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Neuropsyc
Testing for the
     RITE
  Swathi Vijayaraghavan
      Neuro PGY3
Why?
They are interesting and can be useful in
characterizing weakness/deficits in various
cognitive disorders.

They always have about 10 questions on the
RITE that we almost always get wrong.

We might actually use them in real life.

Get an idea of some of the neat Neuropsyc
tests.
Evaluating Intelligence

 Wechsler Adult Intellignce Scale (WAIS-III)--
 IQ test

 Wisconsin Card Sorting Test (WCST)-- tests
 executive functioning and reasoning
WAIS-IV
WAIS-IV (2008)
Intelligence: “The global capacity of a person to act purposefully, to
think rationally, and to deal effectively with his/her environment.”

Verbal Comprehension Scale: similarities, vocabulary, information
( and comprehension)

Working Memory Scale: digit span, arithmetic (and letter-numbering
sequence)

Perceptual Reasoning Scale: block design, matrix reasoning, visual
puzzles (and picture completion & figure weights)

Processing speed Scale: Symbol search, coding, (and cancellation).
WAIS-IV: Verbal
 Comprehension Index (VCI)




Similarities: abstract verbal reasoning (how are a car and
bicycle alike?)
WAIS-IV: Verbal
 Comprehension Index (VCI)




Similarities: abstract verbal reasoning (how are a car and
bicycle alike?)

Vocabulary: degree of learning/comprehension/ability
to verbally express (what is a chair?)
WAIS-IV: Verbal
 Comprehension Index (VCI)



Similarities: abstract verbal reasoning (how are a car and
bicycle alike?)

Vocabulary: degree of learning/comprehension/ability
to verbally express (what is a chair?)

Information: gen info acquired from culture (e.g. “Who
is the Vice President of USA?”)
WAIS-IV: Verbal
 Comprehension Index (VCI)

Similarities: abstract verbal reasoning (how are a car and
bicycle alike?)

Vocabulary: degree of learning/comprehension/ability
to verbally express (what is a chair?)

Information: gen info acquired from culture (e.g. “Who
is the Vice President of USA?”)

Comprehension: abstract social conventions, rules and
expressions (e.g., “What does ‘the grass is always
greener on the other side’ mean?)
WAIS-IV: Working Memory
           Index (WMI)




Arthimetic: concentration on math problems
(eg: How many 30 cent match books can you
get for two dollars?)
WAIS-IV: Working Memory
            Index (WMI)


Arthimetic: concentration on math problems
(eg: How many 30 cent match books can you
get for two dollars?)

Digit Span: attention, concentration, mental
control (eg: repeat # forwards/backwards)
WAIS-IV: Working Memory
            Index (WMI)
Arthimetic: concentration on math problems
(eg: How many 30 cent match books can you
get for two dollars?)

Digit Span: attention, concentration, mental
control (eg: repeat # forwards/backwards)

Letter-Number Sequencing: attention and
working memory (eg: repeat sequence R-3, F-1,
C-2, in numerical order, then in alphabetical)
WAIS-IV: Perceptual
          Reasoning Index



Block design: spatial perception/visual
abstract processing & problem solving (Frontal/
parietal; Autism/ Aspergers patients do better)visual
defects
WAIS-IV: Perceptual
             Reasoning Index


Block design: spatial perception/visual
abstract processing & problem solving (Frontal/
parietal; Autism/ Aspergers patients do better)

Matrix reasoning: nonverbal abstract problem
solving, inductive reasoning, spatial reasoning
WAIS-IV: Perceptual
           Reasoning Index

Block design: spatial perception/visual
abstract processing & problem solving (Frontal/
parietal; Autism/ Aspergers patients do better)

Matrix reasoning: nonverbal abstract problem
solving, inductive reasoning, spatial reasoning

Visual Puzzles: non-verbal reasoning
WAIS-IV: Perceptual
           Reasoning Index
Block design: spatial perception/visual
abstract processing & problem solving (Frontal/
parietal; Autism/ Aspergers patients do better)

Matrix reasoning: nonverbal abstract problem
solving, inductive reasoning, spatial reasoning

Visual Puzzles: non-verbal reasoning

Picture completion: ability to quickly perceive
visual defects
Wisconsin Card
Sorting Test (WCST)
WCST
Subject is given a stack of cards and told to sort
them out but is not given any rules.

During the sorting subject is told if sorting is
correct or incorrect.

