Standard form of the Boston Naming Test: Normative data for the Latin American Spanish speaking adult population

Assessment of visuospatial functions in post-Covid 19 patients: Beyond the traditional paradigm

Several studies indicate that some cognitive changes occur after COVID-19. Visuospatial alterations have been reported in 24-40 %. These alterations may be useful as early biomarkers of neurodegenerative disease. Thus, we can emphasize the importance of visuospatial processes in cognition through quantitative and qualitative analysis of performance on the Clock Test (CDT) and the Rey-Osterrieth Complex Figure (FCRO). Our objective was to describe the performance of post COVID 19 patients in visuospatial tests, with different degrees of respiratory impairment and to perform a qualitative analysis of the performance to check its relationship with alterations in attention and executive functions. This will allow highlighting the executive component of the performance of the CDT and ROCF and differentiate patients with possible cognitive impairment. 77 patients with SARS-CoV-2 infection were evaluated (3 months post-infection) with a complete neuropsychological battery and MRI. Overall, there is a significant difference between FCRO and CDT, with FCRO having only 9 % change and CDT having 51.9 % change. Regarding the correlations observed between groups (VM Inv, VM non I and non hospitalized) the highest correlations were observed between Boston with FCRO copy (r=0.497; p=0.001) and with FCRO memory (r=0.429; p=0.001). Comparing the performance between groups by severity, significant differences were observed only in the TMT A (13.706 p=0.001) and B (9.583 p=0.008) tests and in the phonological fluency letter A (13.445 p=0.001), we observed that the group of non-hospitalized patients had a better performance. Neuropsychological deficits often have a direct impact on daily life by affecting the ability to learn and adapt. Thus, a useful strategy for the neuropsychological characterization of post-COVID-19 patients is the qualitative analysis of visuospatial abilities in conjunction with executive functions that cannot be analyzed in isolation.

"¿Cómo qué, cómo qué? cómo qué?" Single-language echolalia in a bilingual female with progressive supranuclear palsy: a case report

The case study explores bilingualism and neurodegenerative disorders, specifically progressive supranuclear palsy (PSP) with speech and language disorder (PSP-SL). It features a 78-year-old Mexican American woman who exhibits echolalia only in response to Spanish. This selective impairment suggests unevenly affected language control mechanisms despite her proficiency in both languages. Cognitive function is evaluated with neuropsychological tests; she's diagnosed with PSP-SL, depression, and anxiety. Echolalia in response to one language implies complex phonological retrieval mechanisms. Such observations prompt further inquiry into bilingual language control and processing mechanisms. The case supports evidence that bilingualism may attenuate neurodegeneration effects, suggesting better inhibitory control over disinhibited speech through enhanced executive functioning benefits.

Is language translation enough in cross-cultural neuropsychological assessments of patients from Latin America?

OBJECTIVE

The purpose of this review was to highlight the need to consider factors other than language when adapting tests across cultural groups and to offer a list of tests that have been adapted for use among patients from or descended from Latin American Countries. Despite efforts in the field through publications and workshops, the authors were aware of continued errors in cross-cultural assessment of these patients, resulting in misdiagnosis and unintentional inequitable care. Thus, we sought to reinforce the existing literature.

METHOD

We reviewed the literature pertaining to cross-cultural adaptation of neuropsychological measures. Relevant papers were identified by our institution's Academic Enhanced Search Option (AcESO) Database, PubMed, and Google Scholar.

RESULTS

102 papers, articles, and other published literature were reviewed describing issues related to the adaptation of tests for groups originally from or descended from Latin American Countries residing in the United States.

CONCLUSIONS

It is imperative that tests be appropriately developed or adapted for the target population with appropriate normative data available, and ideally administered by a fluent speaker trained in assessment. Inappropriate use of tests not adapted for a particular patient's language and country of origin can result in misdiagnosis, potentially resulting in harm to the individual.

Normative Data Study of Verbal Fluency and Naming Tests in Elderly People in Costa Rica

OBJECTIVE

To generate normative data for the Verbal Fluency Test (VFT) and the Boston Naming Test (BNT) in the Costa Rican population.

