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Cognitive reserve in the recovery and rehabilitation of stroke and traumatic brain injury: A systematic review. 中风和脑外伤康复过程中的认知储备:系统综述。
IF 3 3区 心理学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-09-22 DOI: 10.1080/13854046.2024.2405226
Giulia Oliva, Fabio Masina, Nazanin Hosseinkhani, Sonia Montemurro, Giorgio Arcara

Objective: Cognitive reserve (CR) is the brain's ability to cope with changes related to aging and/or disease. Originally introduced to explain individual differences in the clinical manifestations of dementia, CR has recently emerged as a relevant construct in stroke and traumatic brain injury (TBI). This systematic review aims to investigate whether CR could predict post-stroke and TBI clinical recovery and rehabilitation outcomes, and how different variables used to estimate CR (i.e., proxies) are related to the prognosis and effectiveness of rehabilitation in these clinical populations. Method: A search was made in Pubmed, Embase, and PsycInfo for articles published until 12 January 2023, following the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) protocol guidelines. Results: 31 studies were included after completing all screening stages. Overall, results show that a higher CR was associated with a better prognosis and a more effective rehabilitation in most of the clinical aspects considered: cognitive functioning, functional, occupational, and socio-emotional abilities, as well as psychiatric and neurological scales. Conclusions: A higher CR seems to be associated with a more favorable prognosis and a better rehabilitation outcome after stroke and TBI. Results suggest that CR should be taken into account in clinical practice to make more accurate predictions about recovery and effectiveness of rehabilitation. However, some inconsistencies suggest the need for further investigations, possibly using multiple proxies for CR.

目的:认知储备(CR认知储备(CR)是大脑应对与衰老和/或疾病相关的变化的能力。认知储备最初用于解释痴呆症临床表现的个体差异,最近已成为中风和创伤性脑损伤(TBI)的相关概念。本系统综述旨在研究 CR 是否可以预测中风和创伤性脑损伤后的临床恢复和康复效果,以及用于估算 CR 的不同变量(即替代变量)与这些临床人群的预后和康复效果之间的关系。研究方法:在Pubmed、Embase和PsycInfo上搜索截至2023年1月12日发表的文章,并遵循系统综述和元分析首选报告项目(PRISMA)协议指南。结果在完成所有筛选阶段后,共纳入 31 项研究。总体而言,研究结果表明,在认知功能、功能、职业和社会情感能力以及精神和神经量表等大多数临床方面,CR 越高,预后越好,康复效果越好。结论较高的 CR 似乎与中风和创伤性脑损伤后更有利的预后和更好的康复效果相关。结果表明,临床实践中应考虑 CR,以便更准确地预测康复情况和康复效果。然而,一些不一致的结果表明有必要进行进一步的研究,可能需要使用多种 CR 代用指标。
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引用次数: 0
Comparing in-home telehealth and in-person administration of neuropsychological measures in an outpatient pediatric sample during the COVID-19 pandemic. 比较在 COVID-19 大流行期间对门诊儿科样本进行的居家远程保健和面对面神经心理测量。
IF 3 3区 心理学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-09-19 DOI: 10.1080/13854046.2024.2403734
Madeline C Manning, Pieter J Vuijk, Eline Laurent, Emmaline Cook, Ellen B Braaten, Alysa E Doyle, Mary K Colvin

Objective: Research establishing the validity of neuropsychological assessment using telehealth (teleNP) is much needed in pediatric populations. Method: Current analyses compared performances on twelve common neuropsychological measures completed at home via teleNP or in-person during the COVID-19 pandemic in 476 youth (ages 6 to 17, Mage 11.4 ± 3.0). Results: No differences were found on nine measures. In-person performances on three verbal tests were ∼1 scaled score point lower (all padjusted <.05). Post-hoc analyses showed that the in-person pandemic performances were comparable to an in-person pre-pandemic cohort (unmasked). Conclusions: Overall, teleNP was comparable to in-person assessment. Results indicate that teleNP administration does not result in substantially different performance in pediatric patients undergoing clinical evaluations.