Subject then has to figure out the rules based
on the “corrects” and “incorrects” and then
appropriately sort the cards

Once the subject gets the rules right, they are
then changed and process is repeated.
WCST
Tests cognitive flexibility
  and abstract thought

Sensitive to frontal lobe
      dysfunction

  may be abnormal in
      patients with
 schizophrenia or some
   structural abnl (eg:
     caudate lesions)
Minnesota Multi-Phasic
Personality Inventory

Clinical Scale

Validity Scale

Content Scale

Psy-5 Scale
MMPI: Clinical Scales
 Hypochondriasis        Paranoia

 Depression             Psychasthenia

 Hysteria               Schizophrenia

 Psychopathic Deviate   Hypomania

 Masculinity/           Social Introversion
 Femininity
MMPI: Validity Scales
 L-scale (lie scale)- ppl    TRIN & VRIN (detect
 trying to present self in   inconsistencies)
 positive way
                             Fb-scale (items that
 F-scale (faking good or     less than 10% of gen
 bad)                        pop. support- if score
                             high- subject is not
 K-scale (defensiveness)     paying attention)
 subtler than L-scale
                             Fs-scale (over
 ?-scale (unanswered)        reporting somatic sxs)
Stroop Color Naming
        Test
 Measures selective attention, cognitive
 flexibility, and processing speed.

 Abnl in dementias, neurodegen dz, brain
 damage, ADHD, Schizophrenia, depression,
 addictions

 EEG & FMRI should correlate with inc activity
 in frontal lobes, ant. cingulate gyrus and dorsal
 prefrontal cortex.
Stroop Color Naming
        Test
    Three types of stimuli:

    neutral (Red),

    congruent (Red),

    incongruent (Red)
Stroop Color Naming
        Test
Boston Naming Test
Evaluates for aphasia

60 item object naming

Spontaneous or with cues

High and low frequency objects
Behavioral tests
Mop
Sweep
Broom
Duster
Trail Making Test
Trail Making Test
Trail A: has numbers 1 to 25 spread across a
page and subject has to draw a trail from 1 to
25 (timed test).

Trail B: have to connect letters and numbers in
alternating pattern (timed test).

Can help identify general frontal lobe
(executive) dysfunction (esp. Trails B).
Random stuff..
Conner’s Continuous Performance Test: good for
assessing sustained visual attention; good for dx ADHD

Recognition Memory Test: measures word and face
recognition

PASAT (paced auditory serial addition task): tests
working memory and processing of speed of info;
sensitive to concussion effects

Rey-Osterrich Complex Figure: immediate/delayed
recall, eval memory & construction

Word Memory Test: good to test malingering (the actual
accuracy score is lower than would be for guessing so to
get it would have to intentionally give wrong answers.
Pop quiz hot shot!
A patient with moderate
Parkinson’s Disease
without dementia
would score poorly on
which component of the
WAIS?