METHOD

The sample consisted of 563 healthy older people (aged 59-90 years). Polynomial multiple regression analyses were run to evaluate the effects of the age, sex, and education variables on VFT and BNT scores.

RESULTS

The results showed a significant linear effect of education on the four-letter VF scores and an effect of sex on the letter P score, with females performing better than males. The explained variance ranged from 20.9% to 28.3%. A linear effect of age and education was also found for the four semantic VF scores, with scores decreasing with increasing age and lower education. The sex variable was significant for all semantic categories, with females performing better than males except in the animal category. The explained variance ranged from 21.7% to 30.9%. In the BNT, a linear effect of education was found, so that the more education, the better the score. In addition, a sex effect was also found, with males having higher scores than females. The predictors of the model explained 9.6% of the variance.

CONCLUSIONS

This is the first study that generates normative data for the VF and BNT in the Costa Rican population over 59 years of age based on demographic variables. The use of these normative data will help clinicians in Costa Rica to better understand language functioning in the elderly, allowing for better classification and diagnosis in the future.

Naming assessment in bilinguals for epilepsy surgery-adaptation and standardization of Boston Naming Test in India

PURPOSE

Naming difficulty is associated with temporal lobe epilepsy and a decline in naming ability is reported following dominant temporal lobe resections. The Boston Naming Test (BNT) is the most frequently used test for assessing naming ability. Evaluating naming ability in bilingual/multilingual populations is a challenge when participants are restricted to responding in one language. The study aimed to adapt and standardize the BNT as a valid clinical tool for evaluating bilingual/multilingual people undergoing epilepsy surgery in urban India.

RESULTS

Culture-appropriate adaptations were done, and participants were allowed to respond in any language. Data from 197 participants showed a strong education effect. The adaptation showed strong internal consistency, reliability, construct validity, and high sensitivity to left temporal lobe epilepsy performance.

CONCLUSIONS

The adapted version that allowed for flexible use of more than one language is a useful clinical tool for evaluating bilingual people undergoing epilepsy surgery.

Feasibility Study of the Boston Naming Test for the Arab Population

Introduction The Boston Naming Test (BNT) is a widely used US neuropsychological evaluation of confrontation naming for the examination of adults and children with learning disabilities and diagnosis of communication disorders, aphasia, dementia, and acquired brain injury or dysfunction. The purpose of the present study is to evaluate the practicality of the original English version of the 60-item BNT (BNT-60) on an Arab population and the need for a new adaptive Arabic version sensitive to cultural biases and to offer normative data that can serve as a reference for researchers and clinicians in the Gulf region, especially the Kingdom of Saudi Arabia (KSA). Data relating to the familiarity degree of the BNT-60 were also collected. Methods This research involved 105 randomly selected and cognitively healthy college students who were native Arabic speakers recruited in Jeddah. The Montreal Cognitive Assessment (MOCA) was administered with a cutoff score of 26. The participants were examined for naming accuracy, naming agreement, and familiarity in using the BNT-60. The data were then analyzed and compared with the findings from studies conducted in the United States. Results The BNT-60 was administered to 105 university students from the KSA, and the results were compared with the BNT-60 booklet norms (second edition). Their average performance was noticeably below the norms established by the original test standards. Compared with the participants in the US studies, the participants made approximately 65% more errors on the items including pretzel, wreath, beaver, harmonica, acorn, stilts, harp, hammock, knocker, pelican, muzzle, unicorn, funnel, accordion, asparagus, tripod, yoke, and trellis and 25% more errors on the items including seahorse, dart, igloo, sphinx, palette, and abacus. The item "boomerang" was not compared with the US sample because of differences in the version of the BNT, but the errors in naming this item were as frequent as those in naming the other misrecognized items. The internal consistency among the items' degrees of familiarity was also very high (α = 0.966), and a significant connection (r = 0.837, P < 0.001) was observed between object familiarity and naming accuracy. The Arabic-speaking population in the KSA and English-speaking population in the United States showed very different levels of familiarity with numerous items. Conclusion The participants' familiarity with the BNT objects varied depending on their culture and impacted their naming accuracy and overall scores on the test. Accordingly, the possibility of cultural biases should be considered when administering the BNT to the population of the KSA and the possibility of making changes so that the test better reflects the Arab culture as suggested.

