Normative values of the Brief Repeatable Battery of Neuropsychological Tests in a Brazilian population sample: discrete and regression–based norms

Damasceno, Alfredo; Amaral, Juliana Machado Santiago dos Santos; Barreira, Amilton Antunes; Becker, Jefferson; Callegaro, Dagoberto; Campanholo, Kenia Repiso; Damasceno, Luciana Azevedo; Diniz, Denise Sisterolli; Fragoso, Yara Dadalti; Franco, Paula S; Finkelsztejn, Alessandro; Jorge, Frederico M H; Lana–Peixoto, Marco Aurélio; Matta, Andre Palma da Cunha; Mendonça, Andréia Costa Rabelo; Noal, Janaína; Paes, Renata Alves; Papais–Alvarenga, Regina Maria; Pereira, Adriana Gutterres; Spedo, Carina Tellaroli; Damasceno, Benito Pereira

doi:10.1590/0004-282X20180006

Brasil

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Articles • Arq. Neuro-Psiquiatr. 76 (3) • Mar 2018 • https://doi.org/10.1590/0004-282X20180006 linkcopy

Normative values of the Brief Repeatable Battery of Neuropsychological Tests in a Brazilian population sample: discrete and regression–based norms

Valores normativos da Brief Repeatable Battery of Neuropsychological Tests (BRB–N) em uma amostra da população Brasileira: dados discretos e contínuos

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective Cognitive dysfunction is common in multiple sclerosis. The Brief Repeatable Battery of Neuropsychological Tests (BRB–N) was developed to assess cognitive functions most–frequently impaired in multiple sclerosis. However, normative values are lacking in Brazil. Therefore, we aimed to provide continuous and discrete normative values for the BRB–N in a Brazilian population sample.

Methods We recruited 285 healthy individuals from the community at 10 Brazilian sites and applied the BRB–N version A in 237 participants and version B in 48 participants. Continuous norms were calculated with multiple–regression analysis.

Results Mean raw scores and the 5^th percentile for each neuropsychological measure are provided, stratified by age and educational level. Healthy participants' raw scores were converted to scaled scores, which were regressed on age, sex and education, yielding equations that can be used to calculate predicted scores.

Conclusion Our normative data allow a more widespread use of the BRB–N in clinical practice and research.

Keywords cognition; multiple sclerosis; neuropsychology

Variable	Total (n = 285)	BRB–N Version A (n = 237)	BRB–N Version B (n = 48)	Comparisons^* * Group comparisons were performed with Mann–Whitney U tests, except for percentage distribution, where Fisher's exact test was used.
Male/Female: %	42.6/57.4	44.5/55.5	33.3/66.7	p = 0.199
Age: years (range)	38.14 ± 13.37 (18–66)	37.72 ± 13.40 (18–66)	38.23 ± 11.79 (18–64)	p = 0.599
Education: years (range)	12.34 ± 3.68 (4–22)	12.24 ± 3.59 (3–22)	11.98 ± 4.06 (4–21)	p = 0.693
MMSE: total score (range)	28.51 ± 1.54 (23–30)	28.51 ± 1.57 (23–30)	28.52 ± 1.46 (25–30)	p = 0.948
SRT–LTS	50.17 ± 11.98 (6–71)	49.41 ± 12.33 (6–71)	53.58 ± 9.64 (22–69)	p = 0.037
SRT–CLTR	39.18 ± 14.28 (2–71)	38.18 ± 14.49 (2–71)	43.71 ± 12.46 (17–69)	p = 0.011
SRT–DR	9.27 ± 2.02 (2–12)	9.18 ± 2.07 (2–12)	9.69 ± 1.73 (6–12)	p = 0.167
SpRT	21.35 ± 5.34 (8–30)	21.09 ± 5.22 (8–30)	22.35 ± 5.76 (10–30)	p = 0.104
SpRT–DR	7.54 ± 2.05 (1–10)	7.43 ± 2.00 (1–10)	8.02 ± 2.18 (3–10)	p = 0.036
SDMT	55.89 ± 18.75 (12–110)	55.26 ± 19.54 (12–110)	58.69 ± 14.67 (16–90)	p = 0.054
PASAT	39.28 ± 13.01 (8–60)	39.57 ± 12.88 (8–60)	38.00 ± 13.66 (13–58)	p = 0.452
WLG	24.25 ± 7.04 (5–42)	23.88 ± 7.00 (5–42)	25.85 ± 7.07 (12–42)	p = 0.093

