. Thirty-five individuals injured in the left hemisphere were divided into three groups on the basis of their scores on the Seashore Rhythm Test and the Reitan-Indiana Aphasia Screening Test. The three groups were then compared on 21 measures taken from the Halstead-Reitan Neuropsychological Battery and the Wechsler Adult Intelligence Scale. Results of one-way analyses of variance indicated that 8 measures, commonly associated with left hemisphere problems, differentiated the three groups while 13 measures, commonly associated with right hemisphere or diffuse problems, did not. The findings were interpreted as supporting the hypothesis that rhythm deficits may occur independent of right hemisphere injury. The results also indicated that rhythm deficits are useful in localizing left hemisphere injuries.

On the safety of long-term treatment with lithium

Thirteen patients with bipolar affective illness who had received lithium therapy for 1-5 years were tested retrospectively for evidence of cortical dysfunction. Data on patients younger than 55 show no abnormalities on the Halstead-Reitan Neuropsychological Battery and suggest that chronic lithium therapy is relatively safe. Significantly elevated Halstead Impairment indexes were observed among elderly patients, but these data are difficult to interpret.

Clinical signs in diffuse cerebral dysfunction.

Abnormal responses to 13 questions from a typical mental status examination and 32 signs of neurological dysfunction were correlated with increasing degrees of cognitive impairment as measured by the Halstead-Reitan Neuropsychological Battery. Thirteen of these factors were found to be useful predictors of diffuse cerebral dysfunction when combined into a brief screening examination for application at the bedside.

Neuropsychological effects of electroconvulsive therapy.

Although ECT as the treatment of choice for psychotic depression has been in use for many years, little is known about the neocortical residual of such treatments inferred from behavioral measures. The major portion of the literature has been concerned with inferred or observed changes in affective state. The present study compared pre- and posttreatment performances on the Halstead-Reitan neuropsychological battery of 20 patients who were receiving ECT from two different machines. Most Ss gave indicators of cerebral impairment prior to treatment when performance of one side of the body was contrasted with performance of the other side. After treatment, there was an increased number of Ss who evidenced signs consistent with damage to the right cerebral hemisphere. Some concern was raised that a large number of patients who eventually are subject ot ECT because of depression behave in this way because of an undiagnosed neocortical dysfunction. There is some suggestion that the effect of the procedure is to either create or intensify a right hemisphere focus as inferred from behavioral measures.

Validity of the Halstead-Reitan Neuropsychological Battery in a mixed psychiatric and brain-injured population.

Validity of the Halstead-Reitan Neuropsychological Battery in a mixed psychiatric and brain-injured population.

PSYCHIATRIC AND BEHAVIORAL MANIFESTATIONS OF NORMAL PRESSURE HYDROCEPHALUS

Normal pressure hydrocephalus (NPH) may suggest its presence by behavioral symptoms. Initally, the symptoms often manifest themselves as depression with marked psychomotor retardation. Older patients without a prior psychiatric history who have soft, nonlocalizing neurological signs and fluctuating cognitive and memory deficits in association with prominent affective and/or psychotic symptomatology of recent onset, such as the case reported here, should raise the clinician's index of suspicion. In such cases, the Halstead-Reitan neuropsychological battery may be helpful in differentiating an underlying dementia from a primary psychological dysfunction. When the presence of a dementing process is suspected, etiological diagnosis should be vigorously pursued with a CAT scan and, as indicated on clinical grounds, confirmatory and further delimiting studies such as pneumoencephalography, ventriculography, RISA scanning, electroencephalography, constant-infusion manometric testing, and/or angiography. Treatment of NPH includes one of several forms of shunting procedures and appropriate neuroleptic therapy for behavioral symptoms. Althoug there is a substantial risk (40 to 50 percent)ioral symptoms. Although there is a substantial risk (40 to 50 per cent) of shunt-related complications, as many as 60 per cent of operated patients will show objective imprvement, making the diagnosis of and referral for appropriate surgical treatment of NPH an important challenge for the psychiatrist.