目的:儿科人群亟需通过远程医疗(teleNP)进行神经心理评估的有效性研究。研究方法在 COVID-19 大流行期间,对 476 名青少年(6 至 17 岁,Mage 11.4 ± 3.0)在家中通过远程 NP 或面对面完成的 12 项常见神经心理评估进行了分析比较。结果显示九项测试结果无差异。在三项言语测试中,面对面测试的成绩比远程测试低 1 分(均为调整后的结论):总体而言,远程 NP 与面对面评估结果相当。结果表明,对接受临床评估的儿科患者进行远程 NP 不会导致其表现出现重大差异。
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引用次数: 0
Large-scale evidence for the validity of remote MoCA administration among people with cerebellar ataxia. 小脑共济失调患者远程MoCA管理有效性的大规模证据。
IF 3 3区 心理学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-09-05 DOI: 10.1080/13854046.2024.2397835
Yael De Picciotto, Avigail Lithwick Algon, Inbal Amit, Eli Vakil, William Saban

Objective: For over half a century, studies of rare diseases using in-person cognitive tools have faced challenges, such as long study periods and small sample sizes (e.g. n = 10). The Montreal Cognitive Assessment (MoCA) was widely employed to assess mild cognitive impairment (MCI). We aimed to validate a modified online version of the MoCA in a large sample of a rare disease (population prevalence < .01%). Method: First, we analyzed 20 previous findings (n = 1,377), comparing the MoCA scores between large groups of neurotypically healthy (NH; n = 837) and cerebellar ataxia (CA; n = 540), where studies were conducted in-person. Second, we administered the MoCA in-person to a group of NH (n = 41) and a large group of CA (n = 103). Third, we administered a video conferencing version of the MoCA to NH (n = 38) and a large group of CA (n = 83). Results: We observed no performance differences between online and in-person MoCA administration in the NH and CA groups (p > .05, η2 = 0.001), supporting reliability. Additionally, our online CA group had lower MoCA scores than the NH group (p < .001, Hedges' g = 0.68). This result is consistent with previous studies, as demonstrated by our forest plot across 20 previous in-person findings, supporting construct validity. Conclusion: The results indicate that an online screening tool is valid in a large sample of individuals with CA. Online testing is not only time and cost-effective, but facilitates disease management and monitoring, ultimately enabling early detection of MCI.

目的:半个多世纪以来,使用现场认知工具对罕见疾病进行的研究一直面临着研究周期长、样本量小(如 n = 10)等挑战。蒙特利尔认知评估(MoCA)被广泛用于评估轻度认知障碍(MCI)。我们的目的是在一种罕见疾病的大样本中(人群患病率小于 0.01%)验证经过修改的在线版 MoCA。方法:首先,我们分析了之前的20项研究结果(n = 1,377),比较了神经健康(NH;n = 837)和小脑共济失调(CA;n = 540)两大群体的MoCA得分,这些研究都是亲自进行的。其次,我们对一组神经健康者(n = 41)和一大组小脑共济失调者(n = 103)亲自进行了 MoCA 测试。第三,我们对 NH(n = 38)和一大群 CA(n = 83)进行了视频会议版的 MoCA 测试。测试结果我们观察到,在线和面对面进行 MoCA 测验时,NH 组和 CA 组的表现没有差异(P > .05, η2 = 0.001),这证明了其可靠性。此外,在线 CA 组的 MoCA 分数低于 NH 组(p < .001,Hedges' g = 0.68)。这一结果与之前的研究结果一致,我们的森林图显示了之前 20 项面对面研究的结果,支持建构有效性。结论研究结果表明,在线筛查工具在大样本 CA 患者中是有效的。在线测试不仅省时省力,而且有利于疾病管理和监测,最终实现 MCI 的早期检测。
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引用次数: 0
A clinical evaluation program to monitor neurocognitive risk in children and adolescents with sickle cell disease. 监测镰状细胞病儿童和青少年神经认知风险的临床评估计划。
IF 3 3区 心理学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-09-04 DOI: 10.1080/13854046.2024.2399861
Jennifer N Longoria, Jane E Schreiber, Brian Potter, Darcy Raches, Erin MacArthur, Diana Cohen, Marshetta Brazley-Rodgers, Jane S Hankins, Andrew M Heitzer

