1
|
Anning KL, Langley K, Hobson C, van Goozen SHM. Cool and hot executive function problems in young children: linking self-regulation processes to emerging clinical symptoms. Eur Child Adolesc Psychiatry 2024; 33:2705-2718. [PMID: 38183461 PMCID: PMC11272683 DOI: 10.1007/s00787-023-02344-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 11/28/2023] [Indexed: 01/08/2024]
Abstract
Self-regulation (SR) difficulties are implicated in a wide range of disorders which develop in childhood, including attention deficit hyperactivity disorder (ADHD), oppositional defiance disorder (ODD), anxiety and depression. However, the integration of the existing research evidence is challenging because of varying terminology and the wide range of tasks used, as well as the heterogeneity and comorbidity within and across diagnostic categories. The current study used the Research Domain Criteria (RDoC) framework to guide the examination of different SR processes in young children showing a wide range of symptomatology. Children (aged 4-8) referred by teachers for moderate-to-high conduct, hyperactivity and/or emotional problems at school (assessed using the Strengths and Difficulties Questionnaire (SDQ) subscales; n = 212), and children in SDQ typical ranges (n = 30) completed computerised cognitive control and decision-making tasks. Parents completed questionnaires to assess ADHD, ODD, anxiety and depression symptoms (n = 191). Compared to children with no teacher-reported difficulties, those with moderate-to-high problems showed poorer visuomotor control and decision-making. A factor analysis revealed that task variables adhered to RDoC dimensions and predicted variance in specific disorders: difficulties in cognitive control predicted ADHD symptoms, low reward-seeking was associated with depression and high reward-seeking was associated with ODD. This study highlights how the assessment of cognitive processes positioned within the RDoC framework can inform our understanding of disorder-specific and transdiagnostic difficulties in SR which are associated with diverse clinical symptoms in children.
Collapse
Affiliation(s)
- Kate L Anning
- School of Psychology, Cardiff University, Cardiff, UK.
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom.
| | - Kate Langley
- School of Psychology, Cardiff University, Cardiff, UK
| | | | | |
Collapse
|
2
|
Marzi C, d'Ambrosio A, Diciotti S, Bisecco A, Altieri M, Filippi M, Rocca MA, Storelli L, Pantano P, Tommasin S, Cortese R, De Stefano N, Tedeschi G, Gallo A. Prediction of the information processing speed performance in multiple sclerosis using a machine learning approach in a large multicenter magnetic resonance imaging data set. Hum Brain Mapp 2022; 44:186-202. [PMID: 36255155 PMCID: PMC9783441 DOI: 10.1002/hbm.26106] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 06/02/2022] [Accepted: 09/24/2022] [Indexed: 02/05/2023] Open
Abstract
Many patients with multiple sclerosis (MS) experience information processing speed (IPS) deficits, and the Symbol Digit Modalities Test (SDMT) has been recommended as a valid screening test. Magnetic resonance imaging (MRI) has markedly improved the understanding of the mechanisms associated with cognitive deficits in MS. However, which structural MRI markers are the most closely related to cognitive performance is still unclear. We used the multicenter 3T-MRI data set of the Italian Neuroimaging Network Initiative to extract multimodal data (i.e., demographic, clinical, neuropsychological, and structural MRIs) of 540 MS patients. We aimed to assess, through machine learning techniques, the contribution of brain MRI structural volumes in the prediction of IPS deficits when combined with demographic and clinical features. We trained and tested the eXtreme Gradient Boosting (XGBoost) model following a rigorous validation scheme to obtain reliable generalization performance. We carried out a classification and a regression task based on SDMT scores feeding each model with different combinations of features. For the classification task, the model trained with thalamus, cortical gray matter, hippocampus, and lesions volumes achieved an area under the receiver operating characteristic curve of 0.74. For the regression task, the model trained with cortical gray matter and thalamus volumes, EDSS, nucleus accumbens, lesions, and putamen volumes, and age reached a mean absolute error of 0.95. In conclusion, our results confirmed that damage to cortical gray matter and relevant deep and archaic gray matter structures, such as the thalamus and hippocampus, is among the most relevant predictors of cognitive performance in MS.
