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The processing of verbal memories after traumatic brain injury. 脑外伤后言语记忆的处理。
IF 3 3区 心理学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-07-10 DOI: 10.1080/13854046.2024.2374043
Jennie L Ponsford, Pagan Portelli, Eli Vakil, Marina G Downing

Objective: Memory dysfunction is a persistent cognitive symptom following traumatic brain injury (TBI), negatively impacting capacity for independent living and productivity. Traditional scoring of neuropsychological memory tests does not allow for differentiation of specific impairments of encoding, consolidation and/or retrieval, or the potential impact of strategy deficits. Method: The current study examined performance of 142 moderate-to-severe TBI participants and 68 demographically matched healthy controls on the Rey Auditory Verbal Learning Test (RAVLT) using Item Specific Data Analysis (ISDA) and strategy use analyses. Results: Results revealed significantly greater impairments in encoding, consolidation, and retrieval in TBI participants, compared to controls. Encoding deficits significantly explained the most variance in the long-delayed recall of TBI participants, followed by consolidation, and then retrieval. Participants with TBI showed a reduced ability to spontaneously apply strategies during learning, evident in decreased subjective clusters and increased word omissions, compared to controls. No difference was found between groups in passive learning strategy application, shown through serial clustering. Spontaneous strategy measures both uniquely accounted for variance in the encoding ability of TBI participants. Conclusions: These findings highlight the potential value in using ISDA and strategy use measures to assess RAVLT results to better characterize individual memory profiles and inform rehabilitative interventions.

目的:记忆功能障碍是创伤性脑损伤(TBI)后的一种持续性认知症状,会对独立生活能力和工作效率产生负面影响。神经心理学记忆测试的传统评分方法无法区分编码、巩固和/或检索的特定障碍,也无法区分策略缺陷的潜在影响。研究方法本研究采用特定项目数据分析(ISDA)和策略使用分析法,对142名中度至重度创伤性脑损伤患者和68名人口统计学上匹配的健康对照者在雷伊听觉言语学习测试(RAVLT)中的表现进行了检测。结果显示结果显示,与对照组相比,TBI 参与者在编码、巩固和检索方面的障碍明显更大。在 TBI 参与者的长时延迟回忆中,编码缺陷能明显解释最大的变异,其次是巩固,然后是检索。与对照组相比,创伤性脑损伤患者在学习过程中自发应用策略的能力有所下降,表现为主观词簇减少和漏词增加。在被动学习策略应用方面,通过序列聚类显示,组间没有发现差异。自发策略测量均能独特地解释 TBI 参与者编码能力的差异。结论:这些研究结果凸显了使用 ISDA 和策略使用测量来评估 RAVLT 结果的潜在价值,从而更好地描述个体记忆特征并为康复干预提供依据。
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引用次数: 0
Cognitive phenotypes in patients with drug-resistant temporal lobe epilepsy: Relationships with cortisol and affectivity. 耐药性颞叶癫痫患者的认知表型:与皮质醇和情感的关系。
IF 3 3区 心理学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-07-04 DOI: 10.1080/13854046.2024.2375605
Irene Cano-López, Judit Catalán-Aguilar, Alejandro Lozano-García, Vanesa Hidalgo, Kevin G Hampel, Paula Tormos-Pons, Alicia Salvador, Vicente Villanueva, Esperanza González-Bono

Objective: Drug-resistant temporal lobe epilepsy (TLE) is a neurological disorder characterized by cognitive deficits. This study examined whether patients with TLE and different cognitive phenotypes differ in cortisol levels and affectivity while controlling for demographic and clinical variables. Methods: In this cross-sectional study, 79 adults with TLE underwent neuropsychological evaluation in which memory, language, attention/processing speed, executive function, and affectivity were assessed. Six saliva samples were collected in the afternoon to examine the ability of the hypothalamic-pituitary-adrenal (HPA) axis to descend according to the circadian rhythm (C1 to C6). The cortisol area under the curve concerning ground (AUCg) was computed to examine global cortisol secretion.

