Archives of Clinical Neuropsychology 26 (2011) 144–157

Spanish Multicenter Normative Studies (Neuronorma Project): Norms

for the Abbreviated Barcelona Test
Marı́a Quintana 1, Jordi Peña-Casanova 1,2,*, Gonzalo Sánchez-Benavides 1, Klaus Langohr 3,

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Rosa M. Manero 2, Miguel Aguilar 4, Dolors Badenes 4, José Luis Molinuevo 5, Alfredo Robles 6,
Marı́a Sagrario Barquero 7,†, Carmen Antúnez 8, Carlos Martı́nez-Parra 9, Anna Frank-Garcı́a 10,
Manuel Fernández 11, Rafael Blesa 12, for the Neuronorma Study Team‡
1
Group of Behavioral Neurology, Neuropsychopharmacology Program, Institut Municipal d’Investigació Mèdica, Barcelona, Spain
2
Section of Behavioral Neurology and Dementias, Hospital del Mar, Parc de Salut Mar, Barcelona, Spain
3
Human Pharmacology and Clinical Neurosciences Research Group, Neuropsychopharmacology Program, Institut Municipal d’Investigació Mèdica,
Barcelona, Spain
4
Service of Neurology, Hospital Mútua de Terrassa, Terrassa, Spain
5
Service of Neurology, Hospital Clı́nic, Barcelona, Spain
6
Service of Neurology, Hospital Clı́nico Universitario, Santiago de Compostela, Spain
7
Service of Neurology, Hospital Clı́nico San Carlos, Madrid, Spain
8
Service of Neurology, Hospital Virgen Arrixaca, Murcia, Spain
9
Service of Neurology, Hospital Virgen Macarena, Sevilla, Spain
10
Department of Neurology, Hospital Universitario La Paz, Madrid, Spain
11
Service of Neurology, Hospital de Cruces, Bilbao, Spain
12
Service of Neurology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
*Corresponding author at: Institut Municipal d’Investigació Mèdica, Biomedical Research Park Building, Carrer Dr. Aiguader, 88, 08003 Barcelona, Spain.
Tel.: +34-93-3160765; fax: +34-93-933160723.
E-mail address: [email protected] (J. Peña-Casanova).
Accepted 12 November 2010

Abstract
The abbreviated Barcelona Test (a-BT) is an instrument widely used in Spain and Latin American countries for general neuropsychological
assessment. The purpose of the present study was to provide new norms for the a-BT as part of the Neuronorma project. The sample consisted
of 346 healthy controls. Overlapping cell procedure and midpoint techniques were applied to develop the normative data. Age, education, and
sex influences were studied. Results indicated that although age and education affected the score on this test, sex did not. Raw scores were
transformed to age-adjusted scaled scores (SSA) based on percentile ranks. These SSA were also converted into age–education scaled scores
using a linear regression model. Norms were presented on age–education scaled scores. Also, the a-BT cognitive profile was presented and
should prove to be clinically useful for interpretation. These co-normed data will allow clinicians to compare scores from a-BT with all the
tests included in the Neuronorma project.

Keywords: Norms/normative studies; Assessment; Elderly/geriatrics/aging

Introduction

The availability of appropriate normative data is critical to the quality of neuropsychological assessment. As a result, well-
standardized tests should be chosen (Evans, 2003; Strauss, Sherman, & Spreen, 2006) because normative data are necessary for

†
Deceased.
‡
Members of the Neuronorma Study Team are given in Appendix B.

# The Author 2010. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: [email protected].
doi:10.1093/arclin/acq098 Advance Access publication on 13 December 2010
 M. Quintana et al. / Archives of Clinical Neuropsychology 26 (2011) 144–157 145

diagnostic and descriptive accuracy (Busch & Chapin, 2008). Several integrated neuropsychological batteries have been pub-
lished with the objective of improving precision in diagnosis (Lezak, Howieson, & Loring, 2004).
The Barcelona Test (BT) is a neuropsychological battery that has been standardized and validated in a Spanish population
(Peña-Casanova, 1990). It includes a series of subtests that cover a basic spectrum of the neuropsychological functions:
language, orientation, attention, praxis, visual perceptual functions, memory, and executive functions. The abbreviated form
(a-BT) was designed to evaluate cognitive deficits associated with brain damage. It deals with the most basic and sensitive
neuropsychological items of the original and has a global standard score (Guardia et al., 1997; Peña-Casanova, Guardia,
Bertran-Serra, Manero, & Jarne, 1997; Peña-Casanova, Meza, et al., 1997). It takes only 30– 45 min to administer.
The norms for this test were published in 1997 (Peña-Casanova, Guardia, et al., 1997) and were based on a sample of 341
individuals, aged 20– 80 years (M ¼ 54.80 years, SD ¼ 17.44). Five different groups concerning age and level of education
were considered, resulting in five distinct cognitive profiles (Peña-Casanova, Guardia, et al., 1997).
The Revised BT was later published with an increased normative sample (Peña-Casanova, 2005). In addition, a number of

