This project represents a descriptive analysis of Forms I and II of the Luria-Nebraska Neuropsychological Battery and an investigation of the applicability of Item Response Theory in neuropsychological assessment. Test protocols of 1280 Form I examinees and 405 Form II examinees were analyzed by item and scale using Item Response Theory. The analysis consisted of investigation of the fit of LNNB data to the one and two-parameter IRT models, analysis of item and scale residuals and information values, comparison of traditional and IRT approaches in derivation of the Pathognomonic, Right Hemisphere and Left Hemisphere scales and comparison of two IRT approaches to the identification of biased items. In general, the one-parameter model did not fit the LNNB data. The two-parameter model, however provided a generally good fit to the data. Scale residuals and information functions indicate that the LNNB scales are unidimensional and accurately measure their underlying pyschological constructs. Item analysis identified several items on each scale that do not contribute to the measurement of the scalar trait. Suggestions were made for deletion, relocation or alteration of these items to improve their measurement properties. Substantial differences were found between Form I and Form II based on item characteristic curves and b-value differences. The nature of these differences suggested that the size and ability distribution of the Form II sample may have prevented accurate parameter estimation, obscuring the comparison of the two forms of the battery. A number of items on the Pathognomonic, right Hemisphere and Left Hemisphere scales were identified that contribute little to the measurement properties of these scales. Additional items not on these scales, were identified that are candidates for inclusion on these scales. Comparison of the statistical tests of b-value differences with ICC differences, for identification of potentially biased items, suggests that the latter method may be more efficacious in the neuropsychological domain. It is concluded that the LNNB is an accurate and content valid test of neuropsychological abilities; that IRT methods could improve the measurement properties of the scales and that ICC differences are an effective approach to item bias detection.

The study was planned to investigate issues relating to the Luria-Nebraska Neuropsychological Battery. The aims were to investigate the influence of age, sex and socio-economic status on performance on the Luria-Nebraska Neuropsychological Battery. A sample of forty males and forty females, stratified according to age (25-40 year olds and 50-60 year olds) and socio-economic status was selected. The results suggested that age formed a significant effect on the total and individual scale scores of the battery. There were no significant sex differences on the total score and most of the scale scores of the battery. Sex formed a significant variable on the performance on the intellectual processes and visual scales. A significant negative correlation was found between total and scale scores of the Luria-Nebraska Neuropsychological Battery and socio-economic status. The implications of these findings are discussed. / Thesis (M.A.)-University of Durban-Westville, Durban, 1991.

This study used an archival data set of 26 healthy adult immigrants from a sub-Saharan African country to the United States (Mage 39.0, SD = 11.36; Meducation 16.33, SD = 2.88; 40.7% male). Additional archival data was used for 32 healthy African American adults (Mage 34.06, SD = 11.18; Meducation 16.16, SD = 2.49; 53.1% male). A bivariate correlation indicated that acculturation to African culture, as measured by the mBIQ (M 49.29, SD = 8.66), was significantly positively correlated with ethnicity, r = .632, p = .000, ηp2 = 0.399. Two-way ANOVAs revealed that African Americans were able to name more animals than African immigrants (F(1, 54) = 4.82, p = 0.32, ηp2 = 0.82) and exhibited greater organizational skills during a task of cognitive set shifting and problem solving than African immigrants, regardless of level of acculturation (F(1, 54) = 4.47, p =.039, ηp2 = 0.078). In contrast, African immigrants scored higher than African Americans on indigenous fruit (F(1, 54) = 7.60, p =.008, ηp2 = 0.123) and object naming (F(1, 54) = 5.59, p =.022, ηp2 = 0.094). Results of the study concluded that there are small variance effects in language tasks as well as strategy-based approaches to tasks of novel problem solving. Implications of these findings are discussed relative to future research as well as clinical practice in the assessment of culturally dissimilar people across a racially homogenous population by pushing the field forward with diversified approaches to neuropsychological testing.

The factor structure of the Luria Nebraska Neuropsychological Battery (LNNB) Form II was examined. A principle components factor analysis was performed on a sample of 102 psychiatric and neurologic subjects. It was necessary to remove 45 items from the analysis due to perfect performance by most subjects. The results were orthogonally rotated to simple structure using a Varimax method of rotation, and then compared to previous LNNB Form I and Form II results. Thirty-three factors were generated in the Exploratory Factor Analysis (EFA) . There was a very high agreement with the factors from Form I. Only one new factor was identified that didn't have a comparable Form I factor, and this factor appears to have neurological support. The similarity of the factor solutions between the two forms supports the continued use of factors derived from Form I for the interpretation of Form II, and supports the underlying structure presupposed by Lurian constructs. The present study also tested the significance of the hypothesized factor structures through confirmatory factor analysis (CFA). No hypothesis about the underlying factor structure based on previous exploratory studies was supported. The CFA did suggest that the best factor solution to the LNNB Form II is one that (a) has correlated factors and (b) has items loading on more than one factor. The confirmatory results were interpreted as not supporting the current exploratory results, or the previous factor analytic results. Problems notwithstanding, researchers may be better directed to propose factor models for the LNNB that have correlated factors, and to work samples approaching the 10 to 1 recommended sample size for multivariate analysis. One conclusion that was drawn from the concurrence between the two Form II studies pertains to psychiatric populations used in both studies. It was necessary to exclude a large number of items in each study due to perfect performance by most of the subjects on those items. Most of the items removed were identical in both studies supporting the notion that a shortened version of the LNNB could be administered to psychiatric populations.