Results: Three cognitive phenotypes were identified: memory impairment, generalized impairment, and no impairment. The memory-impairment phenotype showed higher cortisol levels at C4, C5, and C6 than the other groups (p = 0.03, η2 = 0.06), higher cortisol AUCg than the generalized-impairment phenotype (p = 0.004, η2 = 0.14), and a significant reduction in positive affectivity after the evaluation (p = 0.026, η2 = 0.11). Higher cortisol AUCg and reductions in positive affectivity were significant predictors of the memory-impairment phenotype (p < 0.001; Cox and Snell R2 = 0.47).

Conclusions: Patients with memory impairment had a slower decline in cortisol levels in the afternoon, which could be interpreted as an inability of the HPA axis to inhibit itself. Thus, chronic stress may influence hippocampus-dependent cognitive function more than other cognitive functions in patients with TLE.

目的:耐药性颞叶癫痫(TLE)是一种以认知障碍为特征的神经系统疾病。本研究在控制人口统计学和临床变量的前提下,探讨了不同认知表型的颞叶癫痫患者在皮质醇水平和情感方面是否存在差异。研究方法在这项横断面研究中,79 名患有 TLE 的成人接受了神经心理学评估,评估内容包括记忆、语言、注意力/处理速度、执行功能和情感。研究人员在下午采集了六份唾液样本,以检测下丘脑-垂体-肾上腺(HPA)轴根据昼夜节律(C1至C6)下降的能力。计算皮质醇在地面曲线下的面积(AUCg),以检查皮质醇的总体分泌情况:结果:发现了三种认知表型:记忆障碍、全身障碍和无障碍。记忆受损表型在 C4、C5 和 C6 的皮质醇水平高于其他组别(p = 0.03,η2 = 0.06),皮质醇 AUCg 高于普遍受损表型(p = 0.004,η2 = 0.14),评估后积极情绪显著降低(p = 0.026,η2 = 0.11)。较高的皮质醇AUCg和积极情绪的降低是记忆受损表型的重要预测因素(p 2 = 0.47):结论:记忆受损患者下午皮质醇水平的下降速度较慢,这可以解释为 HPA 轴无法自我抑制。因此,与其他认知功能相比,慢性应激可能会对依赖海马的认知功能产生更大影响。
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引用次数: 0
First report of Coffin-Siris Syndrome with SMARCB1 variant, normal intelligence and mild selective neuropsychological deficits: A case report and literature review. 首次报道科芬-西里斯综合征(Coffin-Siris Syndrome)伴有 SMARCB1 变异、正常智力和轻度选择性神经心理障碍:病例报告和文献综述。
IF 3 3区 心理学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-07-04 DOI: 10.1080/13854046.2024.2372879
Massimo Apicella, Andrea Battisti, Elisa Pisaneschi, Deny Menghini, Maria Cristina Digilio, Stefano Vicari

Background: The SMARCB1 gene encodes a subunit of the BRG1-Associated Factor (BAF) complex, and mutations in this gene have been linked to Coffin-Siris Syndrome (CSS) type 3. CSS is characterized by a range of developmental disabilities, facial dysmorphic features, and feeding difficulties. There's been noted genotype-phenotype correlation in CSS, with cases involving SMARCB1 mutations often exhibiting more severe language impairment and intellectual disability. Method: We conducted a review of reported CSS type 3 cases and presented the first instance of CSS associated with a SMARCB1 variant wherein the patient exhibited normal intelligence and only mild selective neuropsychological deficits. The patient underwent evaluation for feeding challenges, growth delay, and dysmorphic features during their second year of life. Subsequently, CSS diagnosis was confirmed due to a de novo heterozygous c.568C > T (p.Arg190Trp) variant in the SMARCB1 gene. Due to learning difficulties, the patient underwent a comprehensive neuropsychological assessment, which was related to the retrospective reconstruction of her medical and developmental history. Results: The patient demonstrated normal intelligence and adaptive functioning, with specific deficits in arithmetic and selective difficulties in verbal learning and long-term memory. Feeding difficulties and language delay observed in early childhood showed significant improvement over time. Discussion: We discuss this case in relation to previously reported CSS type 3 cases, emphasizing neuropsychological aspects. It's evident that neuropsychological features of CSS can vary among affected individuals, highlighting the importance of personalized support and interventions tailored to specific cognitive and emotional needs by healthcare professionals. Our case suggests avenues for future research to identify specific modifiers of phenotypic expression to explain variability in intellect among patients and pinpoint potential targets for gene therapy.

