VALIDITY OF COMPUTERIZED TESTING IN TOXIC ENCEPHALOPATHY

神经毒物对神经行为影响的流行病学研究 暴露是必要的，以了解可能的影响， 职业和环境环境中的化学品接触。的 计算机管理的神经行为评价系统成套测验 提供了一个更全面、更标准的方法来测量神经行为 与传统的纸笔相比， 临床神经心理学测试的类型。然而，传统的测试 已被验证，因此已被证明可测量s-f.c.。脑行为 关系（Lezak，1983）。内斯的确认过程正在进行中。 迄今为止所做的研究还没有评估计算机化版本的 标准测试测量相同水平的认知功能，例如， 按下电脑键表示对任务的积极反应 屏幕上呈现的内容涉及与口头上相同的处理过程 回答考官的问题最近的一项研究表明， 进行评估的能力，内斯检测预测 神经系统疾病患者的功能缺陷 涉及脑功能障碍，即早期帕金森病患者 多发性硬化症和局灶性中风。 拟议研究的目的是验证内斯在 诊断为中毒性脑病（即中枢神经系统）的患者 (CNS)为了改善化学品暴露造成的损害， 中枢神经系统研究中内斯试验性能解释 继发于化学品暴露的功能障碍在内斯上的表现 被诊断为溶剂性和铅性脑病的人将被比较 对比对照组的差异，看看这些差异是否反映了大脑的先天性， 行为关系。在内斯测试中的表现也将 与相关标准测试的性能相比。 这项研究将是重要的，在检查的敏感性和特异性 内斯检测指示神经毒剂的细微脑损伤 暴露。如果内斯被证明是毒性的有效预测因子， 脑病，它将提供一个重要的研究工具， 行为神经毒理学的流行病学研究和一个重要的 中毒性脑病患者随访护理的临床工具。

The epidemiologic study of neurobehavioral effects due to neurotoxicant exposure is necessary in order to understand the possible effects of chemical exposures in occupational and environmental settings. The computer-administered Neurobehavioral Evaluation System (NES) test battery provides a fuller, more standard method of measuring neurobehavioral effects in population groups, compared to the traditional paper and pencil type of clinical neuropsychologicaI tests. However, traditional tests have been validated and thus, have been shown to measure s-f.c.. brain-behavior relationships (Lezak, 1983). The validation process of the NES is ongoing. Studies done to date have not evaluated whether a computerized version of the standard test measures the same level of cognitive functioning, e.g. does pressing a computer key to indicate a positive response to a task presented on the screen involve the same processing 'as verbally responding to a question asked by an examiner? A recent study has been undertaken to evaluate the ability of the NES to detect predicted functional deficits in neurological patients diagnosed with diseases involving cerebral dysfunction, i.e. patients with early Parkinson's disease, multiple sclerosis, and focal strokes. The objective of the proposed study is to validate the use of the NES in patients diagnosed with toxic encephalopathy, i.e. central nervous system (CNS) damage caused by chemical exposure, in order to improve the interpretation of NES test performance in research studies of CNS dysfunction secondary to chemical exposures. Performance on the NES by persons diagnosed with solvent and lead encephalopathy 'will be compared to that of controls to see if the differences reflect a priori brain- behavior relationships. Performance on the NES tests 'will also be compared to performance on the associated standard tests. This study will be important in examining the sensitivity and specificity of the NES to detect subtle brain damage indicative of neurotoxicant exposures. If the NES is shown to be a valid predictor of toxic encephalopathy, it will provide an important research tool in epidemiologic studies of behavioral neurotoxicology and an important clinical tool in the follow-up care of patients with toxic encephalopathy.