Quantitative electroencephalography (QEEG) and neuropsychological syndrome analysis.

The ideographic, syndrome analysis and the nomothetic, standardized test battery approaches to neuropsychological assessment are compared and contrasted within the context of advances in noninvasive technology readily available for use within the examiner's office. By demonstrating the relative strengths and benefits of syndrome analysis, it is suggested that this approach provides a thorough and efficient method of neuropsychological assessment. Subsequently, the utility of an a priori hypothesis testing process approach as a critical technique in syndrome analysis will be supported. It will be proposed that QEEG procedures provide a useful method for further substantiating conclusions generated from a syndrome analysis approach to neuropsychological assessment. Two cases are described demonstrating the utility and flexibility of the QEEG as a confirmatory test of localization following syndrome analysis. In summary, the contributions that neuropsychologists make to the understanding of brain-behavior relationships may be strengthened by combining neuropsychological and neurophysiological assessment methods.

Grip strength asymmetry in depressed boys.

OBJECTIVE: The purpose of this experiment was to investigate the influence of depressed mood on functional motor asymmetry among school-aged boys. Thus, left- and right-hand grip strength as well as fatigue across successive trials was examined among 38 right-handed school-aged boys, half of whom had been classified as depressed (n = 19) and the other half as nondepressed (n = 19). BACKGROUND: There is support in the literature that depressed individuals experience relative right anterior activation, and previous reports of functional motor asymmetries among depressed adults are generally supportive of this notion. To date, however, little is known regarding the neuropsychology of depression as it may pertain to children; in particular, the possibility of functional motor asymmetry within this population has yet to be explored. METHOD: Participants were asked to squeeze a hand dynamometer four times successively with each hand. The order of hand presentation was counterbalanced, and the dependent measure was in kilograms. RESULTS: As hypothesized, depressed boys failed to demonstrate asymmetry for grip strength, although nondepressed boys exhibited right-hand grip strength. In addition, based on trend, right-hand grip strength for depressed boys fatigued more rapidly across successive trials than did right-hand grip strength for nondepressed boys. In contrast, depressed boys maintained left-hand grip strength longer across successive trials than did nondepressed boys. CONCLUSIONS: The data are interpreted as consistent with current neuropsychological theories of emotion, particularly depression, and suggest that the functional motor asymmetries (i.e., failure to demonstrate asymmetric grip strength) observed in depressed adults are also present among depressed children. Implications for increased right hemisphere activation, decreased left hemisphere activation, or a combination of both are discussed.

Investigation of receptive affective prosodic ability in school-aged boys with and without depression.

OBJECTIVE: To investigate the accuracy of affective prosodic speech identification of 38 right-handed school-aged boys, half of whom had been classified as having depression and the other half as not having depression. BACKGROUND: There is support in the literature for relative right posterior hemisphere dysfunction in patients with depression. The literature also suggests that patients with depression may have difficulty processing receptive affective prosodic speech. Less is known, however, regarding the neuropsychology of depression in children. It was hypothesized that children with depression would demonstrate decreased ability in the identification of affective prosody. METHOD: Participants were asked to identify happy, angry, sad, and neutral prosodies within congruent and incongruent verbal statements. RESULTS: As predicted, the ability of boys with depression to identify congruent and incongruent affective prosody was significantly lower compared with boys without depression. CONCLUSION: The results of this experiment are discussed in terms of a right-hemisphere dysfunction model for depression in childhood.

Neuropsychological test performances of young depressed outpatient women. An examination of executive functions.

Thirty young, unmedicated, outpatient, depressed women were compared to an equal number of matching controls on a series of neuropsychological tests purported to be sensitive to the executive functions. Specifically, the measures included the Design Fluency Test, Hand Dynamometer tasks of grip strength, perseveration, and fatigue, the FAS Verbal Fluency Test, the Stroop Color and Word Test, and the Trail Making Test (Parts A and B). Despite past research which has indicated anterior hemispheric asymmetries and impaired neurocognitive performances in depressives, this research failed to identify any reliable differences between depressed and nondepressed women on any of the neuropsychological measures. These results argue against the frequently held stereotype that depressed individuals typically display impaired performances on neurocognitive tasks. Furthermore, since the profile of the depressed sample appeared to differ significantly from past studies, a discussion is provided as to how the characteristics of this group may have impacted the results. Implications of these findings for clinical practice and future research are also provided.

QEEG assisted neuropsychological evaluation of autism.