背景:SMARCB1 基因编码 BRG1 相关因子(BAF)复合物的一个亚基,该基因突变与科芬-西里斯综合征(Coffin-Siris Syndrome,CSS)3 型有关。CSS 的特征是一系列发育障碍、面部畸形和喂养困难。CSS的基因型与表型之间存在显著的相关性,涉及SMARCB1基因突变的病例通常表现出更严重的语言障碍和智力障碍。研究方法我们回顾了已报道的3型CSS病例,并首次发现了与SMARCB1变异相关的CSS病例,患者智力正常,仅有轻度选择性神经心理障碍。患者在出生后第二年接受了喂养困难、发育迟缓和畸形特征评估。随后,由于SMARCB1基因中的c.568C > T (p.Arg190Trp) 杂合子变异,CSS诊断得到确诊。由于存在学习困难,患者接受了全面的神经心理学评估,并对其病史和发育史进行了回顾性重建。结果显示患者的智力和适应能力正常,但在算术方面存在特殊缺陷,在语言学习和长期记忆方面存在选择性困难。幼儿期发现的喂养困难和语言发育迟缓随着时间的推移有了明显改善。讨论:我们结合之前报道的 CSS 3 型病例对该病例进行了讨论,并强调了神经心理学方面的问题。显而易见,不同患者的 CSS 神经心理特征可能会有所不同,这突出了医护人员针对特定认知和情感需求提供个性化支持和干预的重要性。我们的病例为今后的研究指明了方向,即找出表型表达的特定修饰因子,以解释患者智力的差异,并确定基因治疗的潜在靶点。
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引用次数: 0
Neuropsychiatric symptoms as a prodromal factor in Alzheimer's type neurodegenerative disease: A scoping review. 神经精神症状作为阿尔茨海默氏症型神经退行性疾病的前驱因素:一项范围界定综述。
IF 3 3区 心理学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-07-01 Epub Date: 2023-10-26 DOI: 10.1080/13854046.2023.2273574
Diego Alves Ferreira, Lorena Barbosa Cunha Macedo, Maria Paula Foss

Objective: Identifying neuropsychiatric symptoms (NPS) can aid in the early detection of Alzheimer's disease (AD); however, there is still a need for a greater consensus. This review aims to delineate the predominant NPS, compile a comprehensive list of the most commonly employed NPS assessment tools, and corroborate the principal findings regarding the link between NPS and neuropsychological assessment and neurobiological substrates. Methods: To conduct this scoping review, we followed the Preferred Reporting Items for Systematic Reviews guidelines and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). We searched for relevant articles published between 2017 and 2023 in MEDLINE, PsycINFO, PubMed, Web of Science, and Cochrane Library. Results: Of the 61 eligible articles, depression, anxiety, and apathy were the main NPSs. The Neuropsychiatric Inventory Questionnaire and Neuropsychiatric Inventory were the primary assessment tools used to evaluate NPS. Correlations between NPS severity and neurobiological markers were considered clinically significant. Furthermore, clinical procedures prioritized the use of global cognitive screening tools, assessments of executive functions, and functionality evaluations. Conclusion: Standardization of procedures is necessary because of the diversity of methods. The data show that NPS can predict the etiology, severity, form, and type of disease progression, serving as a precursor sign of AD. The results of the most common cognitive screening tools and NPS instruments provided an interesting overview of future clinical approaches.

