Preventive drugs restore visual evoked habituation and attention in migraineurs

Visual system pathway dysfunction has been postulated in migraineurs. We wanted to investigate if any difference exists interictally in visual attention and visual evoked habituation of frequently attacked migraineurs compared to the healthy control group. The effects of 3-month prophylactic migraine treatment on these parameters were also assessed. The migraineurs at headache-free interval (n = 52) and age, sex-matched healthy controls (n = 35) were compared by habituation response to 10 blocks of repetitive pattern-reversal visual stimuli (each block consisted 100 responses). The amplitude changes of 5th and 10th blocks were further compared with that of block 1 to assess the response of habituation (i.e., decrease) or potentiation (i.e., increase). The level of sustained visual attention was assessed by Cancellation test. Migraineurs were randomized to three different preventive treatments: propranolol 40 mg tid, flunarizine 5 mg bid, or topiramate 50 mg bid. After 3 months of preventive treatment, migraineurs data were compared with their baseline values. The groups did not differ by sex and age. In electrophysiological studies, the habituation ability observed in the healthy group was not observed in migraineurs. However, it was restored 3 months after preventive treatment. In migraineurs, compared to their baseline values, the distorted visual attention parameters also improved after treatment. All drugs were effective. The loss of habituation ability and low visual attention performance in migraineurs can be restored by migraine preventive treatment. This electrophysiological study accompanied by neuropsychological test may aid an objective and quantitative assessment tool for understanding migraine pathophysiology

The role of attention on the intelligence test scores of patients with attention deficit hyperactivity disorder

In comparison to healthy children, cases with Attention Deficit Hyperactivity Disorder (ADHD) score lower at subtests of Wechsler Intelligence Scale for Children-Revised (WISC-R). According to the research hypothesis, the lower scores in subtests of WISC-R originate from disordered attentional processes. Sample (age range: 72-149 months) included 143 healthy boys and 215 boys in the ADHD group (Predominantly Attention Deficit: n = 72, Predominantly Hyperactivity/Impulsivity: n = 41, Combined: n = 102). Participation was conditional to informed consent of the parents and approval of the participants/cases. Cases with comorbidity and medication were not included in the DEHB group. Intelligence was measured using WISC-R, types of attention were measured using Stroop Test TBAG version, Cancellation Test and Visual Aural Digit Span Test-B Form. In line with the types of attention that they represent, neuropsychological test scores loaded on three different factors. Except the digit span score, WISC-R scores loaded on a fourth factor. Scores of the DEHB group was significantly lower than that of the healthy control group in 9 out of 12 WISC-R scores. When types of attention were statistically controlled, 7 of the previously significantly different scores ceased to exist. These findings show that the lower scores of the DEBB group in subtests of WISC-R should not be explained by deficits in the cognitive processes that the subtests specifically intend to measure. These findings support the hypothesis that the lower scores are due to a basic inability to attend and are thus secondary to this disorder

Neuropsychological evaluation of the hydrocephalic children: Review of the literature

Hidrosefali, serebral ventriküllerin tümü veya bir bölümünün genişlemesi ile giden ve içindeki beyin omurilik sıvısı miktarının artması sonucu meydana gelen nörolojik ve nöropsikolojik belirtiler topluluğudur. Hidrosefali tanısı konan bireylerin nörolojik bozukluklarına sıklıkla motor, görsel algısal, görsel motor, dikkat, bellek, dil ve yönetici işlevler gibi bilişsel bozulmaların da eşlik ettiği bilinmektedir. Bu becerilerdeki bozulmalar hidrosefali hastalarının akademik ve sosyokültürel becerilerini olumsuz etkilemekte ve bu sorunlar bireyin tüm yaşamına yayılmaktadır. Bu nedenle, hidrosefali hastası çocukların erken döneminde bilişsel bozulmalarının saptanması, uygun tedavi ve rehabilitasyon programlarının geliştirilmesi büyük önem taşımaktadır. Bu çalışmanın temel amacı, hidrosefali hastası bireylerin bilişsel alanda yaşadıkları güçlükleri tanımlamaya yöneliktir

Using neuropsychometric measurements in the differential diagnosis of specific learning disability

