Applied Neuropsychology-Adult最新文献

Confrontation naming measures are commonly used for both diagnostic and clinical research purposes in populations of known or suspected neurodegenerative disorders. The Boston Naming Test (BNT) is the most widely used measure of confrontation naming but has been criticized for outdated and culturally biased content. A new naming measure, the Multilingual Naming Test (MiNT), has been developed that may address these limitations, but research regarding its validity and diagnostic performance relative to existing instruments is limited. The current study examined how the BNT and MiNT performed in a sample of older adults evaluated in an interprofessional memory disorders clinic. Eighty-six individuals (50.0% women) met the inclusion criteria and were included in the study. The average age of participants was 74.2 years (SD = 7.7), and the average education was 16.7 years (SD = 2.5). Most participants were non-Hispanic White (94.2%), and the remaining participants were Hispanic or Black. All participants completed a comprehensive evaluation in English and were administered both the BNT and the MiNT. The strength of agreement as indexed by CCC (.67) was modest for the sample as a whole. Eighty-seven-point five percent classification agreement for impaired vs. normal naming performance was obtained. Eleven cases showed disagreement between BNT and MiNT classification of impairment, with seven of these being borderline score cases. Overall, the results suggest that the MiNT performs similarly at the identification of naming impairments as the BNT, though performance may diverge across different diagnostic groups and may be influenced by age.

Background: Cognitive impairment affects 40-65% of MS patients, encompassing all disease stages and types of clinical courses. This estimation is based on different instruments used and population normative data.

Objective: This study aims to assess the cognitive function in a hospital-based cohort of Portuguese MS patients, to allow estimating the prevalence of cognitive impairment in different phenotypes.

Methods: Three hundred and thirteen patients with Multiple Sclerosis (MS) underwent neuropsychological assessment with the brief repeatable battery of neuropsychological tests (BRBN-T) and the brief international cognitive assessment for multiple sclerosis (BICAMS).

Results: Differences were observed in the cognitive impairment profile of different disease phenotypes and of the different disease severity stages. RRMS patients performed better in the cognitive test of the BRBN-T and BICAMS than those with progressive disease phenotypes. Relationships between cognitive impairment and disability and professional status were relevant. Although similarities could be observed in the cognitive profile of the MS phenotypes, with predominant involvement of verbal memory, verbal fluency, and information processing speed, the latter was found to be more frequent as the disease progressed.

Conclusion: This study contributes to improve knowledge about the cognitive profile of the different MS phenotypes and understand the cognitive characteristics of Portuguese patients.

Executive dysfunction is most often caused by post-traumatic or post-stroke damage to the prefrontal regions of the brain. The aim of this study was to compare the efficacy of two computer-assisted therapy programs for executive dysfunctions in patients with acquired brain injury. Patients were trained using either a newly developed application ExeSystem (designed to help improve the ability to manage and control one's own behavior by performing tasks imitating natural, everyday situations) or a combination of two commercial applications RehaCom and CogniPlus. Data collected after a three-week period of therapy conducted in two 15-person groups of participants indicated comparable efficacy of both therapy programs in improving quality of daily functioning, executive attention, as well as planning and problem-solving but not memory. The improvement in social competence (p = .028) was the only advantage of therapy with the ExeSystem. Therapeutic interactions using computer programs were shown to be positively evaluated by patients (p < .01). This study confirmed at least equal efficacy of computer-based executive function therapy using ExeSystem compared to RehaCom and CogniPlus. However, despite the implementation of a more ecological and comprehensive approach to the content of a new application, the benefits of this approach were limited.

Objective: Epilepsy is a severe disease in which seizures play the leading role. Striking clinical manifestations of the attacks take most of the attention of healthcare professionals. Apart from epilepsy itself, it is well known that epilepsy patients may also have psychiatric comorbidities. These disorders, such as anxiety and depression, are mostly thought to be related to epileptic seizures or antiepileptic medications. In clinical practice, cognitive impairment is another disrupted area of interest in epileptic patients. Our study aimed to detect this deterioration and its correlations with mood disorders and epileptic disease features such as seizure frequency and illness duration.