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studies have reported complementary normative data from several subtests of the a-BT. Cejudo-Bolı́var, Torrealba-Fernández,
Guardia-Olmos, and Peña-Casanova (1998) extended the normative information on the drawing task. Another study
(Garcı́a-Morales, Gigh-Fullà, Guardia-Olmos, & Peña-Casanova, 1998) analyzed the impact of age and education on orien-
tation, digit span, and automatic speech. Gramunt-Fombuena, Cejudo-Bolı́var, Serra-Mayoral, Guardia-Olmos, and
Peña-Casanova (1998) published additional normative data for arithmetic, similarities, digit-symbol, and block design
based on a sample of 264 individuals. There are also Latin American versions, such as the Mexican one (Villa, 1995), although
it has not been published.
Clinically, the a-BT has been used to examine patients with mild cognitive impairment (Frutos-Alegrı́a, Moltó-Jordà,
Morera-Guitart, Sánchez-Pérez, & Ferrer-Navajas, 2007; Rami et al., 2007), Alzheimer’s disease (Peña-Casanova et al.,
2005), schizophrenia (Gil et al., 2008), amyotrophic lateral sclerosis (Duque et al., 2003), and toxic oil syndrome (De la
Paz et al., 2003).
As to psychometric characteristics, this test has shown higher convergent validity with the Alzheimer Disease Assessment
Scale-cognitive part (ADAS-Cog) (Peña-Casanova, Meza, et al., 1997), and excellent test– retest, and inter-rater reliability
(Serra-Mayoral & Peña-Casanova, 2006).
Moreover, the global score of the a-BT correlates with functional scales (Peña-Casanova et al., 2005) such as the Rapid
Disability Rating Scale-2 (Linn & Linn, 1982), the Blessed Dementia Rating Scale (Blessed, Tomlinson, & Roth, 1968),
and the Interview for Deterioration of Daily living in Dementia (IDDD; Teunisse, Derix, & Cléber, 1991).
The a-BT was included in the Spanish Multicenter Normative Studies battery (Neuronorma battery) as a complement
because it includes aspects that are not present in the series of tests normalized in that project. The Neuronorma project
attempts to provide norms for commonly used neuropsychological tests in people aged over 49 years. The results of this
project have been recently published (Peña-Casanova, Blesa, et al., 2009; Peña-Casanova, Gramunt-Fombuena, et al., 2009;
Peña-Casanova, Quiñones-Úbeda, Gramunt-Fombuena, Aguilar, et al., 2009; Peña-Casanova, Quiñones-Úbeda,
Gramunt-Fombuena, Quintana, et al., 2009; Peña-Casanova, Quiñones-Úbeda, Gramunt-Fombuena, Quintana-Aparicio,
et al., 2009; Peña-Casanova, Quiñones-Úbeda, Quintana-Aparicio, et al., 2009; Peña-Casanova, Quintana-Aparicio,
Quiñones-Úbeda, et al., 2009).
In this paper, we provide normative data for the a-BT in the context of the Neuronorma project.

Materials and Methods

Research Participants

Participants in this study included 356 healthy, older adults subjects. A detailed description of recruitment procedures,
sample characteristics, and other aspects of the Neuronorma project has been provided by Peña-Casanova, Blesa, and col-
leagues, (2009). Briefly, participants were independently functioning, community-dwelling, and Spanish speakers aged over
49 with no active neurological/psychiatric disorders or current medical illness that could affect cognition.
Participants were recruited from a variety of sources such as: (1) spouses of patients evaluated at the participating centers;
(2) different senior citizen activity centers; and (3) by word of mouth.
Ten participants did not complete the a-BT subtest and were excluded from the final analyses (n ¼ 346). The sample
included 140 men (40.5%) and 206 women (59.5%). The mean age was 65.04 (SD ¼ 9.38) years, with a mean education of
10.56 years (SD ¼ 5.46). The majority (97%) of study participants were right-handed. Descriptive demographic data for the
sample are presented in Table 1. Additional demographic, sociocultural, and health-related characteristics of the normative
146 M. Quintana et al. / Archives of Clinical Neuropsychology 26 (2011) 144–157

Table 1. Demographic characteristics of the sample

n Percent of total

Age group
50–56 75 21.6
57–59 49 14.4
60–62 33 9.5
63–65 18 5.2
66–68 25 7.2
69–71 49 14.4
72–74 33 9.5
75–77 30 8.6
78–80 21 6.0
.80 13 3.7

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Education (years)
≤5 72 21.0
6 –7 26 7.5
8 –9 66 19.0
10–11 40 11.5
12–13 35 10.1
14–15 32 9.2
≥16 75 21.8
Sex
Men 140 40.5
Women 206 59.5
Total sample 346 100

sample (family antecedents, personal antecedents, and active medical treatment) have been described in detail by
Peña-Casanova, Blesa, and colleagues (2009).
Approval to conduct the study was obtained from the Research Ethics Committee of the Municipal Institute of Medical Care
of Barcelona, Spain, and from the different participating centers. The study was conducted in accordance with the Declaration
of Helsinki (World Medical Association, 1997) and its subsequent amendments, and the European Union regulations concern-
ing medical research. All participants signed an informed consent before being tested and they received no financial reimburse-
ment or any other compensation.

Neuropsychological Measures

A global cognition measure, the Mini Mental Status Examination (Folstein, Folstein, & McHugh, 1975) in a Spanish vali-
dated version (Blesa et al., 2001), was used to select study participants. The age- and education-adjusted cutoff in the study was
24. Functional changes were evaluated by the IDDD (Teunisse et al., 1991) in its Spanish validated version (Böhm et al., 1998).
The a-BT was administered as part of a larger battery of neuropsychological measures in the Neuronorma project
(Peña-Casanova, Blesa, et al., 2009). Testing and scoring were performed by neuropsychologists specifically trained for
this project. All the onsite neuropsychologists were licensed as psychologists and highly experienced in neuropsychological
test administration and diagnosis. Standard administration and scoring procedures were followed as outlined in the original
a-BT manual (Peña-Casanova, 1990). It consists of 41 subtests that generate 55 variables which encompass a basic spectrum
of the neuropsychological functions: language, attention, mental tracking, working memory, repetition, confrontation naming,
semantic fluency, verbal comprehension, reading, writing, praxis, visual perceptual functions, verbal memory (story), visual
memory (figures), numerical reasoning, concept formation, sustained attention, speed, and visuospatial and motor skills
(details are shown in Appendix A).
In a series of subtests, a double score is included: a “pass or fail score” (one point scored for each item passed) and a “time
score” (score adjusted to allow for delay in responding). Credit is only allowed for a correct response. The score may range
from 1 to 3 for correct items depending on the time elapsed for responding.