目的:识别神经精神症状(NPS)有助于早期发现阿尔茨海默病(AD);然而,仍然需要达成更大的共识。本综述旨在描述主要的NPS,编制一份最常用的NPS评估工具的综合清单,并证实关于NPS与神经心理评估和神经生物学基础之间联系的主要发现。方法:为了进行范围界定审查,我们遵循了系统评价的首选报告项目指南和范围界定审查的荟萃分析扩展(PRISMA ScR)。我们在MEDLINE、PsycINFO、PubMed、Web of Science和Cochrane Library上搜索了2017年至2023年间发表的相关文章。结果:在61篇符合条件的文章中,抑郁、焦虑和冷漠是主要的NPS。神经精神问卷和神经精神问卷是用于评估NPS的主要评估工具。NPS严重程度和神经生物学标志物之间的相关性被认为具有临床意义。此外,临床程序优先使用全球认知筛查工具、执行功能评估和功能评估。结论:由于方法的多样性,程序的标准化是必要的。数据显示,NPS可以预测疾病进展的病因、严重程度、形式和类型,作为AD的前兆。最常见的认知筛查工具和NPS仪器的结果为未来的临床方法提供了一个有趣的概述。
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引用次数: 0
Case report: Neuropsychological assessment in a patient with 4H leukodystrophy. 病例报告:1例4H脑白质营养不良患者的神经心理学评估。
IF 3 3区 心理学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-07-01 Epub Date: 2023-11-16 DOI: 10.1080/13854046.2023.2279697
Aya Haneda, Jennifer K Hoots, Hannah A Hagy, Maureen Lacy

Objective: POLR3-HLD or 4H leukodystrophy is an autosomal recessive disorder characterized by hypomyelination, hypodontia, and hypogonadotropic hypogonadism, and caused by variants in POLR3A, POLR3B, POLR1C, or POLR3K genes. Neurological and non-neurological clinical features and disease severity vary. While previous studies reference variable cognition, this is the first report of 4H detailing a comprehensive neuropsychological assessment. Method: The current study presents a 20-year-old, English-speaking, right-handed, non-Hispanic White female with 12 years of education with genetically confirmed 4H POLR3B-related leukodystrophy without hormonal replacement treatment. Results: At age 4, developmental delays, ataxia, hearing loss, and abnormal dentition were present. Imaging, endocrinology, and neurologic examinations revealed hypomyelination, reduced cerebellar volume, delayed bone age density, osteopenia, and evidence of adrenarche without signs of true puberty. Neuropsychological assessment at age 20 revealed global cognitive impairment with intellectual, attention, verbal memory retrieval, construction, executive (e.g. processing speed, sustained attention) and math computation deficits, along with behavioral dysregulation. Conclusion: We present the first detailed neuropsychological assessment of a patient with 4H leukodystrophy. The neuropsychological assessment revealed cognitive and behavioral dysexecutive deficits aligning with hypomyelination observed on imaging. Further longitudinal studies are needed to shed light on the neurobehavioral presentation associated with this disorder to assist care providers, patients, and their families.

