Clinical Neuropsychologist最新文献

{"title":"Enhanced detection of suboptimal effort in psychoeducational assessments for dyslexia.","authors":"Allyson G Harrison, Nathaniel Davin, Beth Pollock","doi":"10.1080/13854046.2024.2422139","DOIUrl":"10.1080/13854046.2024.2422139","url":null,"abstract":"<p><p><b>Objective</b>: Although performance validity tests (PVTs) are routinely administered in neuropsychological evaluations, they are employed less frequently in assessments for specific learning disabilities such as dyslexia, likely due, at least in part, to the limited availability of PVTs to evaluate effort on measures of academic achievement. This is troubling, as previous research suggests that up to 24% of postsecondary students undergoing learning disability assessments produce noncredible test scores indicative of symptom exaggeration or low effort. This paper discusses normative data collected for the revised Dyslexia Assessment of Simulation or Honesty- Revised (DASH-R), a PVT developed specifically to identify symptom exaggeration or magnification during dyslexia testing. <b>Method:</b> We administered the DASH-R to three groups of students: honest responding controls (<i>n</i> = 48), students with documented dyslexia (<i>n</i> = 232), and students coached to simulate dyslexia (<i>n</i> = 42). Students were also administered measures of reading and processing speed. <b>Results:</b> DASH-R scores differentiated simulators from both honest responding controls and those with dyslexia. Further, ROC curve analysis showed that a composite feigning index score derived from the DASH-R could be used diagnostically to detect low effort; an optimal cut score of ≥4 on a seven-variable index yielded high specificity (≥98%) and good sensitivity (71%), with positive predictive accuracy of 86%. Creation of a 9-variable index that included errors on an additional reading test produced improved positive predictive accuracy to 96% while retaining excellent specificity (99%). <b>Conclusions:</b> The DASH-R appears to be a promising disability-specific measure for detecting feigned reading problems in young adults undergoing evaluations for dyslexia.</p>","PeriodicalId":55250,"journal":{"name":"Clinical Neuropsychologist","volume":" ","pages":"1559-1580"},"PeriodicalIF":3.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142569930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disinhibition, rather than moderate-to-severe traumatic brain injury, moderates the impact of anger provocation on subjective emotional experience.","authors":"Michelle Mendez, Jodie Logan, Michaela Filipčíková, Skye McDonald, Travis Wearne","doi":"10.1080/13854046.2024.2406042","DOIUrl":"10.1080/13854046.2024.2406042","url":null,"abstract":"<p><strong>Objective: </strong>Altered reactivity to emotional stimuli is common after traumatic brain injury (TBI), which is suggested to reflect difficulties with emotion regulation. While disinhibition is common after moderate-to-severe TBI, limited research has investigated the link between disinhibition and emotional reactivity in this clinical group. The aim of this research, therefore, was to investigate the relationship between disinhibition and TBI to anger provocation.</p><p><strong>Method: </strong>Thirty-five individuals with moderate-to-severe TBI and thirty-one controls completed an anger induction task. Participants rated their experience of emotions and subjective arousal before and after the induction. Heart rate, respiration and skin conductance were also measured. Disinhibition was measured using the Frontal Systems Behavior Scale.</p><p><strong>Results: </strong>In the full sample, the mood induction led to increased skin conductance, respiration, and self-reported anger, tension, arousal and negative mood. There were no differences between those with TBI and controls. Disinhibition interacted with the impact of anger provocation on subjective, but not objective, outcomes such that those elevated in disinhibition reported increased feelings of anger and tension in response to the mood induction. Disinhibition did not interact with TBI across any subjective and objective emotional measures examined in response to mood induction.</p><p><strong>Conclusions: </strong>While anger causes emotional changes for all individuals, these changes are particularly pronounced among those who are disinhibited, irrespective of whether an individual has sustained a TBI. This is an important consideration when examining emotional regulation post-TBI as the degree of disinhibition appears to alter subjective interpretations of emotional events, which could lead to emotion dysregulation.</p>","PeriodicalId":55250,"journal":{"name":"Clinical Neuropsychologist","volume":" ","pages":"1525-1545"},"PeriodicalIF":3.