The Rao’s Brief Repeatable Battery and Stroop test: normative values with age,education and gender corrections in an Italian population

Abstract

The Brief Repeatable Battery of Neuropsychological Tests (BRB) is by far the most widely used instrument to estimate cognitive dysfunction in multiple sclerosis (MS) patients. However, the paucity of normative data currently limits its applicability. We administered the BRB to 200 healthy subjects to obtain normative values. Moreover, we assessed the influence of demographic factors on the test scores and calculated corrections for these relevant factors. To test executive functions not explored by the BRB, we also included the Stroop word-color task (ST). Higher educational level was associated with better performance on all the tests, except for the world list generation (WLG) and the ST, considering version A, and on Symbol Digit Modalities Test (SDMT), Paced Auditory Serial Addition Test (PASAT) and Selective Reminding Test-Delayed (SRT-D), considering version B. Females performed better than males on the WLG considering version A, and on the SRT-Long Term Storage (SRT-LTS) and SRT-Consistent Long Term Retrieval (SRT-CLTR) considering version B. Increasing age was associated with worse performance on the ST in version A, and on the SRT-LTS, SRT-CLTR and WLG in version B. Our data can improve the applicability of the BRB for both clinical and research purposes.

Keywords

Brief Repeatable Battery cognitive impairment multiple sclerosis normative values Stroop test

Get full access to this article

View all access options for this article.

References

Bobholz JA , Rao SM. Cognitive dysfunction in multiple sclerosis: a review of recent developments . Curr Opin Neurol 2003; 16: 283-288 .

Amato MP , Ponziani G , Siracusa G , Sorbi S. Cognitive dysfunction in early-onset multiple sclerosis: a reappraisal after 10 years . Arch Neurol 2001; 58: 1602-1606 .

Jacobs JW , Bernhard MR , Delgado A , Strain JJ. Screening for organic mental syndromes in the medically ill . Ann Intern Med 1977; 86: 40-46 .

Beatty WW , Goodkin DE. Screening for cognitive impairment in multiple sclerosis. An evaluation of the Mini-Mental State Examination . Arch Neurol 1990; 47: 297-301 .

Mahler ME , Davis RJ , Benson DF. Screening multiple sclerosis patients for cognitive impairment. In Jensen K , Knudsen L , Stenager E , Grant I eds. Current problems in neurology, 10. Mental disorders and cognitive deficits in multiple sclerosis. Libbey , 1989: 11-14.

Rao SM , and the Cognitive Function Study Group of the National Multiple Sclerosis Society . A manual for the Brief Repeatable Battery of Neuropsychological Tests in multiple sclerosis. Medical College of Wisconsin , 1990.

Rao SM , Leo GJ , Bernardin L , Unverzagt F. Cognitive dysfunction in multiple sclerosis. I. Frequency, patterns, and prediction . Neurology 1991; 41: 685-691 .

Peyser JM , Rao SM , LaRocca NG , Kaplan E. Guidelines for neuropsychological research in multiple sclerosis . Arch Neurol 1990; 47: 94-97 .

Bever CT Jr , Grattan L , Panitch HS , Johnson KP. The Brief Repeatable Battery of Neuropsychological Tests for multiple sclerosis: a preliminary serial study . Mult Scler 1995; 1: 165-169 .

10.

Boringa JB , Lazeron RH , Reuling IE , Ader HJ , Pfennings L , Lindeboom J et al. The Brief Repeatable Battery of Neuropsychological Tests: normative values allow application in multiple sclerosis clinical practice . Mult Scler 2001; 7: 263-267 .

11.

Camp SJ , Stevenson VL , Thompson AJ , Miller DH , Borras C , Auriacombe S et al. Cognitive function in primary progressive and transitional progressive multiple sclerosis: a controlled study with MRI correlates . Brain 1999; 122: 1341-1348 .

12.

Scherer P , Baum K , Bauer H , Gohler H , Miltenburger C. [Normalization of the Brief Repeatable Battery of Neuropsychological tests (BRB-N) for German-speaking regions. Application in relapsing-remitting and secondary progressive multiple sclerosis patients] . Nerve-narzt 2004; 75: 984-990 .

13.

Stroop JR. Studies of interference in serial verbal reactions . J Exp Psychol 1935; 18: 643-662 .

14.

Solari A , Mancuso L , Motta A , Mendozzi L , Serrati C. Comparison of two brief neuropsychological batteries in people with multiple sclerosis . Mult Scler 2002; 8: 169-176 .