目的:POLR3-HLD或4H白质营养不良症是一种常染色体隐性遗传病,其特征为髓磷脂沉积减退、骨质疏松和促性腺功能低下,由POLR3A、POLR3B、POLR1C或POLR3K基因变异引起。神经学和非神经学临床特征和疾病严重程度各不相同。虽然以前的研究参考了可变认知,但这是4H详细介绍全面神经心理学评估的第一份报告。方法:本研究报告了一名20岁,英语,右撇子,非西班牙裔白人女性,受教育12年,遗传确诊为4H polr3b相关脑白质营养不良,未经激素替代治疗。结果:4岁时出现发育迟缓、共济失调、听力损失和牙列异常。影像学、内分泌学和神经学检查显示髓鞘增生减少、小脑体积减小、骨龄密度延迟、骨质减少,并有肾上腺素增高的迹象,但没有真正青春期的迹象。20岁时的神经心理学评估显示整体认知障碍,包括智力、注意力、言语记忆检索、构建、执行(如处理速度、持续注意力)和数学计算缺陷,以及行为失调。结论:我们提出了第一个详细的神经心理学评估患者的4H脑白质营养不良。神经心理学评估显示认知和行为执行障碍与影像学观察到的髓鞘退化一致。需要进一步的纵向研究来阐明与这种疾病相关的神经行为表现,以帮助护理人员、患者及其家属。
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引用次数: 0
Regression-based normative data for the D-KEFS Color-Word Interference Test in Norwegian adults ages 20-85. 挪威20-85岁成人D-KEFS颜色-单词干扰测验的回归规范数据
IF 3 3区 心理学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-07-01 Epub Date: 2023-11-16 DOI: 10.1080/13854046.2023.2276967
Jacob Espenes, Ingrid Myrvoll Lorentzen, Ingvild Vøllo Eliassen, Erik Hessen, Knut Waterloo, Santiago Timón-Reina, Tormod Fladby, Kristine B Walhovd, Anders M Fjell, Bjørn-Eivind Kirsebom

Objective: The Delis-Kaplan Executive Function System (D-KEFS) Color-Word-Interference Test (CWIT; AKA Stroop test) is a widely used measure of processing speed and executive function. While test materials and instructions have been translated to Norwegian, only American age-adjusted norms from D-KEFS are available in Norway. We here develop norms in a sample of 1011 Norwegians between 20 and 85 years. We provide indexes for stability over time and assess demographic adjustments applying the D-KEFS norms. Method: Participants were healthy Norwegian adults from Center for Lifespan Changes in Brain and Cognition (LCBC) (n = 899), the Dementia Disease Initiation (n = 77), and Oslo MCI (n = 35). Using regression-based norming, we estimated linear and non-linear effects of age, education, and sex on the CWIT 1-4 subtests. Stability over time was assessed with intraclass correlation coefficients (ICC). The normative adjustment of the D-KEFS norms was assessed with linear regression models. Results: Increasing age was associated with slower completion on all CWIT subtests in a non-linear fashion (accelerated lowering of performance with older age). Women performed better on CWIT-1&3. Higher education predicted faster completion time on CWIT-3&4. The original age-adjusted norms from D-KEFS did not adjust for sex or education. Furthermore, we observed significant, albeit small effects of age on all CWIT subtests. ICC analyses indicated moderate to good stability over time. Conclusion: We present demographically adjusted regression-based norms and stability indexes for the D-KEFS CWIT subtests. US D-KEFS norms may be inaccurate for Norwegians with high or low educational attainment, especially women.

目的:采用Delis-Kaplan执行功能系统(D-KEFS)颜色-文字干扰测验(CWIT);(又名Stroop测试)是一种广泛使用的测量处理速度和执行功能的方法。虽然测试材料和说明已经翻译成挪威语,但挪威只有D-KEFS的美国年龄调整标准可用。我们在这里对1011名年龄在20到85岁之间的挪威人进行了抽样调查。我们提供了随时间推移的稳定性指数,并应用D-KEFS规范评估人口调整。方法:参与者是来自大脑和认知寿命变化中心(LCBC)的健康挪威成年人(n = 899),痴呆症起始(n = 77)和奥斯陆MCI (n = 35)。使用基于回归的归一化,我们估计了年龄、教育程度和性别对CWIT 1-4子测试的线性和非线性影响。通过类内相关系数(ICC)评估随时间变化的稳定性。采用线性回归模型评估D-KEFS标准的规范性调整。结果:年龄的增长与所有CWIT子测试的完成速度减慢呈非线性相关(随着年龄的增长,表现加速下降)。女性在cwit -1和3上表现更好。高等教育预测cwit -3和4的完成时间更快。D-KEFS最初的年龄调整标准没有调整性别或教育程度。此外,我们观察到年龄对所有CWIT子测试的影响虽然很小,但却很显著。ICC分析表明,随着时间的推移,稳定性中等至良好。结论:我们为D-KEFS CWIT子测试提供了基于人口统计学调整的回归规范和稳定性指标。美国的D-KEFS标准对于受教育程度高或低的挪威人来说可能是不准确的,尤其是女性。
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引用次数: 0
Clinical recommendations for conducting pediatric functional language and memory mapping during the phase I epilepsy presurgical workup. 在I期癫痫术前检查中进行儿科功能语言和记忆绘图的临床建议。
IF 3 3区 心理学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-07-01 Epub Date: 2023-11-20 DOI: 10.1080/13854046.2023.2281708
Alyssa Ailion, Priscilla Duong, Moshe Maiman, Melissa Tsuboyama, Mary Lou Smith

