Children and adolescents with Klinefelter syndrome (XXY) have been reported to show deficits in language processing including VIQ < PIQ and a learning disability in reading and spelling. However, whether this is characteristic of adults with Klinefelter syndrome has not been established. Thirty-five men with Klinefelter syndrome, aged 16 to 61, and 22 controls were evaluated with a comprehensive neuropsychological battery. The Klinefelter patients scored significantly below controls in language skills, verbal processing speed, verbal and nonverbal executive abilities, and motor dexterity. Within the Klinefelter sample, three cognitive subgroups were identified: VIQ 7 or more points below PIQ (n = 10), VIQ within 6 points of PIQ (n = 12), and PIQ 7 or more points below VIQ (n = 12). The deficits detected in language, verbal processing speed, and verbal executive skills were found to be isolated to the VIQ < PIQ subgroup, while the abnormalities in motor dexterity and nonverbal executive skills were confined to the PIQ < VIQ subgroup. Older age was significantly correlated with increases in VIQ relative to PIQ in the patient group, which suggests the intriguing possibility that the PIQ < VIQ subgroup primarily emerges in young adulthood, perhaps in response to the reported hormonal abnormalities detected in Klinefelter syndrome patients during puberty. (JINS, 2001, 7, 446–456)

Rapid rate of recovery has been associated with better outcome following closed-head injuries, but few studies have compellingly demonstrated this. This study used growth curve analyses of Disability Rating Scale (DRS) scores at acute hospitalization discharge, 1, 3, and 6 months post injury in a sample of 55 patients with a closed-head injury. Six month post-injury outcome measures were taken from significant other (SO) responses on the NYU Head Injury Family Interview (NYU-HIFI) including severity and burden ratings of affective/neurobehavioral disturbance, cognitive deficits, and physical/dependency status. Rate of recovery (linear and curvilinear recovery curve components) was significantly related to the level of affective/neurobehavioral severity, and the severity and burden of SO-perceived cognitive deficits. Only the intercept of the DRS recovery curve was associated with the SO-perceived severity and burden of physical/dependency status. Growth curve modeling is a meaningful and powerful tool in predicting head injury outcome. (JINS, 2001, 7, 457–467.)

The performance of 16 patients with Alzheimer's disease (AD) was compared to 11 patients with right-frontotemporal dementia (FTD) and 11 patients with left-FTD on a comprehensive neuropsychological battery. Standardized scores (i.e., z scores based on normal control data) were analyzed for 5 cognitive domains. The results revealed that the AD group displayed significant impairment in visual–constructional ability relative to the two FTD groups; however, no significant difference was found between the groups on memory scores (verbal and nonverbal). Patients with left-FTD scored significantly below patients with AD on the language measures (e.g., word retrieval, verbal semantic memory), and verbal executive ability (phonemic fluency); AD patients did not differ from patients with right-FTD on these measures. Patients with right-FTD exhibited significantly more perseverative behavior than AD patients; AD patients did not differ from left-FTD patients on this parameter. These results indicate that the pattern of neuropsychological performance of AD patients is distinguishable from patients with left and right frontal frontotemporal dementia. (JINS, 2001, 7, 468–480)

Schizophrenia spectrum patients (N = 143) and healthy controls (N = 160) were administered the Rey Auditory Verbal Learning Test (RAVLT) and tests of executive functioning to directly investigate the effects of proactive interference (PI) and retroactive interference (RI) on word list recall. It was hypothesized that by virtue of the predicted preferential association between executive functioning and RI (relative to PI), patients would demonstrate increased susceptibility to RI in their ability to recall word lists. Results indicated that patients show increased susceptibility to RI relative to PI. Furthermore, this difference appeared to be related to the frontally-mediated central executive functions that were preferentially associated with RI but not PI susceptibility. (JINS, 2001, 7, 481–490.)

