Biomedical subjects

L Smith-Seemiller

Publications and source records attributed to L Smith-Seemiller.

10 recordsLinked to original sources

PubMed2001

Use of Wisconsin Card Sorting Test short forms with school-age children.

Short forms of the Wisconsin Card Sorting Test (WCST) have been developed and studied in adult populations, however studies addressing their use in children are lacking. This study compared the full WCST to two short forms in a sample of 174 school-age children who were referred for neuropsychological evaluation. Multiple regression was used to predict standard scores (SSs) on the full WCST. Percent scores were obtained, and normative data from the WCST manual was then used to obtain SSs. We found that scores from the short forms were significantly correlated with corresponding scores on the full WCST, however a high proportion of children obtained short form SSs, which differed significantly from the SSs obtained on the full WCST. It is recommended that clinicians use the full WCST with children, unless at least four categories are reached in the first deck.

Journal Article↗

PubMed2000

Internal consistency and concurrent validity of two short forms of the Visual Form Discrimination Test.

The purpose of this study was to evaluate the reliability and concurrent validity of 2 short forms of the Visual Form Discrimination Test, referred to as first half (FH) and front-back (FB). Participants were a mixed sample of 225 patients seen for neuropsychological evaluations. The mean difference score between both short forms and the full form was less than 1 point. The short-total correlations were .85 and .86 for the FH and FB forms, respectively. A binary clinical decision rule, used to classify patients as normal or impaired, resulted in a 93.3% correct and a 94.7% correct classification rate for the FH and FB forms, respectively. It is concluded that the short form of the test, used in conjunction with a clinical decision rule, results in a very minor loss of accuracy.

Adult↗

PubMed1998

Treatment of aggression and irritability after head injury.

Thirteen patients who experienced problems with irritability and aggression following closed head injury (CHI) participated in a non-blind, 8 week open trial and sertraline HCl. Significant reduction in irritability and aggressive outbursts was observed. No significant changes were observed in depressive symptomatology. Results suggest that serotonergic agents may be useful in treating aggression and irritability after head injury. Further placebo-controlled studies using serotonergic agents are indicated.

Adult↗

PubMed1997

Neuropsychological function in restrained versus unrestrained motor vehicle occupants who suffer closed head injury.

It is known that using seatbelts reduces the incidence and severity of closed head injury (CHI) from motor vehicle crashes. One would expect unrestrained occupants in motor vehicle crashes to suffer more severe CHIs than restrained occupants, as reflected by Glasgow Coma Scale (GCS) scores. One might also expect an increased risk of focal injury due to contact forces in unrestrained occupants. The purpose of this study was to test the hypothesis that failure to use seatbelts results in increased severity of neuropsychological sequelae, even with GCS controlled. We also examined the impact of demographic variables on seatbelt use. Subjects included patients admitted to a hospital trauma service who were suspected of having suffered CHI. All patients completed neuropsychological testing, which was entered into a data base along with demographic and clinical information. People who had documented use of seatbelt restraints were compared with those who were unrestrained. Results confirmed that certain demographic variables are associated with the use of seatbelts. Results also suggested that failure to use seatbelt restraints is associated with more severe impairment on tests that are sensitive to frontal lobe dysfunction.

Adolescent↗

PubMed1997

Impact of skull fracture on neuropsychological functioning following closed head injury.

The role of skull fracture in affecting morbidity following closed head injury (CHI) has received a significant amount of attention from researchers. While there is fairly widespread agreement that skull fractures increase the risk of complications such as haematoma, it us unclear whether the presence of skull fracture has predictive value in terms of the neuropsychological sequelae of CHI. The purpose of the current study was to further investigate the role of skull fracture in predicting neuropsychological dysfunction following CHI. Subjects included patients admitted to the trauma service of a large teaching hospital who were suspected of having suffered CHI. All patients completed neuropsychological testing and had normal computerized tomography (CT) scans. Patients who had suffered skull fracture were compared to those who had not suffered skull fracture on selected neuropsychological measures. Groups did not differ in terms of CHI severity as assessed by the Glasgow Coma Scale (GCS). Multivariate analysis of variance revealed that the groups did differ in terms of neuropsychological functioning. Results are interpreted as suggesting that the presence of a skull fracture is predictive of additional neuropsychological dysfunction, even in the absence of intracranial pathology or more severe disturbance of consciousness on the GCS.