Objective: Pediatric epilepsy surgery effectively controls seizures but may risk cognitive, language, or memory decline. Historically, the intra-carotid anesthetic procedure (IAP or Wada Test) was pivotal for language and memory function. However, advancements in noninvasive mapping, notably functional magnetic resonance imaging (fMRI), have transformed clinical practice, reducing IAP's role in presurgical evaluations. Method: We conducted a critical narrative review on mapping technologies, including factors to consider for discordance. Results: Neuropsychological findings suggest that if pre-surgery function remains intact and the surgery targets the eloquent cortex, there is a high chance for decline. Memory and language decline are particularly pronounced post-left anterior temporal lobe resection (ATL), making presurgical cognitive assessment crucial for predicting postoperative outcomes. However, the risk of functional decline is not always clear - particularly with higher rates of atypical organization in pediatric epilepsy patients and discordant findings from cognitive mapping. We found little research to date on the use of IAP and other newer technologies for lateralization/localization in pediatric epilepsy. Based on this review, we introduce an IAP decision tree to systematically navigate discordance in IAP decisions for epilepsy presurgical workup. Conclusions: Future research should be aimed at pediatric populations to improve the precision of functional mapping, determine which methods predict post-surgical deficits and then create evidence-based practice guidelines to standardize mapping procedures. Explicit directives are needed for resolving conflicts between developing mapping procedures and established clinical measures. The proposed decision tree is the first step to standardize when to consider IAP or invasive mapping, in coordination with the multidisciplinary epilepsy surgical team.

目的:小儿癫痫手术可有效控制癫痫发作,但可能存在认知、语言或记忆衰退的风险。历史上,颈动脉内麻醉程序(IAP或Wada测试)对语言和记忆功能至关重要。然而,无创测绘技术的进步,尤其是功能性磁共振成像(fMRI),已经改变了临床实践,减少了IAP在术前评估中的作用。方法:我们对制图技术进行了批判性的叙述回顾,包括考虑不一致的因素。结果:神经心理学研究结果表明,如果术前功能保持完整,手术的目标是雄辩皮层,则有很高的机会下降。记忆和语言衰退在左颞叶前切除术(ATL)后尤为明显,这使得术前认知评估对预测术后结果至关重要。然而,功能衰退的风险并不总是明确的,特别是儿童癫痫患者的非典型组织发生率较高,认知图谱的结果也不一致。迄今为止,我们发现关于IAP和其他新技术用于小儿癫痫侧化/定位的研究很少。基于这一综述,我们引入IAP决策树来系统地导航癫痫术前检查IAP决策中的不一致。结论:未来的研究应针对儿童人群,以提高功能制图的精度,确定哪些方法可以预测术后缺陷,然后制定循证实践指南来规范制图程序。需要明确的指示来解决正在开发的制图程序和已建立的临床措施之间的冲突。建议的决策树是标准化何时考虑IAP或侵入性测绘的第一步,与多学科癫痫外科团队协调。
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引用次数: 0
Forced choice test score of p ≤ .20 and failures on ≥ six performance validity tests results in similar Overall Test Battery Means. 强迫选择测试得分p≤0.20,且≥6项性能效度测试失败,导致类似的Overall test Battery Means。
IF 3 3区 心理学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-07-01 Epub Date: 2023-12-01 DOI: 10.1080/13854046.2023.2284975
Martin L Rohling, Laurence M Binder, Glenn J Larrabee, Jennifer Langhinrichsen-Rohling