Introduction: The aim of this study was to develop a neuropsychometric battery for the differential diagnosis of specific learning disability (SLD), with specific respect to attention deficit hyperactivity disorder (ADHD), and to help resolve the conflicting results in the literature by an integrative utilization of scores on both the Bannatyne categories and neuropsychological tests. Methods: The sample included 168 primary school boys who were assigned to SLD (n=21), ADHD (n=45), SLD and ADHD (n=57), and control groups (n=45). The exclusion criteria were a neurological or psychiatric comorbidity other than ADHD, a level of anxiety and/or depression above the cutoff score, medication affecting cognitive processes, visual and/or auditory disorders, and an intelligence level outside the IQ range of 85–129. Psychometric scores were obtained from the SLD Battery and Wechsler Intelligence Scale for Children-Revised in the form of Bannatyne category scores. Neuropsychological scores were from the Visual–Aural Digit Span Test-Form B, Serial Digit Learning Test, Judgment of Line Orientation, and Mangina Test. The battery was called the Integrative Battery of SLD. Results: The correctness of estimation for classifying cases into the diagnostic dyads (SLD/ADHD, SLD/SLD+ADHD, and SLD+ADHD/ADHD) by an integrative utilization of both the Bannatyne category scores (n=4) and scores from the four neuropsychological tests (n=10) was 92.4%, 81.4%, and 71.8%, respectively. These proportions were generally higher than those obtained using the Bannatyne category scores alone (86.4%, 75.5%, and 73.1%, respectively). The same trend was seen in the classification of children into diagnostic and control groups. However, the proportion of the correctness of estimation was higher than that obtained for the diagnostic dyads. Conclusion: When conducted using appropriately chosen research designs and statistical techniques and if confounding variables are sufficiently controlled, a neuropsychometric battery that includes capacities that relate to intelligence (Bannatyne categories) and those that relate to neurocognitive processes (neuropsychological tests) can be useful in the differential diagnosis of SLD

Dikkat eksikliği hiperaktivite bozukluğu olgularındaki zeka puanında dikkatin rolü

Dikkat Eksikliği Hiperaktivite Bozukluğu (DEHB) olan olgular Wechsler Çocuklar için Zeka Ölçeği (WÇZÖ-R) alt testlerinde sağlıklı gruba göre daha düşük puanlar almaktadır. Araştırmada DEHB olgularının WÇZÖ-R alt testlerinden aldıkları düşük puanların dikkat sürecindeki bozukluktan kaynaklandığı yolundaki hipotez test edilmektedir. Araştırmaya 72-149 yaş/ay aralığında 143 sağlıklı erkek çocuk, 215 erkek DEHB olgusu (Bileşik tip: 102, Dikkat Eksikliği Önde Alt Tip: 72, Hiperaktivite/Dürtüsellik Önde Alt Tip: 41) gönüllü olarak ve ebeveynin bilgilendirilmiş onayı ile katılmıştır. DEHB grubunda eşhastalanım ve ilaç kullanımı dışlama ölçütü olmuştur. Zeka WÇZÖ-R, dikkat türleri Stroop Testi TBAG Formu, İşaretleme Testi ve Görsel İşitsel Sayı Dizileri Testi B Formu ile ölçülmüştür. Nöropsikolojik test puanları, temsil ettikleri dikkat türleri doğrultusunda üç farklı faktöre yüklenmiş, WÇZÖ-R’nin sayı dizileri puanı dışındakiler bu faktörler altında yer almamıştır. Üç WÇZÖ-R alt test puanı dışındaki tüm zeka puanlarında, DEHB grubunun puanı sağlıklı kontrol grubununkinden anlamlı olarak daha düşük bulunmuştur. Nöropsikolojik dikkat türleri istatistiksel olarak kontrol edildiğinde, daha önce anlamlı olan 9 WÇZÖ-R puanından 7’sindeki anlamlı farklar ortadan kalkmıştır. Bu bulgular DEHB olgularının WÇZÖ-R’ den aldıkları düşük puanların, farklı alt testlerin ölçtüğü bilişsel özelliklerde bozukluk veya zekada düşüklük olarak açıklanamayacağına işaret etmiştir. Bulgular düşük puanların dikkat edememeden kaynaklandığı yolundaki hipotezi desteklemiş, zekaya ilişkin süreçlerdeki düşük performansın dikkat eksikliğine ikincil olduğunu göstermiştir