Cognitive impairment with Type 2 Diabetes Mellitus among community-dwelling older adults in Chile: Prevalence, risk factors and cognitive characteristics

Introduction

The aim of this study is to determine prevalence and risk factors of Cognitive Impairment (CI) and its association with Type 2 Diabetes Mellitus (T2DM) in subjects aged 65 years and above. Additionally, we attempt to provide a cognitive profile for T2DM group.

Methodology

A cross-sectional analytical study to assess CI was carried out. We evaluated a sample of community-dwelling residents from Chile. All participants underwent a general interview, lifestyle questionnaires and a comprehensive neuropsychological battery. Regression analyses were performed to evaluate risk of CI with T2DM and influencing factors. Results between groups in the different domains of the neuropsychological assessment were compared by Student's t-tests and MANOVA.

Results

Among all 358 subjects, overall T2DM prevalence were 17.3%. The prevalence of CI was higher in T2DM group compared to the healthy participants (30.7%, p < 0.001). The risk of CI was 2.8 times higher in older people with T2DM compared to older people without the diagnosis. Multiple regression analysis, adjusted for age and gender, demonstrated that age, education, presence of dyslipidemia, and T2DM duration were the predictor variables significantly associated with CI. T2DM group performed worse on global cognitive performance, attention, language, verbal memory, visual memory, visual constructional ability, and executive function. After adjusting for significant covariates from multiple regression analysis, a relationship between "cognition" and T2DM is still observed. Amnesic multi-domain impairment was the specific cognitive identified pattern for T2DM group.

Conclusion

The present study confirms the high prevalence of CI with T2DM among Chilean older adults in a community-based population. T2DM is significantly associated with a higher risk of CI, and age, education, presence of dyslipidemia, and duration of T2DM are risk factors. T2DM patients with CI are impaired in multiple cognitive domains, even after adjusting covariables, resulting in an amnesic multi-domain cognitive profile.

Naming ability assessment in neurocognitive disorders: a clinician's perspective

BACKGROUND

Detecting impaired naming capacity is valuable in diagnosing neurocognitive disorders (ND). A. clinical practice- oriented overview of naming tests validated in ND is not available yet. Here, features of naming tests with validated utility in ND which are open access or available for purchase are succinctly presented and compared.

METHODS

Searches were carried out across Pubmed, Medline and Google Scholar. Additional studies were identified by searching reference lists. Only peer-reviewed journal articles were eligible. A narrative- and tabullar synthesis was used to summarize different aspects of the naming assessment instruments used in patients with ND such as stimuli type, administration time, assessment parameters and accessibility. Based on computational word frequency calculations, the tests were compared in terms of the average frequency of their linguistic content.

RESULTS

Twelve naming tests, relying either on visual or auditory stimuli have been validated in ND. Their content and administration time vary between three and 60 items and one and 20 minutes, respectively. The average frequency of the words of each considered test was two or lower, pointing to low frequency of most items. In all but one test, scoring systems are exclusively based on correctly named items. Seven instruments are open access and four are available in more than one language.

CONCLUSIONS

Gaining insights into naming tests' characteristics may catalyze the wide incorporation of those with short administration time but high diagnostic accuracy into the diagnostic workup of ND at primary healthcare and of extensive, visual or auditory ones into the diagnostic endeavors of memory clinics, as well as of secondary and tertiary brain healthcare settings.

Do neurosteroids have impact on depression and cognitive functions in cases with acromegaly?

OBJECTIVE

Neurosteroids (NSs) are a distinct hormone group and, they are known for their contribution into the status of mood and cognitive functions. Whether they are also involved in the mood disturbances and cognition in acromegaly is not known. Herein we aimed to evaluate the relation of mood status and cognitive functions with the NS levels in cases with acromegaly.