Statistical Analysis

Normative procedures were the same as those used in the Neuronorma project (Peña-Casanova, Blesa, et al., 2009). To sum-
marize, age groups were defined through the overlapping cell procedure described by Pauker (1988). The effect of age,
 M. Quintana et al. / Archives of Clinical Neuropsychology 26 (2011) 144–157 147

education, and sex on raw a-BT subtest scores was studied using coefficients of correlation (r) and determination (R 2). The
a-BT subtest raw scores were converted to age-adjusted scaled scores (SSA; from 2 to 18), SSA based on percentile ranks,
to produce a normal distribution (average 10, SD 3). Linear regressions were applied to the normalized SSA on each variable
to further adjust for education and derived age- and education-adjusted scaled scores (SSAE).
The regression coefficient (b) from this analysis was taken as the basis for education adjustments, when b was significant
value. The formula outlined by Mungas, Marshall, Weldon, Haan, and Reed (1996) employed to calculate SSAE was the fol-
lowing:

SSAE = SSA − (b × [Education (years) − 12])

In this linear regression, the criterion variable was the a-BT score and the predictor variable was years of education. This model
can be applied due to the previously created normal distribution.

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Statistical analyses were performed using R statistical software (v2.7.0) (R Development Core Team, 2008).

Results

Correlations (r) and shared variances (R 2) of all the subtests of the a-BT with age, education, and sex are presented in
Table 2.
Age and education shared variance in the majority of the a-BT subtests. Sex differences accounted for ,2% of shared var-
iance in all subtests, except in arithmetic, indicating no need to control for this demographic variable.
It was not possible to calculate correlations and shared variances in several variables because all the subjects obtained the
same value. For example, the variance was zero in the case of subtests such as language and grammar, or forward series.
For age, shared variance (R 2) ranged between minimal (e.g., ,1% in personal orientation) and significant values (e.g.,
24.8% in digit-symbol). A similar effect occurred in the case of education. The influence of this variable was significant in
the majority of subtests, with high values as in visual memory (R 2 ¼ 30.8%), arithmetic (R 2 ¼ 39.3%), similarities (R 2 ¼
40.6%), and digit-symbol (R 2 ¼ 43.5%).
As an example, Table 3 provides the conversion of the raw scores of the story (narrative fragment) free recall to SSA. In this
table are presented the percentile ranks, the age range of each midpoint (50 – 56, 57– 59, 60– 62, 63– 65, 66– 68, 69– 71, 72– 74,
75– 77, 78– 80, and 81+), the ranges of ages contributing to each normative group, and the number of participants contributing
to each test normative estimate. The SSA have a range from 2 to 18 and a normal distribution (a mean of 10 and an SD of 3).
Due to the large number of subtests, the rest of the SSA tables are presented as Supplementary material 1.
Table 4 provides the conversion of SSA to SSAE for the same previously presented subtest, the story (narrative fragment) free
recall. To use this table, select the appropriated column corresponding to the patient’s years of education, find the patient’s SSA,
and subsequently refer to the corresponding SSAE. See Supplementary material 2 for the other subtests of the a-BT.
We observed that some subtests show a very skewed distribution. In these special subtests, a single item failure represents
impairment. These subsets are presented in Table 5. If the subject obtains the maxim score, the SSA is 18, but if the subject
makes a mistake in such case, the SSA is 2. The same pattern was observed in all age range of each midpoint. Moreover, in this
table, the raw score followed by its percentage in the normative sample is presented.
From these age – education-adjusted scaled scores, a new cognitive profile of the a-BT was designed (Table 6). This profile
includes all scaled scores (from 2 to 18) and percentile ranks. Furthermore, the classification of ability levels is shown: very
impaired, impaired, low average, average, high average, superior, and very superior.

Discussion

The purpose of the present study was to provide new normative data, from a multicenter project, of the a-BT. This brief test
includes the main neuropsychological areas and only takes 30 – 45 min to administer. It is, therefore, a test situated between
screening tests and comprehensive neuropsychological batteries, such as the Repeatable Battery for the Assessment of
Neuropsychological Status (RBANS; Randolph, 1998) or the ADAS-Cog (Rosen, Mohs, & Davis, 1984).
It is of interest that our results indicate that not all the subtests of the a-BT show the same score distribution. Some of them
(e.g., fluency and grammar, informative content of language, orientation, forward and backward series, naming, reading, etc.)
have little or null dispersion of data. These kinds of test are, in fact, categorical or qualitative variables. That is to say, a subject
repeats well (preservation) in contrast to not repeating well (alteration). A fact had previously been pointed out when the BT
was first published (Peña-Casanova, 1990). In other cases (e.g., complex ideational sentence comprehension, pseudoword
reading and discrimination, superimposed figures, etc.), the dispersion is partial, which may affect the correct use of the
148 M. Quintana et al. / Archives of Clinical Neuropsychology 26 (2011) 144–157

Table 2. Correlations (r) and shared variances (R 2) of raw scores with age, years of education, and sex (NA: not applicable because shared variance was zero)

Subtest Age (years) Education (years) Sex

2 2
r R r R r R2

Fluency and grammar NA NA NA NA NA NA

Informative content of language 2.093 .009 .111* .012 .050 .002
Personal orientation 2.034 .001 .035 .001 .065 .004
Spatial orientation 2.075 .006 .086 .007 .026 .001
Temporal orientation 2.171** .029 .063 .004 2.034 .001
Digit Span Forward 2.222*** .049 .475*** .226 2.137* .019
Digit Span Backward 2.269*** .072 .516*** .266 2.187*** .035
Automatized sequences: Forward series NA NA NA NA NA NA
Automatized sequences: Forward series T 2.119* .014 .204*** .042 2.023 .001