Objective: To determine if similar levels of performance on the Overall Test Battery Mean (OTBM) occur at different forced choice test (FCT) p-value score failures. Second, to determine the OTBM levels that are associated with failures at above chance on various performance validity (PVT) tests. Method: OTBMs were computed from archival data obtained from four practices. We calculated each examinee's Estimated Premorbid Global Ability (EPGA) and OTBM. The sample size was 5,103 examinees with 282 (5.5%) of these scoring below chance at p ≤ .20 on at least one FCT. Results: The OTBM associated with a failure at p ≤ .20 was equivalent to the OTBM that was associated with failing 6 or more PVTs at above-chance cutoffs. The mean OTBMs relative to increasingly strict FCT p cutoffs were similar (T scores in the 30s). As expected, there was an inverse relationship between the number of PVTs failed and examinees' OTBMs. Conclusions: The data support the use of p ≤ .20 as the probability level for testing the significance of below chance performance on FCTs. The OTBM can be used to index the influence of invalid performance on outcomes, especially when an examinee scores below chance.

目的:确定在不同的强迫选择测试(FCT) p值评分失败时,是否会出现类似的总体测试电池平均值(OTBM)表现水平。其次,确定在各种性能有效性(PVT)测试中与高于概率的失败相关的OTBM级别。方法:根据四个实践的档案数据计算otbm。我们计算了每位考生的预估病前整体能力(EPGA)和OTBM。样本量为5103名考生,其中282人(5.5%)在至少一项FCT上得分低于机会,p≤0.20。结果:与p≤0.20失败相关的OTBM与在高于机会截止点失败6个或更多pvt相关的OTBM相当。相对于越来越严格的FCT p截止值,平均otbm相似(T分数在30分左右)。正如预期的那样,pvt不及格的人数与考生的otbm之间呈反比关系。结论:数据支持使用p≤0.20作为检验fct上机会以下表现显著性的概率水平。OTBM可以用来衡量无效表现对结果的影响,特别是当考生得分低于机会时。
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引用次数: 0
Phenocopy behavioral variant frontotemporal dementia: A case study. 表型行为变异性额颞叶痴呆症:病例研究。
IF 3 3区 心理学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-07-01 Epub Date: 2024-02-15 DOI: 10.1080/13854046.2024.2315726
Rachel M Peters, Christine M Schieszler-Ockrassa, Angela Gleason, Kathleen Patterson

Objective: Behavioral variant frontotemporal dementia (bvFTD) is a neurodegenerative condition characterized by progressive changes in behavior, cognition, and day-to-day functioning. Progression of the disease usually leads to death 3-5 years after diagnosis. However, there are reports of individuals who are initially diagnosed with bvFTD but fail to progress. These individuals are thought to have what is becoming known as phenocopy bvFTD (phFTD). Methods: This manuscript reviews a single case study of a 68-year-old male Veteran who was diagnosed with bvFTD in 2010, which has not progressed over time. Results: Review of serial neuropsychological evaluations was broadly normal with mild evidence of executive dysfunction with minimal reliable change in his performances from 2015, 2017, and 2022 evaluations. He also has not developed neuroimaging evidence of FTD. Conclusions: This case illustrates the importance of monitoring individuals over time and incorporating neuroimaging data into the diagnosis. We believe this Veteran's presentation is most consistent with what has been described as phFTD.

