Comparison of neuropsychological data in the diagnosis of brain impairment with computerized tomography and other neurological procedures

The accuracy of automated and clinical detection of brain damage and lateralization in neuropsychology

The validity of both computer programs and clinical judgment in neuropsychology for determining the existence and lateralization of brain damage is reviewed. Computerized interpretation in neuropsychology, after a propitious beginning, was largely abandoned due to severe criticism, essentially based on only three studies. Only one of these studies compared clinical judgment with computer programs. A thorough examination of the literature located many more studies assessing the accuracy of computer programs, clinical judgment, and discriminant analysis. When reviewed, these studies found that the computer programs, especially the Neuropsychological Key, were quite accurate though not as accurate as clinical judgment. Computer programs and especially the Lateralization Index are potentially as accurate as expert clinical judgment. The rationale related to computer programs is also discussed. This includes the implications of impairment, criterion adequacy, and methods used in designing the Neuropsychological Key and the Lateralization Index. Since computer programs are completely reliable across studies, they can be used to examine the differences between sample populations and criterion accuracy. Factors contributing to reduced accuracy in both clinical judgment and computer programs are also explicated.

The chronic cerebral effects of cannabis use. I. Methodological issues and neurological findings

This paper examines the research evidence relating sustained use of marijuana to chronic cerebral impairment. Evidence from both American and cross-cultural studies is reviewed, with a particular emphasis on methodological problems in the research. The focus of this paper is on neurological findings while another paper focuses on neuropsychological findings. On the basis of available research, it was concluded that there is no evidence that marijuana produces gross structural cerebral changes and little evidence that it leads to functional impairment, although subtle impairment cannot be ruled out.

Reversible and non-reversible enlargement of cerebrospinal fluid spaces in anorexia nervosa

Brain CT studies of 35 patients with anorexia nervosa confirmed the observations of other authors: cerebral dystrophic changes correlate with weight loss and the reversibility of these changes also correlates with the normalization of body weight. Other corroborated facts are: the most numerous and most pronounced enlargements are of the cortical sulci and the interhemispheric fissure, moderate widening affects the ventricles and the rarest and most insignificant changes are those of the cerebellum. The reversibility of the changes showed a parallel to the extent of the changes themselves and to the duration of improvement of the body weight. The reversibility of the enlargement of the cortical sulci and of the distances between the frontal horns of the lateral ventricles was more often significant than that of the abnormal measurements of the cella media. This difference is based on minimal early acquired brain damage which occurs in 60% of our patients. This high incidence of early acquired minimal brain disease in patients with anorexia nervosa is here discussed as a nonspecific predisposing factor. Although there is no exact explanation of the etiology of the reversible enlargement of cerebrospinal fluid (CSF) spaces in anorexia nervosa, the changes resemble those in alcoholics. The mechanisms of brain changes in alcoholism, as shown experimentally, seem to us to throw light on the probable mechanism of reversible dystrophic brain changes in anorexia nervosa.

Normative data for the Halstead-Reitan neuropsychological tests

Normative data from a large neurologically intact, nonpsychiatric adult sample (male = 111, female = 82) are presented. Despite he size limitations in the upper age ranges, these data are consistent with previously published norms. Sex effects are evident, with females appearing weaker and slower than males on motor tests. The higher than average WAIS FSIQ displayed by this normal sample and the previous use of psychiatric patients as control subjects is discussed.

A comparison of frequency of abnormal results in neuropsychological vs. neurodiagnostic procedures

Compared the frequency of abnormal Impairment Index values and abnormal results on neurodiagnostic procedures in patients (N = 102) classified as Brain-damaged, Normal, or Equivocal on the basis of final medical diagnosis. The Impairment Index called a higher percentage of the Brain-damaged Ss abnormal than did any single neurodiagnostic procedure. Although it called a higher percentage of the other two groups abnormal than did the skull X-ray, the Impairment Index did not differ from computed tomography (CT) or the EEG with respect to abnormality rates in those groups. Thus, in this sample of patients, the Impairment Index was more sensitive to brain damage than any neurodiagnostic measure, yet no more likely to call patients in the other two groups abnormal than were CT or the EEG. Limitations of the study and difficulties in conducting this kind of research are discussed.