The purpose of this study was to extend previous research by Lange and Chelune (
2006
) by evaluating the clinical utility of GAI-memory discrepancy scores to detect memory impairment using estimated ...premorbid GAI scores (i.e., GAI-E) rather than obtained GAI scores. Participants were 34 patients with Alzheimer's-type dementia and a sub-sample of 34 demographically matched participants from the WAIS-III/WMS-III standardization sample. GAI-memory discrepancy scores were more effective at differentiating Alzheimer's patients versus healthy controls when using estimated premorbid GAI scores than obtained GAI scores. However, GAI(E)-memory discrepancy scores failed to provide unique interpretive information beyond that which is gained from interpretation of the memory index scores alone. This was most likely due to the prevalence of obvious memory impairment in this patient population. Future research directions are discussed.
In an acute care setting, evaluation of traumatic brain injury (TBI) is often complicated by alcohol intoxication. The purpose of this study is to evaluate the clinical utility of the protein S100B ...as a biochemical marker for identifying brain injury in patients who are intoxicated at the time of injury.
The study participants were 160 patients who presented to a large urban Level I Trauma Centre in Vancouver, Canada. Patients were classified into four clinical groups (medical controls, trauma controls, mild TBI, and definite TBI) and two day-of-injury alcohol intoxication groups (i.e., sober and intoxicated). Blood samples were collected via venipuncture in heparinized tubes within 8 hours of injury. Measures of S100B concentration were obtained using a commercially available assay kit (Sangtec 100 Elisa).
For those patients who were sober at the time of injury, higher S100B levels were associated with TBI when compared with other physical injuries and general medical complaints. However, for patients who were intoxicated at the time of injury, there were uniformly low S100B levels across all clinical groups.
Although there seems to be a strong association between S100B levels and TBI, further research is required to establish the clinical role of S100B in patients with suspected TBI, particularly in patients whose clinical presentation is complicated by alcohol intoxication.
Malingering in Forensic Neuropsychology Lees-Haley, Paul R.; Iverson, Grant L.; Lange, Rael T. ...
Journal of forensic neuropsychology,
2/18/2003, Volume:
3, Issue:
1-2
Journal Article
Peer reviewed
The MMPI-2 is one of the most widely used instruments in forensic neuropsychology. Unlike most tests, it has the advantage of containing validity scales that assist the examiner in determining the ...level of cooperation of the examinee. Scales that provide information for evaluating the validity of an MMPI-2 profile include VRIN, TRIN, L, F, K, F -K, F
B
, F(p), FBS (Fake Bad Scale), Total Obvious -Subtle, Ds, Dsr, and Ego Strength. This article discusses research available when considering the applicability of these procedures in the context of challenges to their scientific reliability and validity in legal proceedings, according to the standards set forth in Daubert v. Merrell Dow Pharmaceuticals, Inc.
Objective: Identify biomarkers in peripheral blood that relate to chronic post-concussive and behavioural symptoms following traumatic brain injuries (TBIs) to ultimately improve clinical management.
...Research design: We compared military personnel with mild TBIs (mTBIs) (n = 42) to those without TBIs (n = 22) in concentrations of tau, amyloid-beta (Aβ42) and cytokines (tumour necrosis factor alpha (TNFα, interleukin (IL)-6 and -10) in neuronal-derived exosomes from the peripheral blood. We utilized nanosight technology coupled with ultra-sensitivity immunoassay methods. We also examined the impact of post-concussive and behavioural symptoms including depression and post-traumatic stress disorder (PTSD) on these neuronal-derived markers.
Results: We report that concentrations of exosomal tau (F
1, 62
= 10.50), Aβ42 (F
1, 61
= 5.32) and IL-10 (F
1, 59
= 4.32) were elevated in the mTBI group compared to the controls. Within the mTBI group, regression models show that post-concussive symptoms were most related to exosomal tau elevations, whereas exosomal IL-10 levels were related to PTSD symptoms.
Conclusions: These findings suggest that chronic post-concussive symptoms following an mTBI relate to altered exosomal activity, and that greater tau pathology may underlie chronic post-concussive symptoms that develop following mTBIs. It also suggests that central inflammatory activity contributes to PTSD symptoms following an mTBI, providing necessary insights into the role of inflammation in chronic PTSD symptoms.
Abstract
Objective
The Neurobehavioral Symptom Inventory (NSI), a commonly used self-report measure of concussive symptoms, is frequently employed throughout the Defense Health Agency. Embedded ...measures of symptom validity have been developed that include the Validity-10 and total NSI score. A recent investigation in a small sample of veterans (n = 45) suggested that the 12 items on the NSI that do not contribute to the Validity-10 (Remaining-12) perform in a manner similar to the Validity-10. The current study sought to evaluate the classification accuracy of the Validity-10, Remaining-12 and total NSI score in a larger sample to assess the relative utility of each.
Method
The NSI and MMPI-2-RF scores of 255 active duty Service Members and Veterans seen ≥4 months after mild Traumatic Brain Injury (mTBI) were evaluated. MMPI-2-RF criterion were defined as over-reporting (>79 on Fs, RBS, and/or FBS-r; >78 on F-r; >69 on Fp-r) and invalid (>119 on F; >99 on all other scales).
Results
Correlations between all MMPI-2-RF over-report scales and the Validity-10, Remaining-12, and NSI total were roughly commensurate and significant at the p < 0.001 level. AUC values for the RF over-report protocols were as followings: Validity-10 = 0.87, Remaining-12 = 0.89, NSI total = 0.89. AUC values for invalid RF protocols were as follows: Validity-10 = 0.91, Remaining-12 = 0.92, NSI total = 0.93.
Conclusions
The current findings indicate reasonable and equivalent classification accuracies for the Validity-10, Remaining-12, and NSI total score. These data can be taken to suggest that there is limited uniqueness of the Validity-10 relative to the remaining NSI items.
Goal: This paper introduces an automated post-traumatic stress disorder (PTSD) screening tool that could potentially be used as a self-assessment or inserted into routine medical visits for PTSD ...diagnosis and treatment. Methods: With an emotion estimation algorithm providing arousal (excited to calm) and valence (pleasure to displeasure) levels through discourse, we select regions of the acoustic signal that are most salient for PTSD detection. Our algorithm was tested on a subset of data from the DVBIC-TBICoE TBI Study, which contains PTSD Check List Civilian (PCL-C) assessment scores. Results: Speech from low-arousal and positive-valence regions provide the best discrimination for PTSD. Our model achieved an AUC (area under the curve) equal to 0.80 in detecting PCL-C ratings, outperforming models with no emotion filtering (AUC = 0.68). Conclusions: This result suggests that emotion drives the selection of the most salient temporal regions of an audio recording for PTSD detection.
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