The MCMI-III is a survey that helps to quickly and accurately assess DSM-IV related personality disorders and clinical syndromes. The MCMI-III is distinguished from other inventories primarily by its brevity, theoretical anchoring, multiaxial format, tripartite construction and validation schema, use of base rate scores, and interpretive depth. At 175 items, the MCMI-III inventory is much shorter than comparable instruments. Terminology is geared to an eighth-grade reading level. The great majority of patients can complete the MCMI-III in 20 to 30 minutes, facilitating relatively simple and rapid administrations while minimizing patient resistance and fatigue. Unlike the DSM which has hundreds of diagnoses, the Millon creates a concise and specific profile of up to 27 psychiatric diagnoses.
The TOVA uses geometric stimuli and contains two test conditions: target infrequent and target frequent. In the first half of the test (the target infrequent half), the target:nontarget ratio is 1:3.5, ie a target is presented (randomly) only once every 3.5 nontarget presentations. In this half, the task is boring and fatiguing, and the subject must pay close attention to respond to the infrequent target correctly. When a subject does not respond to the target, it is called an error of omission and is a measure of inattention. In the second half of the test (target frequent half), the target: nontarget ratio is 3.5:1, ie 3.5 targets are presented for every 1 nontarget. In this half of the test, the subject expects to respond most of the time but occasionally must inhibit the tendency to respond. When a subject responds to the nontarget, it is called an error of commission and is a measure of impulsivity. Thus the ability to pay attention to a boring, repetitive task is beast measured in the first half of the TOVA, while the ability to inhibit oneself is best measured in the second half. The TOVA uses a specially designed microswitch with an insignificant error of measurement (+/- 1 msec) and which minimizes muscular fatigue. The TOVA immediately analyzes the results quarter by quarter and provides written interpretation and graphics. With hundreds of thousands of deaths from attention-related accidents per year, we need a good way of measuring attention function. The TOVA measures 4 types of attention errors: commission errors, omission errors, response time, and response time variability. Each of the errors are suggestive of the kinds of mistakes and accidents patients will experience.
Wechsler Memory Scale:
The WMS-III is an individually administered battery of learning, memory, and working memory measures. The test is comprised of 11 subtests, with 6 primary and 5 optional; for this study we will use the 6 primary and obtain measures of auditory immediate, visual immediate, immediate, and working memory. The primary subtests can be administered by trained examiners in about 30-35 minutes. Normative scores were developed using a stratified, nationally representative sample of 1,250 healthy adults. This memory test measures visual immediate, auditory immediate, immediate and working memory.
Randt Memory Test:
The RMT consists of seven modules and is designed to measure memory function over broad spectrum of mild to moderate deficits. This test battery has been demonstrated to be a sensitive and reliable instrument for repetitive quantitative measurement of important aspects of memory. It has similar components to the WMS-III in some sections: paired words, short story, picture recognition, but it also assesses acquisition and recall after several trials, and has a 24 hour later component to assess long-term memory. Since each administration booklet has several different forms, the RMT can be used several times on one patient. Although some parts of this test overlap with the WMS, the RMT also has a long-term component.
The BEAM is a computerized EEG. The P300 wave is an event related potential that can be recorded via EEG as a positive deflection in voltage at a latency of roughly 300 + age millesconds. The presence, magnitude, topography, and time of this signal can measure processing speed. Our laboratory has shown P300 latency as an early measure of, and a better predictor of preclinical dementia than memory or mental status tests. Prolonged P300 latency is an antecedent to memory loss and cognitive decline. This test can support the information learned in the other measures of cognition. Different parameters of the BEAM have been correlated with different neurotransmitter systems to provide a basis for the cognitive symptoms and how to reverse them.
Eric R. Braverman, M.D.
Dr. Braverman is a Summa Cum Laude and Phi Beta Kappa graduate of Brandeis University and NYU Medical School, did brain research at Harvard Medical School, and trained at an affiliate of Yale Medical School. He is acknowledged worldwide as an expert in brain-based diagnosis and treatment, and he lectures to and trains doctors in anti-aging medicine.