DESIGN

A total of 33 cases with acromegaly composed the acromegaly group (AG) and, 30 age and gender-matched cases without acromegaly composed the control group (CG). The levels of Allopregnanolone (AP), pregnenolone (PRG), 24S-hydroxycholesterol (24OHC), dehydroepiandrosterone (DHEA), dehydroepiandrosterone sulfate (DHEAS), androsterone (ADT), GH and IGF-1 were measured in each group. Beck Depression Inventory (BDI) was used to assess depressive symptoms, whereas an extensive neuropsychological assessment with several neurocognitive tests were carried out for each subject by an experienced psychologist.

RESULTS

Cases with acromegaly had lower 24OHC and DHEA levels (p = 0.002 and p = 0.007, respectively) in comparison to CG. Of the cognitive functions time to complete 1 s Series was significantly higher and, the scores on Switching Verbal Fluency Test, Boston Naming Test (BNT)-semantic and BNT-phonological, the highest learning point of Oktem Verbal Memory Processes Test (VMPT) were significantly lower in cases with acromegaly in comparison to those in controls (p = 0.004, p = 0.01, p < 0.001, p = 0.02 and p = 0.05, respectively). KAS-perseveration errors were higher in CG (p = 0.03). In AG the levels of AP were negatively correlated with the scores on Months backward Test (MBT), Animal Naming Test, Construction, BNT-spontaneous and positively correlated with BNT-incorrect answers; PRG was positively correlated with VMPT-retention scores, ADT was negatively correlated with MBT and 3 s Series scores, DHEAS was positively correlated with VMPT-the highest learning point whereas it was negatively correlated with MBT scores. Additionally, the scores on BDI were positively correlated with DHEA levels in AG.

CONCLUSION

Cognitive changes may be encountered in acromegaly and, neurosteroids may contribute to the changes in certain cognitive functions.

Regression-Based Normative Data for Independent and Cognitively Active Spanish Older Adults: Verbal Fluency Tests and Boston Naming Test

An increased cognitive reserve is associated with changes in the pattern of cognitive decline during aging. Thus, normative data adapted to the characteristics of the target population are needed to reduce the possibility of false diagnoses. The aim of this work was to develop normative data for the Phonemic Verbal Fluency test, the Semantic Verbal Fluency test and the Boston Naming Test (BNT).

METHOD

Regression-based normative data were calculated from a sample of 118 non-depressed, cognitively active, independent community-dwelling adults aged 55 or older (64.4% women) from SABIEX (University for Seniors at the Universidad Miguel Hernández de Elche). Raw scores were regressed on age, sex, and education.

RESULTS

The effects of age and education varied across neuropsychological measures. No effect of sex was found in any of the tests assessed. Statistically significant differences were found in the proportion of low scores using SABIEX or population-based normative datasets. The level of agreement identifying individuals labeled as showing one or more low scores was only fair-to-good.

CONCLUSIONS

Normative data obtained from the general population might not be sensitive to identify low scores in cognitively active older adults, increasing the risk of misdiagnoses. A friendly calculator is available for neuropsychological assessment.

Validation of the Norma Latina Neuropsychological Assessment Battery in Patients with Alzheimer's Disease in Mexico

To our knowledge, this is the first study reported in the literature that has validated the Norma Latina Battery in a population of people with Alzheimer's disease (AD) in Mexico. The objective of the study was to determine the discriminant validity of the Norma Latina Battery in a group of Mexican individuals with AD and a group of heathy controls (HC). The Norma Latina Battery was administered to 234 Mexican participants (117 HC and 117 individuals with AD). Results show that: (1) the Norma Latina Battery has high discriminative capacity between groups in all domains; (2) participants with AD presented worse scores in each of the cognitive domains compared to the HC and a greater number of low scores in each of the established thresholds or cut-off points; and finally, (3) the Norma Latina Battery had optimal sensitivity and specificity, especially when a set was observed ≥5 scores below the 10th percentile or ≥4 scores below the 5th percentile. In conclusion, it is recommended that both clinicians and researchers use this battery in the evaluation of Mexican people with AD to better understand the prognosis of the disease and its subsequent treatment.

