Screening for more than level of cognitive functioning: the BNI screen for higher cerebral functions

ABSTRACT

Objective: This paper describes the BNI Screen for Higher Cerebral Functions (BNIS) and reviews studies that comment on its reliability, validity, and clinical and research utility. The ability of the BNIS to assess non-cognitive higher brain functions is also described. Methods: We reviewed the original administration manual, studies published in the BNI Quarterly of the Barrow Neurological Institute, and peer-reviewed studies on the BNI Screen identified by an academic database, PubMed and Google Scholar. Thirty-two studies were reviewed that describe normative data, psychometric properties, sensitivity and specificity estimates, the relationship of demographic factors to test performance, and its research utility. Results: The BNIS is a time efficient screening test often taking no longer than 12–18 minutes. In addition to cognitive functioning, it aids in assessing conation, awareness of memory impairment, and affects expression and perception. Sensitivity estimates ranged from 80% to 92.3%. Specificity estimates ranged from 38.9% to 90%. Its construct, concurrent, and predictive validity have been supported by a series of international studies using different language translations of the test. Conclusion: The BNIS is a useful screening test for identifying patients with underlying brain disorders that uniquely measures domains of functioning not sampled by other existing screening tests.

KEYWORDS:

• BNI screen for higher cerebral functions
• normative data
• reliability
• validity
• cross cultural findings
• clinical and research utility

Acknowledgments

The authors wish to thank Lucia Braga, PhD and Olinda Azevedo of the SARAH Network of Rehabilitation Hospitals in Brazil for their review of an earlier version of this manuscript and editorial assistance.

Disclosure statement

The first author was the primary author of the BNI Screen. The copyright of the BNI Screen is held by the Barrow Neurological Institute whose parent company is Dignity Health. Royalties for the Swedish translation of the BNI Screen are paid to Dignity Health for which the first author receives a portion of the royalties. The second author was a co-author of the BNI Screen. She has no other conflict of interest to report. The third author has no conflict of interest to report.

Additional information

Funding

The author(s) reported that there is no funding associated with the work featured in this article.