15.

Buschke H , Fuld PA. Evaluating storage, retention, and retrieval in disordered memory and learning . Neurology 1974; 24: 1019-1025 .

16.

Barbizet J , Cany E. Clinical and psychometrical study of a patient with memory disturbances . Int J Neurol 1968; 7: 44-54 .

17.

Smith A. Symbol digit modalities test. Western Psychological Services , 1991.

18.

Gronwall DM. Paced Auditory Serial-Addition Task: a measure of recovery from concussion . Percept Mot Skills 1977; 44: 367-373 .

19.

Barbarotto R , Laiacona M , Frosio R , Vecchio M , Farinato A , Capitani E. A normative study on visual reaction times and two Stroop colour-word tests . Ital J Neurol Sci 1998; 19: 161-170 .

20.

Lezak MD. Neuropsychological assessment, second edition. Oxford University Press , 1983.

21.

Spinnler H , Tognoni G. Standardizzazione e Taratura Italiana di Test Neuropsicologici . Ital J Neurol Sci 1987; 6: 8-21 .

22.

Sperling RA , Guttmann CR , Hohol MJ , Warfield SK , Jakab M , Parente M et al. Regional magnetic resonance imaging lesion burden and cognitive function in multiple sclerosis: a longitudinal study . Arch Neurol 2001; 58: 115-121 .

23.

Hohol MJ , Guttmann CR , Orav J , Mackin GA , Kikinis R , Khoury SJ et al. Serial neuropsychological assessment and magnetic resonance imaging analysis in multiple sclerosis . Arch Neurol 1997; 54: 1018-1025 .

24.

Smits RC , Emmen HH , Bertelsmann FW , Kulig BM , van Loenen AC , Polman CH. The effects of 4-aminopyridine on cognitive function in patients with multiple sclerosis: a pilot study . Neurology 1994; 44: 1701-1705 .

25.

Ruff RM , Light RH , Parker SB , Levin HS. Benton Controlled Oral Word Association Test: reliability and updated norms . Arch Clin Neuropsychol 1996; 11: 329-338 .

26.

Stuss DT , Stethem LL , Poirier CA. Comparison of three tests of attention and rapid information processing across six age groups . Clin Neuropsychol 1987; 1: 139-152 .

27.

Brittain JL , La Marche JL , Reeder KP , Kenneth P. Effects of age and IQ on Paced Auditory Serial Addition Task (PASAT) performance . Clin Neuropsychol 1991; 5: 163-175 .

28.

Larabee GJ , Trahan DE , Curtiss G , Levin HS. Normative data for the verbal selective reminding test . Neuropsychology 1988; 2: 173-182 .

29.

Nocentini U , Rossini PM , Carlesimo GA , Graceffa A , Grasso MG , Lupoi D et al. Patterns of cognitive impairment in secondary progressive stable phase of multiple sclerosis: correlations with MRI findings . Eur Neurol 2001; 45: 11-18 .

30.

Pujol J , Vendrell P , Deus J , Junqué C , Bello J , Mart1`-Vilalta JL et al. The effect of medial frontal and posterior parietal demyelinating lesions on Stroop interference . Neuroimage 2001; 13: 68-75 .

31.

van den Burg W , van Zomeren AH , Minderhoud JM , Prange AJ , Meijer NS. Cognitive impairment in patients with multiple sclerosis and mild physical disability . Arch Neurol 1987; 44: 494-501 .

32.

Venturini R, Lombardo Radice M, Imperiali MG. Il ‘colour-word test’ o test di Stroop. Organizzazioni Speciali, 1983.

33.

Fischer JS , Priore RL , Jacobs LD , Cookfair DL , Rudick RA , Herndon RM et al. Neuropsychological effects of interferon beta-1a in relapsing multiple sclerosis. Multiple Sclerosis Collaborative Research Group . Ann Neurol 2000; 48: 885-892 .

34.

Sawrie SM , Chelune GJ , Naugle RI , Luders HO. Empirical methods for assessing meaningful neuropsychological change following epilepsy surgery . J Int Neuropsychol Soc 1996; 2: 556-564 .

35.

Temkin NR , Heaton RK , Grant I , Dikmen SS. Detecting significant change in neuropsychological test performance: a comparison of four models . J Int Neuropsychol Soc 1999; 5: 357-369 .