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Mental control: Backward series 2.082 .007 .211*** .045 2.033 .001
Mental control: Backward series T 2.222*** .049 .415*** .173 2.062 .004
Repetition of pseudowords 2.175*** .031 .203*** .041 .052 .003
Repetition of words NA NA NA NA NA NA
Confrontation naming 2.133* .018 .081 .006 2.052 .003
Confrontation naming T 2.241*** .058 .231*** .054 2.049 .002
Responsive naming NA NA NA NA NA NA
Responsive naming T 2.129* .017 .134* .018 .021 .000
Semantic fluency (animals) 2.314*** .099 .444*** .197 2.087 .008
Verbal Commands 2.124* .015 .275*** .076 2.010 .000
Complex ideational sentence compr 2.181*** .033 .351*** .123 2.120* .014
Complex ideational sentence compr T 2.199*** .040 .382*** .146 2.134* .018
Pseudoword reading 2.062 .004 .227*** .051 2.017 .000
Pseudoword reading T 2.086 .007 .273*** .074 2.028 .001
Reading of a text 2.109* .012 .274*** .075 2.012 .000
Pseudoword reading and discrimination 2.137* .019 .253*** .064 2.021 .000
Pseudoword reading and discrimination T 2.216*** .047 .372*** .139 2.034 .001
Sentences and paragraph reading compr 2.241*** .058 .335*** .112 2.072 .005
Sentences and paragraph reading compr T 2.235*** .055 .509*** .259 2.088 .008
Mechanics of writing NA NA NA NA NA NA
Dictated pseudowords 2.030 .001 .088 .008 .113* .013
Dictated pseudowords T 2.321*** .103 .439*** .193 .056 .003
Written picture naming 2.074 .005 .198*** .039 2.053 .003
Written picture naming T 2.163** .027 .270*** .073 2.093 .009
Symbolic gestures (command): right limb 2.106* .011 .134* .018 .043 .002
Symbolic gestures (command): left limb 2.170** .029 .142** .020 .053 .003
Symbolic gestures (imitation): right limb 2.050 .003 .089 .008 2.024 .001
Symbolic gesture (imitation): left limb 2.095 .009 .115* .013 2.027 .001
Bimanual pseudogesture imitation 2.262*** .069 .216*** .047 2.012 .000
Alternating sequences: right limb 2.279*** .078 .334*** .112 .057 .003
Alternating sequences: left limb 2.266*** .071 .300*** .090 .037 .001
Constructional praxis (drawing copy) 2.213*** .045 .482*** .232 2.094 .009
Constructional praxis-(drawing copy T) 2.321*** .103 .561*** .315 2.090 .008
Superimposed figures 2.310*** .096 .295*** .087 .129* .017
Superimposed figures T 2.366*** .134 .336*** .113 .126* .016
Story (narrative fragment) free recall 2.384*** .148 .529*** .280 .049 .002
Story cued recall 2.338*** .114 .499*** .249 .030 .001
Delayed story free recall 2.394*** .155 .488*** .238 2.068 .005
Delayed story cued recall 2.348*** .121 .473*** .224 .039 .002
Visual memory 2.480*** .231 .555*** .308 2.010 .000
Arithmetic 2.228*** .052 .627*** .393 2.318*** .101
Arithmetic T 2.228*** .052 .616*** .380 2.349*** .122
Similarities 2.325*** .105 .637*** .406 2.052 .003
Digit-symbol (coding) 2.498*** .248 .659*** .435 2.059 .004
Block design 2.346*** .120 .484*** .234 2.064 .004
Block design T 2.377*** .142 .507*** .257 2.089 .008
Notes: T ¼ time scored; compr ¼ comprehension.
*p , .05.
**p , .01.
***p , .001.
 M. Quintana et al. / Archives of Clinical Neuropsychology 26 (2011) 144–157 149

Table 3. Age-adjusted scores (SSA) for story (narrative fragment) free recall

Scaled score Percentile range Age range (years)

50–56 57– 59 60– 62 63–65 66–68 69– 71 72–74 75–77 78– 80 81+

2 ,1 3– 4 3– 4 3 –4 3 3 3 3 3– 4 3– 5 3 –5
3 1 5– 6 5 5 4– 5 4 4 4 5
4 2 5 5 5
5 3–5 7 6 6 6
6 6–10 8 7 7 7 6– 7 6 –7 6 6 6 6
7 11–18 9– 10 8– 9 8 –9 8– 9 8– 9 8 –9 7 –8 7 7
8 19–28 11– 12 10– 11 10–11 10 10 10 9 8 7
9 29–40 13 12– 13 12 11 11 11 10 9– 10 8– 9 8
10 41–59 14 14 13–14 12– 13 12– 13 12 11–12 11 10 9 –10

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11 60–71 15– 16 15 15 14 14 13–14 13 12 11
12 72–81 16 16 15– 16 15– 16 15 14–15 13– 14 12– 13 11– 12
13 82–89 17– 18 17 17 17 17 16 15 14– 15 13
14 90–94 18 18 18 18 17–18 16–17 16
15 95–97 19 19 19 18 17 16 14– 15
16 98 20 19 19 19 19 18– 19 17
17 99 — 20 20
18 .99 21 21 21 20– 21 20– 21 20–21 20–21 20– 21 18– 21 16– 21
Age range 50– 60 53– 63 56–66 59– 69 62– 72 65–75 68–78 71– 81 74– 84 77+ (77–90)
Sample size 132 128 121 104 121 126 127 102 66 43

Table 4. Story (narrative fragment) free recall

SSA Education (years)
0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20

2 5 5 4 4 4 4 3 3 3 3 2 2 2 2 2 1 1 1 1 0 0
3 6 6 5 5 5 5 4 4 4 4 3 3 3 3 3 2 2 2 2 1 1
4 7 7 6 6 6 6 5 5 5 5 4 4 4 4 4 3 3 3 3 2 2
5 8 8 7 7 7 7 6 6 6 6 5 5 5 5 5 4 4 4 4 3 3
6 9 9 8 8 8 8 7 7 7 7 6 6 6 6 6 5 5 5 5 4 4
7 10 10 9 9 9 9 8 8 8 8 7 7 7 7 7 6 6 6 6 5 5
8 11 11 10 10 10 10 9 9 9 9 8 8 8 8 8 7 7 7 7 6 6
9 12 12 11 11 11 11 10 10 10 10 9 9 9 9 9 8 8 8 8 7 7
10 13 13 12 12 12 12 11 11 11 11 10 10 10 10 10 9 9 9 9 8 8
11 14 14 13 13 13 13 12 12 12 12 11 11 11 11 11 10 10 10 10 9 9
12 15 15 14 14 14 14 13 13 13 13 12 12 12 12 12 11 11 11 11 10 10
13 16 16 15 15 15 15 14 14 14 14 13 13 13 13 13 12 12 12 12 11 11
14 17 17 16 16 16 16 15 15 15 15 14 14 14 14 14 13 13 13 13 12 12
15 18 18 17 17 17 17 16 16 16 16 15 15 15 15 15 14 14 14 14 13 13
16 19 19 18 18 18 18 17 17 17 17 16 16 16 16 16 15 15 15 15 14 14
17 20 20 19 19 19 19 18 18 18 18 17 17 17 17 17 16 16 16 16 15 15
18 21 21 20 20 20 20 19 19 19 19 18 18 18 18 18 17 17 17 17 16 16
Notes: Education adjustment applying the following formula: SSAE ¼ SSA – (b × [education (years) – 12]), where b ¼ 0.2596. SSA ¼ age-adjusted scaled
scores; SSAE ¼ age– education-adjusted scaled scores.