Age	BRB-N subtests	Educational level
		6–11 years		≥ 12 years
		Mean ± SD	5th percentile	Mean ± SD	5th percentile
18–30	SRT- LTS	50.60 ± 8.97	34.2	54.74 ± 10.54	36.5
	SRT–CLTR	36.65 ± 11.68	18.2	45.68 ± 14.42	23.9
	SpRT	21.58 ± 5.55	10.0	23.62 ± 4.10	15.0
	SDMT	59.88 ± 25.04	38.0	64.82 ± 14.45	44.65
	PASAT	35.11 ± 15.01	10.0	41.63 ± 11.30	23.8
	SRT–DR	9.52 ± 1.54	6.0	10.15 ± 1.54	6.95
	SpRT–DR	7.76 ± 1.98	3.0	8.50 ± 1.47	5.95
	WLG	17.41 ± 6.04	5.0	27.00 ± 6.58	16.75
31–45	SRT- LTS	48.04 ± 12.50	20.45	50.06 ± 11.01	31.5
	SRT–CLTR	34.77 ± 12.80	13.9	41.15 ± 14.39	19.25
	SpRT	20.00 ± 5.39	9.2	22.25 ± 3.92	15.2
	SDMT	46.57 ± 18.27	26.1	60.51 ± 16.30	38.6
	PASAT	33.38 ± 11.78	14.1	47.51 ± 8.61	29.0
	SRT–DR	7.95 ± 2.76	2.3	9.46 ± 1.80	6.0
	SpRT–DR	7.14 ± 2.61	1.2	7.53 ± 2.02	4.0
	WLG	23.23 ± 5.61	9.8	27.53 ± 6.13	20.0
46–66	SRT- LTS	41.63 ± 15.02	15.6	46.83 ± 10.67	28.75
	SRT–CLTR	29.53 ± 14.21	5.1	32.95 ± 10.64	18.25
	SpRT	17.58 ± 3.87	9.4	18.78 ± 5.96	8.2
	SDMT	36.63 ± 12.89	14.2	53.08 ± 14.60	34.6
	PASAT	29.43 ± 11.70	11.1	42.60 ± 10.74	15.2
	SRT–DR	8.19 ± 2.43	3.1	8.86 ± 1.68	6.2
	SpRT–DR	6.12 ± 1.55	4.0	6.86 ± 2.05	2.4
	WLG	19.43 ± 5.82	10.1	23.47 ± 6.14	16.0

Scaled score	Raw score
	SRT			SpRT		SDMT	PASAT	WLG
	LTS	CLTR	DR	Total	DR	SDMT	PASAT	WLG
1	< 6	1	1			< 12	< 8	< 5
2	06-09	2–3	2	< 8	1	12–13	8	5–6
3	10–20	4–6	3	8	2	14–16	9–11	7–9
4	21–22	7–13	4	9–10	3	17–22	12–14	10–11
5	23–26	14–18	5	11–12		23–27	15–18	12–13
6	27–33	19–21		13–14	4	28–35	19–23	14–15
7	34–39	22–25	6	15–16	5	36–39	24–26	16–17
8	40–43	26–29	7	17–18		40–45	27–31	18–19
9	44–48	30–33	8	19	6	46–50	32–37	20–21
10	49–52	34–38	9	20–22	7	51–55	38–43	22–23
11	53–56	39–44		23	8	56–62	44–46	24–26
12	57–60	45–50	10	24–25	9	63–68	47–51	27–30
13	61–62	51–57	11	26		69–75	52–55	31–32
14	63–64	58–60		27	10	76–88	56	33–34
15	65–66	61–64	12	28		89–101	57–58	35–36
16	67	65–67				102–103	59–60	37–38
17	68–69	68–69		29		104–110		39–40
18	70–72	70–72		30				41–42
19								> 42

