Biomedical subjects

William W Beatty

Publications and source records attributed to William W Beatty.

16 recordsLinked to original sources

PubMed2006

Practical methods for the clinical assessment of information processing speed.

The rate at which individuals are capable of processing information is considered a sensitive indicator of brain dysfunction, particularly among clinical populations whose neurocognitive impairments generally are considered relatively mild in nature. Assessment of information processing speed often is confounded, however, by comorbid impairments in other constructs of neurocognition, including attentional capacity, visuospatial perception, language, immediate memory, and motor speed/coordination. This investigation examined the effect of controlling for various potential confounders on the strength of associations among several potential measures of information processing speed. Participants were 64 patients diagnosed with clinically definite multiple sclerosis. Analysis indicated consistent significant and positive associations among measures of processing speed, which generally persisted despite simultaneous statistical control of potential confounding factors. Results imply that examined confounding variables are similarly related to the measures of processing speed. Therefore, any of the measures of information processing speed considered in this study may be used as a proxy for the more direct measure of this construct derived from the Sternberg Memory Scanning Test.

Cognition↗

PubMed2005

Verbal fluency deficits in multiple sclerosis.

A quantitative review of 35 studies with 3673 participants was conducted to estimate and compare the magnitude of deficits upon tests of phonemic and semantic fluency for participants with multiple sclerosis (MS) relative to healthy controls. Participants with MS were substantially but similarly impaired on tests of phonemic and semantic fluency. These deficits were larger than deficits on measures of verbal intelligence, confrontation naming and another widely used measure of executive functioning, the Wisconsin Card Sorting Test, but were of a comparable or smaller magnitude relative to deficits on the oral version of the Symbol Digit Modalities Test (SDMT). This is consistent with other research suggesting that measures of verbal fluency and the SDMT may be amongst the most sensitive neuropsychological measures to cognitive impairment in MS. Increased neurological disability and a chronic progressive (as opposed to a relapsing remitting) disease course were associated with larger deficits on tests of phonemic and semantic fluency. However, it is suggested that this latter finding is attributable to the distinct clinical features of chronic progressive and relapsing remitting sub-types. Thus, patients who follow a chronic progressive course tend to be older, have an increased duration of illness and experience greater neurological disability. Once these variables were controlled for, differences between the two sub-types were substantially attenuated.

Adult↗

PubMed2004

RBANS analysis of verbal memory in multiple sclerosis.

Patients with neurodegenerative diseases that cause mainly subcortical pathology often exhibit impairment when required to recall lists of unrelated words, but their memories are supposedly improved by test procedures that promote retrieval such as recognition or improve the organization of the to-be-remembered materials. Difficulties with floor effects on free recall and ceiling effects on recognition and other methodological concerns raise doubts about the validity of existing studies that tested these ideas. Using the verbal memory subtests of the RBANS, we [Arch. Clin. Neuropsychol. 18 (2003) 509] expressed each patient's performances on Story Memory, List Learning, Story Recall, List Recall, and List Recognition as Z scores relative to his or her age group. Then, the Z scores were subtracted pairwise to test hypotheses about the nature of memory in Parkinson's disease (PD). Contrary to expectation, patients with PD did not show better immediate or delayed recall of stories relative to lists and they did not show better recognition than recall. In the present investigation, the same methodology was used to study verbal memory in multiple sclerosis, a disease that primarily affects subcortical structures. In contrast to previous results for patients with PD, the patients with MS exhibited better recall of stories than of lists and better List Recognition than Recall. Differences in the pathology of entorhinal regions in PD and MS may contribute to the differing patterns of memory impairment of these patients. The results emphasize that most patients with MS with memory impairments have deficits that are relatively mild and potentially remediable.

Adult↗

PubMed2004

Construct validity of the 7/24 spatial recall test.

This investigation was conducted to examine the construct validity of the 7/24 Spatial Recall Test (7/24). Participants were 64 outpatients who met criteria for clinically definite multiple sclerosis (MS). Data obtained from administration of a fixed neuropsychological assessment battery were analyzed to evaluate the relation between demographic, physical, and emotional factors and performance on the 7/24, to examine the measure's convergent/discriminant validity, to determine which variables account for the greatest proportion of variance in 7/24 scores, and to assess further the test's sensitivity to the cognitive sequelae of MS. Findings suggest that 7/24 scores are significantly explained by the constructs of visual-spatial perception/analysis, memory, reasoning, and/or processing speed. The proportion of variance in 7/24 performances accounted for by cognitive and demographic variables, however, was quite low. Relative to the measure's normative sample, participants in this investigation performed significantly poorer on number of responses recalled across Set A learning trials but not on Set A long-delay recall. Results of this investigation indicate some level of sensitivity of the 7/24 to the cognitive impairments associated with MS but offer only weak support for the 7/24 as a valid measure of visuospatial learning/memory.

