Nebraska Neuropsychological Battery Research Articles

Self-perception of mental illness, and subjective and objective cognitive functioning in people with schizophrenia.

Background: People with schizophrenia may have a negative self-perception of mental illness. However, the relationship between the self-perception of illness and subjective and objective cognitive functioning remains unclear.Method: Thirty-seven people with schizophrenia were enrolled in the study group. All subjects completed self-reported self-perception of mental illness questionnaires (Birchwood Insight Scale [BIS], Internalized Stigma of Mental Illness [ISMI]), subjective cognitive functioning (Scale to Investigate Cognition in Schizophrenia [SSTICS]) and objective cognitive functioning (Luria Nebraska Neuropsychological Battery [LNNB]).Results: Spearman’s rank analysis showed that awareness of illness (domain of insight) was positively associated with most domains of SSTICS and ISMI. Total insight was positively correlated with alienation (domain of ISMI). Need for treatment (domain of insight) was negatively correlated with stigma resistance (domain of ISMI). Awareness of symptoms (domain of insight) and total insight were negatively associated with receptive speech and arithmetic (LNNB subtest), respectively. ISMI was positively correlated with most domains of SSTICS, but not with LNNB. The group with good insight had higher scores in attention (domain of SSTICS) and total SSTICS and alienation, stereotype endorsement, social withdrawal (domains of ISMI) and total ISMI than the group with poor insight. The group with mild to moderate internalized stigma had higher scores in explicit memory, attention, language, praxia (domains of SSTICS) and total SSTICS than the group with no internalized stigma.Conclusion: We identified that awareness of illness (domain of insight), internalized stigma were significantly associated with most domains of SSTICS, but not with LNNB. Total insight and awareness of symptoms (domain of insight) were significantly associated with receptive speech and arithmetic (LNNB subtest), respectively. Schizophrenia with higher insight or more internalized stigma reported more subjective cognitive impairment. Future studies with larger samples involving follow up are necessary to verify our findings and extend the applicability.

Impact of neuropsychological rehabilitation on activities of daily living and community reintegration of patients with traumatic brain injury.

Objectives:The present study was targeted to observe the impact of neuropsychological rehabilitation on activities of daily living (ADL) and community reintegration of patients with traumatic brain injury (TBI).Settings and Participants:Based on purposive sampling technique, ten patients with TBI falling in the age range of 20–40 years and fulfilling the inclusion and exclusion criteria were chosen from All India Institute of Speech and Hearing, Mysuru, India.Design:A quasi-experimental design, i.e., nonequivalent control group design was chosen for the study.Materials and Methods:Patients were assessed on Luria–Nebraska Neuropsychological Battery for Adults, Cognitive Symptoms Checklist, and Community Integration Questionnaire. Patients in experimental group were given neuropsychological rehabilitation for 6 months. Brainwave-R and Talking Pen were used as rehabilitative tools.Results:Patients with TBI have significant neuropsychological deficits observed in memory, visuo-spatial organization, arithmetic, spelling, writing, fine motor coordination, and executive functioning. Neuropsychological deficits have a major impact on ADL and community reintegration. Neuropsychological rehabilitation is effective in rehabilitating neuropsychological deficits, which in turn leads to improvement in ADL and community reintegration.Conclusion:Neuropsychological rehabilitation should be one of the major goals in rehabilitation procedures for patients with TBI in order to bring overall improvement in them.

Cognitive Profile of Paranoid Schizophrenia on LNNB

Schizophrenia is a major psychiatric disorder characterized by a disruption in affective, cognitive and social domains, which results in compromised ability to adapt to a changing environment and to function adequately in the community. Schizophrenia is often accompanied by gross and progressive impairment in different functional areas of a person. They are mostly seen in the form of – cognitive impairment (executive functions, information processing, attention, learning and memory), psychomotor activity, speech, thought process, perception, and abstraction. These deficits are evident in nearly all individuals diagnosed with schizophrenia, and their impact on the employment, social relationships and living status of patients is devastating. However, there could be differences among cognitive profiles of different schizophrenia subtypes. Luria Nebraska Neuropsychological Battery (LNNB) is a widely used standardized neuropsychological tool for cognitive assessment. In the present study, 30 male paranoid schizophrenia patients were assessed on the LNNB- Form I to see the profile of cognitive functioning on this tool.