No abstract available. / Thesis (Ph.D.)-University of Natal, Durban, 1989.

The Luria-Nebraska Neuropsychological Battery (LNNB) was published in 1980 as an attempt to provide clinicians with a standardized version of the neuropsychological assessment and diagnostic procedures proposed by A. R. Luria and A, L. Christensen. Research on the LNNB included a series of factor analyses for each of eleven clinical scales. The analyses were completed on the combined scores obtained from a sample of normal, brain-damaged, and psychiatric populations. A second version of the LNNB was published in 1985 as a largely parallel version of Form I, but included changes in stimulus materials, administration procedures, and scoring procedures. The present study completed factor analyses on same eleven clinical scales using data generated with the newer LNNB Form II. The statistical procedures and criteria employed in the present investigation were identical to those used earlier on Form I to allow for comparisons between the two resulting sets of factor structures. The patient populations were different, however, in that all subjects in the current study were receiving inpatient care in a private psychiatric hospital which specializes in long-term treatment. Despite the changes in materials and procedures and the difference in subject parameters, the factors identified in the present investigation are similar to those seen in the Form I studies. However, two trends were observed when comparing the two sets of factor structures. First, in the present study several items were excluded from the statistical procedures because they were performed perfectly by almost everyone and the resulting scores lacked statistical variance. Second, more homogenous factors were obtained with the Form II analysis. That is, some of the complex LNNB Form I factors were reduced to two or more simpler factors. The results of the study lend support to Luna's conceptual model of higher cortical function and to the reliability of the LNNB as an assessment instrument.

Alexandria Luria's approach to neuropsychological assessment and his theory of brain functioning have been exploited in order to develop a neuropsychological evaluation procedure for children which incorporates a conceptualization of brain-behaviour development. Luria's Neuropsychological Investigation for adults was administered to intact children aged eight to 14 years in order to ascertain which tasks were beyond their capabilities. These were then adapted or deleted. The adapted version of the protocol was then administered to a second group of intact children to determine that the proposed adaptations were appropriate. This process was guided by the results of a statistical analysis which revealed significant findings with respect to age, socioeconomic status, and task performance. A model of brain-behaviour development and interpretive protocol were devised. Together these provide a conceptual and interpretive framework for the battery. Developmental trends which emerged whilst developing Luria's Neuropsychological Investigation for Children (LNI-C) were consistent with the progressive development of successively more complex forms of information processing as depicted in this model. They were also in keeping with prominent developmental theories such as those of Piaget and Vygotsky. These trends revealed that children made most mistakes on adult LNI tasks involving abstract reasoning, the simultaneous synthesis of data, and complex goal-directed behaviour - all of which apparently reflect tertiary cortical zone functioning. Fewer mistakes were related to a lack of training and inability to process the same quantity of information as adults - difficulties which seemed related to secondary zone functioning. None of the mistakes made appeared to reflect subcortical or primary zone functioning. The LNI-C was applied to brain-damaged children who had had a CT scan in order to demonstrate its application and the hypothetico-deductive process of interpreting findings using the concepts of syndrome analysis and double dissociation. The LNI-C findings were consistent with the general pattern of symptoms Luria described for different brain disorders and lesion localities in children, although additional insight into the nature of the sequelae present was gained in each case. In early brain damage, the most frequent disturbances were a disruption in the role played by executive functions and the ability to process data simultaneously - both of which are associated with the tertiary zones of the brain. Furthermore, these disturbances appeared to be important factors underlying disturbances to language and educationally acquired skills. The qualitative, process-orientated nature of the LNI-C proved effective for identifying the factors underlying disturbances described in paramedical reports. These seemed to be the linchpins on which retraining should focus. It was argued that the CT scan was limited in its ability to identify the type of diffuse and/or multifocal brain pathology frequently found in children. The usefulness of the model of brain-behaviour ontogeny and interpretive protocol for diagnosis, understanding and predicting the developmental consequences of childhood brain pathology was demonstrated on the basis of nine brain disorders. Finally, areas of future research were highlighted by the study. / Thesis (Ph.D.)-University of Natal, Durban, 1989.

Magister Public Health - MPH / Despite the effectiveness and scale-up of antiretroviral treatment (ART), HIV-Associated neurocognitive disorders (HAND) still persist. Currently no gold standard tool exists to detect all forms of HAND, including major and minor cognitive impairments. In light of this, a newly developed screening tool was conceptualised, namely the Quick Paediatric Neurocognitive Screening tool (QPNST). The QPNST has been developed to detect HAND in perinatally HIV-infected children aged 5-10 years.