A Color-Picture Version of Boston Naming Test Outperformed the Black-and-White Version in Discriminating Amnestic Mild Cognitive Impairment and Mild Alzheimer's Disease

Despite the ubiquity of the Boston naming test (BNT) in clinical practice and research, concerns have been expressed about its poor quality pictures, insufficient psychometric properties, and cultural bias in non-English language backgrounds. We modified the black-and-white BNT with a set of color pictures since color effects have been suggested to improve naming accuracy in the visual naming test. This study aimed to examine and compare the reliability and validity of the color-picture version of BNT (CP-BNT) and the black-and-white version of BNT (BW-BNT) to differentiate amnestic mild cognitive impairment (aMCI) or mild Alzheimer's disease (AD) from the cognitive normals. This study included two subgroups, and each subgroup had 101 normal controls, 51 aMCI, and 52 mild AD. One subgroup undertook BW-BNT and the other conducted CP-BNT. The reliability, convergent and discriminant validity, and the diagnostic accuracy of two versions of BNT were evaluated. The CP-BNT showed a greater area under the curve (AUC) than the BW-BNT for aMCI (80.3 vs.s 69.4%) and mild AD (93.5 vs. 77.6%). The CP-BNT also demonstrated better convergent validity with CDR global scores and better reliability (Cronbach's coefficient 0.66 for the CP-BNT vs. 0.55 for the BW-BNT). At the optimal cutoff value of spontaneous naming, the CP-BNT demonstrated improved sensitivity and specificity for differentiating mild AD from NC with a higher positive predictive value, negative predictive value, and lower false-positive rate. Compared with BW-BNT, CP-BNT is a more reliable and valid test to assess cognitive and naming impairment.

Survey of Spanish Language Neuropsychological Test Use in the Assessment of Hispanic Americans/Latino/as/x

OBJECTIVE

To identify the Spanish language neuropsychological tests most frequently used in the evaluation of Hispanic Americans/Latino/as/x across eight neuropsychological domains. To compare these with previously surveyed most frequently used English language tests in the US/Canada. To describe the norms used with Spanish language tests.

METHOD

An anonymous, uncompensated, 12-min survey was emailed to 169 members of the American Academy of Clinical Neuropsychology, Hispanic Neuropsychological Society, and National Academy of Neuropsychology who self-identified as providing neuropsychological evaluations in Spanish via organizational websites.

RESULTS

The response rate was 36%. Respondents were all licensed U.S. psychologists with the majority fluent in Spanish, conducting less than half their evaluations in Spanish. There was an overlap between the versions of the three most frequently used Spanish versus English neuropsychological tests, but it varied by domain with 3/3 similar for visual-spatial/visuoconstructional skills and sensory/motor functioning domains and 2/3 similar for all other domains except memory (0/3). English language norm use predominated within the mood/personality and sensory/motor functioning domains. In all other domains, Spanish language norms collected in the continental US were preferred to those from foreign Spanish-speaking countries. The most frequently used foreign norms were from Mexico.

CONCLUSION

Except for the memory domain, there was a sizeable overlap between the three most frequently used Spanish and English language neuropsychological tests in the US. Spanish language tests are primarily interpreted with Spanish norms collected in the continental US except within the mood/personality and sensory/motor functioning domains where English language norms predominate.

Normative data for Verbal Fluency and Object Naming Tests in a sample of European Portuguese adult population

The purpose of the present study was to calculate the construct validity, internal consistency and normative data of the Phonological Verbal Fluency Test (letters F, A, S, and M), Semantic Verbal Fluency Test (Animals, Fruits and Professions categories), and Boston Naming Test (short and standard version), and to generate normative data for these tests after adjusting for age, education, and sex. A sample of 293 European Portuguese adults participated in the study. Results showed adequate construct validity and internal consistency for all of the tests and the final multiple regression models found that age and education were significantly associated with P-VFT (letters F, A, S, and M), S-VFT (Animals, Fruits and Professions categories), and BNT performance. Sex was only found to have an effect on the fruit category, with women scoring higher than men. The normative data provided in this study will contribute to improving the clinical practice of neuropsychology in Portugal.