Materials and methods: After obtaining verbal and written consent, we enrolled 52 epilepsy patients in our study. A short demographic form indicating their gender, epileptic disease features, and medication usage information was completed for each patient. The Quick Mild Cognitive Impairment Screen (QMCI) test, the Hamilton Anxiety Rating Scale (Ham-A), and the Hospital Anxiety and Depression Scale (HADS) were applied by an experienced psychologist. Abnormal brain magnetic resonance imaging findings (e.g., encephalomalacia, large arachnoid cysts, a considerable amount of white matter gliotic lesions, neoplastic or vascular space-occupying lesions, hippocampal malformations), vitamin and electrolyte imbalances, other chronic diseases as well as thyroid dysfunction were considered as exclusion criteria since they might interfere with cognition. We excluded abnormalities to this extent because we wanted to acquire a homogenous sampling population without structural disadvantages. Thus, we could be able to determine slight changes in cognition properly.

Results: We found decreased cognitive scores directly proportional to lower education level, higher seizure frequency, longer disease duration, generalized tonic-clonic (GTC) type of seizure, and antiepileptic polytherapy. Also, complying with the literature, a high frequency of depression was found in our study group. Interestingly, decreased anxiety levels of the patients were statistically related to higher seizure frequency, which may indicate adaptive mechanisms to frequent seizures. Finally, a multivariate regression analysis revealed a significant negative impact of GTC type of seizure on cognition.

Conclusion: Epilepsy and epileptic seizures affect cognition negatively. Thus, newly diagnosed epilepsy patients should be assessed for cognitive status as soon as possible. This assessment will allow epileptologists to understand future deteriorations in their patients' cognition. In our study, it is shown that QMCI is an effective and practical way to assess the cognitive statuses of epilepsy patients.

The purpose of this study was to determine how malingered PTSD behavior affects the performance of a continuous performance task (CPT). An analog trauma group, two malingering groups (with or without educational intervention), and a control group were organized according to simulation design. During the CPT, the numbers of errors and response time indicators along with post-error slowing (PES) and recovery (PER) process were measured. Results are as follows: First, the analog trauma group showed deficits of response inhibition and a higher level of PES compared to the control group. Second, malingered PTSD caused a significant number of errors, inconsistent performance, and no PES. Third, there was a significantly more impaired and inconsistent performance in the low level of knowledge of disability. Finally, a discriminant accuracy of more than 90% appeared in the discriminant analysis of all group comparison conditions. Taken together, the results of this study show that post-error behavior indicators are affected by malingered PTSD, and differences according to the degree of knowledge of PTSD can also be confirmed. These results are expected to be used as basic data for the development of tasks for the detection of malingerers in clinical scenes in the future.

The term "Activities of Daily Living" (ADLs) refers to a set of fundamental tasks (i.e., toileting, bathing, personal care, eating, grooming, and getting dressed) considered necessary for living and being autonomous in everyday life. Although in the clinical setting ADLs efficiency is a marker to diagnose dementia, limited evidence on the mechanism implicating muscular function and cognitive alterations in ADLs skills in late adulthood exists. This study primarily intended to determine the extent to which executive functions mediate between muscular strength, as assessed through handgrip strength (HGS) measurement, and ADLs skills of older community-dwellers. A further goal was to explore the impact of gender and cognitive status on ADLs and HGS scores, using education as a covariate. Three hundred and thirty-four older participants, 199 females and 135 males (M_age = 77.5 years, SD = 5.6 years, age range = 63-93 years) completed a battery of tests assessing ADLs, HGS, and executive functions. The results showed that 34-56% of the variance in the ADLs condition was explained by HGS and executive functioning. Furthermore, cognitively healthy participants exhibited better ADLs skills, whereas cognitively impaired individuals, both males and females, exhibited poorer HGS efficiency. In conclusion, in clinical settings, the concurrent evaluation of ADLs skills, motor, and higher-order cognitive processes should be encouraged to detect individuals needing a person-tailored intervention to boost their quality of life.

Purpose: Dementia includes all the symptoms associated with declining mental and cognitive skills, resulting in an inability to perform daily activities.

Objectives: We aimed to translate and adapt the Montréal Cognitive Assessment (MoCA) test into the Moroccan cultural context. We compared the sensitivity and specificity between MoCA and Mini-Mental State of Folstein (MMS) in the screening of dementia.

