Hostname: page-component-78c5997874-4rdpn Total loading time: 0 Render date: 2024-11-10T13:28:14.915Z Has data issue: false hasContentIssue false
  • English
  • Français

Computerized reaction time battery versus a traditional neuropsychological battery: Detecting HIV-related impairments

Published online by Cambridge University Press:  13 January 2003

Gonzalez Raul ,
Heaton Robert K. ,
Moore David J. ,
Letendre Scott ,
Ellis Ronald J. ,
Wolfson Tanya ,
Marcotte Thomas ,
Cherner Mariana ,
Rippeth Julie  and
Grant Igor
...Show all authors
Gonzalez Raul*
Affiliation:
HIV Neurobehavioral Research Center and University of California, San Diego, CA San Diego State University/University of California, San Diego—Joint Doctoral Program in Clinical Psychology, CA
Heaton Robert K.
Affiliation:
HIV Neurobehavioral Research Center and University of California, San Diego, CA San Diego State University/University of California, San Diego—Joint Doctoral Program in Clinical Psychology, CA Department of Psychiatry, University of California, San Diego, CA
Moore David J.
Affiliation:
HIV Neurobehavioral Research Center and University of California, San Diego, CA San Diego State University/University of California, San Diego—Joint Doctoral Program in Clinical Psychology, CA
Letendre Scott
Affiliation:
HIV Neurobehavioral Research Center and University of California, San Diego, CA
Ellis Ronald J.
Affiliation:
HIV Neurobehavioral Research Center and University of California, San Diego, CA Department of Neurosciences, University of California, San Diego, CA
Wolfson Tanya
Affiliation:
HIV Neurobehavioral Research Center and University of California, San Diego, CA
Marcotte Thomas
Affiliation:
HIV Neurobehavioral Research Center and University of California, San Diego, CA Department of Psychiatry, University of California, San Diego, CA
Cherner Mariana
Affiliation:
HIV Neurobehavioral Research Center and University of California, San Diego, CA Department of Psychiatry, University of California, San Diego, CA
Rippeth Julie
Affiliation:
HIV Neurobehavioral Research Center and University of California, San Diego, CA Department of Psychiatry, University of California, San Diego, CA
Grant Igor
Affiliation:
HIV Neurobehavioral Research Center and University of California, San Diego, CA Department of Psychiatry, University of California, San Diego, CA VA San Diego Healthcare System, San Diego, CA
The Hnrc Group
Affiliation:
The San Diego HIV Neurobehavioral Research Center [HNRC] group is affiliated with the University of California, San Diego, the Naval Hospital, San Diego, and the San Diego Veterans Affairs Healthcare System, and includes: Director: Igor Grant, M.D.; Co-Directors: J. Hampton Atkinson, M.D. and J. Allen McCutchan, M.D.; Center Manager: Thomas D. Marcotte, Ph.D.; Naval Hospital San Diego: Mark R. Wallace, M.D. (P.I.); Neuromedical Component: J. Allen McCutchan, M.D. (P.I.), Ronald J. Ellis, M.D., Scott Letendre, M.D., Rachel Schrier, Ph.D.; Neurobehavioral Component: Robert K. Heaton, Ph.D. (P.I.), Mariana Cherner, Ph.D., Julie Rippeth, Ph.D.; Imaging Component: Terry Jernigan, Ph.D. (P.I.), John Hesselink, M.D.; Neuropathology Component: Eliezer Masliah, M.D. (P.I.); Clinical Trials Component: J. Allen McCutchan, M.D., J. Hampton Atkinson, M.D., Ronald J. Ellis, M.D., Ph.D., Scott Letendre, M.D.; Data Management Unit: Daniel R. Masys, M.D. (P.I.), Michelle Frybarger, B.A. (Data Systems Manager); Statistics Unit: Ian Abramson, Ph.D. (P.I.), Reena Deutsch, Ph.D., Tanya Wolfson, M.A.VA San Diego Healthcare System, San Diego, CA)
*
Reprint requests to: Raul Gonzalez, HIV Neurobehavioral Research Center (HNRC), University of California, San Diego, 150 West Washington Street, 2nd Floor, San Diego, CA 92103. E-mail: r2gonzalez@ucsd.edu
Get access Rights & Permissions [Opens in a new window]