Teleneuropsychology for Monolingual and Bilingual Spanish-Speaking Adults in the Time of COVID-19: Rationale, Professional Considerations, and Resources

OBJECTIVE

Neuropsychological assessments with monolingual Spanish and bilingual Spanish/English-speaking adults present unique challenges. Barriers include, but are not limited to, the paucity of test norms, uncertainty about the equivalence of translated neuropsychological tests, and limited proficiency in the provision of culturally competent services. Similar issues generalize to telephone- and video-based administration of neuropsychological tests or teleneuropsychology (TeleNP) with Hispanics/Latinos (as), and few studies have examined its feasibility and validity in this group. The sudden onset of the COVID-19 pandemic prompted neuropsychologists to identify alternative ways to provide equitable care. Clinicians providing TeleNP to this population during (and after) the pandemic must consider safety, professional factors, and systemic barriers to accessing and benefitting from virtual modalities.

METHOD

This clinical process manuscript describes how cross-cultural neuropsychologists across five U.S. academic institutions serving Hispanics/Latinos (as) developed TeleNP models of care during the pandemic.

RESULTS

Workflows, test batteries, and resources for TeleNP assessment with monolingual and bilingual Spanish-speaking patients are included. Factors guiding model development and informing decisions to incorporate virtual administration of neuropsychological tests into their practice are also discussed.

CONCLUSIONS

Provision of TeleNP is a promising modality. Additional research in this area is warranted with focus on cultural and contextual factors that support or limit the use of TeleNP with this community.

Narrative discourse of young and older brazilian adults associated with demographic factors

PURPOSE

1) Compare the discourse performance between young and older adults from the Brazilian Federal District (DF); 2) Compare the mean discourse performance of participants from the DF with the normative discourse of a population from a different region of the country; 3) Verify whether the variables age, educational level and socioeconomic status and scores on the cognitive, behavioral and functional screening tests were associated with discourse performance.

METHOD

A total of 60 healthy volunteers from the DF, 30 older adults and 30 young adults, were selected. Participants were divided into two subgroups according to educational level: low education and high education. The four narrative discourse subtests of the Montreal Communication Evaluation Battery, Brazilian Portuguese version (MAC-BR) were applied to the study sample.

RESULTS

Discourse scores of the older adults were statistically higher than those of the young adults. The discourse scores in the high education group were also better than those in the low education group, with statistically significant difference observed in only one of the MAC-BR subtests. Discourse performance was associated with the sociodemographic variable and the scores on the cognitive and functional screening tests. The discourse performance of the DF sample differed from the national normative discourse with statistically significant difference.

CONCLUSION

The discourse performance of older adults from the Brazilian Federal District differed from that of young adults from the same region, as well as from that of older adults from southern Brazil. Discourse performance was associated with several different variables.

Phonetic-phonological performance of typical younger and aged adults from Brazil's capital city

Given the sociodemographic diversity in Brazil, it is fundamental to understand the speech performance of a sample from the Brazilian capital. The repetition task can assess phonological and motor-phonetic planning. Previous studies found phonological-phonetic performance of speakers to be associated with education, age, and other demographic factors.

OBJECTIVES

To compare the phonetic-phonological performance for speech of younger and aged adults in the capital of Brazil, Federal District (FD); to compare FD performance against national normative means based on São Paulo; to determine the association of phonetic-phonological agility with sociodemographic, cognitive, and neuropsychiatric variables for the sample.

METHODS

Cross-sectional study. A total of 60 volunteers from the FD, comprising 30 older adults and 30 younger ones, were stratified by education into two subgroups: 2‒7 years and ≥8 years of education. Data on age, educational level, and socioeconomic status were collected. The Verbal Agility subtest of the Boston Diagnostic Aphasia Examination was applied to assess phonetic-phonological performance.