Adult↗

PubMed1997

Tc-HMPAO SPECT in persistent post-concussion syndrome after mild head injury: comparison with MRI/CT.

The purposes of this study were: (1) to determine the prevalence of abnormal 99mTc-HMPAO SPECT scans in patients suffering from persistent post-concussive syndrome (PPCS) after mild closed head injury (CHI); (2) to compare SPECT with structural neuroimaging (MRI and CT) in patients with mild CHI; and (3) to investigate correlations between SPECT and clinical data obtained from the patient sample (neuropsychological testing, demographics, psychiatric diagnoses). Forty-three patients were included. SPECT was read as abnormal in 53% of patients and showed a total of 37 lesions while MRI was read as abnormal in 9% and CT scan in only 4.6% of patients after mild CHI. SPECT appears to be more sensitive in detecting cerebral abnormalities after mild CHI, especially in patients with PPCS symptoms, than either CT or MRI. No statistically significant relationship was found between SPECT scan abnormalities and age, past psychiatric history, history of substance abuse, or history of multiple CHI. Education level did not differ between patients with normal and abnormal SPECT. Current neuropsychiatric symptoms did not seem to have any impact on the results of SPECT scan.

Adolescent↗

PubMed1997

Methods of estimating premorbid functioning.

Clinical neuropsychological assessment frequently requires the comparison of obtained scores against some estimate of premorbid level of functioning, but only recently has significant attention been turned to objective methods to accomplish this objective. Clinical judgment, although useful in some circumstances, is generally insufficient. Other methods of estimating premorbid function include demographic regression formulae, such as the Barona formula, subtest scatter methods, such as that suggested by Lezak, and the use of current scores on tests of presumably spared abilities, such as the National Adult Reading Test (NART). Almost all methods predict to some general level of intellectual functioning rather than to specific neuropsychological skills. This paper reviews the suggested methods in terms of the underlying assumptions and the available empirical evidence. Suggestions for future research include the development of skill specific predictors as well as investigations regarding the relation between predictor accuracy and characteristics of the subject, such as high versus low premorbid functioning in the subject. Additionally, there is a great need for methods to predict premorbid functioning in children.

Journal Article↗

PubMed1997

Neuropsychologists' practice patterns in assessing premorbid intelligence.

The current study surveyed practicing neuropsychologists about the methods they use to estimate premorbid levels of function, and their prior training with these methods. Doctoral level psychologists, who are members of the National Academy of Neuropsychology, were sent a questionnaire developed by the authors to assess these variables. Findings suggest that there is relatively little use of strategies specifically designed to assess premorbid ability. Demographics and training were not associated with methods used. Over one third of the respondents indicated that they believed their formal training had not been adequate in helping them to address this issue.

Journal Article↗

PubMed1996

Obsessive-compulsive disorder after closed head injury: review of literature and report of four cases.

An increasing number of recent reports has pointed to the underlying neuropathological substrate for obsessive-compulsive disorder (OCD). Neuropsychological testing may suggest underlying organicity even though the neuroimaging studies and the neurological examination may be normal. Earlier reports are not in agreement about the laterality of deficits. Abnormalities in frontal regions, limbic areas and basal ganglia are noted in functional neuroimaging and neuropsychological studies. In closed head injury the damage tends to be diffuse, and it is not easy to clearly localize deficits or to determine their laterality. In this paper we review the various theories and literature on OCD and organicity, and report on four individuals who developed OCD symptoms after closed head injury. We also discuss their neuroimaging and neuropsychological testing results.

Adolescent↗

PubMed1996

Cognitive dysfunction after closed head injury: contributions of demographic, injury severity and other factors.

Previous studies have identified a number of variables which help to predict cognitive dysfunction following closed head injury (CHI) The purpose of the current study was to evaluate the predictive utility of a number of risk factors in a large sample of trauma patients who suffered CHI and underwent neuropsychological assessment Risk factors included demographic variables, Glasgow coma scale (GCS), CT scan, loss of consciousness (LOC), and blood alcohol level (BAL) Multiple regression was used to assess the role of these variables in predicting cognitive dysfunction Results suggested that LOC did not predict cognitive dysfunction Demographic factors did emerge as predictors of cognitive dysfunction BAL was correlated with initial GCS, but did not predict cognitive dysfunction once post-traumatic amnesia cleared.

Journal Article↗