This is a test of higher cerebral
cortical functions used as a bedside screening instrument
in the context of cerebral cortical and neuropsychiatric
evaluation. A perfect score is zero with the normal
intelligence individual without major psychopathology
generally scoring < 15. The maximum score for the
very grossly impaired is 100. Because the BROCAS SCAN
test concentrates on physical signs, areas of the
cerebral cortex such as temporal lobe and limbic system
involving predominantly symptom profiles are not evaluated
in detail - this is done with the
INSET
evaluation.
The validity score is based on clinical
face value assessment of factors impairing the patient
or the rater's ability to correctly score the patient.
A score of 0 is the highest level of validity indicator
reflecting a score which is likely to be meaningful
at this time. By contrast, a score of four or more
would be very dubious. Patient performance is based
on a core score plus a fine score producing a a total
score. There is also a validity score.
The profile has ten headings spelling
out the ROCAS of the BROCAS namely:
r Spontaneous recall ( usually 0-2)
r Cued recognition ( usually 0)
o Orientation ( usually 0-1)
o Organization ( usually 0-2)
c Concentration ( usually 0-2)
c Calculation ( usually 0-2)
a Apraxia ( usually 0-4)
a Agnosia ( usually 0-2)
s Speech ( usually 0)
s Sensory Motor Reflex. ( usually 0)
Comment on score and subtest interpretative
report
Memory as reflected by recall and retention includes
perseveration, significant verbal or visual difficulties
on spontaneous recall or cued recognition in the
context of age and intelligence
Normal recall/recognition implies
adequate eventual registration (measured, in part,
more acutely by concentration) and retention of information.
Impaired recall with reasonable recognition may
imply difficulty with organizing retained information.
Orientation includes for time, space
and passage of time.
Passage of time is selectively impaired in certain
psychoses; spatial impairment may imply organicity
Organization is reflected by abstraction
of proverbs and ability to coherently put elements
together taking cultural elements into account.
The measure in this instance unfortunately has
more cultural elements than any other part of this
test.
Communication skills are also assessed.
Concentration: The ability of the patient to concentrate
reasonably.
Calculation Simple calculation skills are measured
by subtraction.
Calculation difficulties may reflect specific impairments
including pre-existing
learning difficulties and focal impairments of
either parietal or frontal lobeor generalized concentration
disturbance
Praxic skills pertain, inter alia, to copying,
construction and sequential movements.
Many normal people have significant difficulties
with tests of complex sequences.
Separation of the motor impairment from the perceptual
gnosic difficulties is at times very difficult clinically.
Gnosic elements test both perceptual modality (
auditory, visual, tactile) and organization of information
The test involves relatively simple tasks so abnormality
reflects significant pathology or limited attention
to detail.
Speech involves several somewhat separate elements:
Pronunciation as in dysarthric functions. Comprehension
of complex English phrases in receptive aphasia.
Naming of body parts , colors and objects as in
anomia. Speech generation as reflected by spontaneous
word generation using stipulated criteria as in
expressive aphasia. These tests broadly cover the
spectrum of receptive and expressive speech.
Sensory-motor-reflex elements: This evaluates evidence
for impaired gait or posturing, obvious motor weakness
in the upper limbs with arm sway and flexor-extensor
weakness and also the lower limb strength. Motor
tone, tremor on either side either at rest or on
writing, obvious sensory loss and presence of primitive
reflexes demonstrated by this test.
Because broad elements only are tested this is
no substitute for a detailed neurologic examination.