[pt] A doença de Parkinson (DP) é considerada a segunda doença neurodegenerativa mais comum e suas características motoras são muito mais conhecidas que as não motoras, mas o comprometimento funcional está presente em quase todos os casos. A Estimulação Cerebral Profunda (ECP), que consiste na estimulação elétrica de estruturas subcorticais para diminuir ou cessar os sintomas motores, tem sido usada como uma ferramenta para maior controle dos sintomas motores e está ganhando terreno em estudos com sintomas não motores. É por esse motivo que foi realizada uma revisão sistemática para conhecer os instrumentos utilizados na avaliação neuropsicológica de pessoas com DP submetidas à cirurgia ECP nos núcleus subtalâmicos (NST), além de investigar também se surgiriam efeitos cognitivos após a cirurgia. Além disso, uma bateria neuropsicológica computadorizada, a CompCog, foi validada para pessoas com DP de um hospital público da cidade do Rio de Janeiro e também foi usada para comparar os estágios ON e OFF de 9 pacientes, de uma clínica privada, que fizeram a implantação da ECP-NST. Com as revisões sistemáticas foi possível elaborar um protocolo de avaliação neuropsicológica, posteriormente utilizado nos estudos empíricos e verificar que a fluência verbal foi o aspecto que apresentou maior diferença entre os estágios ON e OFF dos pacientes com ECP-NST. No estudo de validação clínica da CompCog foi possível estabelecer pontos de corte para as pessoas com DP e no estudo de comparação entre estágios ON e OFF de pessoas com DP e ECP-NST foi possível identificar que as variáveis de tempo como tempo médio de reação e tempo total, foram capazes de diferenciar os dois estágios, ON e OFF, da amostra de 9 pessoas nos subtestes de memória incidental, memória episódica e controle inibitório, além de apresentar uma tendência à diferenciação na atenção, velocidade de processamento e memória episódica. / [en] Parkinson s disease (PD) is considered the second most common neurodegenerative disease and its motor characteristics are much better known than non-motor ones, but functional impairment is present in almost all cases. Deep Brain Stimulation (DBS), which consists of electrical stimulation of subcortical structures to decrease or stop motor symptoms, has been used as a tool for greater control of motor symptoms and is gaining ground in studies with non-motor symptoms. It is for this reason that a systematic review was carried out to find out the instruments used in the neuropsychological assessment of people with PD who underwent DBS surgery in subtalamic nuclei (STN) and to investigate whether cognitive effects would arise after surgery. In addition, a computerized neuropsychological battery, the CompCog, was validated for people with PD from a public hospital in the Rio de Janeiro city and was also used to compare ON and OFF stages of 9 patients, from a private clinic, who did the implementation of the DBS-STN. With systematic reviews, it was possible to develop a neuropsychological assessment protocol, later used in empirical studies and to verify that verbal fluency was the aspect that showed the greatest difference between the ON and OFF stages of patients with ECP-NST. In the clinical validation study of CompCog it was possible to establish cutoff points for people with PD and in the comparison study between ON and OFF stages of people with PD and ECP-NST it was possible to identify that the time variables such as mean reaction time and total time, were able to differentiate the two stages, ON and OFF, of the sample of 9 people in the subtests of incidental memory, episodic memory and inhibitory control, in addition to showing a tendency to differentiate in attention, processing speed and episodic memory.

Background. Within the South African context there is a large body of research regarding the associations between maternal gestational drinking and diagnosable child FASDs. However, there remains a paucity of local research regarding the impacts of other kinds of maternal drinking behaviours (e.g. past and present maternal drinking) and related socio-demographic factors on developmentally sensitive areas of child neurocognitive functioning, such as executive functioning (EF). Methods. This study was cross-sectional in design, utilising a gender balanced sample of N=464 children between the ages of 9.00 and 15.12 (year.months) in three rural areas within the Western Cape. Information regarding maternal drinking behaviours (before, during and after pregnancy) and related socio-demographic factors was collected via structured interviews with mothers or proxy respondents. Six subtests from the Cambridge Automated Neuropsychological Battery (CANTAB), were used to assess three aspects of child EF namely: (1) processing speed, assessed by the MOT and RTI subtests, (2) attention, assessed by the MTT and RVP subtests and (3) memory, assessed by the SWM and PAL subtests. Findings. For all three maternal alcohol use behaviours examined, there was an apparent non-significant trend whereby children of mothers who reported alcohol use (before, during and after pregnancy) performed worse (on average) than children of mothers reporting non-alcohol use on the EF subtests. Several of the socio-demographic factors were found to act as significant predictors of subtest specific EF performance including child sex (RTI: B=.46, p<. 01; MTT: B=.05, p<.05), child age (RTI: B=.27, p<.05; MTT: B=.11, p<.01), home language (MOT: B=- .13, p<.05), maternal employment (MTT: B=-.04, p<.05) and household size (SWM: B=-1.29, p<.05). Conclusions. These study findings provide initial insights into the impacts of different types of maternal drinking behaviours and related socio-demographic factors on child EF outcomes within the context of an LMIC, South Africa.