Luria's neuropsychological evaluation in the nordic countries

The publication of Luria's Neuropsychological Investigation (LNI) by Christensen in 1975 introduced Luria's evaluation procedures to worldwide neuropsychology. The LNI demonstrated the benefit of a thorough qualitative analysis of an individual patient's functioning as well as the usefulness of a comprehensive theory of brain functioning. This article reviews the experiences that led to the development of the LNI, discusses its use and extension in Scandinavian countries, and presents clinical and research applications of the LNI in diagnosis and rehabilitation. A series of case examples provides justification and validity for the continued use of the LNI and related procedures. Discussion of the advantages and disadvantages of the LNI and consideration of possible modifications of the procedures and interpretative methods provide the rationale for continued development of Luria's approach.

Extension of Luria's psycholinguistic studies in Poland

One of Luria's basic interests was the organization of human cognitive processes, and thinking in particular. He believed that language and thought are closely related, and hence the manner in which we speak reflects the way we think. To verify this assumption, he and his collaborators performed a number of interesting psycholinguistic experiments with subjects of various ages and cultural backgrounds. The tasks used made the evaluation of both receptive and expressive language possible. The Narrative Ability Test described here stems from Luria's observations to a considerable degree. The test was administered to preschool children (N = 106), schoolchildren (N = 143), adolescents (N = 89), adults (N = 126), and older persons (N = 175). Findings of the 20-year studies with normal and deviant populations indicate close relationships among thought, language, and self-control. It was found that difficulty in developing narratives corresponds with a disability to process complex information. Correlations between narrative skills and age, sex, and social background were also noted.

A neo-Lurian approach to assessment and remediation

The first part of this article presents an operational battery of tasks for measuring the four cognitive processes of Planning, Arousal-Attention, and Simultaneous and Successive processing (PASS) not only based on the qualitative data provided in Luria's syndrome analysis, but also taken from tasks in experimental cognitive psychology and neuropsychology. The second part of the article presents a remedial program based on PASS for enhancement of reading. Because this part provides in some detail the efficacy of the remedial procedure, it simultaneously validates the PASS constructs as well. In both parts of the article, I have been unmistakably guided by Luria's views: Tests are approaches to investigating cognitive functions, and the purpose of testing is to guide rehabilitation.

Introduction: neuropsychological assessment après Luria

Neuropsychological assessment since Alexander R. Luria's death in 1977 has demonstrated increased sophistication and advancement, and a number of models or approaches to neuropsychological assessment are available worldwide today. This article reviews, in the context of this special issue, Luria's influence on the further development of neuropsychological assessment approaches and methods. Contemporary approaches are summarized and contrasted, and a discussion of neo-Lurian adaptations and extensions of his neuropsychological model is presented. Brief comments about the succeeding articles in this issue help to demonstrate the wide influence sustained by Luria's ideas in various regions of the world.

Current trends in cognitive rehabilitation for memory disorders

Progress in the neuropsychology of memory disorders has provided a foundation for development of cognitive rehabilitation for amnesic patients. Accumulating evidence in the past two decades suggested that certain training techniques could be beneficial to many amnesic patients, such as teaching and acquisition of domain-specific knowledge, motor coding, reality orientation, and meta-cognition improvement. In this article we review and discuss the current trends in cognitive rehabilitation of memory disorders and provide a future direction in this emerging field. In addition, our experience in the successful rehabilitation of Korsakoff syndrome patients is also introduced.

Spanish applications of Luria's assessment methods

Luria's neuropsychology has been particularly influential in the Spanish-speaking world. Its impact is observed with regard to not only assessment, but also rehabilitation, and, especially, neuropsychological theorization. In this article, Luria's approach to neuropsychological assessment is examined. A distinction between Luria's neuropsychological tests and Luria's neuropsychological approach is introduced. It is pointed out that, according to Luria, the specific tests used in the neuropsychological assessment are secondary; the theory supporting the neuropsychological testing is of primary importance. The development of neuropsychology in the Spanish-speaking world is briefly presented, and the use of Luria's neuropsychological assessment procedures in Latin America and Spain is analyzed. Finally, neo-Lurianism in the Spanish-speaking world is considered.

[Child neuropsychology in the next millennium]

INTRODUCTION

The progress made in recent decades in neuropsychology has meant a major advance in the recognition of sub-types of various disorders of nervous development.

DEVELOPMENT

Recognition of symptomatology by means of a fragmental study of the components of all the different systems for obtaining information brings to light new therapeutic options. The different neuropsychological tests are used to study not only the final development of a particular ability but also how this has been achieved. Study of the type of mistakes made by each child permits recognition of the neuro-cognitive profile used. Cognitive rehabilitation of different processes presenting in infancy and adolescence offers the possibility of acquiring an alternative system of learning to minimize or substitute for deficiency. This is possible in cases affecting secondary or tertiary processing areas.

