Neuropsychological approaches for the detection and evaluation of toxic symptoms

The purpose of this paper is 3-fold: a) to review briefly the neuropsychological tests that have been used to evaluate the effects of neurotoxicants; b) to identify individual factors that may create heightened sensitivity to neurotoxicants; and c) to discuss test parameters that will increase the sensitivity of neuropsychological tests for detecting symptoms in low-level exposure situations. While the body of literature on neurobehavioral toxicology has increased dramatically during the past 10 years, it remains difficult to discern which tests are most effective in detecting behavioral effects even among workers with significant exposures. Few investigators have evaluated the interactions between individual differences, such as gender and psychiatric function, and exposure to neurotoxicants. Detection of behavioral performance decrements among uniquely susceptible populations such as those with sensitivities to low-level exposures (e.g., multiple chemical sensitivities) will require more difficult tests than are frequently used in current neuropsychological test batteries.