Neurofunctional dopaminergic impairment in elderly after lifetime exposure to manganese

BackgroundManganese (Mn) is an essential element that can become neurotoxic through various exposure windows over the lifespan. While there is clear evidence of Mn neurotoxicity in pediatric and adult occupational populations, little is known about effects in the elderly who may exhibit enhanced susceptibilities due to compromised physiology compared to younger adults. In the province of Brescia, Italy, the Valcamonica area has been the site of three ferroalloy plants operating from 1902 to 2001. Metal emissions of Mn and to a lesser extent lead (Pb) have impacted the surrounding environment, where a high prevalence of Parkinsonism was previously observed. This study aimed to assess neurocognitive and motor functions in healthy elderly subjects residing for most of their lifetime in Valcamonica or in a reference area unimpacted by ferroalloy plant activity. MethodsSubjects were enrolled for extensive neurobehavioral assessment of motor, cognitive and sensory functions. Exposure was assessed with 24h personal air sampling for PM10 airborne particles, surface soil and tap water measurement at individual households, Mn levels in blood and urine and Pb in blood. Dose–response relationships between exposure indicators and biomarkers and health outcomes were analyzed with generalized (linear and logistic) additive models (GAM). ResultsA total of 255 subjects (55% women) were examined; most (52.9%) were within the 65–70 years age class. Average airborne Mn was 26.41ng/m3 (median 18.42) in Valcamonica and 20.96ng/m3 (median 17.62) in the reference area. Average Mn in surface soil was 1026ppm (median 923) in Valcamonica and 421ppm (median 410) in the reference area. Manganese in drinking water was below the LDL of 1μg/L. The GAM analysis showed significant association between airborne Mn (p=0.0237) and the motor coordination tests of the Luria Nebraska Neuropsychological Battery. The calculation of the Benchmark Dose using this dose–response relationship yielded a lower level confidence interval of 22.7ng/m3 (median 26.4). For the odor identification score of the Sniffin Stick test, an association was observed with soil Mn (p=0.0006) and with a significant interaction with blood Pb (p=0.0856). Significant dose–responses resulted also for the Raven's Colored Progressive Matrices with the distance from exposure point source (p=0.0025) and Mn in soil (p=0.09), and for the Trail Making test, with urinary Mn (p=0.0074). Serum prolactin (PRL) levels were associated with air (p=0.061) and urinary (p=0.003) Mn, and with blood Pb (p=0.0303). In most of these associations age played a significant role as an effect modifier. ConclusionLifelong exposure to Mn was significantly associated with changes in odor discrimination, motor coordination, cognitive abilities and serum PRL levels. These effects are consistent with the hypothesis of a specific mechanism of toxicity of Mn on the dopaminergic system. Lead co-exposure, even at very low levels, can further enhance Mn toxicity.

Memory impairment in female schizophrenic patients and its relation with their female sex hormonal profile

Hypothesis Schizophrenic women show deficits in a variety of cognitive domains including executive function, attention, memory, and language. The female sex hormone estrogen acts as a neuroactive hormone that is assumed to have interesting effects on the central nervous system and on the cognitive functions in specific. Aim of the work To determine the memory impairment in a sample of schizophrenic female patients, as well as its relation to the level of their female sex hormone estradiol, to evaluate the usefulness of hormonal therapy as an adjunct therapy to antipsychotic drugs in female schizophrenic patients to improve their cognitive functions. Participants and methods This is a comparative study that included 30 schizophrenic female patients who were admitted for a long time as inpatients of Al Abasseia Psychiatric Hospital, and a control group that matched in age and education. They were subjected to a psychiatric interview, neurological examination, general examination, the scale for the assessment of positive symptoms, and scale for the assessment of negative symptoms, serum estradiol level during 3 consecutive weeks, and the Luria–Nebraska neuropsychological battery, which is a multidimensional battery designed to assess a broad range of neuropsychological functions. (We focused on the items that tested memory functions). Results There were statistically significant differences between both groups in the clinical scales C10 (memory) of the Luria–Nebraska neuropsychological battery, as well the factor scales concerned with memory ME1 (verbal memory) and ME2 (visual and complex memory). The mean estradiol level was inversely correlated with the mean of the memory scales; that is, an increased estradiol level was correlated with better performance of the patient group in memory scales. Conclusion Female schizophrenic patients performed significantly worse in the memory scale (C10), as well as the factor scales concerned with memory ME1 (verbal memory) and ME2 (visual and complex memory); the increased estradiol level was correlated with better performance of the patient group in memory scales, which may be of value in these patients when providing hormonal therapy as an adjunct therapy to antipsychotic drugs.