Materials and methods: The participants in this study were residents in the Fez-Meknes region and over 50 years old. We performed translation and adaptation of the English MoCA 8.1 version into all Moroccan languages: Darija, Tamazight in its three variants (Tachelhit, Tarifit, Atlas Tamazight), and Arabic. We validated Moroccan MoCA according to the Beaton et al. instructions.

Results: The sensitivity, specificity, and alpha Cronbach of the MoCA test were 88.5, 93.8%, and 0.87, while they were 90.2, 90.8%, and 0.79 for the MMS test.

Conclusion: The Moroccan MoCA test had high sensitivity, specificity, and internal reliability compared to the MMS test. The availability of the MoCA in the Moroccan language will be helpful in the screening of dementia and research studies in Morocco and other countries.

The accuracy of neuropsychological assessments relies on participants exhibiting their true abilities during administration. The Test of Memory Malingering (TOMM) is a popular performance validity test used to determine whether an individual is providing honest answers. While the TOMM has proven to be highly sensitive to those who are deliberately exaggerating their symptoms, there is a limited explanation regarding the significance of using 45 as a cutoff score. The present study aims to further investigate this question by examining TOMM scores obtained in a large sample of active-duty military personnel (N = 859, M = 26 years, SD = 6.14, 97.31% males, 72.44% white). Results indicated that no notable discrepancies existed between the frequency of participants who scored a 45 and those who scored slightly below a 45 on the TOMM. The sensitivity and specificity of the TOMM were derived using the forced-choice recognition (FCR) scores obtained by participants on the California Verbal Learning Test, Second Edition (CVLT-II). The sensitivity for each trial of the TOMM was 0.84, 0.55, and 0.63, respectively; the specificity for each trial of the TOMM was 0.69, 0.93, and 0.92, respectively. Because sensitivity and specificity rates are both of importance in this study, balanced accuracy scores were also reported. Results suggested that various alternative cutoff scores produced a more accurate classification compared to the traditional cutoff of 45. Further analyses using Fisher's exact test also indicated that there were no significant performance differences on the FCR of the CVLT-II between individuals who received a 44 and individuals who received a 45 on the TOMM. The current study provides evidence on why the traditional cutoff may not be the most effective score. Future research should consider employing alternative methods which do not rely on a single score.

This paper aims to examine the key factors influencing young drivers' hazard avoidance in Iran. In this study, a hazard avoidance index is defined and calculated for investigating the effect of impulsiveness, behavioral, and psychological characteristics on driving hazard avoidance. A questionnaire and go-no-go and flanker computer tests as well as a driving simulator are used for collecting data from 173 Iranian drivers under the age of 30. For this purpose, different scenarios were used, such as pedestrian crossing, the presence of fixed obstacles, and animals crossing the road, whose various characteristics are also changed. Structural equation modeling and the partial least squares method are applied for investigating the relationship between different variables and the hazard avoidance index. The results show that the driver hazard avoidance index is mostly affected by variables such as inhibitory control, opposite directional response, attentional impulsiveness, motion impulsiveness, non-planning impulsiveness, disregarding the law, and lapses and error. The results could help policymakers to assess diving hazard avoidance and improve training programs related to traffic safety based on the variables that are more effective on inexperienced and novice drivers' hazard avoidance.

While many studies have demonstrated a relationship between depression and cognitive deficits, most have neglected to include measurements of performance validity. This study examined the relationship between depression and cognition after accounting for noncredible performance. Participants were veterans referred for outpatient clinical evaluation. The first set of regression analyses (N = 187) included age, sex, and education in Model 1, Beck Depression Inventory-2 (BDI-2) added in Model 2, and pass/failure of Test of Memory Malingering (TOMM) added in Model 3 as predictors of 12 neuropsychological test indices. The second set of analyses (N = 559) mirrored the first but with Major Depressive Disorder (MDD) diagnosis in Models 2 and 3. In the first analyses, after including TOMM in the model, only the relationship between BDI-2 and verbal fluency remained significant, but this did not survive a Bonferroni correction. In the second analyses, after including TOMM and Bonferroni correction, MDD diagnosis was a significant predictor only for CVLT-II Short Delay Free Recall. Therefore, the relationship between depression and cognition may not be driven by frank cognitive impairment, but rather by psychological mechanisms, which has implications for addressing depressed individuals' concerns about their cognitive functioning and suggest the value of providing psychoeducation and reassurance.