Adult↗

PubMed2003

Changes in neuropsychological test performance over the workday in multiple sclerosis.

Fatigue, a common symptom of multiple sclerosis (MS), is associated with impairment in performing daily activities, poor quality of life and premature retirement from the workforce. There is little doubt that patients with MS can exhibit marked weakness and other objective signs of physical fatigue, but whether cognitive performance by patients declines more rapidly than that by controls as a function of time engaged in mental activity remains controversial. Krupp and Elkins (2000) reported more rapid deterioration of performance by MS patients on two of five cognitive measures when subjects performed 3 hr of continuously effortful tasks between baseline and posttest. Others, using shorter and less taxing interpolated tasks found similar changes in performance over time for patients and controls. In the present study participants completed a timed walk, fatigue ratings and four cognitive tests that emphasized processing novel information before they went to work and again after completing a normal workday. Patients with MS walked somewhat more slowly and performed more poorly on two of the cognitive tests, but they did not show more decline from baseline to posttest on any of these objective measures of cognitive fatigue. By contrast, subjective ratings of fatigue showed a greater increase over the day for patients than for controls. These results confirm other reports that patients' subjective ratings of their fatigue are not valid indicators of their actual performance on cognitive tests. Furthermore, laboratory studies that report "objective" cognitive fatigue in MS may utilize conditions that model the cognitive fatigue associated with the jobs patients actually perform rather poorly.

Adult↗

PubMed2003

RBANS performance: influences of sex and education.

A sample of 278 men and 353 elderly women who resided in the community received the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) as part of a study of health in mature adult Oklahomans. Females attained significantly higher scores on the Immediate and Delayed Memory and the Language Indexes. Males performed better on the Visuospatial/Construction Index, but there was no sex difference on the Attention or Total Indexes. Differences related to sex were modest (2-6 Index points), but combined with the larger effects of education could lead to an adjustment of up to 11 Index points.

Aged↗

PubMed2003

Musical skill in dementia: a violinist presumed to have Alzheimer's disease learns to play a new song.

Previous studies have described patients with possible or probable Alzheimer's disease (AD) who continued to play familiar songs skillfully, despite their dementias. There are no reports about patients with dementia who successfully learned to play new songs, and two papers describe failures of patients with AD to learn to play a new song although they continued to play familiar songs competently. In the present paper we describe a moderately demented patient (SL) with probable AD who learned to play a song (Cossackaya!) on the violin that was published after the apparent onset of his dementia. He showed modest retention of the song at delays of 0 and 10 minutes. This contrasts with his profound disturbance in both recall and recognition on other anterograde memory tests (word lists, stories, figures, environmental sounds, sounds of musical instruments), and marked impairment on measures of remote memory (famous faces, autobiographical memory). SL showed milder deficits in confrontation naming, verbal fluency and attention, but no dyspraxia or aphasic comprehension deficits. Except for the Block Design test, his visuospatial skills were intact. SL's learning of the new song in the absence of any evidence of episodic memory is reminiscent of patients with temporal lobe amnesia who show better memory for song melody than for lyrics or verse, although his retention was not as good.

Aged↗

PubMed2003

Comprehension of affective prosody in multiple sclerosis.

Deficits in cognition have been repeatedly documented in patients with multiple sclerosis (MS), but their ability to comprehend emotional information has received little study. Forty-seven patients with MS and 19 demographic controls received the comprehension portion of the Aprosodia Battery, which is known to be sensitive to the impairments of patients with strokes and other neurological conditions. Patients also received tests of hearing, verbal comprehension and naming, a short cognitive battery, and the Beck Depression Inventory. Patients with MS were impaired in identifying emotional states from prosodic cues. The magnitude of the deficits was greatest for patients with severe physical disability and under test conditions of limited prosodic information. Correlational analyses suggested that the patients' difficulties in comprehending affective prosodic information were not secondary to hearing loss, aphasic deficits, cognitive impairment, or depression. For some patients with MS, deficits in comprehending emotional information may contribute to their difficulties in maintaining effective social interactions.