Cognitive functions in neurofibromatosis type 1 patients and unaffected siblings

Attention, learning, and perceptual problems have been reported at various degrees and rates in neurofibromatosis type 1 (NF1). We aimed to define the cognitive profiles frequently associated with NF1. Children and adolescents with NF1 (n=58) were tested using Wechsler Intelligence Scales for Children- Revised (WISC-R), Judgment of Line Orientation, and Bender Visual-Motor Gestalt tests. Comparison groups were unaffected siblings of NF1 patients (n=20), children with attention deficit and hyperactivity disorder (ADHD, n=40), and normal children (n=40). No difference was found between familial or sporadic NF1 cases. Seventeen/58 (29%) of NF1 cases had a full scale IQ 80 (n=27) scored lower in WISC-R subtests measuring visual perception when compared to a healthy control group of similar intelligence, and lower in arithmetic but better in Bender-Gestalt and Judgment of Line Orientation tests when compared to an ADHD group of similar intelligence. These results indicate a high prevalence of mental retardation in a clinical NF1 series. NF1 patients who have normal intelligence may have impaired visual perception, but their visual perceptual problems are less than in ADHD. The tendency of unaffected siblings of NF1 patients to have mildly but consistently low test scores compared to healthy controls needs to be studied further for underlying genetic or environmental factors

Using Neuropsychometric Measurements in the Differential Diagnosis of Specific Learning Disability

Introduction: The aim of this study was to develop a neuropsychometric battery for the differential diagnosis of specific learning disability (SLD), with specific respect to attention deficit hyperactivity disorder (ADHD), and to help resolve the conflicting results in the literature by an integrative utilization of scores on both the Bannatyne categories and neuropsychological tests. Methods: The sample included 168 primary school boys who were assigned to SLD (n=21), ADHD (n=45), SLD and ADHD (n=57), and control groups (n=45). The exclusion criteria were a neurological or psychiatric comorbidity other than ADHD, a level of anxiety and/ or depression above the cutoff score, medication affecting cognitive processes, visual and/or auditory disorders, and an intelligence level outside the IQ range of 85-129. Psychometric scores were obtained from the SLD Battery and Wechsler Intelligence Scale for ChildrenRevised in the form of Bannatyne category scores. Neuropsychological scores were from the Visual-Aural Digit Span Test-Form B, Serial Digit Learning Test, Judgment of Line Orientation, and Mangina Test. The battery was called the Integrative Battery of SLD. Results: The correctness of estimation for classifying cases into the diagnostic dyads (SLD/ADHD, SLD/SLD+ADHD, and SLD+ADHD/ ADHD) by an integrative utilization of both the Bannatyne category scores (n=4) and scores from the four neuropsychological tests (n=10) was 92.4%, 81.4%, and 71.8%, respectively. These proportions were generally higher than those obtained using the Bannatyne category scores alone (86.4%, 75.5%, and 73.1%, respectively). The same trend was seen in the classification of children into diagnostic and control groups. However, the proportion of the correctness of estimation was higher than that obtained for the diagnostic dyads. Conclusion: When conducted using appropriately chosen research designs and statistical techniques and if confounding variables are sufficiently controlled, a neuropsychometric battery that includes capacities that relate to intelligence (Bannatyne categories) and those that relate to neurocognitive processes (neuropsychological tests) can be useful in the differential diagnosis of SLD