Table 5. Percent distribution of raw scores in selected subtest and age-adjusted scores (SSA) for all age range of each midpoint
Subtest Raw score (%) Scale score 2, percentile range ,1 Scale score 18, percentile range .99

Fluency and grammar 10 (100) 9 10

Automatized sequences: Forward series 1 (0.3) 2 3
2 (6.9)
3 (92.8)
Repetition of words 10 (100) 9 10
Responsive naming 6 (100) 5 6
Mechanics of writing 5 (100) 4 5
150 M. Quintana et al. / Archives of Clinical Neuropsychology 26 (2011) 144–157

Table 6. Cognitive profile of abbreviated Barcelona Test

Subtest percentiles ,1 1 2 3 –5 6 –10 11–18 19– 28 29– 40 41–59 60–71 72– 81 82– 89 90– 94 95–97 98 99 .99

Classification of ability levels Very impaired I LA Average HA Superior Very

superior
Fluency and grammar 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
Informative content of language 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
Personal orientation 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
Spatial orientation 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
Temporal orientation 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
Digit Span Forward 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
Digit Span Backward 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
Automatized sequences: Forward series 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
Automatized sequences: Foward series T 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18

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Mental control: Backward series 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
Mental control: Backward series T 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
Repetition of pseudowords 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
Repetition of words 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
Confrontation naming 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
Confrontation naming T 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
Responsive naming 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
Responsive naming T 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
Semantic fluency (animals) 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
Verbal commands 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
Complex ideational sentence compr 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
Complex ideational sentence compr T 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
Pseudowords reading 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
Pseudowords reading T 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
Reading of a text 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
Pseudoword reading and discrimination 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
Pseudoword reading and discrimination T 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
Sentences & paragraph reading compr 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
Sentences & paragraph reading compr T 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
Mechanics of writing 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
Dictated pseudowords 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
Dictated pseudowords T 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
Writing picture naming 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
Writing picture naming T 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
Symbolic gesture (command, right) 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
Symbolic gesture (command, left) 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
Symbolic gesture (imitation, right) 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
Symbolic gesture (imitation, left) 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
Bimanual pseudogesture imitation 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
Alternating sequences: right limb 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
Alternating sequences: left limb 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
Constructional praxis-copy 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
Constructional praxis-copy T 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
Superimposed figures 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
Superimposed figures T 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
Story (narrative fragment) free recall 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
Story cued recall 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
Delayed story: free recall 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
Delayed story: cued recall 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
Visual memory 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
Arithmetic 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
Arithmetic T 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
Similarities 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
Digit-symbol (coding) 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
Block design 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
Block design T 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18

Notes: I ¼ impaired; LA ¼ low average; HA ¼ high average; T ¼ time score; compr ¼ comprehension.
 M. Quintana et al. / Archives of Clinical Neuropsychology 26 (2011) 144–157 151

overall Neuronorma analysis method based on normal distributions. This problem also appears in other neuropsychological
tasks such as digit repetition (Peña-Casanova, Quiñones-Úbeda, Quintana-Aparicio, et al., 2009) or in some subtests of the
Visual Object and Space Perception Battery (Peña-Casanova, Quintana-Aparicio, Quiñones-Úbeda, et al., 2009). To minimize
this effect, some authors suggest dealing with data in a raw score form rather than converting them into scaled scores (Lezak
et al., 2004). We certainly agree with such a proposition and recognize the statistical problems of forcing these kinds of scores
into a normal distribution. Finally, the rest of the subtests (e.g., semantic fluency, constructional praxis-drawing copy, all
measures of memory, digit-symbol, arithmetic, similarities, and block design) show a clear variability of scores.
In spite of the psychometrically different measures, given the characteristics and purposes of this normative project, we
decided to maintain the same model of statistical analysis for all the subtests. Thus, we developed normative data following
the single procedure used in the Neuronorma project.
The normative data used should be recent because when a test is re-normed, there is typically a reduction in the resulting
standard scores with the new version (Pae et al., 2005). As a result, a better performance with regard to the original sample, and