Adjuvants, Immunologic↗

PubMed2003

Analyzing the subcortical dementia syndrome of Parkinson's disease using the RBANS.

On mental status examinations, groups of equally impaired patients with subcortical (Huntington's disease, HD; Parkinson's disease, PD) or cortical (Alzheimer's disease, AD) dementias exhibit different patterns of neuropsychological deficits. Using the Repeatable Battery for Assessment of Neuropsychological Status (RBANS), classification accuracies of 90% or greater have been reported for individual patients with AD or HD. To test the generality of the RBANS classification algorithm, we studied patients with dementia (AD and PDD) and without dementia (PDND). Classification accuracies were AD: 87%, PDD: 78%, and PDND: 39%. Comparisons of performance on subtests of the RBANS showed that all groups performed more poorly on tests that require motor skill or rapid information processing and that memory performance by the PD groups was not improved by procedures that enhance encoding and facilitate retrieval. The RBANS is useful for discriminating patterns of cognitive impairment in PD and AD, but only if the diagnosis of dementia is established independent of the RBANS test results. Cognitive slowing is not specific to subcortical dementia and current concepts of memory dysfunction in PD may require re-examination.

Aged↗

PubMed2002

Declines in switching underlie verbal fluency changes after unilateral pallidal surgery in Parkinson's disease.

Declines in verbal fluency are consistently reported in patients with Parkinson's disease (PD) after pallidal surgery. In the present study, the clustering and switching components of semantic or category fluency (oral naming of items obtainable in supermarkets) were examined at baseline and four months after unilateral deep brain stimulation or pallidotomy in 45 patients with PD (30 left, 15 right pallidal surgery). Post-operative declines were observed for supermarket fluency total score and switching, but not for average cluster size. These findings support the proposal that semantic fluency decrements after pallidal surgery reflect a disruption of frontal-basal ganglia circuits mediating efficient shifting between semantic categories, or perhaps efficient access to categories, rather than a degradation of semantic stores.

Basal Ganglia↗

PubMed2002

Sex difference in geographical knowledge: driving experience is not essential.

When required to locate places on outline maps, males consistently perform more accurately than females. This sex difference in geographical knowledge has been observed in samples throughout the United States, in all age ranges examined from the second to the 9th decade of life and in samples differing in average education level from high school to postgraduate degrees. Both males and females appear to acquire geographical knowledge during surface travel through the environment. The information acquired during everyday travel is apparently integrated into topographic representations that comprise a cognitive map. This process is less efficient in females probably because they attend to and remember more about landmarks and less about distance and directional cues than do males. To examine the importance of driving experience on the ability to locate places on an outline map of the Oklahoma City metropolitan area, adolescents who were too young to drive and older persons with varying amounts of experience traveling in the metropolitan area were studied. In the present study the magnitude of the sex difference in accuracy, though not the absolute level of performance, was similar in groups of people too young to drive and in younger and older drivers. Hence, the sex difference in geographical knowledge cannot be the product of differences in driving that may exist between males and females.

Adolescent↗

PubMed2002

Age and educational influences on RBANS index scores in a nondemented geriatric sample.

Research has indicated the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS; Randolph, 1998) to be sensitive to the effects of brain dysfunction and capable of accurately discriminating cortical from subcortical dementias (Randolph, Tierney, Mohr, & Chase, 1998). It recently has been demonstrated, however, that certain indices of the measure are susceptible to educational influences (Lineweaver, Zone, Chelune, Hermann, & Dow, 2001). The present investigation examined the effects of age and education on the six RBANS indices in a sample of nondemented older adults. Education accounted for a statistically significant proportion of the variance across all RBANS indices for this group (range=1.9-7.6%), while age increased the variance accounted for on four of six indices (range=0.5-2.2%). Regression-based educational corrections for index scores were derived to allow for appropriate adjustment. Effects of age, although statistically significant, were too small to make clinical adjustment on three of the four index scores worthwhile. On the Delayed Memory Index, however, correction for age for persons 80 years old and higher should be considered.

Aged↗

PubMed2002

Minimal neuropsychological assessment of MS patients: a consensus approach.