P01-411 - Neuropsychological assessment in patients with multiple sclerosis

Multiple Sclerosis (MS) is one of the most common neurological diseases and disabling in young adults, who often have cognitive dysfunction.The authors of this paper proposes to assess neuropsychological functions most affected in a group of MS patients and compares them with a group of healthy people.This study consists of two groups: the group of patients with definite diagnosis of MS (n = 31) and the control group (n = 15). Data collection is done through a questionnaire sociodemographic and clinical data and a battery of neuropsychological assessment (Luria Nebraska Neuropsychological Battery). Data analysis is performed using the program SigmaStat.The results show that the group of MS patients compared with the control group presented a significantly lower performance at various scales, and also indicate that in this patient group, there is no relationship between cognitive functioning and duration of disease (as noted in several studies).This work also indicates a strong diagnostic validity of the Luria Nebraska Neuropsychological Battery, in the differentiation between normal individuals and patients in the neurological point of view (including patients with MS).

Explaining age and sex differences in children's handwriting: A neurobiological approach

The present study aimed to assess the effect of age and sex on children's writing performance, as well as to investigate possible age and sex differences between proficient, intermediate and poor writers. Two hundred and ten children aged 7 to 12 years were examined during spontaneous writing, copying and writing to dictation, using the writing scale of the Luria – Nebraska neuropsychological battery. Results showed a significant effect of age in writing performance. The trend towards writing proficiency in childhood was found to be sex related, while boys were overrepresented among the poor writers. The findings are interpreted on the basis of the neurobiological theories of brain development as well as on the different rates of cerebral maturation between the sexes.

Cognitive and emotional effects of renal transplantation

Background:Recent studies have shown a high prevalence of depression and cognitive changes in patients with end-stage renal disease (ERSD) and renal transplant recipients. There are few data available on the cognitive and emotional changes in patients undergoing renal transplantation in India.Aim:To evaluate the changes in cognitive profile and depression in renal transplant recipients.Methods:Thirty consecutive patients undergoing renal transplantation were evaluated 1 month before and 3 months after successful renal transplant with Beck Depression Inventory (BDI), Weschler Adult Performance Intelligence Scale (WAPIS), Luria Nebraska Neuropsychological battery (LNNB) and Life satisfaction scale.Results:Our study revealed an 86.7% prevalence of depression in ESRD patients as compared to 56.7% in post renal transplant patients. Analysis of neurocognitive functions on LNNB did not reveal any significant impairment. Furthermore, analysis of the Life satisfaction scale revealed most of the patients scored high satisfaction levels despite the stress of their disease. Results on WAPIS brought out significant improvement in intelligence quotient (IQ) after renal transplantation.Conclusion:Successful renal transplant is associated with improvement in depression, IQ and life satisfaction.

Neuropsychological correlates of P300 abnormalities in patients with schizophrenia and obsessive–compulsive disorder

The cognitive significance of P300 abnormalities in schizophrenia and obsessive–compulsive disorder (OCD) was investigated. P300 was measured by an auditory oddball paradigm, in which a series of standard tones (1000 Hz) and target tones (1500 Hz) were presented. The subject's task was to count the number of the presented target tones. Cognitive functions were evaluated by neuropsychological tests, which were chosen to be sensitive to frontal and temporal dysfunction. Twenty-two schizophrenic patients, 19 OCD patients and 21 healthy controls participated. Event-related potentials measured at 15 electrode sites, which consisted of five levels on the left–right dimension and three levels on the anterior–posterior dimension, were included in the statistical analysis. P300 amplitudes on all 15 electrode sites were significantly smaller in schizophrenic and OCD patients than in the controls. Schizophrenic patients performed poorly on almost all neuropsychological tests, while OCD patients showed impaired performance on the Rey–Osterrieth Complex Figure Test and on a controlled oral word association test. In schizophrenic patients, P300 amplitude was associated with performance on verbal memory and learning by the Luria–Nebraska Neuropsychological Battery, while for OCD patients, P300 amplitude was related to the Trail Making Test, Part B response time. These results indicate that schizophrenic patients have generalized cognitive impairments, which are substrated by a wide range of cortical dysfunctions. The major cognitive deficits observed in OCD patients were impairments of controlled attention and self-guided, flexible behavior, which are mediated by the fronto-striatal system. The neurophysiological mechanisms underlying P300 abnormalities observed in schizophrenic and OCD patients are discussed.