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a consequent over-estimation of performance, will be found with regard to the original norms (Baxendale, 2010; Iverson,
Franzen, & Lovell, 1999; Hiscock, 2007). Starting from this premise, the “Flynn effect” (Flynn, 1984, 1987) could be con-
nected. Related IQ effect notwithstanding, it is important to adopt new norms in neuropsychology (Bush, 2010; Strauss
et al., 2006).
Consistent with the findings of previous studies (Cejudo-Bolı́var et al., 1998; Garcı́a-Morales et al., 1998;
Gramunt-Fombuena et al., 1998; Peña-Casanova et al., 2005; Peña-Casanova, Meza, et al., 1997), age and education contrib-
uted to the raw score on most subtests of the a-BT. Consequently, adjustments were necessary so raw scores were converted to
SSA. This transformation generated a normal distribution for a posterior application of a regression model to adjust for edu-
cation. Thanks to this, the method applied to all subtests and we developed a single record form for the representation of
test results (Table 6). In this cognitive profile, the percentile ranks for each scaled score are presented. The combination
between scaled scores and percentiles ranks has been considered the best possible way to express normative data (Crawford
& Garthwaite, 2009).
Furthermore, the cognitive profile is very useful as a visual representation of the test performance to facilitate interpretation
(Bowman, 2002; Strauss et al., 2006). It is well suited to documenting the specific cognitive changes or constancies that can
occur with disease progression. On the other hand, it permits comparison with other test results due to the fact that the norms of
the a-BT were obtained from the same study sample and the same statistical procedures for data analyses as all the other
Neuronorma normative data (Peña-Casanova, Blesa, et al., 2009). This procedure has been used to enhance the comparison
with cognitive scores, both at a single point in time and across time, and it is able to simultaneously obtain multiple data
for the same normative sample (Smith & Ivnik, 2003). It also permits the establishment of a cognitive profile separate from
cognitive domains and the comparison among other neuropsychological tests (Kern et al., 2008). These co-normed data
will allow clinicians to compare scores from the a-BT with all the tests included in the Neuronorma project. However, the
validity of these norms is heavily dependent upon the similarity between the characteristics of the patient being assessed
and the demographic, cultural, and linguistic features of the normative sample (Ivnik et al., 1992a). Therefore, the
Neuronorma normative data may not apply to all Spanish-speaking populations.
There has recently been an increase in co-norming tests and batteries (Attix et al., 2009) including the outstanding Mayo
Clinic Studies known as Mayo’s Older Americans Studies (Ivnik et al., 1992a, 1992b, 1992c; Machulda et al., 2007; Steinberg,
Bieliauskas, Smith, & Ivnik, 2005a, 2005b) and Mayo’s Older African Americans Normative Studies (MOAANS) (Ferman
et al., 2005; Lucas, Ivnik, Willis, et al., 2005; Lucas et al., 2005a, 2005b, 2005c; Pedraza et al., 2005; Rilling et al., 2005),
and in a Spanish population, the Neuronorma Project (Peña-Casanova, Blesa, et al., 2009; Peña-Casanova,
Gramunt-Fombuena, et al., 2009; Peña-Casanova, Quiñones-Úbeda, Gramunt-Fombuena, Aguilar, et al., 2009;
Peña-Casanova, Quiñones-Úbeda, Gramunt-Fombuena, Quintana, et al., 2009; Peña-Casanova, Quiñones-Úbeda,
Gramunt-Fombuena, Quintana-Aparicio, et al., 2009; Peña-Casanova, Quiñones-Úbeda, Quintana-Aparicio, et al., 2009;
Peña-Casanova, Quintana-Aparicio, Quiñones-Úbeda, et al., 2009).
There are several limitations of the present study. First, the large number of normative tables generated. This fact is,
however, inherent to the statistical procedures applied (overlapping cell procedure, midpoint, age, and education adjustments).
One possible solution could be a computer application to convert the raw scores to the appropriate age and education adjust-
ment scale scores. Secondly, we presented norms for age ranging from 50 to 90 years; therefore, no new normative data under
50 years are available for this set of norms using the Neuronorma method. These and other general limitations of Neuronorma
project have been discussed in a previous paper (Peña-Casanova, Blesa, et al., 2009).
Despite its limitations, the methods used to obtain the norms for the a-BT (e.g., the conversion to age and education scaled
scores, overlapping cell procedure, and midpoint) show a series of advantages. For example, this method signifies that the
group means are more stable, resulting in less abrupt mean shifts between age blocks (Busch, Chelune, & Suchy, 2006).
152 M. Quintana et al. / Archives of Clinical Neuropsychology 26 (2011) 144–157

Moreover, it manages to solve the limitation of using large groups that are age-stratified with no overlapping by allowing the
comparison with more adjacent ages.
We also obtained the same metric for all the subtests which made one cognitive profile possible. In the original normative
data (Peña-Casanova, Guardia, et al., 1997), five different cognitive profiles were published. Moreover, the sample came from
different Spanish regions (for more information, see Peña-Casanova, Blesa, et al., 2009); therefore, it was a multicenter project
and thus achieved a better representation of the Spanish population. Finally, the normative data for the a-BT were developed in
conjunction with norms for all the neuropsychological tests comprising the Neuronorma test battery. This same co-norming
process had been previously used by Rilling and colleagues (2005) for older African Americans on the Mattis Dementia
Rating Scale, as part of the MOAANS project.
We anticipate that this feature of Neuronorma norms will facilitate interpretation of a-BT performance within the context of
a patient’s overall neuropsychological profile, although the a-BT is of interest on its own as a general cognitive functioning
battery. Moreover, it can be used as a complement to the Neuronorma battery, since it includes cognitive domains not assessed

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by the battery such as orientation, reading, writing, repetition, graphic constructional praxis for simple figures, symbolic
gesture, numerical reasoning, and concept formation.
In summary, the a-BT is a brief test and the normative data presented in this study could be very useful for neuropsychol-
ogists interested in assessing the cognitive functioning of the Spanish population.

Supplementary material

Supplementary material is available at Archives of Clinical Neuropsychology online.

Funding

This study was mainly supported by a grant from the Pfizer Foundation and by the Medical Department of Pfizer, SA. Spain.
It was also supported by the Behavioral Neurology group of the Program of Neuropsychopharmacology of the Institut
Municipal d’Investigaciò Mèdica, Barcelona, Spain. Dr. Jordi Peña-Casanova has received an intensification research grant
from the CIBERNED (Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas), Instituto
Carlos III (Ministry of Health and Consumer Affairs of Spain). Dr. Peña-Casanova (2008) has received the “Alzheimer
Award” from the Spanish Society of Neurology, as a leader of the Neuronorma project and as well the Neuronorma Group
(2010) have received the “Alzheimer Award” from the Spanish Society of Neurology.

Conflict of Interest

None declared.

