京都大学 / 新制・課程博士 / 博士(人間健康科学) / 甲第24540号 / 人健博第111号 / 新制||人健||8(附属図書館) / 京都大学大学院医学研究科人間健康科学系専攻 / (主査)教授 澤本 伸克, 教授 稲富 宏之, 教授 髙橋 良輔 / 学位規則第4条第1項該当 / Doctor of Human Health Sciences / Kyoto University / DFAM

Regardless of the reason, many patients/clients do not have access to face-to-face medical, neuropsychological, or mental health consultation, assessment, or treatment (Cowain, 2001). The term Remote Neuropsychological Assessment (RNA) has been proposed by Browndyke to denote the general use of telecommunication and Internet-based technologies in neuropsychological assessment and practice (as cited in Schatz & Browndyke, 2002). RNA (Telemedicine) offers a plausible, potentially cost-effective solution to individuals in need of medical, neuropsychological, or mental health consultation, assessment, or treatment that are located in geographical areas away from the specialist (Armstrong, 2006; Berman, 2005; Cowain, 2001; Jacobsen, Sprenger, Andersson, & Krogstad, 2003). The purpose of this study was to examine if test performance for RNA administration of the Cognistat is comparable to test performance for the pencil-paper administration. A one-way repeated measures multivariate analysis of variance (MANOVA) was used to analyze the data. The main effect for administration modality was not significant, F(9, 126) = .375, p = .945. The present study demonstrated the utility of a widely used neurobehavioral screening test that provides a differentiated profile of cognitive status can now reliably be used through a video-conferencing administration. The importance of this finding is that a more comprehensive detection of deficits in multiple domains of cognitive functioning for screening purposes is now possible remotely.

A neuropsychological examination is often used in tandem with other measures to confirm the diagnosis of idiopathic Normal Pressure Hydrocephalus (iNPH) and to assess improvement in cognitive functioning after a lumbar puncture test. Improvement in symptoms is thought to predict benefit from installation of a ventriculoperitoneal shunt that redirects CSF from the brain. Although the 72-hour external lumbar drain (ELD) has long been the gold-standard drainage procedure, hospitals are increasingly opting for the high-volume lumbar puncture, during which 50ml of CSF is released over an hour before the patient is tested for improvement in symptoms. The primary aims of this study were to evaluate the changes in cognitive performance produced by the two LP procedures and to compare the results produced by each procedure. In a review of medical records, 40 patients met criteria for inclusion. Cognitive functioning in the 72-hour ELD (n = 10) group was compared to changes in patients in the HVLP group, in terms of baseline level of functioning and post-drain changes. Statistical methods used to determine change included ANOVA and Reliable Change Indices. Dominant-hand Grooved Pegboard Test showed significant change after lumbar puncture, with higher mean change in the 72-hour ELD group. 72-hour ELD patients had a slightly higher rate of Reliable Change than HVLP patients. Cognitive changes were bi-directional in both groups. Results suggest that changes in cognitive functioning after lumbar puncture occur in a minority of patients, regardless of procedure type, and may have low predictive value for VPS benefit.

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Thesis (M.Soc.Sc. Psychology)--University of Waikato, 2006. / Includes bibliographical references (leaves 58-69)

Neuropsychologists are becoming increasingly aware that there is a complex interplay of cognitive, personality, and sociocultural factors that affect an individual's performance on neuropsychological tests. The current study investigated the effect of one aspect of the sociocultural environment, that is, quality of education, on performance on neuropsychological tests of executive function. The sample included 40 high school learners: Group A comprised learners with a high quality of education and Group B comprised learners with a low quality of education. Four tests of executive function were administered: the Verbal Fluency Test, the Design Fluency Test, the Stroop Test and the Wisconsin Card Sorting Test. Results indicated that quality of education significantly affected the participants' performance with Group A performing significantly better than Group B on all the tests of executive function. These findings have implications for the interpretation of neuropsychological test performance in cross-cultural research and practice. / Psychology / M.A. (Clinical Psychology)

Background: Assessment of dementia in adults with intellectual disabilities poses specific challenges. Firstly, there is a paucity of validated, standardised and appropriate neuropsychological assessments of memory for adults with intellectual disabilities. Secondly, there are difficulties determining whether performance on neuropsychological assessments are attributable to preexisting intellectual disabilities, ‘normal’ ageing or part of a dementing process. A systematic review was therefore carried out to examine if there are memory changes associated with ‘normal’ ageing in the Down syndrome population. Following this an exploratory empirical research project was undertaken to examine one aspect of construct validity (i.e. convergent validity) of an associative memory test in a sample of adults with intellectual disabilities. This research project is presented as a journal article titled ‘Convergent validity of the Visual Association Test (VAT) in adults with intellectual disabilities’. Methods: 40 participants aged between 18-45 years were recruited from Community Learning Disability Teams. Participants completed the VAT and subtests of the modified Cambridge Cognitive Examination (CAMCOG-DS). IQ was assessed using the Wechsler Adult Intelligence Scale, Fourth Edition (WAIS-IV). Correlational analysis of the test variables were carried out. Participants with a diagnosis of dementia were excluded from the study. Results: All participants performed well on the VAT irrespective of age, gender or IQ. It was well received by participants. No significant correlations were found between the VAT and the subtests of the CAMCOG-DS or with the subtests of the WAIS-IV. Therefore, there was no evidence of convergent validity with this test in this sample of participants. Conclusions: While the VAT was found to be an easy, quick test to use with people with intellectual disabilities and all participants scored above ‘floor’ level, it was not found to have convergent validity with the CAMCOG-DS. Further research is needed to determine if the VAT represents a useful tool for assessment with this population.

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Reitan and Wolfson's General Neuropsychological Deficit Scale and Left and Right Neuropsychological Deficit Scales were applied to Halstead-Reitan test data of individuals with psychotic or substance abuse disorders with and without a head injury.