Objective: Sickle cell disease (SCD) is an inherited hematologic disorder that impacts approximately 100,000 Americans. This disease is associated with progressive organ damage, cerebral vascular accident, and neurocognitive deficits. Recent guidelines from the American Society of Hematology (ASH) recommend cognitive screening with a psychologist to help manage cerebrovascular risk and cognitive impairment in this population. SCD patients benefit from neuropsychology services and several institutions already have programs in place to monitor cognitive risk. Program Description: We describe a longitudinal neurocognitive evaluation program at our institution that serves all patients with SCD, regardless of disease severity or referral question. The Sickle Cell Assessment of Neurocognitive Skills (SCANS) program was established in 2012. We outline the program's theoretical framework, timepoints for evaluation, test battery, logistics, patient demographics, integration with research programming, and multidisciplinary collaboration to support optimal outcomes. Program Outcomes: Our program has provided 716 targeted neuropsychological evaluations for patients over the last decade. Nearly 26% of patients in the program have been followed longitudinally. The most common diagnoses generated across cross-sectional and longitudinal evaluations include cognitive disorder (n = 191), attention-deficit/hyperactivity disorder (n = 75), and specific learning disorder (n = 75). Approximately 87% of patients who participated in SCANS during late adolescence successfully transitioned from pediatric to adult care. Conclusion: We discuss considerations for developing programming to meet the needs of this population, including tiered assessment models, timing of evaluations, scope, and reimbursement. Program models that utilize prevention-based tiered models or targeted evaluations can assist with serving large volumes of patients.

目的:镰状细胞病(SCD)是一种遗传性血液病,影响着约 10 万美国人。这种疾病与渐进性器官损伤、脑血管意外和神经认知缺陷有关。美国血液学会(ASH)最近发布的指南建议由心理学家进行认知筛查,以帮助管理该人群的脑血管风险和认知障碍。SCD 患者从神经心理学服务中获益匪浅,一些机构已经制定了监控认知风险的计划。项目简介:我们介绍了本机构的一项纵向神经认知评估项目,该项目为所有 SCD 患者提供服务,无论疾病严重程度或转诊问题如何。镰状细胞神经认知能力评估(SCANS)项目成立于 2012 年。我们概述了该计划的理论框架、评估时间点、测试电池、后勤保障、患者人口统计学、与研究计划的整合以及多学科合作以支持最佳结果。项目成果:在过去十年中,我们的项目已为患者提供了 716 次有针对性的神经心理评估。该项目对近 26% 的患者进行了纵向随访。横向和纵向评估中最常见的诊断包括认知障碍(191 例)、注意力缺陷/多动障碍(75 例)和特殊学习障碍(75 例)。在青春期晚期参加 SCANS 的患者中,约有 87% 成功地从儿科转为成人护理。结论:我们讨论了制定方案以满足该人群需求的注意事项,包括分层评估模型、评估时机、范围和报销。利用以预防为基础的分层模式或针对性评估的计划模式可以帮助为大量患者提供服务。
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引用次数: 0
Neuropsychology practice guidance for the neuropsychiatric aspects of Long COVID. Long COVID 神经心理学实践指南。
IF 3 3区 心理学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-08-23 DOI: 10.1080/13854046.2024.2392943
Christine H Koterba, Ciaran M Considine, Jacqueline H Becker, Kristen R Hoskinson, Rowena Ng, Gray Vargas, Michael R Basso, Antonio Enrique Puente, Sara M Lippa, Douglas M Whiteside