Collapse
Affiliation(s)
- Chiara Marzi
- MS Center and 3T‐MRI Research Unit, Department of Advanced Medical and Surgical Sciences (DAMSS)University of Campania “Luigi Vanvitelli”NapoliItaly,Department of Electrical, Electronic, and Information Engineering “Guglielmo Marconi” – DEIAlma Mater Studiorum – University of BolognaBolognaItaly
| | - Alessandro d'Ambrosio
- MS Center and 3T‐MRI Research Unit, Department of Advanced Medical and Surgical Sciences (DAMSS)University of Campania “Luigi Vanvitelli”NapoliItaly
| | - Stefano Diciotti
- Department of Electrical, Electronic, and Information Engineering “Guglielmo Marconi” – DEIAlma Mater Studiorum – University of BolognaBolognaItaly,Alma Mater Research Institute for Human‐Centered Artificial IntelligenceUniversity of BolognaBolognaItaly
| | - Alvino Bisecco
- MS Center and 3T‐MRI Research Unit, Department of Advanced Medical and Surgical Sciences (DAMSS)University of Campania “Luigi Vanvitelli”NapoliItaly
| | - Manuela Altieri
- MS Center and 3T‐MRI Research Unit, Department of Advanced Medical and Surgical Sciences (DAMSS)University of Campania “Luigi Vanvitelli”NapoliItaly,Department of PsychologyUniversity of Campania “Luigi Vanvitelli”NapoliItaly
| | - Massimo Filippi
- Neuroimaging Research Unit, Division of NeuroscienceVita‐Salute San Raffaele University, IRCCS San Raffaele Scientific InstituteMilanItaly,Neurology and Neurophysiology UnitVita‐Salute San Raffaele University, IRCCS San Raffaele Scientific InstituteMilanItaly
| | - Maria Assunta Rocca
- Neuroimaging Research Unit, Division of NeuroscienceVita‐Salute San Raffaele University, IRCCS San Raffaele Scientific InstituteMilanItaly,Neurology and Neurophysiology UnitVita‐Salute San Raffaele University, IRCCS San Raffaele Scientific InstituteMilanItaly
| | - Loredana Storelli
- Neuroimaging Research Unit, Division of NeuroscienceVita‐Salute San Raffaele University, IRCCS San Raffaele Scientific InstituteMilanItaly
| | - Patrizia Pantano
- Department of Human NeurosciencesSapienza University of RomeRomeItaly,IRCCS NeuromedPozzilliItaly
| | - Silvia Tommasin
- Department of Human NeurosciencesSapienza University of RomeRomeItaly
| | - Rosa Cortese
- Department of Medicine, Surgery and NeuroscienceUniversity of SienaSienaItaly
| | - Nicola De Stefano
- Department of Medicine, Surgery and NeuroscienceUniversity of SienaSienaItaly
| | - Gioacchino Tedeschi
- MS Center and 3T‐MRI Research Unit, Department of Advanced Medical and Surgical Sciences (DAMSS)University of Campania “Luigi Vanvitelli”NapoliItaly
| | - Antonio Gallo
- MS Center and 3T‐MRI Research Unit, Department of Advanced Medical and Surgical Sciences (DAMSS)University of Campania “Luigi Vanvitelli”NapoliItaly
| | | |
Collapse
|
3
|
Ostellino S, Benso A, Politano G. The integration of clinical data in the assessment of multiple sclerosis - A review. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2022; 221:106900. [PMID: 35623208 DOI: 10.1016/j.cmpb.2022.106900] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 05/18/2022] [Accepted: 05/18/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND AND OBJECTIVES Multiple Sclerosis (MS) is a neurological disease associated with various and heterogeneous clinical characteristics. Given its complex nature and its unpredictable evolution over time, there isn't an established and exhaustive clinical protocol (or tool) for its diagnosis nor for monitoring its progression. Instead, different clinical exams and physical/psychological evaluations need to be taken into account. The Expanded Disability Status Scale (EDSS) is the most used clinical scale, but it suffers from several limitations. Developing computational solutions for the identification of bio-markers of disease progression that overcome the downsides of currently used scales is crucial and is gaining interest in current literature and research. METHODS This Review focuses on the importance of approaching MS diagnosis and monitoring by investigating correlations between cognitive impairment and clinical data that refer to different MS domains. We review papers that integrate heterogeneous data and analyse them with statistical methods to understand their applicability into more advanced computational tools. Particular attention is paid to the impact that computational approaches can have on personalized-medicine. RESULTS Personalized medicine for neuro-degenerative diseases is an unmet clinical need which can be addressed using computational approaches able to efficiently integrate heterogeneous clinical data extracted from both private and publicly available electronic health databases. CONCLUSIONS Reliable and explainable Artificial Intelligence are computational approaches required to understand the complex and demonstrated interactions between MS manifestations as well as to provide reliable predictions on the disease evolution, representing a promising research field.