Measure	Predictors	B	t	Significance	CI95%		R square	SD residual
Measure	Predictors	B	t	Significance	Lower bound	Upper bound	R square	SD residual
SRT – LTS	(Constant)	10.355	10.064	< 0.001	8.32	12.38	0.146	2.885
	Sex	0.042	0.103	0.917	-0.76	-0.76
	Age	-0.064	-4.269	< 0.001	-0.09	-0.03
	Education	0.179	3.129	0.002	0.06	0.29
SRT – CLTR	(Constant)	9.953	10.138	< 0.001	8.01	11.88	0.194	2.753
	Sex	-0.410	-1.056	0.291	-1.17	0.35
	Age	-0.064	-4.470	< 0.001	-0.09	-0.03
	Education	0.227	4.153	< 0.001	0.11	0.33
SpRT	(Constant)	12.553	12.385	< 0.001	10.55	14.55	0.221	2.774
	Sex	0.665	1.681	0.094	-0.11	1.44
	Age	-0.098	-6.670	< 0.001	-0.12	-0.06
	Education	0.095	1.711	0.088	-0.01	0.20
SDMT	(Constant)	9.669	11.292	< 0.001	7.98	11.35	0.372	2.343
	Sex	0.092	0.275	0.783	-0.56	0.75
	Age	-0.090	-7.203	< 0.001	-0.11	-0.06
	Education	0.297	6.294	< 0.001	0.20	0.39
PASAT	(Constant)	7.047	7.187	< 0.001	5.11	8.98	0.197	2.684
	Sex	0.667	1.742	0.083	-0.08	1.42
	Age	-0.031	-2.201	0.028	-0.05	-0.003
	Education	0.314	5.811	< 0.001	0.20	0.42
SRT – DR	(Constant)	10.642	11.285	< 0.001	8.78	12.50	0.171	2.581
	Sex	-0.725	-1.967	0.050	-1.45	0.001
	Age	-0.051	-3.718	< 0.001	-0.07	-0.02
	Education	0.193	3.714	< 0.001	0.09	0.29
SpRT – DR	(Constant)	11.300	12.948	< 0.001	9.57	13.02	0.213	2.388
	Sex	0.128	0.376	0.706	-0.54	0.80
	Age	-0.073	-5.776	< 0.001	-0.09	-0.04
	Education	0.149	3.108	0.002	0.05	0.24
WLG	(Constant)	6.499	6.912	< 0.001	4.64	8.35	0.264	2.573
	Sex	-0.786	-2.141	0.033	-1.51	-0.06
	Age	-0.018	-2.141	0.178	-0.04	0.008
	Education	0.389	7.506	< 0.001	0.28	0.49

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Academia Brasileira de Neurologia - ABNEURO R. Vergueiro, 1353 sl.1404 - Ed. Top Towers Offices Torre Norte, 04101-000 São Paulo SP Brazil, Tel.: +55 11 5084-9463 | +55 11 5083-3876 - São Paulo - SP - Brazil
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[TFN1] BRB–N: brief repeatable battery of neuropsychological tests; CLTR: consistent long term retrieval; DR: delayed recall; LTS: long term storage; MMSE: mini mental state examination; PASAT: paced auditory serial addition test; SDMT: symbol digit modalities test; SpRT: spatial recall test; SRT: selective reminding test; WLG: word list generation.

[TFN2] ^*
Group comparisons were performed with Mann–Whitney U tests, except for percentage distribution, where Fisher's exact test was used.