The present case study utilizes neuropsychological procedures, quantitative electroencephalography (QEEG) and magnetic resonance imaging (MRI) to identify neural substrates of "autism" in a 25 year old Caucasian male. A priori hypotheses formed from a neuropsychological evaluation were supported by data from QEEG and MRI. Specifically, the neuropsychological evaluation was suggestive of left anterior deactivation and right frontal activation. Consistent with these results, QEEG data revealed relative activation of the right frontal region, while MRI results were suggestive of multiple small focal areas over the left frontal region and a teardrop shaped area of low attenuation across the right frontal region. The possible relation of right cerebral dysfunction and autism is discussed.

The Affective Auditory Verbal Learning Test: peripheral arousal correlates.

The present study assessed the usefulness of the affective list alternatives to the Rey Auditory Verbal Learning Test (RAVL) in the induction of physiological arousal. It was anticipated that affective verbal learning would lead to arousal patterns characteristic of different emotions (Izard, 1977), with significant increases in blood pressure following negative list learning and significant decreases following positive list learning. Since diastolic blood pressure increased significantly following the learning of negatively valanced words and decreased significantly following the learning of positively valanced words, this was supported. Given the abundance of research on lateral asymmetries in emotional and verbal processing, the affective list alternatives to the RAVL may provide an objective means for evaluating individual differences in affective verbal learning as well as the induction of emotion. The Affective Auditory Verbal Learning Test (AAVL) may potentially provide a tool for assessment of cerebral dysfunction in the clinic or in the assessment of affective disorders.

Relationships between verbal and nonverbal fluency measures: implications for assessment of executive functioning.

This experiment evaluated the relationship between verbal and nonverbal fluency measures commonly employed in neuropsychological assessment. Three fluency measures, the Controlled Oral Word Association Test, the Design Fluency Test, and the Ruff Figural Fluency Test, were administered to a sample of 61 men and 73 women in college. Analyses indicated that scores on the Controlled Oral Word Association Test were significantly correlated with scores on the Fixed but not the Free Condition of the Design Fluency Test. Scores on the Ruff test were significantly more closely correlated with the Fixed versus the Free Condition, although they were also correlated with the total scores on the Design Fluency Test. Differential correlations are discussed in terms of the varying structure inherent in the measures of fluency and their presumed taxing of frontally mediated executive processes.

Physiological and neuropsychological correlates of hostility.

This experiment tested two hypotheses linking right cerebral arousal to hostility and physiological arousal. A replication of previous research supporting heightened physiological (systolic blood pressure, diastolic blood pressure and heart rate) reactivity among high-hostility subjects was partially successful. Hemispheric lateralization of cerebral activity in response to stress was also measured. Low- and high-hostility subjects were identified using the Cook-Medley Hostility Scale (CMHS). Physiological measures (systolic blood pressure, diastolic blood pressure and heart rate) were recorded and dichotic listening procedures were administered before and after administration of the cold-pressor paradigm. The primary finding of this research was greater right cerebral activation to stress among high-hostility subjects, as indicated by their enhanced ability to identify syllables presented to the left ear. Data further supported previous findings of heightened physiological reactivity to stress among high-hostility subjects and suggest a positive relationship between right cerebral activity and cardiovascular arousal.

Age differences in intention to left and right hemispace using a dichotic listening paradigm.

This study assessed the influence of age (younger women and elderly women living in communities) on cerebral laterality using dichotic listening. Previous research has purported to show a relative right cerebral decline with age. To date, however, research on the right hemiaging hypothesis has provided mixed findings. It is possible that these mixed findings are caused by use of simple versus complex dichotic listening tasks. As a test of this hypothesis, older women were expected to have a heightened right ear advantage (REA) for phonemic speech sounds and greater difficulty switching intention to the left ear when instructed to focus to either the left or the right ear. No age difference was found using the traditional presentation of concurrent phonemes. However, the right hemiaging hypothesis was supported on the intentional task, in which older women were less able to switch intention to the left but not to the right ear. Implications for right hemiaging are discussed.

The affective Auditory Verbal Learning Test.

The study of emotion is hindered by the lack of tests for affect perception or comprehension. One solution is to develop affective versions of well-known tests. Using an index of word norms (Toglia & Battig, 1978), positively and negatively valenced word lists were developed as alternate forms of the affectively neutral Auditory Verbal Learning Test (RAVL; Rey, 1964). Participants (N=102) received either the original RAVL list, the positively valenced list, or the negatively valenced list. Results are depicted across acquisition trials and location within the list for comparison of primacy and recency effects. Each word list yielded comparable patterns of acquisition. Participants receiving the negative list evidenced an enhanced primacy effect, while participants receiving the positive list evidenced an enhanced recency effect. The positive and negative lists may prove useful in the evaluation of individuals with affective disorders and may provide an alternative for affect induction through an active learning paradigm.

A neuropsychological model relating self-awareness to hostility.

