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Advanced Neurology PVT in Indonesian neurological patients

one culture may not automatically apply to others. 13,24,25 semantic category as the ones on the first page (e.g., udang
Finally, we anticipate a significant intercorrelation between [prawn], terasi [prawn paste], ikan [fish], kaviar [caviar],
PVT scores, as well as correlations between age, educational cumi [squid]) are displayed. The examinee is then asked to
level, and overall cognitive function. identify and name three words that appeared on the first
page (i.e., udang [shrimp], ikan [fish], and cumi [squid]).
2. Materials and methods The test administrator provides feedback by stating the
2.1. Materials number of correct responses. All stimuli are presented in
Bahasa Indonesia. Based on the original ASTM manual,
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2.1.1. NV-MSVT (Green, 2008) the cut-off for determining invalid performance is a score
The NV-MSVT is a computerized PVT that uses colored below 85. However, in a previous simulation study, we
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images as stimuli. Several scores are obtained from this test: suggested increasing the cut-off score to below 89.
immediate recognition (IR), delayed recognition (DR),
consistency (CNS), DR variations (DRV), DR archetypes 2.1.3. RDS, LDF-1, and LDF-2
(DRA), paired associates (PA), and free recall (FR). More The RDS, LDF-1, and LDF-2 are embedded validity
detailed information on these scores is provided in the test measures derived from the Digit Span (DS). This study
manual. 26 used the DS from the Wechsler Adult Intelligence Scale-
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The NV-MSVT manual classifies “pass” or “fail” Fourth Edition-Indonesian version. Although the RDS
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scores based on the examinee’s performance on the “easy” was initially developed for the WAIS-R, its diagnostic
subtests first, which are reflected in Criterion A (composed ability has been established and found comparable to later
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of Criteria A1 and A2). Criterion A1 is met if the mean versions of the WAIS. The RDS is the most commonly
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of IR, DR, CNS, DRA, DRV, and PA is ≤90. Criterion A2 used embedded PVT in neuropsychological assessment.
is met if the mean of DR, CNS, DRA, and DRV is ≤88. The RDS score is calculated by summing the raw scores for
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In addition to these original cut-off scores, our previous the longest forward and backward DSs with no errors in
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simulation study suggested lowering Criteria A1 and A2 both trials. The LDF-1 is the longest span in the forward
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to ≤87 and ≤81, respectively, to maintain a specificity of condition in which at least one trial of a given pair is
0.90. If an examinee fails either Criterion A1 or Criterion repeated correctly, and the LDF-2 is the longest span in
A2, the patient’s performance on Criterion B (composed of the forward condition in which both trials are repeated
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Criteria B1, B2, and B3) should be examined to determine correctly. The original cut-off scores for the RDS, LDF-
whether the failure is due to invalid performance or severe 1, and LDF-2 were ≤6, ≤4, and ≤3, respectively. 33,34 In a
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cognitive impairment. This approach is also known as previous simulation study, an increased cut-off score for
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the “genuine memory impairment profile” approach. the RDS of ≤7 was recommended, while the cut-off scores
Criterion B1 is met if PA - (DR + CNS + DRA + DRV)/4 for LDF-1 and LDF-2 remained unchanged.
is >−11. Criterion B2 is met if (IR + DR + CNS)/3 - (PA 2.2. Participants
+ FR)/2 is <20. Finally, Criterion B3 is met if the IR,
DR, CNS, DRA, and DRV standard deviations are ≥12. Our study was prospective in design. Eligible participants
Failure on at least two of these criteria indicates invalid were adults (≥18 years) with neurological disorders. A total
performance. We calculated Criteria A and B for all of 141 participants were recruited for this study, and they
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participants according to the formulas outlined above. were divided into three groups: those with a neurocognitive
disorder due to possible neurodegenerative disease (ND)
2.1.2. TMJPI (n = 50), patients with a history of stroke (PS; n = 42),
The TMJPI is a standalone, paper-and-pencil PVT and a mixed-etiology group (n = 47). The mixed-etiology
constructed based on the Amsterdam Short-Term Memory group consisted of individuals diagnosed with epilepsy
(ASTM) test. 27,28 The TMJPI test booklet consists of two (n = 20), TBI (n = 7), brain tumor (n = 6), Parkinson’s
training items and 30 test items. Each item consists of three disease (n = 5), multiple sclerosis (MS; n = 4), cerebral
pages. On the first page, the examinee is presented with small vessel disease (CSVD; n = 2), neuropathy (n = 2),
five stimulus words from a common semantic category, and chronic migraine (n = 1). Participants with Parkinson’s
such as seafood (e.g., ikan [fish], cumi [squid], kerang disease were included in the mixed-etiology group, as they
[oyster], kepiting [crab], udang [shrimp]). The examinee is constituted a small subgroup, and their cognitive status was
asked to read these words aloud and memorize them. On likely better than that of the ND patients (e.g., Parkinson’s
the next page, a distractor is shown in the form of a simple disease participants were able to provide consent, while
addition or subtraction task (e.g., 5 + 2 = ?), which must ND participants were not). Group classifications were
be solved. On the third page, the five words from the same based on the primary diagnosis made by the neurologist,

Volume 4 Issue 2 (2025) 88 doi: 10.36922/an.5661