Objective: The coronavirus disease-2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), has had a profound global impact on individual health and well-being in adults and children. While most fully recover from COVID-19, a relatively large subgroup continues to experience persistent physical, cognitive, and emotional/behavioral symptoms beyond the initial infection period. The World Health Organization has termed this phenomenon "Post-COVID-19 Condition" (PCC), better known as "Long COVID." Due to the cognitive and psychosocial symptoms, neuropsychologists often assess and recommend treatment for individuals with Long COVID. However, guidance for neuropsychologists' involvement in clinical care, policy-making, and research has not yet been developed. The authors of this manuscript convened to address this critical gap and develop guidance for clinical neuropsychologists working with patients presenting with Long COVID. Method: Authors include pediatric and adult neuropsychologists with expertise in Long COVID and behavioral health. All authors have been engaged in clinical and research efforts examining the impact of COVID-19. Authors summarized the literature-to-date pertinent to the neuropsychiatric sequelae of Long COVID and developed guidance for neuropsychologists working with individuals with Long COVID. Conclusions: Research findings regarding neuropsychiatric symptoms associated with Long COVID are mixed and limited by methodological differences. As they practice and conduct research, neuropsychologists should remain mindful of the evolving and tenuous nature of the literature.

目的:由严重急性呼吸系统综合征冠状病毒-2(SARS-CoV-2)引起的冠状病毒病-2019(COVID-19)大流行对全球成人和儿童的个人健康和福祉产生了深远的影响。虽然大多数人从 COVID-19 中完全康复,但仍有相对较大的亚群在最初感染期后继续出现持续的身体、认知和情绪/行为症状。世界卫生组织将这种现象称为 "后 COVID-19 症状"(PCC),也就是我们常说的 "长 COVID"。由于存在认知和社会心理症状,神经心理学家通常会对 Long COVID 患者进行评估并提出治疗建议。然而,神经心理学家参与临床护理、政策制定和研究的指南尚未制定。本手稿的作者们召集了会议,以解决这一关键性空白,并为临床神经心理学家在治疗长COVID患者时提供指导。方法:作者包括儿科和成人神经心理学家,他们都具有 Long COVID 和行为健康方面的专业知识。所有作者都参与了研究 COVID-19 影响的临床和研究工作。作者总结了与 Long COVID 神经精神后遗症相关的最新文献,并为神经心理学家治疗 Long COVID 患者制定了指南。结论:与 Long COVID 相关的神经精神症状的研究结果参差不齐,并受到方法学差异的限制。神经心理学家在进行实践和研究时,应始终注意文献的不断发展和不稳定性。
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引用次数: 0
The role of cognitive reserve and depression on executive function in older adults: A 10-year study from the Wisconsin Registry for Alzheimer's Prevention. 认知储备和抑郁对老年人执行功能的影响:威斯康星州阿尔茨海默氏症预防登记处的一项为期 10 年的研究。
IF 3 3区 心理学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-08-23 DOI: 10.1080/13854046.2024.2388904
Loredana Frau, Erin Jonaitis, Rebecca E Langhough, Megan Zuelsdorff, Ozioma Okonkwo, Davide Bruno

