This Master thesis focuses on the neuropsychological test called Rey-Osterrieth complex figure test and its diagnostic value in the clinical assesment of schizophrenic patients. Deficiency of cognitive functioning is a dominating feature in the clinical picture of schizophrenic patients. Attention is brought especially to the specific aspects of the ROCF performance in the clinical group of schizophrenic patients. Theoretical part is based on the realized investigative studies focused on the Rey-Osterrieth complex figure test and its value in cognitive assesment in psychodiagnostic praxis. The diagnostic method ROCF is presented in its complexity, the way of administration, assesment and interpretation are described and attention is also brought to the specific features of ROCF performance in healthy, neurological and psychiatric patients with focus on schizophrenic individuals. Empirical part of the thesis in the first section compares the ROCF performance of Czech healthy individuals and schizophrenic patients. The influence of demografic and other factors on the ROCF performance was analyzed and isolated elements of the figure and their difficultness was evaluated in both surveyed groups. Outcomes of this master thesis could contribute to the present knowledge of the diagnostic possibilities of...

The diagnosis of neurodegenerative diseases leading to dementia is increasingly moving to the earlier stages in an effort to find the disease-modifying treatment for these diseases. Prodromal and preclinical stages of the diseases have become the primary research interests. Neuropsychology is specifically focused on early cognitive markers and development of methods that would be able to reliably assess these markers and to evaluate the risk of progression of cognitive decline in individual cases. The theoretical part of the thesis presents the current knowledge in the field of neurodegenerative diseases, it is specifically focused on Alzheimer's disease (AD) as the most common cause of dementia. We also present the current trends in neuropsychological diagnostics of early AD and the approach to subjective and objective evaluation of cognitive functioning. Building on that, we present the rationale for the empirical part of the thesis. The empirical part of the thesis extends the existing knowledge in the field of AD. We present and discuss seven original publications that follow three basic objectives: first, to characterize subjective cognitive complaints of individuals at risk of AD, second, to evaluate the potential of selected standard and experimental neuropsychological methods to detect...

Objectives: The purpose of the current study was to evaluate whether a 12-week neuropsychological rehabilitation program has a positive effect on the improvement of cognitive functions and what methods can be used to measure this effect. Furthermore, this study intended to verify the effect of the chosen training plan on the resulting state of cognitive functions, in particular with regard to the frequency and duration of the plan. Methodology: Forty-three patients diagnosed with MS were randomized into an experimental condition or the control group. The experimental condition included 26 patients (22 women and 4 men), whole the control group consisted of 17 patients (12 women and 5 men). All of these patients had a cognitive defect that was assessed at the beginning of the study and monitored using the neuropsychological tests after the participation in the training program. Participants in the experimental group received their rehabilitation of cognitive functions using a PC training program, which they completed in their home environments (30 minutes/4 times per week, for 8 consecutive weeks). Overall, there were 32 training sessions on predetermined days with a specific detailed training plan. The control group received no training. The neuropsychological tests used at the beginning and the...

Pro les of cognitive de cit and the use of a short neuropsychological battery in di erent types of dementia Eva Bolceková Abstract This work focuses on cognitive de cit pro les and the use of a short neuropsychological battery in patients with di erent types of dementia. Increasing prevalence of dementia syndromes highlights the need of their e cient diagnostics in clinical-psychological practice. Theoretical part of this work presents an overview of neurodegenerative diseases with em- phasis on their neuropsychological presentation. We describe the cogni- tive domains and their neuropsychological examination. We address in detail the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and its experimental Czech version. Research part of the work is based on neuropsychological examinations of 311 patients with cognitive de cit and 118 healthy controls. Patients' group is comprised of subjects with Alzheimer's disease, mild cognitive impairment, vascular cognitive impairment, Lewy Body disease, frontotemporal lobar degene- ration and patients with depression. We assess their cognitive pro les, present sensitivity, speci city, positive and negativne predictive values of RBANS scores for the groups and compare the results of control subjects with the original normative sample. We...