Collapse
Affiliation(s)
- Sofia Ostellino
- Department of Control and Computer Engineering, Politecnico di Torino, Italy.
| | - Alfredo Benso
- Department of Control and Computer Engineering, Politecnico di Torino, Italy.
| | - Gianfranco Politano
- Department of Control and Computer Engineering, Politecnico di Torino, Italy.
| |
Collapse
|
4
|
Virgilio E, Vecchio D, Crespi I, Barbero P, Caloni B, Naldi P, Cantello R, Dianzani U, Comi C. Serum Vitamin D as a Marker of Impaired Information Processing Speed and Early Disability in Multiple Sclerosis Patients. Brain Sci 2021; 11:brainsci11111521. [PMID: 34827520 PMCID: PMC8615879 DOI: 10.3390/brainsci11111521] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 11/02/2021] [Accepted: 11/15/2021] [Indexed: 01/18/2023] Open
Abstract
Slowed information processing speed (IPS) is the hallmark and first cognitive domain to be altered in multiple sclerosis (MS) patients. Insufficient serum vitamin D was previously associated with disease development, relapses, and progression, but little is reported on cognition. However, vitamin D and cognitive impairment (CI) in other neurodegenerative diseases have already been linked. We explored the possible correlation between vitamin D and IPS at diagnosis and early disability at last follow-up in 81 MS patients. At diagnosis, we collected vitamin D levels and performed a Symbol Digit Modalities Test (SDMT). Raw scores were adjusted for age, gender, and educational level. Early disability was evaluated with MS severity score (MSSS) and age-related MSSS (ARMSS). A total of 71 patients (86.58%) showed hypovitaminosis D (19.71 ± 8.76 ng/mL) and 18 patients (21.95%) had CI. Patients with CI showed severe hypovitaminosis D (p = 0.004). No patients with sufficient vitamin D levels had CI. We found a positive correlation between vitamin D levels at diagnosis and (1) SDMT raw and z-score that persisted after correction for sunlight exposure and MRI baseline characteristics, and (2) EDSS, MSSS, and ARMSS after a mean 2 year follow-up. Low vitamin D levels may affect both cognition and early disability in newly diagnosed MS patients.
Collapse
Affiliation(s)
- Eleonora Virgilio
- Neurology Unit, Department of Translational Medicine, Maggiore Della Carità Hospital, University of Piemonte Orientale, 28100 Novara, Italy; (D.V.); (P.B.); (B.C.); (P.N.); (R.C.)
- Ph.D. Program in Medical Sciences and Biotechnologies, Department of Translational Medicine, University of Piemonte Orientale, 28100 Novara, Italy
- Neurology Unit, Department of Translational Medicine, S. Andrea Hospital, University of Piemonte Orientale, 13100 Vercelli, Italy;
- Correspondence: ; Tel.: +39-0321-3733964
| | - Domizia Vecchio
- Neurology Unit, Department of Translational Medicine, Maggiore Della Carità Hospital, University of Piemonte Orientale, 28100 Novara, Italy; (D.V.); (P.B.); (B.C.); (P.N.); (R.C.)
- Interdisciplinary Research Center of Autoimmune Diseases (IRCAD), Department of Health Sciences, University of Piemonte Orientale, 28100 Novara, Italy;
| | - Ilaria Crespi
- Clinical Biochemistry, Department of Health Sciences, University of Piemonte Orientale, 28100 Novara, Italy;
| | - Paolo Barbero
- Neurology Unit, Department of Translational Medicine, Maggiore Della Carità Hospital, University of Piemonte Orientale, 28100 Novara, Italy; (D.V.); (P.B.); (B.C.); (P.N.); (R.C.)
| | - Beatrice Caloni
- Neurology Unit, Department of Translational Medicine, Maggiore Della Carità Hospital, University of Piemonte Orientale, 28100 Novara, Italy; (D.V.); (P.B.); (B.C.); (P.N.); (R.C.)
| | - Paola Naldi
- Neurology Unit, Department of Translational Medicine, Maggiore Della Carità Hospital, University of Piemonte Orientale, 28100 Novara, Italy; (D.V.); (P.B.); (B.C.); (P.N.); (R.C.)
| | - Roberto Cantello
- Neurology Unit, Department of Translational Medicine, Maggiore Della Carità Hospital, University of Piemonte Orientale, 28100 Novara, Italy; (D.V.); (P.B.); (B.C.); (P.N.); (R.C.)