Cognitive impairment is common in multiple sclerosis (MS), yet patients seen in MS clinics and neurologic practices are not routinely assessed neuropsychologically. In part, poor utilization of NP services may be attributed to a lack of consensus among neuropsychologists regarding the optimal approach for evaluating MS patients. An expert panel composed of neuropsychologists and psychologists from the United States, Canada, United Kingdom, and Australia was convened by the Consortium of MS Centers (CMSC) in April, 2001. Our objectives were to: (a) propose a minimal neuropsychological (NP) examination for clinical monitoring of MS patients and research, and (b) identify strategies for improving NP assessment of MS patients in the future. The panel reviewed pertinent literature on MS-related cognitive dysfunction, considered psychometric factors relevant to NP assessment, defined the purpose and optimal characteristics of a minimal NP examination in MS, and rated the psychometric and practical properties of 36 candidate NP measures based on available literature. A 90-minute NP battery, the Minimal Assessment of Cognitive Function in MS (MACFIMS), emerged from this discussion. The MACFIMS is composed of seven neuropsychological tests, covering five cognitive domains commonly impaired in MS (processing speed/working memory, learning and memory, executive function, visual-spatial processing, and word retrieval). It is supplemented by a measure of estimated premorbid cognitive ability. Recommendations for assessing other factors that may potentially confound interpretation of NP data (e.g., visual/sensory/motor impairment, fatigue, and depression) are offered, as well as strategies for improving NP assessment of MS patients in the future.

Cognition Disorders↗

PubMed2002

Sex differences in cognitive impairment in multiple sclerosis.

Multiple sclerosis (MS) is twice as prevalent in females as in males, but the possibility of sex differences in the cognitive sequellae of the disease has not been considered. In this study male patients with MS performed more poorly than female patients on tests of verbal and nonverbal memory, visuospatial construction, and on the Mini Mental State Exam (MMSE) and the Wisconsin Card Sorting Test (WCST). The groups of male and female patients were similar in age, education, and on several measures of neurologic and emotional disturbance. Among normals there are no sex differences on the MMSE and WCST. Sex differences on the memory and visuospatial construction tests were larger in magnitude for the patients than for normal controls, implying that male patients are somehow especially vulnerable to cognitive deficits. Reanalysis of existing databases could clarify questions about the existence and source of cognitive sex differences in MS.

Cognition Disorders↗

PubMed2002

Cognition in a patient with very mild right-sided hemiparkinsonism.

Non-demented patients with Parkinson's disease (PD), especially if they are high functioning and early in the course of their disease, usually exhibit mild deficits in anterograde recall memory for verbal and non-verbal material, visuospatial reasoning, visuomotor construction, temporal ordering and sequencing. Impairments in problem solving and verbal fluency tests may also occur. PD patients with predominantly right-sided symptoms usually exhibit more severe difficulties with verbal than with non-verbal tasks. We report a case of a highly educated right-handed man with very mild right-sided hemiparkinsonism who never received anti-Parkinsonian or other psychoactive medication. Our patient showed anterograde and retrograde amnesia for faces and spatial locations and difficulties on complex visuospatial tasks that required manual responses, but normal to above average performance on all other cognitive tests. The specific pattern of cognitive loss early in PD may depend on which spatial, facial or verbal pre-frontal striatal circuits are deprived of their dopaminergic inputs.

Aged↗

PubMed2002

Predicting functional performance by patients with Alzheimer's disease using the Problems in Everyday Living (PEDL) Test: a preliminary study.

Findings from a recent population-based survey indicate that about 33% of patients with dementia reside alone. Because many of these patients may not have a caregiver who visits them regularly, the need for a neuropsychological (NP) test to predict patients' functional competence to live alone safely is evident. In this study, we compared the accuracy of predicting Instrumental and Basic Activities (IADLs and ADLs) of 22 patients with Alzheimer's disease using several standard NP tests and the newly developed Problems in Everyday Living (PEDL) test. Performance of IADLs and ADLs as rated by caregivers was significantly correlated with performance on the PEDL, the Mini-Mental State Exam (MMSE), and with the Shipley Institute of Living Test of Verbal Abstraction (SILS-A), but not with vocabulary or naming. The PEDL was the best predictor of IADL scores (r = 0.71), compared to the MMSE (r = 0.52) and the SILS-A (r = 0.57), while the MMSE was the best predictor of ADL performance (r = 0.69), compared to the PEDL (r = 0.58) and the SILS-A (r = 0.50).

Activities of Daily Living↗