RESULTS

No statistically significant difference in performance for verbal agility was found between aged and younger adults from the FD. There was a statistically significant difference in the phonetic-phonological performance of the FD sample compared with the Brazilian normative mean values. Cognitive and socioeconomic variables were associated with verbal agility.

CONCLUSIONS

In the capital of Brazil, economic status, age, education, and cognitive variables were associated with verbal agility performance, despite there being no difference in phonetic-phonological performance between younger and aged adult groups. Regional differences in phonetic-phonological performance were also evident.

Normative Data for Test of Verbal Fluency and Naming on Ecuadorian Adult Population

Objective: To generate normative data for verbal fluency and naming test in an Ecuadorian adult population. Methods: The sample consisted of 322 healthy adults (18-84 years old) recruited from Quito, Ecuador. The verbal fluency and Boston Naming Test (BNT) were administered as part of a larger comprehensive neuropsychological battery. Multiple linear regression analyses were used to generate the normative data taking into account age, education, and sex. Results: For phonological verbal fluency, results indicated that only education was significantly related to the performance of the letters "A," "S," and "M." However, the performance on the letter "F" was significantly associated with age and education. For semantic fluency, the performance on "animals" was significantly influenced by age, quadratic age, and education, whereas that for "fruits" was explained by quadratic age, education, and sex. The performance on the BNT was significantly influenced by age and education. A Microsoft Excel-based calculator was created to help clinicians to obtain the normative data on this test. Conclusion: This normative data will help neuropsychologist in Ecuador to use these tests both in research and in their clinical practice to improve the diagnosis of cognitive deficits in the population.

Cognitive outcomes following laser interstitial therapy for mesiotemporal epilepsies

Objective

To provide a review of cognitive outcomes across a full neuropsychological profile in patients who underwent laser interstitial thermal therapy (LiTT) for mesiotemporal epilepsy (mTLE).

Methods

We examined cognitive outcomes following LiTT for mTLE by reviewing a consecutive series of 26 patients who underwent dominant or nondominant hemisphere procedures. Each patient's pre- and postsurgical performance was examined for clinically significant change (>1SD improvement or decline on standardized scores), with a neuropsychologic battery that included measures of language, memory, executive functioning, and processing speed.

Results

Presurgical performance was largely consistent with previous research, where patients suffering from dominant hemisphere epilepsies demonstrated deficits in verbal learning and memory, whereas patients with nondominant hemisphere scored lower on visually mediated tests. Case-by-case review comparing presurgical to postsurgical scores revealed clinically significant improvement in both dominant and nondominant patients in learning and memory and other aspects of cognition such as processing speed and executive functioning. Of the few patients who did experience clinically significant decline following LiTT, a greater proportion had undergone dominant hemisphere procedures.

Conclusions

Compared with the outcome literature of dominant open anterior temporal lobectomies (ATLs), where postsurgical decline has been documented in up to 40%-60% of cases, our LiTT case series exhibited a much lower incidence of postoperative language or verbal memory decline. Moreover, promising rates of postoperative improvements were also observed across multiple cognitive domains. Future studies exploring cognitive outcomes following LiTT should include comprehensive neuropsychological findings, rather than only select domains, as clinically significant change can occur in areas other than those typically associated with mesiotemporal structures.

[DIABDEM project: A pilot study of prevalence of cognitive impairment in diabetes mellitus in 2 Hispanic countries]

INTRODUCTION

The prevalence of chronic noncommunicable diseases such as type 2 diabetes mellitus (T2DM) and dementia increase with ageing. In this context, an association between T2DM and cognitive impairment has been described in the literature. However, there are few studies in the Hispanic population. This research project presents a pilot study that will evaluate the feasibility of the DIABDEM project that will determine the prevalence of cognitive impairment in old people with diagnosis of T2DM in Spain and Chile.

MATERIALS AND METHODS

It is a observation-based pilot study, non-experimental, descriptive-comparative and cross-sectional. The sample will involve 72 participants (39 Spaniards and 33 Chileans), 65 year-old or older, men and women, community dwelling, and who have not been previously diagnosed with dementia, with or without a T2DM diagnosis. Participants will fill in a research protocol form collecting socio-demographic and clinical data, lifestyle details, and neuropsychological variables.