Objective: The current study examined the longitudinal relationship between cognitive reserve (CR), depression, and executive function (EF) in a cohort of older adults. Methods: 416 participants were selected from the Wisconsin Registry for Alzheimer's Prevention. They were native English speakers, aged ≥50+, and cognitively unimpaired at baseline, with no history of neurological or other psychiatric disorders aside from depression. Depression was assessed with the 20-item Center for Epidemiologic Studies Depression Scale (CES-D). A composite score, based on the premorbid IQ (WRAT-3 Reading subtest) and years of education was used to estimate CR. Another composite score from four cognitive tests was used to estimate EF. A moderation analysis was performed to evaluate the effects of CR and Depression on EF at follow-up after controlling for age, gender, and APOE risk score. Moreover, a multinomial logistic regression was used to predict conversion to Mild Cognitive Impairment (MCI) from the healthy baseline. Results: The negative relationship between depression and EF was stronger in individuals with higher CR levels, suggesting a possible floor effect at lower CR levels. In the multinomial regression, the interaction between CR and depression predicted conversion to MCI status, indicating that lower CR paired with more severe depression at baseline was associated with a higher risk of subsequent impairment. Conclusions: This study sheds light on the intricate relationship between depression and EF over time, suggesting that the association may be influenced by varying levels of CR. Further studies may replicate these findings in clinical populations.

研究目的本研究考察了一组老年人认知储备(CR)、抑郁和执行功能(EF)之间的纵向关系。方法:从威斯康星州阿尔茨海默氏症预防登记处选取了 416 名参与者。他们以英语为母语,年龄≥50 岁以上,基线认知能力无障碍,除抑郁症外,无神经或其他精神疾病史。抑郁症采用 20 项流行病学研究中心抑郁量表(CES-D)进行评估。根据病前智商(WRAT-3 阅读子测试)和受教育年限得出的综合得分用于估算 CR。另一项来自四项认知测试的综合得分用于估算EF。在控制年龄、性别和 APOE 风险评分后,进行了调节分析,以评估 CR 和抑郁对随访时 EF 的影响。此外,还使用多项式逻辑回归预测从健康基线转为轻度认知障碍(MCI)的情况。结果显示在 CR 水平较高的个体中,抑郁与 EF 之间的负相关更强,这表明在 CR 水平较低时可能存在底线效应。在多项式回归中,CR 与抑郁之间的交互作用预测了向 MCI 状态的转换,表明基线时较低的 CR 与较严重的抑郁配对与较高的后续损伤风险相关。结论:本研究揭示了抑郁与 EF 之间随时间变化的复杂关系,表明这种关系可能受到不同 CR 水平的影响。进一步的研究可能会在临床人群中复制这些发现。
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引用次数: 0
Health insurance coverage moderates the relationship between metabolic syndrome and baseline memory outcomes in Latino older adults. 医疗保险的覆盖面可调节拉丁裔老年人代谢综合征与基线记忆结果之间的关系。
IF 3 3区 心理学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-08-19 DOI: 10.1080/13854046.2024.2392303
Jordana Breton, Janelle T Foret, Abbey M Hamlin, Nazareth Ortega, Alexandra L Clark

Objective: Latino adults are at increased risk of metabolic syndrome (MetS) and have lower rates of health insurance (HI) coverage. Although inadequate HI coverage and MetS have been independently linked to poor cognition, their potential interactive effects have not yet been examined. The present study explored whether HI moderated the association between MetS and cognition. We hypothesized that Latinos with MetS that did not have HI would demonstrate poorer cognition than those with HI, whereas there would be minimal differences in cognition across HI status in those without MetS. Methods: Cross-sectional data from 805 Latino older adults enrolled in the Health and Aging Brain Study-Health Disparities was utilized. Analysis of covariance adjusting for sociodemographics examined MetS x HI interactions on memory and attention/executive functions composites. Results: Results revealed a significant MetS x HI interaction on memory (F = 4.33, p = 0.037, ηp2 = .01); Latino adults with MetS and no HI coverage had worse memory performance than those with MetS who had HI coverage (p = 0.022, ηp2 = .01), whereas there was no significant difference in memory between HI coverage groups in those without MetS (p > .05, ηp2 = .002). No MetS x HI interaction was observed for the attention/executive functions composite (F = 0.29, p = 0.588, ηp2 < .001). Conclusion: Latino older adults with MetS that do not have HI coverage may be at risk for poorer memory outcomes. Increasing the accessibility of HI coverage may help reduce cognitive health disparities in Latino older adults with vascular health comorbidities.

