Luria-Nebraska Neuropsychological

Battery

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.

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.

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.

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.

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 theHalstead-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.