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142332774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interpreting the direct- and derived-Trail Making Test scores in Argentinian children: Regression-based norms, convergent validity, test-retest reliability, and practice effects.","authors":"Vanessa Arán Filippetti, Marisel Gutierrez","doi":"10.1080/13854046.2024.2423414","DOIUrl":"10.1080/13854046.2024.2423414","url":null,"abstract":"<p><p><b>Objective:</b> We carried out two research studies (using a cross-sectional and a longitudinal design) to establish regression-based normative data, and to examine the convergent validity, the test-retest reliability, and the changes in performance with practice (1-month and 1-year interval) of the direct- and derived- (B-A, B + A, and B/A ratio) Trail Making Test (TMT) scores in Spanish-speaking children. <b>Method:</b> In S1 (<i>n</i> = 413 6- to 15-year-old children and adolescents), regression-based norming procedure and partial correlations were employed. In S2 (<i>n</i> = 110 6- to 12-year-old children), intraclass correlation coefficient (ICC_2,1), Pearson's r-product-moment correlations, and paired t-tests were used. <b>Results:</b> S1 demonstrated that age was associated with better performance on both TMT-A and TMT-B. This improvement was more strongly related to direct scores than derived measures B-A and B/A. Additionally, TMT-B was found to be more related to other executive functions (EF) compared to the performance of TMT-A. Among the derived scores, only the B-A was related primarily to cognitive flexibility, while the B + A index was associated with most EF, suggesting a general measure of cognitive functioning. In S2, fair to good test-retest reliability coefficients were found at Time 2 for TMT-A and TMT-B, as well as the B + A index, both in 6 to 8-year-olds (ICCs .61 to .74) and 9 to 12-year-olds (ICCs .53 to .65). There was a significant increase in performance on TMT-A and TMT-B from the first assessment (Time 1) to the follow-up testing at Time 2 in older children. However, this significant improvement was not observed for TMT-B in the younger group. Test scores on the TMT direct measures improved significantly across 1-year. The B-A and B/A ratio scores did not change across examinations. <b>Conclusions:</b> These findings have important implications for assessing EF and developing interventions that target cognitive flexibility in pediatric populations.</p>","PeriodicalId":55250,"journal":{"name":"Clinical Neuropsychologist","volume":" ","pages":"1696-1721"},"PeriodicalIF":3.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142591058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship of subjective and objective cognition with post-stroke mood differs between early and long-term stroke.","authors":"Andrea Kusec, Nele Demeyere","doi":"10.1080/13854046.2024.2417865","DOIUrl":"10.1080/13854046.2024.2417865","url":null,"abstract":"<p><p><b>Objective:</b> Depression and anxiety affects approximately 1 in 3 stroke survivors. Performance on standardized objective cognitive tests and self-reported subjective cognitive symptoms are associated with concurrent depression and anxiety, but longitudinal data on whether and how objective and subjective cognition relate to emotional outcomes are lacking. <b>Method:</b> <i>N</i><b> </b><i>=</i> 99 stroke survivors (<i>M</i> age = 68.9, <i>SD</i> = 13.1; Median NIH Stroke Severity = 5) completed measures of depression and anxiety (Hospital Anxiety and Depression Scale; HADS), objective cognition (Oxford Cognitive Screen) and subjective cognitive symptoms (Cognitive Failures Questionnaire) at 6-months, 4.5, and 5.5 years post-stroke. The contribution of objective and subjective cognition to depression and anxiety was determined <i>via</i> mixed-effects models. <b>Results:</b> We found no evidence that age, stroke severity, years of education, and participant sex related to changes in HADS-Depression or HADS-Anxiety scores (Marginal <i>R</i>²=0.03 and 0.05, respectively). Objective cognitive impairments at 6-months and increases in subjective cognitive symptoms at 5.5 years significantly related to increased HADS-Depression scores (Marginal <i>R</i>²=0.22). Only increases in subjective cognitive symptoms at 5.5 years significantly related to increased HADS-Anxiety scores (Marginal <i>R</i>²=0.20). When conducting models in reverse, HADS-Depression and HADS-Anxiety scores did not reciprocally explain changes in subjective cognitive symptoms. <b>Conclusions:</b> Objective cognitive abilities are more strongly associated with depression at 6-months post-stroke, while subjective cognitive symptoms are more relevant to both long-term post-stroke depression and anxiety. There may be a unique unidirectional influence of subjective cognitive symptoms to post-stroke depression and anxiety.</p>","PeriodicalId":55250,"journal":{"name":"Clinical Neuropsychologist","volume":" ","pages":"1651-1672"},"PeriodicalIF":3.