Luria-Nebraska Neuropsychological Battery

Definition

The Luria-Nebraska Neuropsychological Battery, also known as LNNB or Luria-Nebraska Battery, is a standardized test battery used in the screening and evaluation of neuropsychologically impaired individuals.

Purpose

The LNNB was developed in an attempt to combine the qualitative techniques of some neuropsychological tests with the quantitative techniques of others. However, the scoring system that most clinicians use is primarily quantitative. The battery measures specific neuropsychological functioning in several areas including motor skills, language abilities, intellectual abilities, nonverbal auditory skills, and visual-spatial skills.

The battery is used by clinicians as a screening tool to determine whether a significant brain injury is present or to learn more about known brain injuries. It is also used to determine what the patient is or is not able to do with regard to neuropsychological functioning. For example, the LNNB may be used to determine which intellectual or cognitive tasks a patient may or may not be able to complete. The battery can also be used to arrive at underlying causes of a patient's behavior. More specifically, information regarding the location and nature of the brain injury or dysfunction causing a patient's problems is collected.

The LNNB is also used to help distinguish between brain damage and functional mental disorders such as schizophrenia . Also, within the category of schizophrenia, the battery can be used to help distinguish between patients with normal neuropsychological functioning and those with clear deficits. Besides its specifically clinical use, the battery is sometimes used for legal purposes— the presence or severity of a brain injury may be measured as part of an evaluation used in the court system.

Precautions

Because of the length of the test and complexity in interpretation, the examiner must be competent and properly trained. Also, the fact that many patients are, indeed, brain damaged can make test administration difficult or frustrating.

Description

The LNNB is based on the work of A. R. Luria, a Russian neuropsychologist who performed pioneering theoretical and clinical work with regard to brain function. Luria believed in a primarily qualitative approach to assessment and was opposed to standardization. He did not believe that neuropsychological functioning could be measured quantitatively. Thus, although his name is part of the test itself, his contribution to the LNNB is entirely theoretical. Also, the LNNB is based, in part, on Luria's Neuropsychological Investigation, a measure developed by Christensen in 1975. This test included items asked by Luria in his clinical interviews, some of which are used in the LNNB.

The battery, written in 1981 by Charles Golden, is appropriate for people aged 13 and older and takes between 90 and 150 minutes to complete. It consists of 269 items in the following 11 clinical scales:

• reading
• writing
• arithmetic
• visual
• memory
• expressive language
• receptive language
• motor function
• rhythm
• tactile
• intellectual

Scores for three summary scales can also be calculated: pathognomonic, right hemisphere, and left hemisphere. A children's version of the battery, called the Luria-Nebraska Neuropsychological Battery for Children (LNNB-C), appropriate for children aged eight to 12, is also available.

Results

The probability of brain damage is assessed by comparing an individual's score on each of the battery's 11 clinical scales to a critical level appropriate for that person's age and education level. For example, if a person has five to seven scores above the critical level, they most likely have some sign of neurological impairment. Eight or more scores above the critical level indicate a clear history of neurological disorder.

The battery has been criticized by researchers on the grounds that it overestimates the degree of neuropsychological impairment. In other cases, it has been found to fail to detect neuropsychological problems. Also, the intellectual processes scale has not been found to correspond well to other measures of intelligence, such as the Wechsler Adult Intelligence Scale (WAIS).

Other research, however, has found it to be a useful measure. It has been found as effective as the Halstead-Reitan Battery in distinguishing between brain-damaged individuals and nonbrain-damaged individuals with psychiatric problems. Part of the inconsistencies in opinion regarding the LNNB may be due to the specific nature of the population being tested by the battery and the difficulties in administration and scoring that some clinicians experience.

See also Intelligence tests; Kaufman Assessment Battery for Children; Kaufman Short Neuropsychological Assessment; Neuropsychological testing

Resources

BOOKS

Golden, Charles J., and Shawna M. Freshwater. "Luria-Nebraska Neuropsychological Battery" In Understanding Psychological Assessment: Perspectives on Individual Differences, edited by William I. Dorfman and Michael Hersen. New York: Kluwer Academic/Plenum Publishers, 2001.

Golden, Charles J., Shawna M. Freshwater, and Jyothi Vayalakkara. "The Luria-Nebraska Neuropsychological Battery." In Neuropsychological Assessment in Clinical Practice: A Guide to Test Interpretation and Integration, edited by Gary Groth-Marnat. New York: John Wiley and Sons, 2000.

Lezak, Muriel D. Neuropsychological Assessment. New York: Oxford University Press, 1995.

Moses, James A., Jr., Ph.D., Charles J. Golden, Ph.D., Rona Ariel, Ph.D., and John L. Gustavson, Ph.D. Interpretation of the Luria-Nebraska Neuropsychological Battery. Volume 1. New York: Grune and Stratton, 1983.

Strub, Richard L., M.D., and F. William Black, Ph.D. The Mental Status Exam in Neurology. Philadelphia: F. A. Davis, 2000.

Ali Fahmy, Ph.D.