| | - Umberto Dianzani
- Interdisciplinary Research Center of Autoimmune Diseases (IRCAD), Department of Health Sciences, University of Piemonte Orientale, 28100 Novara, Italy;
- Clinical Biochemistry, Department of Health Sciences, University of Piemonte Orientale, 28100 Novara, Italy;
| | - Cristoforo Comi
- Neurology Unit, Department of Translational Medicine, S. Andrea Hospital, University of Piemonte Orientale, 13100 Vercelli, Italy;
- Interdisciplinary Research Center of Autoimmune Diseases (IRCAD), Department of Health Sciences, University of Piemonte Orientale, 28100 Novara, Italy;
| |
Collapse
|
5
|
Walker CS, Berard JA, Walker LAS. Validation of Discrete and Regression-Based Performance and Cognitive Fatigability Normative Data for the Paced Auditory Serial Addition Test in Multiple Sclerosis. Front Neurosci 2021; 15:730817. [PMID: 34867152 PMCID: PMC8634595 DOI: 10.3389/fnins.2021.730817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 10/14/2021] [Indexed: 11/26/2022] Open
Abstract
Cognitive fatigability is an objective performance decrement that occurs over time during a task requiring sustained cognitive effort. Although cognitive fatigability is a common and debilitating symptom in multiple sclerosis (MS), there is currently no standard for its quantification. The objective of this study was to validate the Paced Auditory Serial Addition Test (PASAT) discrete and regression-based normative data for quantifying performance and cognitive fatigability in an Ontario-based sample of individuals with MS. Healthy controls and individuals with MS completed the 3″ and 2″ versions of the PASAT. PASAT performance was measured with total correct, dyad, and percent dyad scores. Cognitive fatigability scores were calculated by comparing performance on the first half (or third) of the task to the last half (or third). The results revealed that the 3″ PASAT was sufficient to detect impaired performance and cognitive fatigability in individuals with MS given the increased difficulty of the 2″ version. In addition, using halves or thirds for calculating cognitive fatigability scores were equally effective methods for detecting impairment. Finally, both the discrete and regression-based norms classified a similar proportion of individuals with MS as having impaired performance and cognitive fatigability. These newly validated discrete and regression-based PASAT norms provide a new tool for clinicians to document statistically significant cognitive fatigability in their patients.
Collapse
Affiliation(s)
| | | | - Lisa A. S. Walker
- Department of Psychology, Carleton University, Ottawa, ON, Canada
- The Ottawa Hospital Research Institute, Ottawa, ON, Canada
- The University of Ottawa Brain and Mind Research Institute, Ottawa, ON, Canada
| |
Collapse
|
6
|
Op den Kelder R, Van den Akker AL, Ensink JBM, Geurts HM, Overbeek G, de Rooij SR, Vrijkotte TGM, Lindauer RJL. Longitudinal Associations Between Trauma Exposure and Executive Functions in Children: Findings from a Dutch Birth Cohort Study. Res Child Adolesc Psychopathol 2021; 50:295-308. [PMID: 34482489 PMCID: PMC8885557 DOI: 10.1007/s10802-021-00847-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/06/2021] [Indexed: 11/26/2022]
Abstract
This study is the first to distinguish two possible predictive directions between trauma exposure and executive functioning in children in a community sample. The sample consists of 1006 children from two time points with a seven years’ time interval of a longitudinal Dutch birth cohort study, the ABCD-study (Van Eijsden et al., 2011). We analyzed the longitudinal associations between trauma exposure and executive functioning using structural equation modeling. The results demonstrated that (after controlling for prenatal substance exposure and mothers’ educational level) trauma exposure before age 5 is predictive of poorer executive functioning at age 12 and trauma exposure between age 6 and 12. However, the association between executive functioning at age 5 and trauma exposure between age 6 and 12 was not statistically significant. Our results indicate that early life trauma exposure has a long term impact on later executive functioning and not the other way around. On top of that, trauma exposure seems to accumulate across childhood when children are exposed to a traumatic event before the age of 5. When looking at the potential moderating role of parenting behavior we found no evidence for such a moderating effect of parenting behavior. Our findings showed that children exposed to trauma early in life may experience problems in executive functioning later in life and they seem at higher risk for cumulative trauma exposure. Clinical practice should take this into account in both the way they provide (early) mental health care and in prevention and recognition of early trauma exposure.
Collapse
Affiliation(s)
- R Op den Kelder
- Research Institute of Child Development and Education, University of Amsterdam, Amsterdam, The Netherlands.
- Levvel Academic Center for Child and Adolescent Psychiatry, Amsterdam, The Netherlands.