Neuropsychological Assessment in Clinical Practice: A Guide to Test Interpretation and Integration

Back to table of contents Previous article Next article Book Forum: NeuropsychiatryFull AccessNeuropsychological Assessment in Clinical Practice: A Guide to Test Interpretation and IntegrationMANFRED SPITZER, M.D., PH.D., MANFRED SPITZERSearch for more papers by this author, M.D., PH.D., Ulm, GermanyPublished Online:1 Mar 2002https://doi.org/10.1176/appi.ajp.159.3.502AboutSectionsView EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail As stated in the preface, this book tries to provide a comprehensive guide to neuropsychology—and so it does! It is divided into four parts. General insights into neuropsychology and neurological syndromes are provided and the terminology behind neurological assessments are explained in the first part. This is accomplished by presentations of short and prototypical clinical descriptions of paradigmatic disorders. These descriptions are taken from the points of view of different clinical settings, such as a neurological hospital, a rehabilitation unit, a psychiatric practice, and a judicial context. These sample cases start with a short history, present results of neuropsychological assessments, and explain test results in relation to the patients’ medical condition and history. Therapeutic conclusions and a prognosis are derived from this information. In essence, the first section of the book emphasizes the importance of thorough history-taking and delivers concise insights into important neurological syndromes in which neuropsychological issues are particularly relevant.The second part is centered around the description of the four major neuropsychological assessment batteries, namely, the Wechsler Intelligence Scale, the Wechsler Memory Scale, the Halstead-Reitan Neuropsychological Test Battery, and the Luria Nebraska Neuropsychological Battery. The history and the development of each battery, including its subtests, are discussed, and practical instructions on how to administer and evaluate test results, how to use norms, and how to calculate correction factors for age and education are provided.The third part examines in depth the assessment and evaluation of functional domains. It provides a comprehensive overview of tests with respect to important higher cognitive functions, such as attention, visuoconstructive abilities, executive function, and emotional processes. Starting with the neuroanatomical background, this section of the book also presents patients’ sample test results and provides normative data.The fourth part is devoted to the integration of test results, treatment, and therapy planning. It culminates in a manual on how to report the neuropsychological results taken during clinical neuropsychological assessment. As in the previous chapters, this is done by presenting exemplary reports on patients.The book is extremely readable and filled with illustrative stories. Readers who have not yet invested much time in the study of neuropsychology will not have problems following the author. Groth-Marnat does a very good job in catching the readers’ attention and keeping it. This book is not only for the neuropsychological novice, however. It provides the clinical practitioner with what is needed to update and deepen his or her understanding of the field.If you are looking for a thorough introduction into neuropsychological assessment, test interpretation, and integration of neuropsychological test results, this book is well worth adding to your library. It may not be the right book if you are looking for a fast, in-depth reference in daily clinical routine, or if you are looking for a quick reference on the variety of neuropsychological tests. However, if you want a practitioner’s guide to practical test interpretation and integration, the book is definitely a very good choice.Edited by Gary Groth-Marnat. New York, John Wiley & Sons, 2000, 672 pp., $89.95. FiguresReferencesCited byDetailsCited byNone Volume 159Issue 3 March 2002Pages 502-502 Metrics History Published online 1 March 2002 Published in print 1 March 2002

Standardized memory tests and the appraisal of everyday memory

Although ecological validity of traditional tests of memory has been questioned, use of these tests remains the standard in clinical practice. More recently, however, standardized measures with more emphasis on ecological relevance have been developed. One hundred and nineteen adults with diagnosed brain injuries completed traditional instruments of memory assessment, the Luria Nebraska Neuropsychological Battery Memory Scale (LNNB-M) and the Wechsler Memory Scale-Revised (WMS-R). Subjects also completed the Rivermead Behavioural Memory Test (RBMT), an instrument designed to measure everyday memory. Additionally, clinicians rated subjects' day-to-day memory functioning at the rehabilitation facility. Results suggest that RBMT is most accurate in classifying severity of memory impairment as rated by clinicians. The LNNB-M and WMS-R were relatively accurate at classifying severely impaired and unimpaired subjects, but were much less accurate at classifying subjects in the mild and moderate impairment ranges. Implications for interpretation and use of these instruments in rehabilitation settings are discussed.

Neuropsychological and clinical correlates of temporal lobe anatomy in schizophrenia.

Twenty-five DSM-III schizophrenic patients were assessed neuromorphologically and neuropsychologically. Reduced temporal lobes were found through magnetic resonance imaging (MRI) evaluation. In addition, in order to look for the neuropsychological correlates of temporal anatomy in schizophrenia, patients were divided into cognitive normal and abnormal schizophrenics, according to their Luria Nebraska Neuropsychological Battery profile. The latter group had statistically significant temporal lobe abnormalities as assessed by MRI, irrespective of medication, clinical picture or any other relevant variables. The implication of such findings in the light of the diaschisis model is discussed.