Construct validity of auditory verbal learning test

Amaç: İşitsel Sözel Öğrenme Testi (Auditory Verbal Learning Test: AVLT) nöropsikoloji yazınında, belleğin kapsamlı değerlendirilmesi için sıklıkla kullanılan bir ölçüm aracıdır. Test sözel öğrenmeyi; anlık ve gecikmeli serbest hatırlama, tanıma türü hatırlama, geriye ve ileri doğru bozucu etki olarak ölçmektedir. Türk toplumuna uyarlama çalışmaları yapılmış olan AVLT’nin araştırma ve geliştirme (AR-GE) çalışmaları sürmektedir. Mevcut çalışmanın amacı; testin AR-GE sürecine katkı sağlamak amacıyla kurutlu geçerliğini incelemektir. Yöntem: Mevcut amaç doğrultusunda 20-69 yaş aralığında, tanılanmış herhangi bir psikiyatrik veya nörolojik rahatsızlığın bulunmayan; düzeltilmemiş görme ve işitme bozukluğu bulunmayan 78 sağlıklı katılımcıdan veriler elde edilmiştir. AVLT bu testi uygulama eğitimi almış iki psikolog tarafından, katılımcılara bireysel olarak uygulanmıştır. Bulgular: AVLT puanlarının temsil ettikleri özellik kümelerini incelemek amacıyla uygulanan temel bileşenler analizi, testin yapısıyla uyumlu olarak öğrenme ve serbest hatırlama, tanıma türü hatırlama bileşenlerini ayrı ayrı içermiştir. Yapısal Eşitlik Modeli (YEM) çalışmasında ise bu iki bileşene çeldiricilerin etkisi eklenmiştir. Yaş, eğitim ve cinsiyetin AVLT puanlarıyla ilişkisini belirlemek amacıyla, betimsel düzeyde incelemeler yapılmıştır. Sonuç: Belleğin gelişimsel süreçten etkilendiği yolundaki yazınla uyumlu olan bu bulgular AVLT’nin öğrenme/serbest hatırlama, tanıma ve çeldirici puanlarının kuramsal bilgiyle uyumlu bir bileşen örüntüsü gösterdiğini ortaya koymaktadır. Bu sonuç Türk toplumunda testin, geçerli bir ölçme aracı olduğuna işaret etmektedir.Objective: Auditory Verbal Learning Test (AVLT) is frequently used in neuropsychology literature to comprehensively assess the memory. The test measures verbal learning as immediate and delayed free recall, recognition, and retroactive and proactive interference. Adaptation of AVLT to the Turkish society has been completed, whereas research and development studies are still underway. The purpose of the present study is to investigate the construct validity of the test in order to contribute to the research and development process. Method: In line with this purpose, the research data were obtained from 78 healthy participants aged between 20 and 69. The exclusion criteria included neurological and/or psychiatric disorders as well as untreated auditory/visual disorders. AVLT was administered to participants individually by two trained psychologists. Results: Principal component analysis that is used to investigate the components represented by the AVLT scores consisted of learning, free recall and recognition, in line with the construct of the test. Distractors were also added to these two components in structural equation model. Analyses were carried out on descriptive level to establish the relatioships between age, education, gender and AVLT scores. Conclusion: These findings, which are consistent with the literature indicating that memory is affected by the developmental process, suggest that learning/free recall, recognition, and distractor scores of the AVLT demonstrate a component pattern consistent with theoretical knowledge. This conclusion suggests that AVLT is a valid measurement test for the Turkish society

Relationship between diagnosis of adhd in offspring and current and retrospective self-reports of parental adhd

This study aimed to discover the relationship between parental self-reports of ADHD symptoms and the diagnosis of ADHD in offspring, to demonstrate the extent to which parental ADHD symptoms predict ADHD diagnosis in offspring, to examine the contribution of adult ADHD scales to ADHD diagnosis, and to provide findings on the psychometric utility of adult ADHD scales. The sample consisted of 6-12-year-old boys diagnosed with ADHD (n = 149), boys in the control group (n = 47) and both parents (n = 392). Amongst the many exclusion criteria was the comorbidity of neurological and psychiatric disorders. Parental self-reports of current ADHD symptoms were obtained using the Adult Attention Deficit Hyperactivity Disorder Scale (ADD/ADHD Scale), and past symptoms were retrospectively obtained using the Wender-Utah Rating Scale (WUR Scale). For children diagnosed with ADHD, the frequency of parents with ADHD symptoms was higher than the parents without ADHD symptoms; the significance was derived from the group in which both parents displayed ADHD symptoms. The ADHD symptom scores of the parents led to a high accuracy level when predicting ADHD in children (sensitivity) but led to a low accuracy level when classifying children without any diagnosis in the control group (specificity). The study disclosed the psychometric strengths and weaknesses of the ADD/ADHD and WUR scales for measuring parental ADHD symptoms and provided original findings on their psychometric properties