| | - A L Van den Akker
- Research Institute of Child Development and Education, University of Amsterdam, Amsterdam, The Netherlands
- Research Institute of Child Development and Education/Research Priority Area YIELD, University of Amsterdam, Amsterdam, The Netherlands
| | - J B M Ensink
- Levvel Academic Center for Child and Adolescent Psychiatry, Amsterdam, The Netherlands
- Department of Child and Adolescent Psychiatry, Amsterdam UMC, Location AMC, University of Amsterdam, Amsterdam, The Netherlands
| | - H M Geurts
- Department of Psychology (Brain and Cognition)/ Research Priority Area YIELD, University of Amsterdam, Amsterdam, The Netherlands
| | - G Overbeek
- Research Institute of Child Development and Education, University of Amsterdam, Amsterdam, The Netherlands
- Research Institute of Child Development and Education/Research Priority Area YIELD, University of Amsterdam, Amsterdam, The Netherlands
| | - S R de Rooij
- Department of Public Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Department of Clinical Epidemiology, Biostatistics and Bio-Informatics, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - T G M Vrijkotte
- Department of Public Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - R J L Lindauer
- Levvel Academic Center for Child and Adolescent Psychiatry, Amsterdam, The Netherlands
- Department of Child and Adolescent Psychiatry, Amsterdam UMC, Location AMC, University of Amsterdam, Amsterdam, The Netherlands
| |
Collapse
|
7
|
Paparella G, Fasano A, Hallett M, Berardelli A, Bologna M. Emerging concepts on bradykinesia in non-parkinsonian conditions. Eur J Neurol 2021; 28:2403-2422. [PMID: 33793037 DOI: 10.1111/ene.14851] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 03/24/2021] [Accepted: 03/29/2021] [Indexed: 12/22/2022]
Abstract
BACKGROUND AND PURPOSE Bradykinesia is one of the cardinal motor symptoms of Parkinson's disease. However, clinical and experimental studies indicate that bradykinesia may also be observed in various neurological diseases not primarily characterized by parkinsonism. These conditions include hyperkinetic movement disorders, such as dystonia, chorea, and essential tremor. Bradykinesia may also be observed in patients with neurological conditions that are not seen as "movement disorders," including those characterized by the involvement of the cerebellum and corticospinal system, dementia, multiple sclerosis, and psychiatric disorders. METHODS We reviewed clinical reports and experimental studies on bradykinesia in non-parkinsonian conditions and discussed the major findings. RESULTS Bradykinesia is a common motor abnormality in non-parkinsonian conditions. From a pathophysiological standpoint, bradykinesia in neurological conditions not primarily characterized by parkinsonism may be explained by brain network dysfunction. CONCLUSION In addition to the pathophysiological implications, the present paper highlights important terminological issues and the need for a new, more accurate, and more widely used definition of bradykinesia in the context of movement disorders and other neurological conditions.
Collapse
Affiliation(s)
| | - Alfonso Fasano
- Edmond J. Safra Program in Parkinson's Disease, Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada.,Division of Neurology, University of Toronto, Toronto, Ontario, Canada.,Krembil Brain Institute, Toronto, Ontario, Canada
| | - Mark Hallett
- Human Motor Control Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland, USA
| | - Alfredo Berardelli
- IRCCS Neuromed, Pozzilli, Italy.,Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Matteo Bologna
- IRCCS Neuromed, Pozzilli, Italy.,Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| |
Collapse
|
8
|
Doskas T, Vavougios GD, Karampetsou P, Kormas C, Synadinakis E, Stavrogianni K, Sionidou P, Serdari A, Vorvolakos T, Iliopoulos I, Vadikolias Κ. Neurocognitive impairment and social cognition in multiple sclerosis. Int J Neurosci 2021; 132:1229-1244. [PMID: 33527857 DOI: 10.1080/00207454.2021.1879066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
PURPOSE/AIM OF THE STUDY The impairment of neurocognitive functions occurs in all subtypes of multiple sclerosis, even from the earliest stages of the disease. Commonly reported manifestations of cognitive impairment include deficits in attention, conceptual reasoning, processing efficiency, information processing speed, memory (episodic and working), verbal fluency (language), and executive functions. Multiple sclerosis patients also suffer from social cognition impairment, which affects their social functioning. The objective of the current paper is to assess the effect of neurocognitive impairment and its potential correlation with social cognition performance and impairment in multiple sclerosis patients. MATERIALS AND METHODS An overview of the available-to-date literature on neurocognitive impairment and social cognition performance in multiple sclerosis patients by disease subtype was performed. RESULTS It is not clear if social cognition impairment occurs independently or secondarily to neurocognitive impairment. There are associations of variable strengths between neurocognitive and social cognition deficits and their neural basis is increasingly investigated. CONCLUSIONS The prompt detection of neurocognitive predictors of social cognition impairment that may be applicable to all multiple sclerosis subtypes and intervention are crucial to prevent further neural and social cognition decline in multiple sclerosis patients.