目的:拉丁裔成年人患代谢综合征(MetS)的风险增加,而他们的医疗保险(HI)覆盖率较低。虽然医疗保险覆盖率不足和代谢综合征与认知能力差有独立联系,但尚未研究它们之间潜在的交互影响。本研究探讨了健康保险是否会调节 MetS 与认知能力之间的关系。我们假设,患有 MetS 但没有 HI 的拉美人的认知能力会比有 HI 的人差,而没有 MetS 的拉美人在不同 HI 状态下的认知能力差异很小。研究方法利用参加 "健康与老龄化大脑研究--健康差异 "的 805 名拉丁裔老年人的横截面数据。调整社会人口统计学因素后进行协方差分析,研究 MetS x HI 在记忆力和注意力/执行功能组合上的交互作用。结果显示结果表明,MetS x HI 在记忆力方面存在明显的交互作用(F = 4.33,p = 0.037,ηp2 = .01);患有 MetS 但没有 HI 保险的拉丁裔成年人的记忆力比患有 MetS 但有 HI 保险的成年人差(p = 0.022,ηp2 = .01),而在没有 MetS 的人群中,HI 保险组之间的记忆力没有明显差异(p > .05,ηp2 = .002)。在注意力/执行功能综合方面,未观察到 MetS x HI 的交互作用(F = 0.29,p = 0.588,ηp2 < .001)。结论患有 MetS 的拉丁裔老年人如果没有医疗保险,可能会面临记忆力较差的风险。提高医疗保险的可及性可能有助于减少患有血管健康合并症的拉美裔老年人在认知健康方面的差异。
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引用次数: 0
Hashimoto encephalopathy: a literature review and case report with comprehensive neuropsychological evaluation. 桥本脑病:文献综述和病例报告及综合神经心理学评估。
IF 3 3区 心理学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-08-18 DOI: 10.1080/13854046.2024.2388905
Lauren A-M Schenck, Halle T McCracken, Frank Andrasik, Brandon C Baughman

Objective: Hashimoto's encephalopathy (HE), a rare immune-mediated disorder, manifests as altered mental state, cognitive and psychological dysfunction, seizures, and myoclonus. Little is known, however, about the neuropsychological profiles of individuals with HE due to the sparse amount of research. This report overviews HE, summarizes findings from available published neuropsychological evaluations, and details neuropsychological examinations of a 57-year-old White woman with a confirmed HE diagnosis evidencing persistent neuropsychological impairment at two discrete timepoints. Method: An extensive literature search was conducted on PubMed and Google Scholar for studies including neuropsychological evaluations of HE cases. Our neuropsychological evaluation included chart review, diagnostic clinical interview, performance-based neurocognitive assessment, and measures of personality and psychopathology. Results: Our assessment revealed a largely subcortical pattern of neurocognitive impairment and impactful neuropsychiatric symptoms that, together, significantly impacted the patient's quality of life and functional status. The patient's performance improved during a six-month re-evaluation within the domains of cognition, psychological functioning, and functional independence. Conclusions: This article highlights the complexity and possible long-term sequela of HE. Complex medical history (including autoimmune disorders) and psychiatric presentation at onset may be factors related to longer-term cognitive dysfunction. Neuropsychology and psychology can serve important and unique roles in assessing long-term functioning and response to treatment in such cases.

