Cluster subtypes on the California Verbal Learning Test–Second Edition (CVLT–II) in a traumatic brain injury sample

Abstract

Subtypes of learning and memory on the California Verbal Learning Test-Second Edition (CVLT-II; Delis, Kramer, Kaplan, & Ober, 2000) were examined in a clinical sample of 223 persons with traumatic brain injury (TBI), screened to remove individuals with complicating premorbid (e.g., psychiatric) or comorbid (e.g., financial compensation-seeking) histories. The z scores from 4 key CVLT-II variables were entered into a two-stage cluster analysis. These variables were selected to represent 4 latent constructs, identified in a recent confirmatory factor analysis: List A1 (Attention Span), List A5 (Learning Efficiency), Long Delay Free Recall (Delayed Memory), and False Positives (Inaccurate Memory). Six reliable subtypes were found (similar to those in the standardization sample) that were differentiated by both level and pattern of performance, with differences in level of performance meaningfully related to length of coma. In conclusion, the impact of TBI on CVLT-II performance can be manifested in various patterns that are not specifically unique, but are affected by injury severity.

Verbal Learning Strategy Following Mild Traumatic Brain Injury

“…Indeed, list recall in moderate-severe TBI has been suggestive of a disorganized haphazard learning style coupled with an increased reliance on serial clustering (Deluca, Schultheis, Madigan, Christodoulou, & Averill, 2000; Millis & Ricker, 1994). Recalling that our prior work focused on early learning inefficiency (Geary et al, 2010), our finding of less consistent recall from trial 1 to trial 2 may suggest that the mTBI participants are responding to the second trial as if it were a novel list versus a repeated presentation (Delis et al, 2000a) or possibly reflective of diminished attention (DeJong & Donders, 2010). This has also been offered as a theory to explain behavior in patients with frontal lobe dysexecutive syndrome (Roofeh et al, 2006; Stuss & Alexander, 2007).…”

Personalized Web-Based Cognitive Rehabilitation Treatments for Patients with Traumatic Brain Injury: Cluster Analysis (Preprint)

“…Cluster analysis has been extensively applied in the study of TBI in the last 30 years [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31]. Nevertheless, we have identified several common limitations such as the number of TBI patients that were clustered (<100 in many studies), the clustering approaches (only hierarchical clustering and k-means and not discussing other possible techniques), the specific implementation of such techniques (most of them restricted to only commercial products), as well as the lack of relation between the obtained clusters and rehabilitation tasks.…”

“…We have worked with public GNU libraries, as opposed to the state-of-the-art publications presented in Table A1, wherein most techniques were implemented using commercial packages [15][16][17][18][20][21][22][23][25][26][27][29][30][31]. Previous research presented in Table A1 applied clustering techniques in a batch mode as desktop applications.…”

“…Our baseline assessment consisted of 12 cognitive functions, thereby allowing for a comprehensive description of the patient's profiles, involving cognitive aspects addressed by such different functions, ranging from visual attention to gnosis. Meanwhile, previous clustering research presented in Table A1 addresses specific functions-only one of them in most cases: memory [14,16,[18][19][20][21][24][25][26]30], executive functions [17,21,31], or attention [22]. We have proposed different clustering techniques and applied state-of-the-art CVIs to all of them.…”

High Resolution Diffusion Tensor Imaging of Cortical-Subcortical White Matter Tracts in TBI

“…[ INSERT TABLE 3 HERE] Recalling that our prior work focused on early learning inefficiency (Geary et al, 2010), a finding of less consistent recall across initial trials may be a plausible explanation of what may underlie trial 1 learning deficiency. Less consistent responding from trial 1 to two trial 2 may suggest that the mild TBI participants are responding to the second trial as if it were a novel list versus a repeated presentation or possibly reflective of diminished attention (DeJong & Donders, 2010). This has also been offered as a theory to explain behavior in patients with frontal lobe dysexecutive syndrome (Roofeh et al, 2006;Stuss & Alexander, 2007).…”