EXPECTED RESULTS

This study will evaluate the feasibility of the DIABDEM project that will determine the prevalence rate of cognitive impairment in old people with T2DM. On one hand, the aim of this study will establish risk and protectors factors potentially associated with the development of cognitive impairment in T2DM. On the other hand, it is expected to identify a specific neuropsychological profile in people with T2DM, proposing later a brief and useful neuropsychological battery in order to discriminate early cognitive impairment in people with T2DM.

CONCLUSION

Findings in this pilot study will obtain greater knowledge about the feasibility of the DIABDEM project, which will provide evidence about cognitive complications in T2DM.

Trajectories of memory, language, and visuoperceptual problems in people with stroke during the first year and controls in Colombia

AIM

Neuropsychological normative data for Latin America have been recently published, and for Colombia, in particular, but longitudinal neuropsychological outcomes after stroke have not yet been examined in this global region. The purpose of the current study was to compare functioning of individuals with stroke in Colombia, South America during the first year post-stroke to healthy controls across neuropsychological assessments of memory, language, and visuoperceptual impairments.

METHOD

A sample of 50 individuals with stroke (mean age = 51.58) and 50 matched healthy controls (mean age = 51.54) from Colombia were included in this study. Because of a lack of access to health services, individuals with stroke did not receive any inpatient or outpatient cognitive or behavioral rehabilitation. Participants were assessed on 10 visuoperceptual, language, and memory tasks at 3, 6, and 12   months.

RESULTS

Trajectories of neuropsychological performance were significantly worse among individuals with stroke than healthy controls across every index. Further, hierarchical linear models suggested that although both individuals with stroke and controls generally improved over time on these assessments, the improvements among individuals with stroke were often of no greater magnitude than the improvements seen in controls, suggesting extremely low levels of rehabilitation gains in Colombia. Only three of the 10 neuropsychological assessments did a significant time*group interaction occur, suggesting greater gains for the stroke group than controls.

CONCLUSION

These findings suggest profound disparities in post-stroke cognitive functioning in Colombia compared to other more developed global region and underscore the importance of comprehensive cognitive rehabilitation services for individuals with stroke in Colombia and other similar global regions. Implications for rehabilitation Because this study found only negligible cognitive improvements beyond practice effects over the first year after stroke in Colombia among individuals without access to acute rehabilitation, it is imperative that comprehensive cognitive rehabilitation services be implemented immediately during the acute rehabilitation period. Memory, language, and visuoperceptual training strategies can be implemented for people with stroke in underserved global regions as part of the standard of care for stroke rehabilitation. Cognitive rehabilitation strategies should be adapted into Spanish and pilot tested in Latin America to ensure cultural equivalence. Culturally competent cognitive rehabilitation strategies should be tailored based on varied educational and literacy levels.

Item analysis of the Spanish version of the Boston Naming Test with a Spanish speaking adult population from Colombia

OBJECTIVE

The Boston Naming Test (BNT) is a widely used measure of confrontation naming ability that has been criticized for its questionable construct validity for non-English speakers. This study investigated item difficulty and construct validity of the Spanish version of the BNT to assess cultural and linguistic impact on performance.

METHODS

Subjects were 1298 healthy Spanish speaking adults from Colombia. They were administered the 60- and 15-item Spanish version of the BNT. A Rasch analysis was computed to assess dimensionality, item hierarchy, targeting, reliability, and item fit.

RESULTS

Both versions of the BNT satisfied requirements for unidimensionality. Although internal consistency was excellent for the 60-item BNT, order of difficulty did not increase consistently with item number and there were a number of items that did not fit the Rasch model. For the 15-item BNT, a total of 5 items changed position on the item hierarchy with 7 poor fitting items. Internal consistency was acceptable.

CONCLUSIONS

Construct validity of the BNT remains a concern when it is administered to non-English speaking populations. Similar to previous findings, the order of item presentation did not correspond with increasing item difficulty, and both versions were inadequate at assessing high naming ability.