The Nova Multilingual Neuropsychological Battery: Traumatic brain injury pilot study.

摘要

The purpose of the current study was to determine if the Nova Multilingual Neuropsychological Battery (NMNB) can detect neurological deficits in the traumatic brained injured (TBI) Hispanic sample by comparing subtest mean scores to the normal group mean scores. The NMNB is comprised of 39 subtests and was developed to account for language and cultural factors thought to influence neuropsychological test results. It was hypothesized that significant differences would be found in NMNB measures sensitive to brain damage. A sample size of 100 English-Spanish speaking bilinguals (50 TBI and 50 cognitively intact participants) was tested in Spanish in order to compare cognitive performance across the various NMNB measures. Due to the number of comparisons, the alpha level for this study was set to .01 to reduce Type I error. Results of the ANCOVA's partially supported the hypothesis after controlling for age and education. Findings show that the NMNB measures were able to successfully detect the TBI Spanish group from the normal Spanish group. Significant differences were displayed in the tests measuring nonverbal abilities, memory and learning, visual spatial skills, and executive functioning. More specifically, no significant differences were displayed in the tests measuring crystallized premorbid abilities, while tests measuring more fluid abilities detected problems with abstract thinking and information processing in the TBI sample. A similar deficit pattern was displayed across all measures of higher functioning systems. Deficits were detected in the nonverbal measures that involved complex attention (selective, divided, and alternating forms of attention) and concentration for visuospatial tasks, pattern synthesis and manipulation, but not for simple visuospatial attentional activities. Significant differences were found in motor speed, but not in the number of errors. These findings support previous research indicating that Hispanics tend to favor accuracy over speed. Additionally, results reveal significant differences across all memory measures. Using Cohen's d, large effect sizes were displayed between the groups ranging from 1.5 to 2.3 in the verbal and visual memory measures. Similar effect sizes were also displayed in tests of executive functioning. Preliminary data of this study suggests that the NMNB may be a sound assessment tool for detecting neurological impairments in TBIs. Collectively, the NMNB displayed significant differences in motor and processing speed, memory, visuospatial tasks, and executive functioning commonly documented in non-Hispanic TBIs. This study concluded that culturally sensitive neuropsychological tests that also control for demographic variables such as age and education can provide accurate results for Hispanics with TBI. However, these results should be interpreted with caution as this study was limited to a small sample size with an unequal proportion of TBI severity levels and educational experiences beyond educational levels. Future studies should focus on obtaining larger samples with varying TBI severity levels. Samples should also include bilingual Hispanics tested in English as well as monolingual Spanish speakers in order to develop profiles that may be useful in differential diagnosis.