Appendix A

Variables of the abbreviated Barcelona Test

# Subtest Description NI Scoring Score

range

1 Fluency and grammar Conversation, picture description, and narrative speech — Categorical descriptive rating scale from 0– 10
tasks nonfluent to fluent speech
2 Informative content of Conversation, picture description, and narrative speech — Informative content rating scale from no 0– 10
language tasks information to normality
3 Personal orientation Questions on: First name and last name, age, date of 7 Correct: 1 point 0– 7
birth, place of birth, relative’s names, address, and Incorrect: 0 point
occupation
4 Spatial orientation Questions on: City, neighborhood, type of place, name of 5 Correct: 1 point 0– 5
the place, and floor Incorrect: 0 point

(continued on next page)

 M. Quintana et al. / Archives of Clinical Neuropsychology 26 (2011) 144–157 153

Appendix A. (continued)
# Subtest Description NI Scoring Score
range

5 Temporal orientation Questions on: Date, day of the week, time, month, part of 6 Correct: 1 point 0– 23
the day, and year Incorrect: 0 point
For month correct: 5 points
For year correct: 10 points
For part of the day correct: 5 points
6 Digit Span Forward Repetition of digit sequences of increasing length (3–9) 7 The most large string repeated forward 0– 9
forward
7 Digit Span Backward Repetition of digit sequences of increasing length (2–8) 7 The most large string repeated backward 0– 8
backward

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8 Automatized sequences: Counting to 20, days of the week, and months of the year 3 Correct: 1 point 0– 3
Forward series Incorrect: 0 point
9 Automatized sequences: Time scored in forward automatized series 0-1-2 depending on time 0– 6
Forward series time
10 Mental control: Backward Reversal of the series included in subtest # 8 3 Correct: 1 point 0– 3
series Incorrect: 0 point
11 Mental control: Backward Time scored in backward automatized series 0-1-2 depending on time 0– 6
series time
12 Repetition of pseudowords For example, sinapo, sotupo, basomida, adicapo 8 Correct: 1 point 0– 8
Incorrect: 0 point
13 Repetition of words For example, silla, botella, cuchara, elefante [chair, 10 Correct: 1 point 0– 10
bottle, spoon, elephant] Incorrect: 0 point
14 Confrontation naming 14 line drawings of different entities (e.g., cow, spoon, 14 Correct: 1 point 0– 14
bottle, ship) Incorrect: 0 point
15 Confrontation naming time Time scored in confrontation naming 0-1-2-3 depending on time 0– 42
16 Responsive naming Answer a question through a word (e.g., What do you do 6 Correct: 1 point 0– 6
with a pencil?) Incorrect: 0 point
17 Responsive naming time Time scored in responsive naming 0-1-2-3 depending on time 0– 18
18 Semantic fluency (animals) Generation of as many names of animals as possible in 1 point for each acceptable response Unlimited
1 min
19 Verbal Commands To carry out commands of increasing difficulty (e.g., 6 1 point for each correct command 0– 16
make a fist, put the pencil on top of the card, then put it
back)
20 Complex ideational sentence Answer yes/no a question (e.g., is a dog bigger than a 9 Correct: 1 point 0– 9
comprehension horse? and are a father’s brother and a brother’s father Incorrect: 0 point
the same?)
21 Complex ideational sentence Time scored in complex ideational comprehension 0-1-2-3 depending on time 0– 27
comprehension time
22 Pseudoword reading E.g., lafu, tumo, tolamo, and so forth 6 Correct: 1 point 0– 6
Incorrect: 0 point
23 Pseudoword reading time Time scored in reading pseudowords 0-1-2-3 depending on time 0– 18
24 Reading of a text Reading a 56-word text 56 1 point for each word correctly read 0– 56
25 Pseudoword reading and Pointing pseudowords through multiple choice 6 Correct: 1 point 0– 6
discrimination Incorrect: 0 point
26 Pseudoword reading and Time scored in pseudoword reading and discrimination 0-1-2-3 depending on time 0– 18
discrimination time
27 Sentence and paragraph Multiple-choice sentence/paragraph completion (four 8 Correct: 1 point 0– 8
reading comprehension alternatives) Incorrect: 0 point
28 Sentence and paragraph Time scored in sentence and paragraph reading 0-1-2-3 depending on time 0– 24
reading comprehension comprehension
time
29 Mechanics of writing Coping a sentence and spontaneous writing 1 0– 5 qualitative scale (state of the grapho- 0– 5
motor skills)
30 Dictated pseudowords Dictated pseudowords (e.g., lafo, togamo, tumi) 6 Correct: 1 point 0– 6
Incorrect: 0 point
31 Dictated pseudowords time Time scored in dictated pseudowords 0-1-2-3 depending on time 0– 18
32 Written picture naming To write the name of the item shown (e.g., spoon, air- 6 Correct: 1 point 0– 6
plane, pencil, cow) Incorrect: 0 point
33 Written picture naming time Time scored in written picture naming 0-1-2-3 depending on time 0– 18

(continued on next page)

154 M. Quintana et al. / Archives of Clinical Neuropsychology 26 (2011) 144–157

Appendix A. (continued)
# Subtest Description NI Scoring Score
range

34 Symbolic conventional ges- To carry out symbolic gestures for communication 5 Correct: 2 points 0– 10
tures (commands): right (commands, right limb/hand; e.g., How would you Impaired: 1 point
limb/hand pretend to. . .wave good bye, salute like a soldier, etc.) Failed: 0 point
35 Symbolic conventional ges- Items of subtest #34: commands, left limb/hand 5 Correct: 2 points 0– 10
tures (commands): left Impaired: 1 point
limb/hand Failed: 0 point
36 Symbolic conventional ges- Items of subtest #34: imitation, right limb/hand 5 Correct: 2 points 0– 10
tures (imitation): right Impaired: 1 point
limb/hand Failed: 0 point