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New2Neuropsychology (N2N): An organization to promote diversity, equity, and inclusion in neuropsychology.","authors":"Taylor Rose Schmitt, Ryan Van Patten, Libby A DesRuisseaux, Milena Yurievna Gotra, Kelsey C Hewitt, Jennifer Peraza, Alexander Tan, Kristen L Votruba, John A Bellone, Cady Block, Leah D Talbert, Courtney Ray, Erin T Kaseda, Ronnise Owens, Michelle Nicole Martinez, Carol C Persad, Anthony Y Stringer","doi":"10.1080/13854046.2024.2417860","DOIUrl":"10.1080/13854046.2024.2417860","url":null,"abstract":"<p><strong>Objective: </strong>To introduce New2Neuropsychology (N2N), an organization that seeks to increase recruitment of historically underrepresented minoritized (URM) students, and to examine preliminary data on N2N's impact and effectiveness in increasing knowledge about neuropsychology for URM students.</p><p><strong>Method: </strong>This paper reviews relevant literature on factors informing the development of N2N. We also present descriptive data on N2N's impact to date, and results of pre- and post- surveys for presentations about neuropsychology delivered to 90 college students (mean age = 24.23, 64.4% juniors or seniors) between November 2021 - March 2023.</p><p><strong>Results: </strong>N2N has reached >500 students in events across 27 schools and, with the American Academy of Clinical Neuropsychology, disseminated $84,000 in scholarships to URM students. N2N presentation attendees reported increased understanding of neuropsychology and the training pathway (<i>p</i>s < .001, Cohen's <i>d</i>s = 0.94 - 1.73) and increased confidence in their ability to become neuropsychologists <i>(p < .</i>001, <i>d</i> = 0.41). There were no overall pre-post differences for interest in pursuing a career in neuropsychology (<i>p</i> > .05); however, a subset of students who reported low interest at baseline (<i>n =</i> 57) reported a statistically significant increase in their interest post-presentation (<i>p</i> < .01, <i>d</i> = 0.36).</p><p><strong>Conclusions: </strong>To date, N2N has progressed toward its goal, showing preliminary success increasing knowledge about neuropsychology for URM students. With continued development and support, N2N seeks to transform the pathway to neuropsychology for URM students, expanding accessibility of N2N resources across diverse groups and connecting URM students to neuropsychology research and clinical experiences.</p>","PeriodicalId":55250,"journal":{"name":"Clinical Neuropsychologist","volume":" ","pages":"1393-1416"},"PeriodicalIF":3.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142481308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contextualized cognition: Clarifying associations between remote unsupervised performance and clinically relevant contextual factors.","authors":"Timothy W Brearly, Daniel B Elbich, Maria Dhinojwala, Jonathan G Hakun","doi":"10.1080/13854046.2025.2534720","DOIUrl":"https://doi.org/10.1080/13854046.2025.2534720","url":null,"abstract":"<p><p><b>Objective:</b> Ambulatory cognitive assessments show promise as scalable, low friction performance metrics that address limitations of clinician-administered testing. However, influences of contextual factors on unsupervised testing are not well understood. This study evaluated associations between remote, unsupervised, ambulatory cognitive assessments and self-ratings of mood, arousal, stress, pain, and distraction during task performance. <b>Method:</b> 190 participants (ages 18-89) engaged in a 14-day ecological momentary assessment (EMA) protocol using the Mobile Monitoring of Cognitive Change (M2C2) platform. Participants completed ambulatory assessments of processing speed (Symbol Search) and working memory (Rotation Span) and provided self-ratings of contextual factors 5 times daily. Age stratified multilevel modeling (<65, ≥65 years of age) was used to analyze within- and between-person associations between context and performance. <b>Results:</b> In multilevel models where all 5 contextual factors were examined, within-person variation in momentary arousal and distraction levels were significantly associated with variation in performance on each cognitive task, with higher arousal and lower distraction being associated with better performance across both age groups. Significant between-person associations were limited to adults ≥65 years of age, where characteristic levels of arousal and distraction were associated with Rotation Span performance. <b>Conclusions:</b> This study highlighted distraction and arousal at time of task completion as important for understanding variation in remote, unsupervised cognitive testing. Monitoring of these associations using EMA may complement weaknesses of traditional supervised testing approaches, such as testing at a single time or set intervals. It also may facilitate individualized treatment recommendations for cognitive difficulties associated with contextual factors.