Collapse
Affiliation(s)
- Triantafyllos Doskas
- Department of Neurology, Athens Naval Hospital, Athens, Greece.,Department of Neurology, University Hospital of Alexandroupolis, Alexandroupolis, Greece
| | | | | | | | | | | | | | - Aspasia Serdari
- Department of Psychiatry, University Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - Theofanis Vorvolakos
- Department of Psychiatry, University Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - Ioannis Iliopoulos
- Department of Neurology, University Hospital of Alexandroupolis, Alexandroupolis, Greece
| | | |
Collapse
|
9
|
Pitteri M, Dapor C, Ziccardi S, Guandalini M, Meggiato R, Calabrese M. Visual-Attentional Load Unveils Slowed Processing Speed in Multiple Sclerosis Patients: A Pilot Study with a Tablet-Based Videogame. Brain Sci 2020; 10:E871. [PMID: 33218213 PMCID: PMC7699274 DOI: 10.3390/brainsci10110871] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 11/04/2020] [Accepted: 11/16/2020] [Indexed: 11/30/2022] Open
Abstract
Slowing in information processing speed (IPS) is the key cognitive deficit in multiple sclerosis (MS). Testing IPS in different cognitive load conditions by using computerized tools might reveal initial IPS slowness underestimated by classic paper-and-pencil tests. To investigate the extent to which IPS can be affected by increased task demands, we developed three tasks based on the manipulation of the visual-attentional load, delivered with a home-made, tablet-based videogame. Fifty-one patients with MS (pwMS), classified as having no cognitive impairment in classic paper-and-pencil tests, and 20 healthy controls (HC) underwent the videogame tasks; reaction times (RTs) and accuracy were recorded. A significant reduced performance of pwMS as compared with HC was found on the videogame tasks, with pwMS being on average slower and less accurate than HC. Furthermore, pwMS showed a significantly more pronounced decrement in accuracy as a function of the visual-attentional load, suggesting a higher susceptibility to increased task demands. Significant correlations among the Symbol Digit Modalities Test (SDMT) and the videogame mean RTs and accuracy were found, providing evidence for the concurrent validity of the videogame as a valid tool to test IPS in pwMS. The high potential that might derive from the adoption of computerized assessment tools in clinical practice should be taken into consideration and investigated further.
Collapse
Affiliation(s)
- Marco Pitteri
- Correspondence: (M.P.); (M.C.); Tel.: +39-045-8124678 (M.C.)
| | | | | | | | | | - Massimiliano Calabrese
- Neurology Section, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, 37134 Verona, Italy; (C.D.); (S.Z.); (M.G.); (R.M.)
| |
Collapse
|
10
|
Identifying Perceptual, Motor, and Cognitive Components Contributing to Slowness of Information Processing in Multiple Sclerosis with and without Depressive Symptoms. SPANISH JOURNAL OF PSYCHOLOGY 2020; 23:e21. [DOI: 10.1017/sjp.2020.23] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Abstract
Increasing findings suggest that different components of the stimulus-response pathway (perceptual, motor or cognitive) may account for slowed performance in Multiple Sclerosis (MS). It has also been reported that depressive symptoms (DS) exacerbate slowness in MS. However, no prior studies have explored the independent and joint impact of MS and DS on each of these components in a comprehensive manner. The objective of this work was to identify perceptual, motor, and cognitive components contributing to slowness in MS patients with and without DS. The study includes 33 Relapsing-Remitting MS patients with DS, 33 without DS, and 26 healthy controls. Five information processing components were isolated by means of ANCOVA analyses applied to five Reaction Time tasks. Perceptual, motor, and visual search components were slowed down in MS, as revealed by ANCOVA comparisons between patients without DS, and controls. Moreover, the compounding effect of MS and DS exacerbated deficits in the motor component, and slowed down the decisional component, as revealed by ANCOVA comparisons between patients with and without DS. DS seem to exacerbate slowness caused by MS in specific processing components. Identifying the effects of having MS and of having both MS and DS may have relevant implications when targeting cognitive and mood interventions.
Collapse
|
11
|
Darwish H, Farran N, Hannoun S, Tadros N, Yamout B, El Ayoubi NK, Khoury SJ. Serum vitamin D level is associated with speed of processing in multiple sclerosis patients. J Steroid Biochem Mol Biol 2020; 200:105628. [PMID: 32061642 DOI: 10.1016/j.jsbmb.2020.105628] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 01/16/2020] [Accepted: 02/12/2020] [Indexed: 01/01/2023]
Abstract
Multiple Sclerosis (MS) is often associated with low serum 25(OH)D levels, as well as cognitive dysfunctions. The relationship between 25(OH)D and the most commonly affected cognitive domain in MS; processing speed, is poorly explored. The purpose of this study is to: (1) assess the effect of serum 25(OH)D change on processing speed in MS, and (2) explore the relationship between serum 25(OH)D and brain volume changes in MS. A retrospective chart review was conducted, data from 299 patients were extracted (baseline), of whom 163 had follow-up measurements (after at least a 9-month interval). The Symbol Digits Modalities Test (SDMT) was used as a measure of processing speed. MRI data was available from 78 individuals at baseline, and 70 at follow-up. SDMT scores and brain volumes (Cerebellum (total, grey, and white), intracranial, Grey Matter (GM), and White Matter (WM)) were compared based on 25(OH)D levels and their changes towards follow-up. Results indicated that patients with deficient 25(OH)D levels had lower SDMT scores when compared to those with sufficient levels, and SDMT scores improved as a function of 25(OH)D. For MRI measures, only patients with sufficient 25(OH)D levels during both assessment periods had significant changes in intracranial and total cerebellum volumes. We conclude that 25(OH)D levels seem to have an effect on processing speed in MS, thus the importance of clinical monitoring and supplementation in this regard is reinforced.
