Ramírez R M, Chirivella-Garrido J, Caballero M C, Ferri-Campos J, Noé-Sebastián E
Servicio de Daño Cerebral, Hospital NISA Valencia al Mar, Valencia, España.
Rev Neurol. 2004;38(1):28-33.
To validate the test of memory malingering (TOMM), and to study the influence of intelligence and memory on its performance in brain injury patients.
A total of 30 patients with traumatic head injury were included in the study. All patients were assessed with the Complutense verbal learning test, the Visual Reproduction subtest of the Wechsler memory scale-revised, the Boston naming test, two fluency tests (FAS, and animals), the Wechsler adult intelligence test-III, and with the TOMM. Cognitive results below 1 standard deviation (SD) from normative data were considered 'abnormal'. A parametric correlation between TOMM scores and cognitive tests was used to detect whether memory and intelligence were affecting TOMM performance. Statistical significance was set up at p<0.05.
Between 46.1% (Boston) and 81.4% (WAIS-III performance IQ) of the sample presented cognitive deficits. Up to 83.3% of the patients scored above the cutoff point suggestive of malingering in the TOMM (45/50). Significance correlations were found between TOMM scores and memory or intelligence indexes.
The TOMM is a useful tool to detect malingering in head injured patients. Effects of low intelligence coefficients, as well as memory deficits should be considered in clinical practice when evaluating patients with TOMM scores suggestive of malingering.
验证记忆伪装测试（TOMM），并研究智力和记忆对脑损伤患者该测试表现的影响。
本研究共纳入30例创伤性颅脑损伤患者。所有患者均接受了Complutense言语学习测试、韦氏记忆量表修订版的视觉再现子测试、波士顿命名测试、两项流畅性测试（FAS和动物）、韦氏成人智力量表第三版以及TOMM测试。认知结果低于常模数据1个标准差（SD）被视为“异常”。使用TOMM分数与认知测试之间的参数相关性来检测记忆和智力是否影响TOMM表现。统计学显著性设定为p<0.05。
样本中46.1%（波士顿命名测试）至81.4%（韦氏成人智力量表第三版操作智商）的患者存在认知缺陷。高达83.3%的患者在TOMM测试中得分高于提示伪装的临界值（45/50）。在TOMM分数与记忆或智力指标之间发现了显著相关性。
TOMM是检测头部受伤患者伪装的有用工具。在临床实践中，当评估TOMM分数提示伪装的患者时，应考虑低智力系数以及记忆缺陷的影响。