Neuropsychological advances may help researchers better understand the relationship between psychological constructs. This paper proposes a neuropsychological model explaining the negative relationship between hostility and "self-awareness," which has been suggested by previous research [H. A. Demaree and D. W. Harrison (1995a) "Behavioral, Physiological, and Neuropsychological Correlates of Hostility," manuscript submitted for publication; L. H. Epstein and P. A. Cluss (1982) "A Behavioral Medicine Perspective on Adherence to Long-Term Medical Regimes," Journal of Consulting and Clinical Psychology, Vol. 50, pp. 950-971; M. F. Scheier et al. (1974) "Self-Awareness and Physical Aggression," Journal of Experimental and Social Psychology, Vol. 10, pp. 254-273]. The authors review the role of the right cerebrum in both hostility and "self-awareness"--including arousal, perceptual, expressive, and integrative processes. Using identifiable tracts in the brain, the model suggests how deficits in "self-awareness"--poor awareness of physiological arousal, natural and emotional environment, etc.--may enhance the probability of hostility expression. This model is supported by previous empirical research and provides direction for future neuropsychological investigation.

Age differences in hemispheric activation to sensory condition.

The effects of combinations of bright or dim light and noise levels on hand strength, fatigue, motor perseveration, and tapping rate were evaluated in 13 undergraduate and 13 elderly females. Increments in the intensity of sensory conditions produced opposite effects on grip strength at the left, as opposed to the right hand. Reliable asymmetry in hand strength (right > left) was observed in bright but not dim lighting in the younger group. In the elderly group, the extent of asymmetrical hand strength was related to the combination of light and noise intensity. Data suggest that increments in sensory conditions may differentially activate the cerebral hemispheres of the elderly and younger groups affecting grip strength. Results are discussed in relation to the hemiaging hypothesis.

Case study: topographical brain mapping in hostility following mild closed head injury.

Previous research suggests that right frontal and temporal lobe arousal may inhibit and elicit hostility, respectively. For example, emotional lability (including rage) has resulted from lesion of the bulbar motor nuclei, and neocortical upper motor neurons in particular (Lieberman & Benson, 1977). Ablation of hypothalamic sites has resulted in sham rage (Flynn, Cummings & Tomiyasu, 1988; Sachdev, Smith, Matheson & Last, 1992; Tonkonogy & Geller, 1992) suggesting that these frontal pathways may inhibit hostility. In the present study, a patient with hostility management problems secondary to closed head injury from a motor vehicle accident was evaluated using topographical brain mapping and quantitative electroencephalograph (QEEG) techniques. Comparisons of beta magnitude were performed between frontal and temporal sites at the right and left cerebrums. The results support the contention of an oppositional anterior to posterior mediation of hostility. The present electroencephalagraphic research supports the predominant neuropsychological theory that the right orbital-frontal region inhibits the right amygdaloid bodies, thereby decreasing hostility level (Kolb & Wishaw, 1990).

Auditory affect perception in a dichotic listening paradigm as a function of verbal fluency classification.

This study evaluated cerebral asymmetry for affect perception as a function of fluency classification. After being assigned to a fluency category using scores on the FAS test (Borkowski, Benton, & Spreen, 1967), forty-five right-handed subjects with normal auditory acuity listened to the Bryden and MacCrae (1989) Dichotic Emotional Words Tape. Subjects higher in fluency exhibited significantly greater right and left ear advantages than subjects lower in fluency. Conversely, REA scores for words were significantly greater than REA scores for affect, while LEA scores for affect were significantly greater than LEA scores for words.

Hemispheric asymmetry as a function of handedness: perception of facial affect stimuli.

Hemispheric asymmetry in 14 left- and 14 right-handed persons shown tachistoscopically presented emotional stimuli to left and right visual fields was examined using a forced-choice, reaction-time paradigm in which subjects were asked to identify positive and negative faces. Neutral faces were included within the two-alternative forced-choice paradigm. Reaction time and response-bias measures were recorded. Analysis indicated differential lateralization for left-handed and right-handed subjects with respect to neutral affective stimuli. While right-handed subjects' perceptions of neutral stimuli remained consistent across visual fields, left-handed ones identified neutral stimuli as more positive (happy) when presented to the left visual field and negative (angry) when presented to the right visual field. Implications for differential lateralization patterns among left- and right-handed adults are discussed.

Blood-retinal barrier breakdown following experimental retinal ischemia and reperfusion.

