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Computerized reaction time battery versus a traditional neuropsychological battery: Detecting HIV-related impairments

Published online by Cambridge University Press:  13 January 2003

Gonzalez Raul ,
Heaton Robert K. ,
Moore David J. ,
Letendre Scott ,
Ellis Ronald J. ,
Wolfson Tanya ,
Marcotte Thomas ,
Cherner Mariana ,
Rippeth Julie  and
Grant Igor
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Gonzalez Raul*
Affiliation:
HIV Neurobehavioral Research Center and University of California, San Diego, CA San Diego State University/University of California, San Diego—Joint Doctoral Program in Clinical Psychology, CA
Heaton Robert K.
Affiliation:
HIV Neurobehavioral Research Center and University of California, San Diego, CA San Diego State University/University of California, San Diego—Joint Doctoral Program in Clinical Psychology, CA Department of Psychiatry, University of California, San Diego, CA
Moore David J.
Affiliation:
HIV Neurobehavioral Research Center and University of California, San Diego, CA San Diego State University/University of California, San Diego—Joint Doctoral Program in Clinical Psychology, CA
Letendre Scott
Affiliation:
HIV Neurobehavioral Research Center and University of California, San Diego, CA
Ellis Ronald J.
Affiliation:
HIV Neurobehavioral Research Center and University of California, San Diego, CA Department of Neurosciences, University of California, San Diego, CA
Wolfson Tanya
Affiliation:
HIV Neurobehavioral Research Center and University of California, San Diego, CA
Marcotte Thomas
Affiliation:
HIV Neurobehavioral Research Center and University of California, San Diego, CA Department of Psychiatry, University of California, San Diego, CA
Cherner Mariana
Affiliation:
HIV Neurobehavioral Research Center and University of California, San Diego, CA Department of Psychiatry, University of California, San Diego, CA
Rippeth Julie
Affiliation:
HIV Neurobehavioral Research Center and University of California, San Diego, CA Department of Psychiatry, University of California, San Diego, CA
Grant Igor
Affiliation:
HIV Neurobehavioral Research Center and University of California, San Diego, CA Department of Psychiatry, University of California, San Diego, CA VA San Diego Healthcare System, San Diego, CA
The Hnrc Group
Affiliation:
The San Diego HIV Neurobehavioral Research Center [HNRC] group is affiliated with the University of California, San Diego, the Naval Hospital, San Diego, and the San Diego Veterans Affairs Healthcare System, and includes: Director: Igor Grant, M.D.; Co-Directors: J. Hampton Atkinson, M.D. and J. Allen McCutchan, M.D.; Center Manager: Thomas D. Marcotte, Ph.D.; Naval Hospital San Diego: Mark R. Wallace, M.D. (P.I.); Neuromedical Component: J. Allen McCutchan, M.D. (P.I.), Ronald J. Ellis, M.D., Scott Letendre, M.D., Rachel Schrier, Ph.D.; Neurobehavioral Component: Robert K. Heaton, Ph.D. (P.I.), Mariana Cherner, Ph.D., Julie Rippeth, Ph.D.; Imaging Component: Terry Jernigan, Ph.D. (P.I.), John Hesselink, M.D.; Neuropathology Component: Eliezer Masliah, M.D. (P.I.); Clinical Trials Component: J. Allen McCutchan, M.D., J. Hampton Atkinson, M.D., Ronald J. Ellis, M.D., Ph.D., Scott Letendre, M.D.; Data Management Unit: Daniel R. Masys, M.D. (P.I.), Michelle Frybarger, B.A. (Data Systems Manager); Statistics Unit: Ian Abramson, Ph.D. (P.I.), Reena Deutsch, Ph.D., Tanya Wolfson, M.A.VA San Diego Healthcare System, San Diego, CA)
*
Reprint requests to: Raul Gonzalez, HIV Neurobehavioral Research Center (HNRC), University of California, San Diego, 150 West Washington Street, 2nd Floor, San Diego, CA 92103. E-mail: [email protected]
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Abstract

In recent years, interest in the use of computerized neuropsychological (NP) assessment measures has increased. However, there are limited data regarding how performance on these measures relates to performance on more traditional, clinical instruments. In the present study, 82 HIV+ men, who were all believed on clinical grounds to have neurobehavioral impairment, completed a traditional NP battery (TNB) and the California Computerized Assessment Package (CalCAP, a collection of computerized reaction time tests). Summary scores based on a TNB, as well as those based on the CalCAP, demonstrated significant associations with both degree of immunosuppression (CD4 count) and detectable viral load in cerebrospinal fluid, but not with detectable viral load in plasma. Established norms on the TNB and CalCAP batteries resulted in classifying 57% and 49% of the HIV+ sample as impaired, respectively. When using the TNB as the “gold standard,” impairment classifications based on CalCAP summary scores exhibited a sensitivity of 68% and a specificity of 77%. Overall agreement on impairment classifications between batteries was low (kappa = .44). Data from this study suggest that traditional NP batteries and computerized reaction time tests do not measure the same thing, and are not interchangeable in examining HIV-related NP impairments. (JINS, 2003, 9, 64–71.)

Keywords

Neuropsychological assessmentHIVReaction timeCalCAPComputerized testingSensitivityCSF viral loadCD4
Type
Research Article
Information
Journal of the International Neuropsychological Society , Volume 9 , Issue 1 , January 2003 , pp. 64 - 71
Copyright
Copyright © The International Neuropsychological Society 2003

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