Methodologic Considerations in Neuropsychologic Testing of Ataxic Patients

Lalonde, Robert; Botez, Thérèse; Botez, M.I.

doi:10.1001/archneur.1992.00530270032011

Cited by 10 publications

(2 citation statements)

References 8 publications

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“…However, the amount of supratentorial vascular lesions occurring in our patients may have masked the cognitive relevance of infratentorial lesions, and it is also possible that more specific neuropsychological tests might have shown other subtle cognitive effects. Actually, neuropsychological batteries including tests for visuospatial skills 30 showed abnormal results when used in subjects with predominant infratentorial pathology (eg, large vessel cerebellar infarcts, Friedreich ataxia, and olivopontocerebellar atrophy). 8 -10,31 On the other hand, we found that patients with midbrain atrophy had worse general cognitive and executive functions than the other VaD patients.…”

Section: Discussionmentioning

confidence: 99%

Infratentorial Abnormalities in Vascular Dementia

Bastos-Leite

Flier

Straaten

et al. 2006

Stroke

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Background and Purpose-Infratentorial abnormalities may cause cognitive deficits, but current research criteria for vascular dementia (VaD) do not consider them. Our purposes were to determine the prevalence of infratentorial abnormalities in VaD, their relation with supratentorial abnormalities, and whether they are relevant to cognition. Methods-We examined 182 patients (120 men, mean ageϭ73 years, SDϭ8) with probable VaD at inclusion into a multicenter clinical trial. MRI scans were evaluated for infratentorial vascular abnormalities, midbrain atrophy, cerebellar atrophy, basilar artery diameter and tortuosity, and supratentorial abnormalities.

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Section: Discussionmentioning

confidence: 99%

Infratentorial Abnormalities in Vascular Dementia

Bastos-Leite

Flier

Straaten

et al. 2006

Stroke

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“…In certain instances, judicious test selection may obviate the need to modify standardized tests. For example, Lalonde, Botez, and Botez (1992) used measures of visual spatial functions (e.g., Raven Matrices, Hooper Visual Organization Test) with no motor component in their study of patients with olivopontocerebellar atrophy (OPCA) who, virtually by definition, are motor-impaired. Clearly, the performance of OPCA patients on such measures as Block Design (Wechsler, 1981) or the Trail Making Test (Reitan 8c Tarshes, 1959) would be diminished by this factor alone and would complicate inferences about the extent to which other relevant abilities were compromised or preserved.…”

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confidence: 99%

The role of nonstandard neuropsychological assessment in rehabilitation: History, rationale, and examples.

Caplan¹,

Shechter²

1995

Psychological Assessment in Medical Rehabilitation.

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CAPlANANDSHKtlERsional creativity, observational expertise, flexibility, and ingenuity in the service of developing a multidimensional understanding of patientstheir abilities and deficits, their emotional state, self-regulatory functions, the impact of environmental variables on test performance, and so forth.Thus, Although the merits of unvarying standardized procedures are unarguable for some purposes, we contend that clinical assessment of cognitively compromised or emotionally distressed patients frequently demands a more flexible approach. In this, we concur with the statement of two experienced neuropsychologists who wrote:In evaluating clinical patients, however, the neuropsychological examiner encounters a wide range of emotional and physical problems that can interfere with testing and sometimes cause the results to be invalid. Through sensitive handling of the patient and appropriate minor adjustments in testing procedures (emphasis added), such problems can usually be overcome, while still adhering to the essential standardized aspects of the test. (Heaton & Heaton, 1981, p. 526) Other authors have made similar points. In setting forth guidelines for the evaluation of stroke patients, Hibbard and Gordon (1992) explicitly stated, "Testing procedures should be modified to test maximal functioning and learning abilities" (p. 14). Barbara Wilson, a pediatric neuropsychologist, wrote There are situations in which the test administration procedures must be modified in order to obtain meaningful information . . . the whole issue of goals of an assessment enters here. For some, adherence to standardized procedures is important and a "cannot do" score is felt to be sufficient information. For others-and we generally find ourselves in this group-the goal of the assessment is to obtain all information possible about the functioning capacities of the child and to facilitate the production of maximum performance (pp. 157-158).A focal concept of this chapter is that cognitive, emotional, or physical limitations, though certainly worthy of assessment in their own right, may undercut the validity of certain tests, thereby forcing examiners to choose between (a) by-the-book administration that yields data of questionable meaning and (b) procedural modification in an attempt to derive some useful information from the measures. A major objective of this chapter is to suggest ways that clinicians may avoid this kind of psychometric showdown by viewing the evaluation process in a less constrained manner.By way of illustration, consider the hazards of attempting to assess verbal memory in a patient with expressive aphasia. The typical format for testing this function requires the individual to repeat material (e.g., story content, word lists, digit strings) that is read by the examiner. That

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Focusing Attention on Cognitive Impairment in Spinocerebellar Ataxia

Geschwind¹

1999

Arch Neurol

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Methodologic Considerations in Neuropsychologic Testing of Ataxic Patients

Cited by 10 publications

References 8 publications

Infratentorial Abnormalities in Vascular Dementia

Infratentorial Abnormalities in Vascular Dementia

The role of nonstandard neuropsychological assessment in rehabilitation: History, rationale, and examples.

Focusing Attention on Cognitive Impairment in Spinocerebellar Ataxia

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