目的:行为变异性额颞叶痴呆症(bvFTD)是一种神经退行性疾病,以行为、认知和日常功能的渐进性改变为特征。病情恶化通常会导致患者在确诊后 3-5 年死亡。不过,也有报告称,有些人最初被诊断为 bvFTD,但病情没有进展。这些人被认为患有所谓的表型 bvFTD(phFTD)。方法:本手稿回顾了一例研究,研究对象是一名 68 岁的男性退伍军人,他于 2010 年被诊断为 bvFTD,但随着时间的推移,病情并未发展。研究结果连续的神经心理学评估结果大致正常,有轻微的执行功能障碍证据,2015 年、2017 年和 2022 年的评估结果对其表现的可靠改变极小。他也没有出现 FTD 的神经影像学证据。结论:本病例说明了对患者进行长期监测并将神经影像学数据纳入诊断的重要性。我们认为这名退伍军人的表现最符合 phFTD 的描述。
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引用次数: 0
The Cognitive Awareness Scale for Basic and Instrumental activities of daily living to measure self-awareness after acquired brain injury: Preliminary evidence of its validity. 测量后天性脑损伤后自我意识的日常生活基础和工具活动认知意识量表:其有效性的初步证据。
IF 3 3区 心理学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-07-01 Epub Date: 2023-11-08 DOI: 10.1080/13854046.2023.2278822
Daniel Salazar-Frías, María Rodríguez-Bailón, Giorgia Ricchetti, Alba Navarro-Egido, María Jesús Funes

Objective: There is a crucial need for reliable tools to measure impaired self-awareness (ISA) in patients with acquired brain injury (ABI) across cognitive-functional domains. The aim of this study was to assess the psychometric properties of the Cog-Awareness ADL Scale, which is a novel self-proxy discrepancy method for measuring ISA in both basic and instrumental activities of daily living. Methods: This multicenter study included 54 patients (no-low ISA n = 33; severe ISA, n = 21) from four outpatient rehabilitation units in Málaga-Granada, Spain, and 51 healthy controls. The participants and proxy raters completed the Cog-Awareness ADL Scale and the Patient Competency Rating Scale (PCRS). Agreement between both scales was assessed using Spearman's correlations and the Bland-Altman plot. Group comparisons were made on measures of SA, cognitive abilities and demographic variables. Sensitivity and specificity were analysed by ROC curve analysis. Results: Convergent validity was supported by strong correlations with the PCRS and its subscales (rho's ranging from 0.51 to 0.80, p < 0.01 for all). The Bland-Altman plot confirmed measurement agreement (only 3.70% of the scores were outside the 95% limits). External validity was demonstrated by effectively discriminating between healthy controls and ABI patients with no-low and severe ISA on each discrepancy index while controlling for cognitive/demographic variables. The Cog-Awareness ADL Scale showed optimal diagnostic accuracy (AUC = 0.95, sensitivity = 0.90, specificity = 0.90). Conclusions: The Cog-Awareness ADL Scale proved to be a feasible, valid, and clinical tool to assess ISA across different cognitive-functional domains, in Spanish ABI-patients.

目的:迫切需要可靠的工具来测量获得性脑损伤(ABI)患者跨认知功能领域的自我意识受损(ISA)。本研究的目的是评估Cog Awareness ADL量表的心理测量特性,这是一种新的自我代理差异方法,用于测量日常生活的基本活动和工具活动中的ISA。方法:这项多中心研究包括54名患者(无低ISA n = 33;严重ISA,n = 21)来自西班牙格拉纳达马拉加的四个门诊康复单位,以及51名健康对照。参与者和代理评分者完成了Cog意识ADL量表和患者能力评定量表(PCRS)。两个量表之间的一致性使用斯皮尔曼相关性和布兰德-奥特曼图进行评估。对SA、认知能力和人口统计学变量进行了分组比较。ROC曲线分析敏感性和特异性。结果:聚合有效性得到了与PCRS及其分量表的强相关性的支持(ρ在0.51至0.80之间,p 结论:Cog Awareness ADL量表被证明是一种可行、有效和临床的工具,可以评估西班牙ABI患者不同认知功能领域的ISA。
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引用次数: 0
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Clinical Neuropsychologist
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