Collapse
Affiliation(s)
- Hala Darwish
- Hariri School of Nursing, American University of Beirut, PO Box 11 0236, Riad El-Solh 1107 2020 Beirut, Lebanon; Nehme and Therese Tohme Multiple Sclerosis Center, American University of Beirut Medical Center, PO Box 11 0236, Riad El-Solh 1107 2020 Beirut, Lebanon.
| | - Natali Farran
- Hariri School of Nursing, American University of Beirut, PO Box 11 0236, Riad El-Solh 1107 2020 Beirut, Lebanon
| | - Salem Hannoun
- Nehme and Therese Tohme Multiple Sclerosis Center, American University of Beirut Medical Center, PO Box 11 0236, Riad El-Solh 1107 2020 Beirut, Lebanon
| | - Natalie Tadros
- Hariri School of Nursing, American University of Beirut, PO Box 11 0236, Riad El-Solh 1107 2020 Beirut, Lebanon
| | - Bassem Yamout
- Nehme and Therese Tohme Multiple Sclerosis Center, American University of Beirut Medical Center, PO Box 11 0236, Riad El-Solh 1107 2020 Beirut, Lebanon; Neurology Department, Faculty of Medicine, American University of Beirut, PO Box 11 0236, Riad El-Solh 1107 2020 Beirut, Lebanon
| | - Nabil K El Ayoubi
- Nehme and Therese Tohme Multiple Sclerosis Center, American University of Beirut Medical Center, PO Box 11 0236, Riad El-Solh 1107 2020 Beirut, Lebanon; Neurology Department, Faculty of Medicine, American University of Beirut, PO Box 11 0236, Riad El-Solh 1107 2020 Beirut, Lebanon
| | - Samia J Khoury
- Nehme and Therese Tohme Multiple Sclerosis Center, American University of Beirut Medical Center, PO Box 11 0236, Riad El-Solh 1107 2020 Beirut, Lebanon; Neurology Department, Faculty of Medicine, American University of Beirut, PO Box 11 0236, Riad El-Solh 1107 2020 Beirut, Lebanon
| |
Collapse
|
12
|
Abbing A, de Sonneville L, Baars E, Bourne D, Swaab H. Anxiety reduction through art therapy in women. Exploring stress regulation and executive functioning as underlying neurocognitive mechanisms. PLoS One 2019; 14:e0225200. [PMID: 31794566 PMCID: PMC6890254 DOI: 10.1371/journal.pone.0225200] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 10/26/2019] [Indexed: 12/21/2022] Open
Abstract
Objectives To explore possible working mechanisms of anxiety reduction in women with anxiety disorders, treated with art therapy (AT). Methods A RCT comparing AT versus waiting list (WL) condition on aspects of self-regulation. Stress regulation (heart rate and heart rate variability) and executive functioning (daily behavioural and cognitive performance aspects of executive functioning (EF)) were evaluated in a pre-post design. Participants were women, aged 18–65 years with moderate to severe anxiety symptoms. Results Effectiveness of AT compared to WL was demonstrated in a higher resting HRV post treatment, improvements in aspects of self-reported daily EF (emotion control, working memory, plan/organize and task monitor), but not in cognitive performance of EF, stress responsiveness and down regulation of stress. The decrease in anxiety level was associated with improvements in self-reported daily EF. Conclusions AT improves resting HRV and aspects of EF, the latter was associated with art therapy-related anxiety reduction.