Functional Ability and Performance on Neuropsychological Indices in Chronic Psychiatric Outpatients

Thirty adults in a psychiatric day hospital were subjects in a study designed to examine the relationship between performance in social, occupational, and leisure spheres with neurological functioning and demographic variables. All subjects were administered the Wechsler Adult Intelligence Scale, the Southern California Sensory Integration Test, and Luria Nebraska Neuropsychological Battery. A rating scale adapted from the DSM III, Axis V as well as extensive chart reviews, were used to assess functional performance. This study revealed that very few neurological or demographic variables predicted the subjects performance in social, occupational, or leisure situations. Implications of these and other results are discussed.

Mania following head injury: Case reports and neuropsychological findings

Mania secondary to head injury is reported to be rare. Two cases of florid manic psychoses following head injury are reported along with neurological and neuropsychological investigations. Findings on the Luria Nebraska Neuropsychological Battery (LNNB) suggested residual cognitive deficits, predominantly of right hemisphere. Temporal proximity, clinical neurological findings, EEG changes and deficits on LNNB suggest a causal link between head injury and mania.

Psychomotor disturbances in psychiatric patients as a possible basis for new attempts at differential diagnosis and therapy

This study investigates the presence and course of motor symptoms in endogenous (n = 42) and non-endogenous (n = 15) depressed patients (both medicated and unmedicated) in comparison to 15 healthy control persons. As in our previous studies on schizophrenic and depressed patients, we used a motor test battery, which consisted of the Motorische Leistungsserie, a modified version of the Lincoln Oseretzky Motor Development Scale and the motor subtest of the Luria Nebraska Neuropsychological Battery. Previous findings had suggested the existence of a psychotic motor syndrome (PMS) in endogenous depressed patients (and schizophrenics), involving disturbances of the lips and tongue, fine and gross movements of the dominant right hand and the complex motor coordination of the extremities. We re-confirmed the PMS in acute endogenous depressed patients, both medicated and unmedicated. Such a motor syndrome did not exist in healthy controls, or in non-endogenous depressed patients, irrespective of the severity of the depressive syndrome. This PMS showed a clear improvement with the amelioration of the depressive symptoms in endogenous depressed patients towards the end of the hospital treatment period and disappeared entirely in patients in a symptom free interval. This may be suggestive of a possible role for the PMS as a state marker for endogenous depression, in contrast to the persistence of the PMS in schizophrenics (trait marker), described previously. The results of factorial analyses on motor performance did not reveal differences in the factorial structure between depressives, schizophrenics and normals. However, they indicated disturbances on a general motor factor, which may account for the performance deficits in psychotic patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Neurological Dysfunction in Serious Delinquents

Gross neurological dysfunction was uncommon in 71 (40 male, 31 female) incarcerated seriously delinquent adolescents. Neurological soft signs, measured by the Physical and Neurological Examination for Soft Signs (PANESS), were found to be correlated with educational attainment and intellectual endowment, and associated with undersocialized conduct disorder. Neurological soft signs were also associated with uncompensated neurophysiological deficits as measured by the Luria Nebraska Neuropsychological Battery (LNNB), particularly in the areas of attention and language. Neurological soft signs were not found to be related to severity of delinquency or to violent behavior.

The assessment of specific neuropsychological skills using scales derived from factor analysis of the Luria-Nebraska Neuropsychological battery.

The major scales of the Luria--Nebraska Neuropsychological Battery have been factor analyzed in a series of recent studies. These factors tend to be organized around one or two basic neuropsychological skills. The present study developed 30 scales of items loading heavily on those factors and determined performance norms on the scales on a group of 81 normal subjects. The Luria--Nebraska Battery was administered to eight groups of subjects with brain-damage localized to the frontal, sensorimotor, parietal-occipital or temporal areas of the right or left hemisphere. The performance of each of these groups on the 30 factor scales is described. The factor scales appear to facilitate assessment of specific skill deficits and appear potentially useful for both diagnosis and rehabilitation.

Re-examination of the factor structure of the Receptive Language scale of the Luria-Nebraska Neuropsychological Battery.

The Receptive Language scale of the Luria--Nebraska Neuropsychological Battery assesses verbal comprehension skills ranging widely in complexity. Although a relatively complex factor structure was anticipated, a previous factor analysis of the scale revealed only one strong factor, phonemic discrimination. The present study re-examined the factor structure of the Receptive Language items using a substantially larger number of subjects with a larger proportion of brain-damaged subjects than in the earlier study. Seven major factors emerged which varied on a dimension of complexity of comprehension from phonemic discrimination through comprehension of complex grammatical relationships. Reasons for the difference in results obtained in the present study are suggested and theoretical implications of the findings are discussed.