Archives of clinical neuropsychology : the official journal of the National Academy of Neuropsychologists
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Arch Clin Neuropsychol · Feb 2007
Randomized Controlled Trial Multicenter Study Comparative StudyThe influence of different error estimates in the detection of postoperative cognitive dysfunction using reliable change indices with correction for practice effects.
The reliable change index (RCI) expresses change relative to its associated error, and is useful in the identification of postoperative cognitive dysfunction (POCD). This paper examines four common RCIs that each account for error in different ways. ⋯ These rules are applied to 160 patients undergoing coronary artery bypass graft (CABG) surgery who completed neuropsychological assessments preoperatively and 1 week postoperatively using error and reliability data from a comparable healthy nonsurgical control group. The rules all identify POCD in a similar proportion of patients, but the use of the within-subject standard deviation (WSD), expressing the effects of random error, as an error estimate is a theoretically appropriate denominator when a constant error correction, removing the effects of systematic error, is deducted from the numerator in a RCI.
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Arch Clin Neuropsychol · May 2006
Comparative StudyExamination of postconcussion-like symptoms in healthy university students: relationships to subjective and objective neuropsychological function performance.
This study examined postconcussion-like symptoms in a group of university students and explored their relationships to neuropsychological function performance. A sample of 124 students was recruited. All of the participants received the Rivermead Post-Concussion Symptoms Questionnaire (RPQ) and completed a comprehensive set of neuropsychological tests. ⋯ There were no significant differences between low symptom reporters and high symptom reporters, except for self-reported dysexecutive problems. A comparison of the healthy high symptom reporters and a convenient sample of traumatic brain injury patients revealed that the patients performed significantly worse on neuropsychological functions than the high symptom reporters, despite non-significant differences between symptom endorsement. Our findings demonstrate that: (a) the base rate of postconcussion-like symptoms in a group of healthy university students is relatively high and (b) postconcussion symptom (PCS) is not related to neuropsychological functions in normal people.
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Arch Clin Neuropsychol · May 2006
Comparative StudyMisdiagnosis of the persistent postconcussion syndrome in patients with depression.
The purpose of this study is to examine the prevalence of postconcussion-like symptoms in patients with depression. Participants were 64 physician-diagnosed inpatients or outpatients with depression who had independently-confirmed diagnoses on the Structured Clinical Interview for DSM-IV. ⋯ Approximately 9 out of 10 patients with depression met liberal self-report criteria for a postconcussion syndrome and more than 5 out of 10 met conservative criteria for the diagnosis. Implications for forensic neuropsychology will be discussed.
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Arch Clin Neuropsychol · Jul 2005
Assessing the enduring residual neuropsychological effects of head trauma in college athletes who participate in contact sports.
The present study examined the enduring residual neuropsychological effects of head trauma in college athletes using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), Postconcussion Syndrome Checklist, and the Stroop task. Based on a brief self-report concussion history survey, male and female athletes who participated in ice hockey, field hockey, lacrosse, and/or soccer were assigned to one of three concussion-history conditions: Non-concussed, Non-recent concussed (i.e., more than 2 years since last concussion), or Recent concussed (i.e., 2 years or less since last concussion). A fourth group of subjects consisting of non-concussed/non-athletes served in the control condition. ⋯ In recent concussed athletes, lower delayed memory scores correlated with more severe Postconcussion Symptom Checklist scores (r = -.90), while more severe/higher number of concussions correlated with increased processing speed on the Stroop interference task (r = .90). These findings indicate that recent head injury produces alterations in neuropsychological function, especially that of memory, that resolve with time. More provocatively, the data also suggest that participation in contact sports may produce sub-clinical cognitive impairments in the absence of a diagnosable concussion presumably resulting from the cumulative consequences produced by multiple mild head trauma.
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Arch Clin Neuropsychol · Aug 2003
CommentNeurobiology and neuropathology underlie the neuropsychological deficits associated with traumatic brain injury.
The neurobiological and neuropathological bases that underlie the neuropsychological deficits associated with traumatic brain injury (TBI), including mild TBI, are further reviewed. The article provides an update on neuroimaging methods and findings in the study of TBI since the author's published address of the 1999 Distinguished Neuropsychologist Award of the National Academy of Neuropsychology (see Bigler, 2001a). ⋯ The article provides further guidelines in making the link between neuroimaging findings and neuropsychological outcome in the clinical practice of neuropsychology. The article also opines on the future role and importance that neuroimaging will play in neuropsychological practice, particularly functional neuroimaging methods.