More Luria tests

from "Higher Cortical Functions in Man" p. 428

Complex motor functions

1. Reaction tests-- basic format is for subject to raise his hand in response to a tap or another stimulus. This then can be the basis of more complex tests.
Abnormalities are rarely seen with simple reaction tests, exceptions being "freezing" in position in htn, motor impersistence in frontal lesions, or premature responses in frontal lesions.
Next step is to respond alternately, eg. raise the left hand to one tap, and the right to two taps, or raise the hand with one tap and refrain from moving the hand with two. Start with strict alternating pattern, eg a-b-a-b-a-b- then suddenly break the stereotype and go out of order eg b-b and see what the patient does. Alternately, can ask for an oral answer to a stimulus eg. to one tap, say "I must" or "left" and to 2 taps "I must not" or "right." The third stage is to tell the subject to respond orally and perform appropriate motor action at same time (cites Kohomskaya, 1956, 1958). Then give a complex response, eg to one stimulus give a weak response, and to another a strong response of same hand.

2. " Raise finger if I raise fist, and fist if I raise my finger"
3. Ask patient to copy a series of figure eg. circle, triangle, square and cross, then a second series eg square square triangle, cross and see if they perseverate. May use five elements. May see forget last response, perseverate, not remember etc. Temporal lobe lesions may make it difficult to copy to verbal instruction but OK to copy from sight. Differentiate the two by asking patient to repeat the command before performing it.

4.