Identification of Specific Neurological Disorders Using Double Discrimination Scales Derived from the Standardized Luria Neuropsychological Battery

Abstract

The Standardized Luria-Nebraska Neuropsychological Battery has been validated in a number of studies and has shown its effectiveness in making basic neuropsychological discriminations. A major advantage of this battery, compared to other test batteries, is its structure. The test consists of 269 separate items, each of which is designed to measure a different neuropsychological skill. As a result, these items can be combined in a number of ways to form scales aimed at specific neurological processes. It is the purpose of the present study to investigate whether or not the Luria Battery can be successful in discriminating specific neurological disorders by the development of what is termed “double discrimination scales.” Using this process, two scales are established to diagnose any given neurological process. The first represents items in which the patients with a specific disorder do worse than a general neurological control group while the second scale represents items in which the patients with a neurological disorder do better than the general neurological control group. For a patient to be diagnosed as having a given process, the patient must score in the proper range on both scales. This method was applied to a sample of 24 multiple sclerosis patients who were compared with 74 patients diagnosed as normal, 106 psychiatric patients, and 101 brain damaged patients. Using the double discrimination procedure, the accuracy of identification of 100% was achieved in all groups. The study supported the usefulness of the double discrimination approach with the Standardized Luria Neuropsychological Battery and opens up the possibilities for scales to be developed for a wide variety of diseases in specific lateralized disorders.