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Medical diagnosis, prognosis, and classification of pathological states belong to the class of almost non-formalized problems. Therefore, formalization of knowledge of skilled clinicians is of significant importance for training and advanced training of medical specialists.The current state of knowledge in neuropsychology allows a general-purpose scheme of presentation of information to be developed on the basis of the syndrome analysis approach. This approach allows determination of the central mechanism of a pathology associated with a lesion in specific brain structures [11].The clinical data required for solving this problem were taken from our clinical experience or from the literature [1][2][3][4][5][6][7][10][11][12][13][14][15][16][17][18][19][20][21][22][23]. This information was used for description of higher mental functions; brain systems involved in implementation of these functions; dysfunction symptoms and the degree of their manifestation; tests revealing these dysfunctions. Structural OrganiTation of Neuropsyc.hological KnowledgeThe method of structural organization and presentation of neuropsychological information developed in our laboratory reveals the cardinal questions intended to answer diagnostically significant questions. Once answered, they make the diagnosis beyond doubt. Such an approach is very useful in building up a knowledge base for expert systems.The scheme described in this work is of general purpose, because it provides extrapolation of knowledge with no regard for existing concepts. In our opinion, it is correct determination of a defect, rather than its name, that is of real importance.The developed scheme of neuropsychological examination provides for syndrome analysis of various disorders. It is based on the morphological principle, i.e., on the connection between the damaged area of the brain and the pattern of disorders caused by this lesion. This principle was successfully used in description of neurological and EEG information. The main advantage of this approach is that it allows the whole complex of clinical data to be compared with the data of neuropsychology [8-10 I.The functional status of various brain systems (both cortical and subcortical) is shown in Diagram 1. Particular attention was given to the functions of speech. There is a separate scheme for the symptoms of speech pathology. For each area of the brain there is a description of the central mechanism of the disorder.The following description of the temporal areas of the brain can be regarded as an example.Temporal Areas of the Brain (42 and 22 Secondaiy Fields)A. Disorders of auditory gnosis (left hemisphere): a) narrowing of the ability of auditory perception of verbal and nonverbal stimuli; b) arrhythmia (disorder of perception and assessment of accentuated and nonaccentuated rhythms). B. Disorders of auditory nonverbal gnosis (right hemisphere): a) disorder of auditory gnosis: 1) amusia (disorder of recognition of melodies); 2) arrhythmia (disorder of perception and assessment of rhythmic structures, e...
Medical diagnosis, prognosis, and classification of pathological states belong to the class of almost non-formalized problems. Therefore, formalization of knowledge of skilled clinicians is of significant importance for training and advanced training of medical specialists.The current state of knowledge in neuropsychology allows a general-purpose scheme of presentation of information to be developed on the basis of the syndrome analysis approach. This approach allows determination of the central mechanism of a pathology associated with a lesion in specific brain structures [11].The clinical data required for solving this problem were taken from our clinical experience or from the literature [1][2][3][4][5][6][7][10][11][12][13][14][15][16][17][18][19][20][21][22][23]. This information was used for description of higher mental functions; brain systems involved in implementation of these functions; dysfunction symptoms and the degree of their manifestation; tests revealing these dysfunctions. Structural OrganiTation of Neuropsyc.hological KnowledgeThe method of structural organization and presentation of neuropsychological information developed in our laboratory reveals the cardinal questions intended to answer diagnostically significant questions. Once answered, they make the diagnosis beyond doubt. Such an approach is very useful in building up a knowledge base for expert systems.The scheme described in this work is of general purpose, because it provides extrapolation of knowledge with no regard for existing concepts. In our opinion, it is correct determination of a defect, rather than its name, that is of real importance.The developed scheme of neuropsychological examination provides for syndrome analysis of various disorders. It is based on the morphological principle, i.e., on the connection between the damaged area of the brain and the pattern of disorders caused by this lesion. This principle was successfully used in description of neurological and EEG information. The main advantage of this approach is that it allows the whole complex of clinical data to be compared with the data of neuropsychology [8-10 I.The functional status of various brain systems (both cortical and subcortical) is shown in Diagram 1. Particular attention was given to the functions of speech. There is a separate scheme for the symptoms of speech pathology. For each area of the brain there is a description of the central mechanism of the disorder.The following description of the temporal areas of the brain can be regarded as an example.Temporal Areas of the Brain (42 and 22 Secondaiy Fields)A. Disorders of auditory gnosis (left hemisphere): a) narrowing of the ability of auditory perception of verbal and nonverbal stimuli; b) arrhythmia (disorder of perception and assessment of accentuated and nonaccentuated rhythms). B. Disorders of auditory nonverbal gnosis (right hemisphere): a) disorder of auditory gnosis: 1) amusia (disorder of recognition of melodies); 2) arrhythmia (disorder of perception and assessment of rhythmic structures, e...
A study by Wiens, Bryan, and Crossen (1993) suggests the Wide Range Achievement Test-Revised (WRAT-R) Reading subtest and North American Adult Reading Test (NAART) are adequate predictors of Wechsler Adult Intelligence Scale-Revised (WAIS-R) IQ scores for a normal population. Although it is common practice to use reading scores to estimate premorbid IQ in clinical populations, the WRAT-R and NAART have not been compared using individuals with brain dysfunction. The current study cross-validated the Wiens et al. (1993) study using neurologically impaired populations: traumatic brain injury (n = 118), dementia (n = 37), and other neurologic impairments (n = 77). The results were generally consistent across all three groups: (a) the WRAT-R and NAART were equivalent and accurate estimates of average VIQ levels; (b) the WRAT-R and NAART were equivalent but underestimates of higher intelligence ranges; and (c) the WRAT-R is a more accurate estimate for lower VIQ ranges, although both are overestimates. This third finding is in contrast to Wiens et al.'s (1993) results that suggest the WRAT-R is an accurate estimate of lower IQ ranges for normals. It is concluded that the WRAT-R is the preferred measure of premorbid verbal intelligence for psychometric and clinical reasons.
Examines age-related decline in Digit-Symbol performance using variables obtained from a slow-motion analysis of a first person perspective video filmed during test completion, including superimposed cross-hairs indicating eye movements. Standard WAIS-3 DSCT scores and the video-derived variables were compared across two age groups (mean age 20 years vs. mean age 59 years). The older group performed more poorly overall, t(16)=-2.359, p=.031. The correlation between writing time per item and overall performance was (negatively) larger in the older group compared with the younger group, z=-2.180, p=.014. There was no difference between the groups' correlation coefficients with respect to key search latency and overall performance, z=-0.064, p=.525. Overall these results suggest that characterisation of the age-related slowing on Digit-Symbol tests as a psychomotor deficit is appropriate.
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