CONCLUSIONS

The recognition of alternative routines, used to overcome specific disorders of nervous system development, makes one reflect on the way in which information is acquired, processed and produced by the brain and the possibility of generating auxiliary strategies for processing, even in healthy brains, so that perhaps options will be available in the case of future lesions (aphasia, Alzheimer's disease, etc.).

Physical "phantasies" and family functions: overcoming the mind/body dualism in somatization

In this article, we examine some of the ways in which family therapists have conceptualized the experience of illness of unexplained physical origin. We argue that opinions about the etiology of somatic symptoms should not be the primary focus of therapeutic work with people who share the prototypical characteristics of what has been defined as "somatization disorder." We suggest that current research in neurobiology can expand the linguistic resources of clinicians and help them avoid perpetuating unhelpful dichotomies between the mind and the body.

General paralysis of the insane and AIDS in old age psychiatry: epidemiology, clinical diagnosis, serology and ethics--the way forward

While the incidence of general paralysis of the insane (GPI) has declined, AIDS (acquired immune deficiency syndrome) has emerged as a new illness. Today, in England and Wales, as many elderly people die from AIDS as from neurosyphilis, although both diagnoses are rare in this age group. Both are serious medical conditions with psychiatric manifestations. For both, serological tests may identify the disease, and treatment may be of benefit, but there is considerable social stigma attached to the diagnoses. Ethical guidelines for serological testing for HIV (human immunodeficiency virus) have been available for over a decade. In view of the similarities between the diseases, it may be unethical to test patients for syphilis routinely. Epidemiology, risk factors, neurological and neuropsychiatric features and ethics must be considered before testing for both syphilis and HIV.

Historical trends in biological and medical investigations of reading disabilities: 1850-1915

The theoretical roots of neuropsychological research lie in the case studies of reading disability completed during the late nineteenth and early twentieth centuries. This article reviews the methods, technologies, and operating tenets of these studies. The results suggest that the assumptions of anatomical and functional modularity for cortical processes became guiding principles for diagnosing and correcting reading difficulties. The advent of neuron doctrine shifted the focus of neuropsychological explanations of reading difficulties from gross neuroanatomical studies to investigations of the microstructure of the central nervous system. Early definitions of reading disabilities are interpreted across the dimensions of focal lesions, autonomous cognitive processes, comorbidity with other symptoms and syndromes, etiology, and permanence.

Ethical aspects of research on brain morphology in psychiatric patients

Morphometric and functional brain research is now an integral part of the most concentrated effort in a century to understand some of the most distressing illnesses to which man can fall victim. It will undoubtedly expand. The only ones with anything to fear from this work are those who, for ideological reasons, cannot accept its basic premises. The ethical issues it raises are not in general insurmountable, though the questions posed by the concept of informed consent remain.

Brain plasticity and behavior

Brain plasticity refers to the brain's ability to change structure and function. Experience is a major stimulant of brain plasticity in animal species as diverse as insects and humans. It is now clear that experience produces multiple, dissociable changes in the brain including increases in dendritic length, increases (or decreases) in spine density, synapse formation, increased glial activity, and altered metabolic activity. These anatomical changes are correlated with behavioral differences between subjects with and without the changes. Experience-dependent changes in neurons are affected by various factors including aging, gonadal hormones, trophic factors, stress, and brain pathology. We discuss the important role that changes in dendritic arborization play in brain plasticity and behavior, and we consider these changes in the context of changing intrinsic circuitry of the cortex in processes such as learning.

Neuropsychological assessment in Alzheimer's disease: current status and future directions

Neuropsychological assessment involves the observation and measurement of an individual's behavior in relation to a given stimulus that has been selected for its likelihood to provoke an abnormal response in the presence of neurological damage. This approach incorporates a medical and psychological approach to diagnosis in that both pathology-specific signs and deviations from normal distributions are examined. In the case of Alzheimer's disease (AD), this methodology has assumed considerable importance. This is because behavioral indicators remain the principal basis for provisional diagnosis when there are no biological markers. Observations of elderly persons with and without senile dementia have led to the development of stimuli, or tests, that are able to assess the functioning of specific cognitive processes affected in AD as opposed to more common age-associated changes. Many of these tests have been found to be culturally portable. Diagnostic difficulties arise principally from the fact that many neuropsychological tests cannot be used in isolation, from uncertainty as to the limits of "normal" functioning and from the psychometric problems related to pathological thresholds and item-weighting. The usefulness of neuropsychological testing in the future could undoubtedly be enhanced by the use of measures derived from indices of decline in functioning rather than normative data and the development of functional testing in collaboration with cerebral imaging.