Neurology researchers evaluate evidence base for tests for clinical cognitive assessment
West Orange, NJ. July 28, 2015 Recommendations for improving clinical cognitive testing were reported by the American Academy of Neurology’s (AAN) Behavioral Neurology Section (BNS) Group, led by Kirk R. Daffner, MD, of Boston, Mass. The Group focused on the Neurobehavioral Status Exam (NBSE), conducting evidence-based reviews of testing used for five domains – attention, language, memory, spatial cognition, and executive function). “Improving clinical cognitive testing” (doi: 10.1212/WNL.0000000000001763) was published online ahead of print on July 10, 2015, in Neurology, the official journal of the AAN.
While the NBSE is used to determine the differential diagnoses and guide intervention, there are no guidelines for selecting tests to include in an NBSE, and little information on how it is used in clinical practive. The NBSE Workgroup was formed to review use of the NBSE in office-based clinical practice, toward the goal of quality improvement in cognitive assessment. Data were collected from 200 AAN-BNS members who conduct NBSE. Responses were reviewed by experts in each of the five domains.
“This survey is an important step in our knowledge of how behavioral neurologists apply single-domain cognitive testing in their practices,” said A.M. Barrett, MD, of Kessler Foundation, director of the subgroup on spatial cognition tests. “This evidence-based evaluation of commonly used tests provides insights that will inform the decision making process for selecting tests for the NBSE.”
Members of the - AAN Behavioral Neurology Section Workgroup: Kirk R. Daffner, MD*, Seth A. Gale, MD*, A.M. Barrett, MD, Bradley F. Boeve, MD, Anjan Chatterjee, MD, H. Branch Coslett, MD, Mark D'Esposito, MD, Glen R. Finney, MD, Darren R. Gitelman, MD, John J. Hart Jr, MD, Alan J. Lerner, MD, Kimford J. Meador, MD, Alison C. Pietras, BA, Kytja S. Voeller, MD and Daniel I. Kaufer, MD.
About A.M. Barrett, MD
A.M. Barrett, MD, a cognitive neurologist and clinical researcher, studies brain-behavior relationships from the perspectives of cognitive neurology, cognitive neuroscience, and cognitive neurorehabilitation. Dr. Barrett is an expert in hidden cognitive disabilities after stroke, which contributes to safety problems & rehospitalization, increased caregiver burden, & poor hospital-to-home transition. She is a founder of the Network for Spatial Neglect, which promotes multidisciplinary research for this underdiagnosed hidden disability. Dr. Barrett is also professor of physical medicine & rehabilitation at Rutgers New Jersey Medical School and adjunct professor of neurology at Columbia University School of Medicine. She is Chair of the Neural Repair and Rehabilitation Section, the American Academy of Neurology, and a former president of the American Society for Neurorehabilitation.
Dr. Barrett is author of the reference article Spatial Neglect on emedicine.com.
•Chen P, Barrett AB, Hreha K, Goedert KM, Chen C. Kessler Foundation Neglect Assessment Process Uniquely Measures Spatial Neglect during Activities of Daily Living)” (doi: 10.1016/j.apmr.2014.10.023) Arch Phys Med Rehabil.
• Barrett AM, Muzaffar T. Spatial cognitive rehabilitation and motor recovery after stroke. Curr Opin Neurol 2014;27:653-8. doi:10.1097/WCO.0000000000000148
• Goedert KM, Chen P, Boston RC, Foundas AL, Barrett AM. Presence of motor-intentional aiming deficit predicts functional improvement of spatial neglect with prism adaptation. Neurorehabilitation and Neural Repair epub Dec 27 2013. DOI: 10.1177/1545968313516872
About Kessler Foundation
Kessler Foundation, a major nonprofit organization in the field of disability, is a global leader in rehabilitation research that seeks to improve cognition, mobility and long-term outcomes, including employment, for people with neurological disabilities caused by diseases and injuries of the brain and spinal cord. Kessler Foundation leads the nation in funding innovative programs that expand opportunities for employment for people with disabilities. For more information, visit KesslerFoundation.org; Facebook.com/KesslerFoundation; Tweet us @KesslerFdn