The purpose of this study was to examine the effects of acute ischemia and reperfusion on blood-retinal barrier (BRB) function in the rabbit eye. Hydrostatic pressure (140 mmHg) was used to create total retinal ischemia for intervals of 20, 40, 60, 80 or 100 min in the rabbit eye. The location, size and permeability-surface-area product normalized to the area of retinal leakage (PS') of ischemia-induced BRB lesions were then measured using contrast-enhanced magnetic resonance imaging (MRI) after various intervals of reperfusion. Diffuse outer BRB leakage occurred in most eyes subjected to 80 or 100 min of ischemia. A posterior region of outer BRB sparing was found in eyes that underwent lesser durations of ischemia. On day 1 after retinal ischemia, a linear relationship was found between mean PS' and duration of ischemia for periods of ischemia between 20 and 100 min [slope: 5.65 x 10(-6) to 5.96 x 10(-6) cm min-1 (min ischemia)-1; r2 > or = 0.69]. Lesion size also increased between 20 and 100 min of ischemia. In a longitudinal study, eyes exposed to 60 min of ischemia showed a decrease in PS' and a lesion size over an 8-week period of observation. However, leakage was still present on post-ischemia day 57 in two of three eyes examined. Data obtained in these experiments are expected to prove useful in future studies aimed at understanding how BRB damage relates to neuroretinal damage after ischemia-reperfusion injury.

The neuropsychology of depression and its implications for cognitive therapy.

The past few years have witnessed a growing interest in the specialty of neuropsychology as well as continued support for cognitive therapy of depression. The purpose of this paper is the examination of the neuropsychology of depression and its implications for A. T. Beck's cognitive theory and therapy of depression ([1963] "Thinking and Depression: Idiosyncratic Content and Cognitive Distortions," Archives of General Psychiatry, Vol. 9, pp. 324-333; [1964] "Thinking and Depression," Archives of General Psychiatry, Vol. 10, pp. 561-571; [1967] Depression: Clinical, Experimental, and Theoretical Aspects, New York: Harper & Row). Specifically, the neuropsychological and cognitive theory and therapy literatures related to depression are reviewed followed by an integration of these areas. Neuropsychological evidence is presented that both supports cognitive theory and therapy of depression and helps explain why such therapy may prove ineffective in treating depression. Implications for clinical practice, including neuropsychological assessment of depressives, and potential future research directions are also provided.

Visual field asymmetry in facial affect perception: moderating effects of hypnosis, hypnotic susceptibility level, absorption, and sustained attentional abilities.

Effects of hypnotic level, affect valence and cerebral asymmetry on reaction time (RT) in the discrimination of Ekman and Friesen's (1978) stimuli of angry and happy faces were studied in counterbalanced conditions of waking and hypnosis. Assessed previously on two hypnotic susceptibility scales [Harvard Group Scale of Hypnotic Susceptibility; Stanford Hypnotic Susceptibility Scale, Form C (SHSSC)], non-depressed subjects were 16 low (0-4 SHSSC) and 17 highly (10-12 SHSSC) hypnotizable, right-handed college students. Subjects were required to identify affects of faces, presented tachistoscopically to left (LVF) or right (RVF) visual fields, by using a forced-choice RT paradigm. Highs were significantly faster than lows in angry and happy affect recognition. Hypnosis had no significant effects. For highs only, angry emotional valence was identified faster when presented to the right hemisphere (LVF), but there were no significant hemispheric effects for happy emotional valence. For lows there were no hemispheric differences. Gender was a nonsignificant factor. Significant correlations showed that faster reaction times to angry and happy stimuli, in both LVF and RVF in waking and hypnosis, were obtained by subjects who reported more deeply absorbed and extremely focused and sustained attention on the Tellegen (1982) Absorption Scale and a subscale of the Differential Attentional Processes Inventory (Grumbles & Crawford, 1981). Vividness of Visual Imagery Questionnaire (Marks, 1973) and Affect Intensity Measure (Larsen, 1985), in general, did not correlate with RTs. The potential role of the fronto-limbic attentional system in the recognition of external visual sensory affect is discussed.

Cerebral asymmetry in facial affect perception by women: neuropsychological effects of depressed mood.

40 right-handed women, half of whom had been classified with depressed mood and the other half as nondepressed, participated in a tachistoscopic study of the influence of depressed mood on the cerebral hemispheric processing of Ekman and Friesen's 1976 happy, sad, and neutral emotional faces using a forced-choice reaction-time paradigm with only happy and sad alternatives as response manipulanda. The women with depressed mood were also characterized by elevated scores on both state and trait anxiety, suggestive of an anxious-depressive state with heightened arousal. Primary findings for the tachistoscopic data indicated that women with depressed mood as compared to nondepressed women displayed significantly faster reaction times to sad faces presented in the right visual field and happy faces presented in the left visual field. These results are suggestive of differential arousal of both the left and right cerebral hemispheres in this sample of anxious-depressed women and are discussed in light of arousal theory.