</p>","PeriodicalId":55250,"journal":{"name":"Clinical Neuropsychologist","volume":" ","pages":"1-26"},"PeriodicalIF":2.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144765816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determining whether false positive rates increase with performance validity test battery expansion.","authors":"Robert J Kanser, Martin L Rohling, Jeremy J Davis","doi":"10.1080/13854046.2024.2416543","DOIUrl":"10.1080/13854046.2024.2416543","url":null,"abstract":"<p><strong>Objective: </strong>Performance validity test (PVT) misclassification is an important concern for neuropsychologists. The present study determined whether expanding PVT analysis from 4-PVTs to 8-PVTs could lead to elevated rates of false positive performance validity misclassifications.</p><p><strong>Method: </strong>Retrospective analysis of 443 patients who underwent a fixed neuropsychological test battery in a mixed clinical and forensic setting. Rates of failing two PVTs were compared to those predicted by Monte Carlo simulations when PVT analysis extended from 4-PVTs to 8-PVTs. Indeterminate performers (IDT; <i>n =</i> 42; those who failed two PVTs only after PVT analysis extended from 4-PVTs to 8-PVTs) were compared to a PVT-Fail group (<i>n</i> = 148; those who failed two PVTs in the 4-PVT battery or failed >2 PVTs).</p><p><strong>Results: </strong>Rate of failing two PVTs remained stable when PVT analysis extended from 4- to 8-PVTs (12.9 to 11.9%) and was significantly lower than those predicted by Monte Carlo simulations. Compared to PVT-Fail, the IDT group was significantly younger, had stronger neuropsychological test performance, and demonstrated comparable rates of forensic referral and conditions with known neurocognitive sequelae (e.g. stroke, moderate-to-severe TBI).</p><p><strong>Conclusions: </strong>Monte Carlo simulations significantly overestimated rates of individuals failing two PVTs as PVT battery length doubled. IDT did not differ from PVT-Fail across variables with known PVT effects (e.g. age, referral context, neurologic diagnoses), lowering concern that this group is comprised entirely of false-positive PVT classifications. More research is needed to determine the effect of PVT battery length on validity classification accuracy.</p>","PeriodicalId":55250,"journal":{"name":"Clinical Neuropsychologist","volume":" ","pages":"1546-1558"},"PeriodicalIF":3.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142481390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examining the utility of the BAARS-IV scales as embedded symptom validity indicators for adult attention-deficit/hyperactivity disorder evaluations.","authors":"John-Christopher A Finley, Anthony D Robinson, Brian M Cerny, Gabriel P Ovsiew, Neil H Pliskin, Matthew Calamia, Devin M Ulrich, Matthew S Phillips, Jason R Soble","doi":"10.1080/13854046.2024.2420376","DOIUrl":"10.1080/13854046.2024.2420376","url":null,"abstract":"<p><p><b>Objective:</b> This study investigated whether extreme cut-scores on the Barkley Adult Attention-Deficit/Hyperactivity Disorder (ADHD) Rating Scale-Fourth Edition (BAARS-IV) self-report scales could serve as symptom overreporting indicators in adult ADHD evaluations. <b>Method:</b> The sample consisted of 162 adults who underwent a neuropsychological evaluation for ADHD. Patients were classified into valid (<i>n</i> = 115) and invalid (<i>n</i> = 47) groups based on multiple criterion symptom validity tests. <b>Results:</b> Overreporting cut-scores identified for each of the BAARS-IV scales demonstrated acceptable classification accuracy or better. The Current Total scale yielded the highest classification accuracy (area under the curve of .83). An optimal raw cut-score of ≥56 for this scale yielded 47% sensitivity when upholding ≥90% specificity. A cut-score of ≥31 for the Current Inattention scale (90% specificity; 47% sensitivity) and ≥29 for the Current Sluggish Cognitive Tempo scale (88% specificity; 46% sensitivity) were also relatively strong indicators of overreporting. The Current Total and Current Sluggish Cognitive Tempo scales captured nonredundant aspects of symptom validity, and using them together increased sensitivity to 57% while maintaining ≥90% specificity. <b>Conclusions:</b> Findings provide preliminary support for the criterion and construct validity of extreme cut-scores on the BAARS-IV Current Sluggish Cognitive Tempo, Current Inattention, and Current Total scales as indicators of ADHD symptom overreporting. However, employing the cut-scores from the Current Sluggish Cognitive Tempo (≥29) and Current Total (≥56) together may be the most promising way to detect overreporting. Scores above both of these cut-points should, at a minimum, prompt further investigation into the validity of a patient's reported symptoms.</p>","PeriodicalId":55250,"journal":{"name":"Clinical Neuropsychologist","volume":" ","pages":"1581-1597"},"PeriodicalIF":3.