目的:桥本脑病(HE)是一种罕见的免疫介导疾病,表现为精神状态改变、认知和心理功能障碍、癫痫发作和肌阵挛。然而,由于研究数量稀少,人们对 HE 患者的神经心理学特征知之甚少。本报告概述了高血压,总结了已发表的神经心理学评估结果,并详细介绍了对一名确诊为高血压的 57 岁白人女性进行的神经心理学检查,该患者在两个不连续的时间点上出现了持续性神经心理障碍。研究方法我们在 PubMed 和 Google Scholar 上进行了广泛的文献检索,以了解有关 HE 病例神经心理学评估的研究。我们的神经心理学评估包括病历审查、诊断性临床访谈、基于表现的神经认知评估以及人格和精神病理学测量。评估结果我们的评估结果显示,患者的神经认知功能障碍主要表现为皮层下模式,并伴有严重的神经精神症状,这些症状严重影响了患者的生活质量和功能状态。在为期 6 个月的重新评估中,患者在认知、心理功能和功能独立性方面的表现均有所改善。结论:本文强调了高血压的复杂性和可能出现的长期后遗症。复杂的病史(包括自身免疫性疾病)和发病时的精神表现可能是导致长期认知功能障碍的相关因素。神经心理学和心理学可在评估此类病例的长期功能和治疗反应方面发挥重要而独特的作用。
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引用次数: 0
Performance validity in a presurgical epilepsy population. 在手术前癫痫人群中的有效性。
IF 3 3区 心理学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-08-13 DOI: 10.1080/13854046.2024.2391128
Sofia Lesica, Hien Luu, Michael Lawrence

Objective: This study examined the performance validity test (PVT) pass/fail rate in a sample of presurgical epilepsy candidates; assessed whether performance validity was associated with reduced performance across cognitive domains; investigated the relationship between performance validity and self-report mood questionnaires; and assessed whether PVT performance was associated with demographic or clinical factors (i.e. sex, race/ethnicity, age, years of education, reported history of special education, seizure longevity, and number of anti-seizure medications). Methods: One hundred and eighty-three presurgical epilepsy candidates were examined. Each patient's assessment battery included a stand-alone performance validity measure and two embedded validity measures. Results: PVT failure rate in this sample (10%) was associated with reduced performance on all neurocognitive measures: Full Scale IQ (FSIQ; r = -0.26), CVLT-II Total Learning (r = -0.36) and Long Delay Free Recall (LDFR; r = -0.38), BVMT-R Delayed Recall (r = -0.28), and Wisconsin Card Sorting Test (Categories Completed; r = -0.32). In addition, PVT failure rate was associated with elevated scores on the Beck Anxiety Inventory (r = .22) but not on the Beck Depression Inventory (BDI-II; r = .14). Correlations that were significant at the α = 0.05 level maintained significance following post hoc Bonferroni correction. The valid and invalid groups did not differ significantly in sex, race/ethnicity, age, years of education, reported history of special education, seizure longevity, and number of anti-seizure medications. Conclusions: Results from this study suggest that PVT performance was not impacted by demographic or clinical factors and therefore may be a reliable indicator of performance validity in a presurgical epilepsy sample.

研究目的本研究检测了手术前癫痫患者样本的表现有效性测试(PVT)通过/失败率;评估了表现有效性是否与认知领域表现下降有关;调查了表现有效性与自我报告情绪问卷之间的关系;评估了表现有效性是否与人口统计学或临床因素(即性别、种族/民族、年龄、受教育年限、报告的特殊教育史、癫痫发作持续时间和抗癫痫药物的数量)有关。研究方法对 183 名手术前癫痫患者进行了检查。每位患者的评估电池包括一个独立的表现效度测量和两个嵌入式效度测量。结果:在该样本中,PVT 失败率(10%)与所有神经认知测量的成绩下降有关:全量表智商(FSIQ;r = -0.26)、CVLT-II 总学习(r = -0.36)和长延迟自由回忆(LDFR;r = -0.38)、BVMT-R 延迟回忆(r = -0.28)和威斯康星卡片分类测试(类别完成;r = -0.32)。此外,PVT 失败率与贝克焦虑量表(Beck Anxiety Inventory)(r = 0.22)的得分升高有关,但与贝克抑郁量表(Beck Depression Inventory)(BDI-II;r = 0.14)的得分升高无关。在 α = 0.05 水平上具有显著性的相关性在进行事后 Bonferroni 校正后仍具有显著性。有效组和无效组在性别、种族/民族、年龄、受教育年限、报告的特殊教育史、癫痫发作持续时间和抗癫痫药物数量方面没有显著差异。结论本研究的结果表明,PVT 的表现不受人口统计学或临床因素的影响,因此可能是衡量手术前癫痫样本表现有效性的可靠指标。
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引用次数: 0
Methods for assessment of rey auditory verbal learning test performance in memory clinic patients and healthy adults - at the cross-roads of learning theory and clinical utility. 记忆门诊病人和健康成年人的雷伊听觉言语学习测试成绩评估方法--学习理论与临床实用性的交叉点。
IF 3 3区 心理学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-08-12 DOI: 10.1080/13854046.2024.2384616
Ove Almkvist, Anna Rennie, Eric Westman, John Wallert, Urban Ekman