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37 Symbolic conventional ges- Items of subtest #34: imitation, left limb/hand 5 Correct: 2 points 0– 10
tures (imitation): left limb/ Impaired: 1 point
hand Failed: 0 point
38 Bimanual pseudogesture Pseudogesture imitation with two hands (e.g., forming a 4 Correct: 2 points 0– 8
imitation ring with each hand and then putting one ring in the Impaired: 1 point
hole) Failed: 0 point
39 Alternating sequences: right Serial hand sequences (e.g., fist-palm-side, tapping, 4 Correct: 2 points 0– 8
limb/hand graphic—pencil—test of alternation) Impaired: 1 point
Failed: 0 point
40 Alternating sequences: left Items of subtest #39: left limb/hand 4 Correct: 2 points 0– 8
limb/hand Impaired: 1 point
Failed: 0 point
41 Constructional praxis (draw- To copy of six figures: circle, square, triangle, cross, 6 Correct: 3 points 0– 18
ing copy) cube, and house Minor changes: 2 points
Impaired: 1 point
Failed: 0 point
42 Constructional praxis (draw- Time scored in drawing copy Bonus: 1-2-3 depending on time 0– 36
ing copy) time
43 Superimposed figures To identify line drawings of various objects superim- 5 1 point for each object correctly recognized 0– 20
posed upon one another (five cards on which were
drawn four superimposed line drawings)
44 Superimposed figures time Time scored in the overlapping figures test Bonus: 1-2-3 depending on time 0– 35
45 Story (narrative fragment) The examinee listens two each of two narrative frag- 23 Item correctly repeated: 1 point 0– 23
free recall ments (with 9 and 14 items, respectively) and Partially correct item: 0.5 point
immediately after hearing each is asked to retell it
from memory
46 Story cued recall A standard question cue is provided when an item is not 23 Item correctly repeated after cue: 1 point 0– 23
spontaneously remembered Partially correct item after cue: 0.5 point
47 Delayed story free recall Five minutes after the completion of immediate recall 23 Item correctly repeated: 1 point 0– 23
examinee is asked to remember the two narratives Partially correct item: 0.5 point
48 Delayed story cued recall A standard question cue is provided when an item is not 23 Item correctly repeated after cue: 1 point 0– 23
spontaneously remembered Partially correct item after cue: 0.5 point
49 Visual memory Reproduction of five simple line drawings of increasing 5 Each design is scored on a four-point scale 0– 16
difficulty after a 10 s presentation of the design and (0– 3) except designs 4 and 5 that are
10 s delay (with interference). Designs 4 and 5 are scored on a five-point score (0– 4)
presented together
50 Arithmetic Ten mental arithmetic problems 10 Correct: 1 point 0– 10
Incorrect: 0 point
51 Arithmetic time Time scored in arithmetic problem resolution 0-1-2 depending on time 0– 20
52 Similarities To say in what way two objects or concepts are alike 6 Correct: 2 points (abstract similarity) 0– 12
(e.g., In what way are a dog and a lion alike?) Poor: 1 point
Failed: 0 point
Incorrect: 0 point
53 Digit-symbol (coding) Copying a coding pattern in 60 s 60 Correct: 1 point 0– 60
Incorrect: 0 point
54 Block design To arrange blocks according to a model (six models) 6 Correct: 1 point 0– 6
Incorrect: 0 point
55 Block design time Time scored in block design 0-1-2-3 depending on time 0– 18

Note: NI ¼ number of items.

 M. Quintana et al. / Archives of Clinical Neuropsychology 26 (2011) 144–157 155

Appendix B

Steering committee: J.P.-C., Hospital del Mar, Barcelona, Spain; R.B., Hospital de la Santa Creu i Sant Pau, Barcelona,
Spain; M.A., Hospital Mútua de Terrassa, Terrassa, Spain.
Principal investigators: J.P.-C., Hospital de Mar, Barcelona, Spain; R.B., Hospital de la Santa Creu i Sant Pau, Barcelona,
Spain; M.A., Hospital Mútua de Terrassa, Terrassa, Spain; J.L.M., Hospital Clı́nic, Barcelona, Spain; A.R., Hospital Clı́nico
Universitario, Santiago de Compostela, Spain; M.S.B., Hospital Clı́nico San Carlos, Madrid, Spain; C.A., Hospital Virgen
Arrixaca, Murcia, Spain; C.M.-P., Hospital Virgen Macarena, Sevilla, Spain; A.F.-G., Hospital Universitario La Paz,
Madrid, Spain; M.F., Hospital de Cruces, Bilbao, Spain.
Genetics substudy: Rafael Oliva, Service of Genetics, Hospital Clı́nic, Barcelona, Spain.
Neuroimaging substudy: Beatriz Gómez-Ansón, Radiology Department and IDIBAPS, Hospital Clı́nic, Barcelona, Spain.
Research Fellows: Gemma Monte, Elena Alayrach, Aitor Sainz, and Claudia Caprile, Fundació Clinic, Hospital Clinic,

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Barcelona, Spain; Gonzalo Sánchez, Behavioral Neurology Group. Institut Municipal d’Investigació Médica. Barcelona,
Spain.
Clinicians, Psychologists and Neuropsychologists: Nina Gramunt (Coordinator), Peter Böhm, Sonia González, Yolanda
Buriel, Marı́a Quintana, Sonia Quiñones, Gonzalo Sánchez, Rosa M. Manero, Gracia Cucurella, Institut Municipal
d’Investigació Mèdica. Barcelona, Spain; Eva Ruiz, Mónica Serradell, Laura Torner, Hospital Clı́nic. Barcelona, Spain;
Dolors Badenes, Laura Casas, Noemı́ Cerulla, Silvia Ramos, Loli Cabello, Hospital Mútua de Terrassa, Terrassa, Spain;
Dolores Rodrı́guez, Clinical Psychology and Psychobiology Dept. University of Santiago de Compostela, Spain; Marı́a
Payno, Clara Villanueva, Hospital Clı́nico San Carlos. Madrid, Spain; Rafael Carles, Judit Jiménez, Martirio Antequera,
Hospital Virgen Arixaca. Murcia, Spain; Jose Manuel Gata, Pablo Duque, Laura Jiménez, Hospital Virgen Macarena.
Sevilla, Spain; Azucena Sanz, Marı́a Dolores Aguilar, Hospital Universitario La Paz. Madrid, Spain; Ana Molano, Maitena
Lasa, Hospital de Cruces. Bilbao, Spain.
Data management and biometrics: Josep Maria Sol, Francisco Hernández, Irune Quevedo, Anna Salvà, Verónica Alfonso,
European Biometrics Institute. Barcelona, Spain.
Administrative management: Carme Pla,† Romina Ribas, Department of Psychiatry and Forensic Medicine, Universitat
Autònoma de Barcelona, and Behavioral Neurology Group. Institut Municipal d’Investigació Mèdica. Barcelona, Spain.
English edition: Stephanie Lonsdale, Program of Neuropsychopharmacology, Institut Municipal d’Investigació Mèdica,
Barcelona, Spain.

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