Similarities
Vocabulary
Block Design
Arithmetic
Digit Span

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Behavioral tests

  • 1. Neuropsyc Testing for the RITE Swathi Vijayaraghavan Neuro PGY3
  • 2. Why? They are interesting and can be useful in characterizing weakness/deficits in various cognitive disorders. They always have about 10 questions on the RITE that we almost always get wrong. We might actually use them in real life. Get an idea of some of the neat Neuropsyc tests.
  • 3. Evaluating Intelligence Wechsler Adult Intellignce Scale (WAIS-III)-- IQ test Wisconsin Card Sorting Test (WCST)-- tests executive functioning and reasoning
  • 5. WAIS-IV (2008) Intelligence: “The global capacity of a person to act purposefully, to think rationally, and to deal effectively with his/her environment.” Verbal Comprehension Scale: similarities, vocabulary, information ( and comprehension) Working Memory Scale: digit span, arithmetic (and letter-numbering sequence) Perceptual Reasoning Scale: block design, matrix reasoning, visual puzzles (and picture completion & figure weights) Processing speed Scale: Symbol search, coding, (and cancellation).
  • 6. WAIS-IV: Verbal Comprehension Index (VCI) Similarities: abstract verbal reasoning (how are a car and bicycle alike?)
  • 7. WAIS-IV: Verbal Comprehension Index (VCI) Similarities: abstract verbal reasoning (how are a car and bicycle alike?) Vocabulary: degree of learning/comprehension/ability to verbally express (what is a chair?)
  • 8. WAIS-IV: Verbal Comprehension Index (VCI) Similarities: abstract verbal reasoning (how are a car and bicycle alike?) Vocabulary: degree of learning/comprehension/ability to verbally express (what is a chair?) Information: gen info acquired from culture (e.g. “Who is the Vice President of USA?”)
  • 9. WAIS-IV: Verbal Comprehension Index (VCI) Similarities: abstract verbal reasoning (how are a car and bicycle alike?) Vocabulary: degree of learning/comprehension/ability to verbally express (what is a chair?) Information: gen info acquired from culture (e.g. “Who is the Vice President of USA?”) Comprehension: abstract social conventions, rules and expressions (e.g., “What does ‘the grass is always greener on the other side’ mean?)
  • 10. WAIS-IV: Working Memory Index (WMI) Arthimetic: concentration on math problems (eg: How many 30 cent match books can you get for two dollars?)
  • 11. WAIS-IV: Working Memory Index (WMI) Arthimetic: concentration on math problems (eg: How many 30 cent match books can you get for two dollars?) Digit Span: attention, concentration, mental control (eg: repeat # forwards/backwards)
  • 12. WAIS-IV: Working Memory Index (WMI) Arthimetic: concentration on math problems (eg: How many 30 cent match books can you get for two dollars?) Digit Span: attention, concentration, mental control (eg: repeat # forwards/backwards) Letter-Number Sequencing: attention and working memory (eg: repeat sequence R-3, F-1, C-2, in numerical order, then in alphabetical)
  • 13. WAIS-IV: Perceptual Reasoning Index Block design: spatial perception/visual abstract processing & problem solving (Frontal/ parietal; Autism/ Aspergers patients do better)visual defects
  • 14. WAIS-IV: Perceptual Reasoning Index Block design: spatial perception/visual abstract processing & problem solving (Frontal/ parietal; Autism/ Aspergers patients do better) Matrix reasoning: nonverbal abstract problem solving, inductive reasoning, spatial reasoning
  • 15. WAIS-IV: Perceptual Reasoning Index Block design: spatial perception/visual abstract processing & problem solving (Frontal/ parietal; Autism/ Aspergers patients do better) Matrix reasoning: nonverbal abstract problem solving, inductive reasoning, spatial reasoning Visual Puzzles: non-verbal reasoning
  • 16. WAIS-IV: Perceptual Reasoning Index Block design: spatial perception/visual abstract processing & problem solving (Frontal/ parietal; Autism/ Aspergers patients do better) Matrix reasoning: nonverbal abstract problem solving, inductive reasoning, spatial reasoning Visual Puzzles: non-verbal reasoning Picture completion: ability to quickly perceive visual defects
  • 18. WCST Subject is given a stack of cards and told to sort them out but is not given any rules. During the sorting subject is told if sorting is correct or incorrect. Subject then has to figure out the rules based on the “corrects” and “incorrects” and then appropriately sort the cards Once the subject gets the rules right, they are then changed and process is repeated.
  • 19. WCST Tests cognitive flexibility and abstract thought Sensitive to frontal lobe dysfunction may be abnormal in patients with schizophrenia or some structural abnl (eg: caudate lesions)
  • 20. Minnesota Multi-Phasic Personality Inventory Clinical Scale Validity Scale Content Scale Psy-5 Scale
  • 21. MMPI: Clinical Scales Hypochondriasis Paranoia Depression Psychasthenia Hysteria Schizophrenia Psychopathic Deviate Hypomania Masculinity/ Social Introversion Femininity
  • 22. MMPI: Validity Scales L-scale (lie scale)- ppl TRIN & VRIN (detect trying to present self in inconsistencies) positive way Fb-scale (items that F-scale (faking good or less than 10% of gen bad) pop. support- if score high- subject is not K-scale (defensiveness) paying attention) subtler than L-scale Fs-scale (over ?-scale (unanswered) reporting somatic sxs)
  • 23. Stroop Color Naming Test Measures selective attention, cognitive flexibility, and processing speed. Abnl in dementias, neurodegen dz, brain damage, ADHD, Schizophrenia, depression, addictions EEG & FMRI should correlate with inc activity in frontal lobes, ant. cingulate gyrus and dorsal prefrontal cortex.
  • 24. Stroop Color Naming Test Three types of stimuli: neutral (Red), congruent (Red), incongruent (Red)
  • 26. Boston Naming Test Evaluates for aphasia 60 item object naming Spontaneous or with cues High and low frequency objects
  • 30. Trail Making Test Trail A: has numbers 1 to 25 spread across a page and subject has to draw a trail from 1 to 25 (timed test). Trail B: have to connect letters and numbers in alternating pattern (timed test). Can help identify general frontal lobe (executive) dysfunction (esp. Trails B).
  • 31. Random stuff.. Conner’s Continuous Performance Test: good for assessing sustained visual attention; good for dx ADHD Recognition Memory Test: measures word and face recognition PASAT (paced auditory serial addition task): tests working memory and processing of speed of info; sensitive to concussion effects Rey-Osterrich Complex Figure: immediate/delayed recall, eval memory & construction Word Memory Test: good to test malingering (the actual accuracy score is lower than would be for guessing so to get it would have to intentionally give wrong answers.
  • 32. Pop quiz hot shot! A patient with moderate Parkinson’s Disease without dementia would score poorly on which component of the WAIS? Similarities Vocabulary Block Design Arithmetic Digit Span

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