Abstract

In recent years, interest in the use of computerized neuropsychological (NP) assessment measures has increased. However, there are limited data regarding how performance on these measures relates to performance on more traditional, clinical instruments. In the present study, 82 HIV+ men, who were all believed on clinical grounds to have neurobehavioral impairment, completed a traditional NP battery (TNB) and the California Computerized Assessment Package (CalCAP, a collection of computerized reaction time tests). Summary scores based on a TNB, as well as those based on the CalCAP, demonstrated significant associations with both degree of immunosuppression (CD4 count) and detectable viral load in cerebrospinal fluid, but not with detectable viral load in plasma. Established norms on the TNB and CalCAP batteries resulted in classifying 57% and 49% of the HIV+ sample as impaired, respectively. When using the TNB as the “gold standard,” impairment classifications based on CalCAP summary scores exhibited a sensitivity of 68% and a specificity of 77%. Overall agreement on impairment classifications between batteries was low (kappa = .44). Data from this study suggest that traditional NP batteries and computerized reaction time tests do not measure the same thing, and are not interchangeable in examining HIV-related NP impairments. (JINS, 2003, 9, 64–71.)

Keywords

Neuropsychological assessmentHIVReaction timeCalCAPComputerized testingSensitivityCSF viral loadCD4
Type
Research Article
Information
Journal of the International Neuropsychological Society , Volume 9 , Issue 1 , January 2003 , pp. 64 - 71
Copyright
Copyright © The International Neuropsychological Society 2003