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Atypical language organization in a Spanish-speaking adolescent with drug-resistant epilepsy: A multicultural case report.","authors":"Jenna A Chiang, Laura K Winstone-Weide, Dave F Clarke, Rosario C DeLeon","doi":"10.1080/13854046.2024.2405086","DOIUrl":"10.1080/13854046.2024.2405086","url":null,"abstract":"<p><p><b>Objective</b>: Epilepsy disproportionally affects children from Hispanic/Latino backgrounds, particularly among those born outside the U.S. Longstanding health-related disparities associated with ethnicity (e.g. language use) further contribute to gaps in care. Neuropsychologists are beginning to outline best practices when working with non-English speakers; however, the lack of appropriately normed/validated measures for pre-surgical language evaluation is a limiting factor. This report informs practices among neuropsychologists by discussing atypical language organization in a non-English speaker using a multicultural framework and collaborative therapeutic assessment process. <b>Method</b>: The current study presents a 16-year-old, right-handed, monolingual Spanish-speaking, Latina designated female with drug-resistant focal seizures with impaired awareness. Comprehensive presurgical epilepsy workup included: CBC, video EEG, brain MRI, functional MRI, PET, MEG, baseline neuropsychological evaluation by bilingual Spanish-English providers, and Wada testing. <b>Results</b>: Neuropsychological testing revealed the most pronounced deficits in language, working memory, and processing speed domains. Functional MRI showed bilateral language activation, which Wada testing confirmed along with bilateral memory representation. <b>Conclusion</b>: Diagnosis, treatment, surgical intervention, and post-operative status are discussed. The clinical course is examined through a multicultural lens, highlighting limitations in international health services, barriers accessing health care in the U.S., and patient-specific factors that were considered as a part of the clinical decision-making process. Targeted recommendations related to culturally-informed care are offered.</p>","PeriodicalId":55250,"journal":{"name":"Clinical Neuropsychologist","volume":" ","pages":"1722-1741"},"PeriodicalIF":3.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142332773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Right temporal variant frontotemporal dementia initially presenting with gradually progressing heading disorientation: A case report.","authors":"Yuta Komori, Masanori Kurihara, Ryoji Goto, Maki Obata, Kenji Ishibashi, Kenji Ishii, Aya Midori Tokumaru, Kazutomi Kanemaru, Katsuhiko Takeda, Atsushi Iwata","doi":"10.1080/13854046.2024.2428917","DOIUrl":"10.1080/13854046.2024.2428917","url":null,"abstract":"<p><p><b>Objective</b>: Previous studies of topographical disorientation have focused on cerebrovascular diseases. However, a detailed assessment of patients with neurodegenerative diseases may aid our understanding of spatial navigation. We report the case of a patient with right temporal variant frontotemporal dementia (rtvFTD) initially presenting with heading disorientation, a distinct category of topographical disorientation. <b>Method</b>: The patient was a 71-year-old woman with gradually increasing episodes of getting lost in a familiar environment. Detailed neuropsychological assessment, magnetic resonance imaging (MRI), and positron emission tomography (PET) studies were performed. <b>Results</b>: Topographical disorientation was conspicuous in the patients' cognitive dysfunction despite preserved general cognition. She could not dictate a route or draw a map from her nearest train station to her home, although she recognized environmental landmarks relatively well. Neuropsychological assessments, including the card-placing test, suggested heading disorientation. The MRI and PET abnormalities were large but confined to the right hemisphere and involved the retrosplenial region, an area associated with heading disorientation in cerebrovascular diseases, and the cortical areas that comprise a network together with the retrosplenial region. Amyloid PET was negative, ruling out Alzheimer's disease. Her topographical symptoms gradually worsened. Behavioral symptoms and loss of empathy gradually became apparent fulfilling the criteria for rtvFTD. <b>Conclusions</b>: Neuropsychological assessment revealed heading disorientation in the initial stage of rtvFTD. Based on previous studies, heading disorientation was likely attributed to neurodegeneration in the right hemispheric network centered in the retrosplenial region. The gradual progression of topographical symptoms contrasted with previous reports of heading disorientation due to cerebrovascular diseases.</p>","PeriodicalId":55250,"journal":{"name":"Clinical Neuropsychologist","volume":" ","pages":"1742-1759"},"PeriodicalIF":3.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}