Background: Knowledge is still lacking regarding the preferred method for evaluation of learning in the Rey Auditory Verbal Learning Test (RAVLT). Validity of different methods was examined by the effect size in differentiating diagnostic stages in memory clinic patients versus healthy adults and the strength of association between RAVLT performance and brain atrophy. Method: The study included individuals with dementia (n = 247), Mild Cognitive Impairment (MCI, n = 709), Subjective Cognitive Impairment (SCI, n = 175) and cognitively unimpaired adults serving as healthy controls (HC, n = 102). All patients went through a comprehensive clinical examination and neuropsychological assessment of cognition including episodic memory gauged with RAVLT and brain imaging of medial temporal atrophy, cortical atrophy, and white matter hyperintensity. Results: The standard method for evaluation of learning in RAVLT (summed score over five trials) together with the late learning method (mean of trials 4 and 5) were the two most powerful methods according to group differentiation (discriminant validity). Both methods also showed considerable association with medial temporal atrophy (construct validity). The initial RAVLT performance represented by results on trial 1 and the constant in regression analysis with the power function provided information regarding attention that was important for the separation of SCI and HC. Conclusions: The most favorable clinical utility was indicated by discriminant and construct validity by total learning (standard method) including both attention- and learning-related parts and late learning of RAVLT performance, while theoretical understanding of mental processes involved in RAVLT performance was provided by the distinction between initial versus the subsequent learning performance.

背景:关于雷伊听觉言语学习测验(RAVLT)学习评估的首选方法,目前仍缺乏相关知识。本研究通过区分记忆门诊病人与健康成人诊断阶段的效应大小,以及雷氏听觉言语学习测验成绩与脑萎缩之间的关联强度,对不同方法的有效性进行了研究。研究方法研究对象包括痴呆症患者(247 人)、轻度认知障碍患者(MCI,709 人)、主观认知障碍患者(SCI,175 人)以及作为健康对照的认知功能未受损成年人(HC,102 人)。所有患者都接受了全面的临床检查和认知神经心理学评估,包括用 RAVLT 测定外显记忆,以及颞叶内侧萎缩、皮质萎缩和白质密度增高的脑成像。结果RAVLT 学习评估的标准方法(5 次试验的总分)和晚期学习方法(第 4 次和第 5 次试验的平均分)是两种最有效的组间区分方法(判别效度)。这两种方法还显示出与内侧颞叶萎缩有相当大的关联(构造效度)。以试验 1 的结果为代表的 RAVLT 初始成绩和幂函数回归分析中的常数提供了有关注意力的信息,这些信息对于区分 SCI 和 HC 非常重要。结论包括注意力和学习相关部分在内的总学习(标准方法)以及 RAVLT 表现的后期学习的判别有效性和建构有效性显示了最有利的临床实用性,而对 RAVLT 表现所涉及的心理过程的理论理解则体现在对初始学习表现和后续学习表现的区分上。
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引用次数: 0
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Clinical Neuropsychologist
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