The Luria-Nebraska Neuropsychological Battery: a promise that may be partly fulfilled

Validity of the Luria-Nebraska language scales in aphasia

The language scales of the Luria-Nebraska Neuropsychological Battery (LNNB) were administered to patients classified as either Broca's (n = 7) or Wernicke's (n = 7) aphasics. Group comparisons were made on the standard scales (e.g., Receptive Speech, Expressive Speech, Reading & Writing) and on 13 factor-analytically derived subscales (McKay & Golden, 1981). Results indicated that the standard T-score profile failed to discriminate the distinctively different language syndromes. Only two of the 13 factor scales differentiated the groups. Although Wernicke's patients were more impaired than Broca's patients on factor-analytically derived measures of basic language comprehension, it was concluded that the subscales added little to the standard profile in terms of aphasia syndrome identification. Distinctively different profiles of impaired and retained language abilities did not emerge on the LNNB factor scales. The battery cannot be recommended for use with aphasic patients.

Testing to detect brain damage: an alternative to what may no longer be useful

Kane, Parsons, and Goldstein (1985) recently demonstrated that the Halstead-Reitan Battery, the Luria-Nebraska Neuropsychological Battery, and the Wechsler Adult Intelligence Scale are all equally effective when used to detect brain damage. This commentary raises the question of whether this type of testing and test development is still useful. Several arguments are made suggesting that it is not. First, it is shown that detecting brain damage alone is usually not clinically useful. Instead, it is argued that neuropsychological instruments more effectively contribute to clinical diagnosis and treatment when used to delineate cognitive function. Additionally, it is demonstrated that brain-damage detection has a number of pitfalls. A method to develop instruments to delineate cognitive function is proposed, and a recent example of such an approach is provided.

Lateralizing brain damage with the Luria-Nebraska Neuropsychological Battery: diagnostic effectiveness as compared to the Halstead-Reitan Neuropsychological Test Battery

This investigation examined the ability of the Luria-Nebraska Neuropsychological Battery (LNNB) to lateralize brain damage, since substantial statistical and methodological issues have been raised regarding the initial LNNB lateralization validation study. A comparison was then made of the ability of the LNNB and the Halstead-Reitan Neuropsychological Test Battery to lateralize brain damage. Both neuropsychological batteries were administered to 30 predominantly left- or right-hemisphere-damaged subjects (15 in each group) with discriminant analysis classification procedures demonstrating similar, above chance, accuracy in lateralizing cerebral dysfunction. Cross-validation of objective clinical rules designed to aid in LNNB test interpretation resulted in classification of brain damage and lateralization at levels below reported values from the test developer's laboratory. The limited role such simplistic rules have in assessment is discussed, as is the need to evaluate dimensions of test usefulness other than those related to gross diagnostic decisions (e.g., presence or laterality of brain damage) in determining the instrument of choice for clinical neuropsychological practice. More research is recommended to fully define the limits of the clinical utility of the LNNB.

Does depression in patients with known or suspected cerebral disease contribute to impairment on the Luria-Nebraska Neuropsychological Battery?

Both the Luria-Nebraska Neuropsychological Battery (LNNB) and the Beck Depression Inventory (BDI) were administered to 48 consecutively referred patients. These consecutively seen patients comprised 25 cases of confirmed brain damage and 23 cases of "suspected" or questionable damage. Product-moment correlations were calculated between the BDI and three LNNB-derived indices of impairment. No relationship was found between depression and any of the LNNB performance indicators, indicating that the battery may be robust in the presence of depression. Necessary constraints on this implication were discussed and explicated in light of the concurrent need to evaluate new neuropsychological instruments in realistic clinical contexts.

WAIS-R factor and performance on the Luria-Nebraska's Intelligence, Memory, and Motor Scales: a canonical model of relationships

The pattern and level of performance on the WAIS-R and the Luria-Nebraska's Intelligence, Memory, and Motor Scales were examined for 93 neurologically impaired adults. Maximum likelihood factor analyses of the WAIS-R indicated the presence of strongly correlated (.72) Verbal Comprehension and Perceptual Organization dimensions. Comparisons of these factors to those of the standardization group revealed an acceptable level of similarity (.94) for Verbal Comprehension, but not for Perceptual Organization (.53). Canonical correlations between WAIS-R factor scores and the three Luria-Nebraska scaled scores accounted for 82% of the total variance. Each set of procedures evidently is indexing the same theoretical constructs. Implications of these findings for our understanding of the measurement models that underlie clinical neuropsychology are discussed.

Cognitive deficits among functionally psychotic patients: a rehabilitative perspective

Psychological and neuropsychological assessments of psychiatric patients are usually designed to contribute to or document psychiatric diagnoses. The present article suggests that reframing the task to focus on cognitive rehabilitation issues can contribute significantly to the treatment of the chronic patient. A test protocol is proposed and exemplary tests suggested.

Statistical relationships and discriminative accuracy of the Halstead-Reitan, Luria-Nebraska, and Wechsler IQ scores in the identification of brain damage

Ninety-two patients (46 brain-damaged and 46 control) were administered both the Halstead-Reitan and Luria-Nebraska Neuropsychological Batteries and the WAIS. The relationship between the Luria and the Halstead Battery was assessed using a common metric, T scores, and also by comparing impairment ratings for both batteries. Diagnostic screening accuracy was compared using discriminative functions and by computing the percentage of brain-damaged and control cases falling above and below the combined group medians. Results of the discriminative analyses were also compared with those obtained using only IQ scores from the WAIS. Findings support the comparability of the two neuropsychological test batteries with respect to diagnostic screening accuracy and the extent to which they measure level of impairment. Interestingly, equivalent discrimination between organic and control subjects was obtained using WAIS IQ scores. However, differences in the instruments did emerge on an individual case basis.

Luria left in the lurch: unfulfilled promises are not valid tests

The Luria-Nebraska Neuropsychological Battery (LNNB) remains the subject of controversy among neuropsychologists. Substantial criticisms of a theoretical and applied nature have called into question its research basis as a clinical tool. In response to this, Stambrook (1983) has concluded that further research on the LNNB by neuropsychologists is required. The present commentary disputes this need, pointing to the test author's and publisher's primary responsibility for such research. Tests or batteries may be dropped from one's clinical practice without invoking an obligation on the part of neuropsychology.