The present study investigated the criterion-based validity of the Mini-Mental State Examination (MMSE), the Cognitive Capacity Screening Examination (CCSE), and the Neurobehavioral Cognitive Status Examination (NCSE) in a sample of older adults with suspected cognitive impairment. As cognitive screening tests, the MMSE, CCSE, and NCSE should predict performance relative to a more thorough testing procedure. In the present study, performance on the Halstead-Reitan Neuropsychological Test Battery (HRNTB) was employed as the criterion measure. Scores on the General Neuropsychological Deficit Scale (G-NDS), a global performance measure computed from the HRNTB, served as the standard by which to judge the presence of cognitive impairment. The sensitivity, specificity, and predictive value of each screening test, as well as how well each screening test correlated with the G-NDS, were investigated. Results of this investigation found that, although the MMSE, CCSE, and NCSE were all significantly correlated with the G-NDS, only the NCSE demonstrated an appropriate balance between high sensitivity and specificity. When a rigorous neuropsychological evaluation was employed as the criterion standard, the NCSE accurately detected the presence of cognitive impairment: in 82% of the cases. The MMSE and CCSE, however, failed to detect cognitive deficits in approximately 80% of the cases. These findings strongly suggest that the MMSE and CCSE may have limited utility in the identification of cognitive impairment in older adults. The heightened sensitivity of the NCSE appears to be the result of several unigue features of the instrument, including a multidimensional scoring system and a graded series of increasingly difficult items within each ability area. Future studies need to examine the utility of the NCSE in other geriatric settings, as well as with more diverse populations suffering from a variety of organic mental syndromes.

Neuropsychological aspects of preclinical stages of neurodegenerative diseases are an extensively studied topic in neuropsychological research. Neuropsychological assessment can be helpful for the estimation of conversion risk in individual cases. The focus of neuropsychological research shifted from the evaluation of dementia to mild cognitive impairment (MCI) or even to the detection of cognitive change before significant cognitive decline. In the theoretical part is presented a contemporary outline of preclinical stages of neurodegenerative diseases. The construct of MCI is the most studied topic in the prodromal stage of neurodegeneration and this part is dedicated to comprehensive analysis of MCI. The empirical research includes five studies on screening methods of cognitive abilities, memory and verbal fluency tests. We present normative and validity data in older adults and show their detection potential in MCI or preclinical stages of neurodegenerative diseases. Furthermore, we tried to show the detection potential of different memory measures in patients with MCI and estimate the relations between hippocampal atrophy and memory performance. Key words mild cognitive impairment, dementia syndrome, Alzheimer's Disease, neuropsychological assessment, diagnostic procedures

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[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.

[pt] Pacientes com lesões encefálicas adquiridas (LEA) apresentam prejuízos neuropsicológicos e funcionais. O presente estudo teve como objetivo identificar o perfil neuropsicológico destes pacientes atendidos em um serviço de neurocirurgia de um hospital público do Rio de Janeiro, avaliando as evidências de validade clínica da Bateria Breve de Rastreio Cognitivo (BBRC) no comprometimento cognitivo. Método: Participaram do estudo 30 pacientes submetidos a neurocirurgia de crânio e 30 de de coluna atendidos no ambulatório neurocirúrgico. Todos realizaram a BBRC que mostrou que o grupo crânio apresentou um comprometimento do funcionamento cognitivo global (MEEM- 35), memória incidental e imediata e no desenho do relógio. O resultado inicial mostrou prejuízo em alguns domínios das funções executivas, tais como memória operacional, estratégias de memória episódica e planejamento. A pesquisa sugere que a BBRC pode ser utilizada no contexto hospitalar para pacientes com LEA pós cirúrgicos. / [en] Patients with Acquired Brain Injury (ABI) have neuropsychological and functional injuries. The present study aimed to identify the neuropsychological profile of these patients treated at a neurosurgical service of a public hospital in Rio de Janeiro, evaluating the evidence of clinical validity of the Battery Cognitive Screening brief (BCSB) in cognitive injuries. Method: Thirty patients who was submitted to brain s neurosurgery and 30 spinal s neurosurgeries attended at clinic participated in the study. All underwent the BCSB, which showed that the search group had impairment in global cognitive functioning (MMSE-35), memory and in clock drawing test. The initial result showed injuries in the domains of executive functions, such as working memory, episodic memory strategies and planning. Research suggests that BBRC can be used in the hospital setting for post-surgical ABI patients.

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