Language deficits are a major characteristic of neurobehavioral dysfunction in pediatric HIV disease. An object decision task, which assessed reaction time facilitation following a semantic or identical prime in comparison to an unrelated prime, was used to investigate whether semantic processing abnormalities could be responsible, in part, for these deficits. Thirty children with vertically acquired HIV infection (M age 9.0 years; range 6–13) participated. Either a picture of the same object (repetition prime), a semantically related object (semantic prime), a semantically unrelated object, or a nonsense object preceded a target picture, which in 50% of the cases was a real object. Brain scans of children were rated and used together with neurobehavioral functioning to classify children as having HIV-related CNS abnormalities (n = 13) or not (n = 17). Increased semantic priming but not repetition priming was associated with a greater degree of cortical atrophy. Furthermore, CNS compromised children had significantly faster reaction times following a semantic prime compared to an unrelated prime than non-compromised patients. This facilitation following semantic priming for the CNS compromised patients (13.3%) almost equaled the facilitation following repetition priming (15.3%) while for the non-compromised patients facilitation following semantic priming (7.9%) was clearly smaller than following repetition priming (14.6%). These data suggest that HIV infection in children may result in a reduced neural network leading to impoverished semantic representations characterized by poor differentiation between closely related objects. (JINS, 2001, 7, 491–501.)

The CERAD Neuropsychological Battery, includes 7 measures: Verbal Fluency; Modified Boston Naming; Mini-Mental State; Word List Learning, Recall and Recognition; Constructional Praxis. It was originally developed to evaluate patients with a clinical diagnosis of Alzheimer's disease, but is increasingly used in epidemiological studies of the incidence and prevalence of dementia in the elderly. The current study reports norms for African American and White representative community residents 71 years of age and older in North Carolina, and compares performance with that of African Americans in Indianapolis and with Whites in the Monongahela Valley, Pennsylvania. For all 3 studies, increased education and younger age was related to better performance on each of the 7 measures. Sex differences, when present, tended to favor women. Although on average African Americans performed more poorly than Whites, with demographic characteristics controlled, no significant racial differences were found in the North Carolina sample. Both African American and White participants in North Carolina performed more poorly than their racial counterparts in the other 2 studies, possibly because of selection-induced differences in health and educational status. Nevertheless, the use of an identical evaluation battery, such as the CERAD neuropsychologic instrument, facilitates comparisons not otherwise possible, and should be encouraged. (JINS, 2001, 7, 502–509.)

A sample of 20 right-handed Aruaco Indians (12 male, 8 female; age 8–30 years) from the Sierra Nevada de Santa Marta (Colombia) participated in this study. A brief neuropsychological test battery (visuoconstructive and visuoperceptual abilities, memory, ideomotor praxis, verbal fluency, spatial abilities, concept formation) was individually administered. In addition, a handedness questionnaire was included. In some neuropsychological tests performance was virtually perfect (Recognition of Overlapped Figures and Ideomotor Praxis Ability test), whereas performance in other tests was impossible (e.g., Block Design using a time limit). It was proposed that two types of variables were significantly affecting performance: (1) educational level; and (2) cultural relevance. Some tests appeared significant and meaningful whereas others were meaningless and even impossible to understand. The appropriateness of current neuropsychological instruments for cross-cultural assessment is discussed. (JINS, 2001, 7, 510–515.)

The ability of subject F.F., diagnosed with Down syndrome, to appreciate nonliteral (interpreting metaphors and idioms) and literal (vocabulary knowledge, including highly specific and unusual items) aspects of language was investigated. F.F. was impaired in understanding both metaphors and idioms, while her phonological, syntactic and lexical–semantic skills were largely preserved. By contrast, some aspects of F.F.'s executive functions and many visuospatial abilities were defective. The suggestion is made that the interpretation of metaphors and idioms is largely independent of that of literal language, preserved in F.F., and that some executive aspects of working memory and visuospatial and imagery processes may play a role. (JINS, 2001, 7, 516–527.)

