Dynamics of Neuropsychological Testing

How should we analyze repeated trials in neuropsychological testing? It has long been known that experimental subjects display distinct stages of acclimatization and subsequent saturation during cognitive testing (Thurstone, 1927). For example, in list learning tests examining memory, it has been demonstrated that repeated exposure to a fixed enumeration of items can improve recall. However, we think it is equally important to examine acclimatization of the subjects to the test taking procedure itself. In other words, subjects must grow comfortable with the paradigm of the test before we can assume the results correspond with our interpretations of them. In this paper, we examine results of the Rey AuditoryVerbal Learning Test administered to the largest Alzheimer’s disease family history cohort. We demonstrate the most informative signal in a neuropsychological test may contradict a priori assumptions about the test’s interpretation.