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Army Individual Test Battery. (1944). Manual of directions and scoring. Washington, D.C.: War Department, Adjutant General's Office.Google Scholar
Butters, N., Grant, I., Haxby, J., Judd, L.L., Martin, A., McClelland, J., Pequegnat, W., Schacter, D., & Stover, E. (1990). Assessment of AIDS-related cognitive changes: Recommendations of the NIMH Workshop on Neuropsychological Assessment Approaches. Journal of Clinical & Experimental Neuropsychology, 12, 963–978.CrossRefGoogle Scholar
Centers for Disease Control. (1992). 1993 revised classification system for HIV infection and expanded surveillance case definition for AIDS among adolescents and adults. Morbidity and Mortality Weekly Report, 41, 1–19.Google Scholar
Diehr, M.C., Heaton, R.K., Miller, W., & Grant, I. (1998). The Paced Auditory Serial Addition Task (PASAT): Norms for age, education, and ethnicity. Assessment, 5, 375–387.CrossRefGoogle Scholar
Dunlop, O., Bjorklund, R.A., Abdelnoor, M., & Myrvang, B. (1992). Five different tests of reaction time evaluated in HIV seropositive men. Acta Neurologica Scandinavica, 86, 260–266.CrossRefGoogle Scholar
Ellis, R.J., Hsia, K., Spector, S.A., Nelson, J.A., Heaton, R.K., Wallace, M.R., Abramson, I., Atkinson, J.H., Grant, I., McCutchan, & J.A., the HNRC Group. (1997). Cerebrospinal fluid human immunodeficiency virus type 1 RNA levels are elevated in neurocognitively impaired individuals with acquired immunodeficiency syndrome. Annals of Neurology, 42, 679–688.CrossRefGoogle Scholar
Golden, C.J. (1978). Stroop Color and Word Test. Chicago: Stoelting.Google Scholar
Grant, I. & Martin, A. (1994). Neuropsychology of HIV infection. New York: Oxford University Press.Google Scholar
Gronwall, D.M. & Sampson, H. (1974). The psychological effects of concussion. Auckland, New Zealand: Auckland U Press.Google Scholar
Gronwall, D.M. (1977). Paced auditory serial addition task: A measure of recovery from concussion. Perceptual and Motor Skills, 44, 367–375.CrossRefGoogle Scholar
Halstead, W.C. (1947). Brain and intelligence. Chicago: University of Chicago Press.Google Scholar
Heaton, R.K., Grant, I., Butters, N., White, D.A., Kirson, D., Atkinson, J.H., McCutchan, J.A., Taylor, M.J., Kelly, M.D., Ellis, R.J., Wolfson, T., Velin, R., Marcotte, T.D., Hesselink, J.R., Jernigan, T.L., Chandler, J., Wallace, M., Abramson, & I., the HNRC Group. (1995). The HNRC 500—Neuropsychology of HIV infection at different disease stages. Journal of the International Neuropsychological Society, 1, 231–251.CrossRefGoogle Scholar
Heaton, R.K., Grant, I., & Matthews, C.G. (1991). Comprehensive norms for an expanded Halstead-Reitan Battery: Demographic corrections, research findings, and clinical applications. Odessa, FL: Psychological Assessment Resources, Inc.Google Scholar
Heaton, R.K., Kirson, D., Velin, R.A., Grant, & I., the HNRC Group. (1994). The utility of clinical ratings for detecting cognitive change in HIV infection. In I. Grant & A. Martin (Eds.), Neuropsychology of HIV infection (pp. 188–206). New York: Oxford University Press.Google Scholar
Klove, H. (1963). Clinical neuropsychology. In F. M. Forster (Ed.), The Medical Clinics of North America. New York: Saunders.Google Scholar
Martin, A., Heyes, M.P., Salazar, A.M., Kampen, D.L., Williams, J., Law, W.A., Coats, M.E., & Markey, S.P. (1992). Progressive slowing of reaction time and increasing cerebrospinal fluid concentrations of quinolinic acid in HIV-infected individuals. Journal of Neuropsychiatry and Clinical Neurosciences, 4, 270–279.Google Scholar
Martin, E.M., Pitrak, D.L., Novak, R.M., Pursell, K.J., & Mullane, K.M. (1999). Reaction times are faster in HIV-seropositive patients on antiretroviral therapy: A preliminary report. Journal of Clinical and Experimental Neuropsychology, 21, 730–735.CrossRefGoogle Scholar
Miller, E., Satz, P., & Visscher, B. (1991). Computerized and conventional neuropsychological assessment of HIV-1 infected homosexual men. Neurology, 41, 1608–1616.CrossRefGoogle Scholar
Miller, E.N. (1996). CalCAP: California Computerized Assessment Package (manual) (Version Revision 4.1). Los Angeles: Norland Software.Google Scholar
Mulder, J., McKinney, N., Christopherson, C., Sninsky, J., Greenfield, L., & Kwok, S. (1994). Rapid and simple PCR assay for quantitation of human immunodeficiency virus type 1 RNA in plasma: Application to acute retroviral infection. Journal of Clinical Microbiology, 32, 292–300.CrossRefGoogle Scholar
Reitan, R.M. & Wolfson, D. (1993). The Halstead-Reitan Neuropsychological Test Battery: Theory and clinical interpretation. Tucson, AZ: Neuropsychology Press.Google Scholar
Rey, A. (1941). The psychological examination in the traumatic cases of encephalopathy. Archives de Psychologie, 28, 286–340.Google Scholar
Rey, A. (1962). The clinical examination in psychology. Paris: Presses Universitaires de France.Google Scholar
Rourke, S.B., Halman, M.H., & Bassel, C. (1999a). Neurocognitive complaints in HIV-infection and their relationship to depressive symptoms and neuropsychological functioning. Journal of Clinical & Experimental Neuropsychology, 21 (6), 737–756.CrossRefGoogle Scholar
Rourke, S.B., Halman, M.H., & Bassel, C. (1999b). Neuropsychiatric correlates of memory-metamemory dissociations in HIV-infection. Journal of Clinical & Experimental Neuropsychology, 21 (6), 757–768.CrossRefGoogle Scholar
Smith, A. (1982). Symbol Digit Modalities Test. Los Angeles: Western Psychological Services.Google Scholar
Wechsler, D. (1981). Wechsler Adult Intelligence Scale–Revised (manual). New York: The Psychological Corporation.Google Scholar
Wechsler, D. (1987). Wechsler Memory Scale–Revised. New York: The Psychological Corporation.Google Scholar
Wilkie, F.L., Eisdorfer, C., Morgan, R., Loewenstein, D.A., & Szapocznik, J. (1990). Cognition in early human immunodeficiency virus infection. Archives of Neurology, 47 (4), 433–440.CrossRefGoogle Scholar
Worth, J.L., Savage, C.R., Baer, L., Esty, E.K., & Navia, B.A. (1993). Computer-based neuropsychological screening for AIDS dementia complex. AIDS, 7, 677–681.CrossRefGoogle Scholar