The stated intent of this rather hefty book is to “provide a readily available handbook for neuropsychology interns, fellows, and practicing clinicians,” with a focus on the “major differential diagnoses that neuropsychologists are routinely asked to make,” particularly in a hospital-based neuropsychological practice. These are optimistic goals that are frequently, although not always, fulfilled. The editors are to be commended for their success in organizing a knowledgeable and erudite group of contributors, who generally have conformed to the recommended stylistic and content guidelines. However, as is typical of most edited works, the stated intent(s) of the book are rather unevenly addressed in both the scope of the included topics and by the various authors. The book includes 30 chapters divided into five sections: General Issues (101 pp.), Pediatric Psychology (64 pp.), Geriatric Psychology (66 pp.), Neurological Disorders (159 pp.), and Neuropsychological Syndromes (225 pp.), and an appendix of medical abbreviations. The result is a not-so-brief handbook that is useful as a desk reference guide for students, interns, fellows, and nonneuropsychological clinicians working with neurological patients. For experienced neuropsychologists, the book is likely to be of less value due to its intentionally brief reviews of most topics.

Asperger's Syndrome, edited by Ami Klin and colleagues of the Yale University Child Study Center, contains contributions from 27 authors representing 13 universities, and several agencies and clinical practices in the United Kingdom, Canada, and the USA. This is a thorough and sorely needed review of the research, diagnostic process, treatment options, and outcomes associated with Asperger's syndrome (AS). Written for professionals, the volume is research-based, and in this relatively new field of study, is as useful in elucidating the questions still requiring investigation as in describing what is currently known. Several aspects of diagnosis are covered, including the development of AS as a formal diagnostic category, a review of clinical features and associated conditions, differential diagnostic considerations (particularly high functioning Autism, Schizoid Personality Disorder, developmental language disorders, and Nonverbal Learning Disability), and special consideration of the contributions of motor functioning, social language use, and neuropsychological functioning to differential diagnosis. Of special interest to neuropsychologists may be the chapter reviewing neuropsychological and neuroimaging studies of AS, from which inferences can be drawn about potential neurodevelopmental processes leading to the manifestations of this disorder. Other chapters focus on genetic factors, clinical outcomes in adolescence and adulthood, pharmacological intervention, and general treatment considerations. A chapter on assessment suggests practical guidelines for assessment of cognitive, neuropsychological, communicative, social–emotional, and adaptive functioning. A set of essays by parents closes the volume, providing an important reconnection to the everyday challenges faced by individuals with AS and their families.

The authors of this compact and readable book, a neurologist and neuropsychologist, have attempted to present an overview of material necessary for the establishment of a clinic to treat those who have suffered a MHI. While the authors are clearly experts in the treatment of these patients and have presented many interesting points from a unique perspective, several limitations narrow the application of the authors' suggestions.

The six chapters of this compact volume provide an economical introduction to the symptomology, assessment, and treatment approaches to visuospatial neglect. Neglect researchers may find themselves slightly disappointed by the scant attention devoted to theoretical issues regarding neural mechanisms or etiology. To be fair, however, the authors acknowledge that theoretical synthesis is not the purpose of the book,which is aimed primarily at an audience of clinicians and therapists. As such, this monograph admirably fulfills its mission, which is to provide a succinct but comprehensive overview of the clinical assessment and rehabilitation of neglect disorders.

Working memory is one of the hot topics in cognitive neuroscience. It is purported to be involved in most cognitive operations from attention to learning to executive functioning to consciousness. Theoretical conceptualizations are equally diverse, with models emphasizing cognitive processes, biological structures, and neural computations.

This collection of case studies demonstrates an ideal in the practice of neuropsychological rehabilitation. In each of the 20 case studies presented, Barbara Wilson's treatment approach is guided by a firm foundation in scientific theory, while maintaining the flexibility and creativeness characteristic of an art.