Collapse
Affiliation(s)
- Annemarie Abbing
- Faculty of Health, University of Applied Sciences Leiden, Leiden, The Netherlands
- Clinical Neurodevelopmental Sciences, Faculty of Social Sciences, Leiden University, Leiden, The Netherlands
- * E-mail:
| | - Leo de Sonneville
- Clinical Neurodevelopmental Sciences, Faculty of Social Sciences, Leiden University, Leiden, The Netherlands
- Leiden Institute for Brain and Cognition, Leiden, The Netherlands
| | - Erik Baars
- Faculty of Health, University of Applied Sciences Leiden, Leiden, The Netherlands
| | - Daniëlle Bourne
- Department of Psychiatry, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Hanna Swaab
- Clinical Neurodevelopmental Sciences, Faculty of Social Sciences, Leiden University, Leiden, The Netherlands
- Leiden Institute for Brain and Cognition, Leiden, The Netherlands
| |
Collapse
|
13
|
Wojcik CM, Beier M, Costello K, DeLuca J, Feinstein A, Goverover Y, Gudesblatt M, Jaworski M, Kalb R, Kostich L, LaRocca NG, Rodgers JD, Benedict RH. Computerized neuropsychological assessment devices in multiple sclerosis: A systematic review. Mult Scler 2019; 25:1848-1869. [PMID: 31637963 PMCID: PMC6875828 DOI: 10.1177/1352458519879094] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Background: The proliferation of computerized neuropsychological assessment devices (CNADs) for screening and monitoring cognitive impairment is increasing exponentially. Previous reviews of computerized tests for multiple sclerosis (MS) were primarily qualitative and did not rigorously compare CNADs on psychometric properties. Objective: We aimed to systematically review the literature on the use of CNADs in MS and identify test batteries and single tests with good evidence for reliability and validity. Method: A search of four major online databases was conducted for publications related to computerized testing and MS. Test–retest reliability and validity coefficients and effect sizes were recorded for each CNAD test, along with administration characteristics. Results: We identified 11 batteries and 33 individual tests from 120 peer-reviewed articles meeting the inclusion criteria. CNADs with the strongest psychometric support include the CogState Brief Battery, Cognitive Drug Research Battery, NeuroTrax, CNS-Vital Signs, and computer-based administrations of the Symbol Digit Modalities Test. Conclusion: We identified several CNADs that are valid to screen for MS-related cognitive impairment, or to supplement full, conventional neuropsychological assessment. The necessity of testing with a technician, and in a controlled clinic/laboratory environment, remains uncertain.
Collapse
Affiliation(s)
- Curtis M Wojcik
- Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Meghan Beier
- Division of Rehabilitation Psychology and Neuropsychology, Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | - John DeLuca
- Department of Physical Medicine and Rehabilitation and Department of Neurology, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Anthony Feinstein
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Yael Goverover
- New York University, New York, NY, USA/South Shore Neurologic Associates, New York, NY, USA
| | | | - Michael Jaworski
- Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Rosalind Kalb
- National Multiple Sclerosis Society, New York, NY, USA
| | - Lori Kostich
- The Mandell MS Center, Mount Sinai Rehabilitation Hospital, Hartford, CT, USA
| | | | - Jonathan D Rodgers
- Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA/Jacobs Neurological Institute, Buffalo, NY, USA/Canisius College, Buffalo, NY, USA
| | - Ralph Hb Benedict
- Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA/Jacobs Neurological Institute, Buffalo, NY, USA
| | | |
Collapse
|
14
|
Manca R, Mitolo M, Stabile MR, Bevilacqua F, Sharrack B, Venneri A. Multiple brain networks support processing speed abilities of patients with multiple sclerosis. Postgrad Med 2019; 131:523-532. [PMID: 31478421 DOI: 10.1080/00325481.2019.1663706] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objectives: Many people affected by multiple sclerosis (MS) experience cognitive impairment, especially decreases in information processing speed (PS). Neural disconnection is thought to represent the neural marker of this symptom, although the role played by alterations of specific functional brain networks still remains unclear. The aim is to investigate and compare patterns of association between PS-demanding cognitive performance and functional connectivity across two MS phenotypes. Methods: Forty patients with relapsing-remitting MS (RRMS) and 25 with secondary progressive MS (SPMS) had neuropsychological and MRI assessments. Multiple regression models were used to investigate the relationship between performance on tests of visuomotor and verbal PS, and on the verbal fluency tests, and functional connectivity of four cognitive networks, i.e. left and right frontoparietal, salience and default-mode, and two control networks, i.e. visual and sensorimotor. Results: Patients with SPMS were older and had longer disease history than patients with RRMS and presented with worse overall clinical conditions: higher disease severity, total lesion volume, and cognitive impairment rates. However, in both patient samples, cognitive performance across tests was negatively correlated with functional connectivity of the salience and default-mode networks, and positively with connectivity of the left frontoparietal network. Only the visuomotor PS scores of the RRMS group were also associated with connectivity of the sensorimotor network. Conclusions: PS-demanding cognitive performance in patients with MS appears mainly associated with strength of functional connectivity of frontal networks involved in the evaluation and manipulation of information, as well as the default mode network. These results are in line with the hypothesis that multiple neural networks are needed to support normal cognitive performance across MS phenotypes. However, different PS measures showed partially different patterns of association with functional connectivity. Therefore, further investigations are needed to clarify the contribution of inter-network communication to specific cognitive deficits due to MS.
Collapse
Affiliation(s)
- Riccardo Manca
- Department of Neuroscience, University of Sheffield , Sheffield , UK
| | - Micaela Mitolo
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Diagnostica Funzionale Neuroradiologica , Bologna , Italy
| | | | | | - Basil Sharrack
- Academic Department of Neuroscience, Sheffield Teaching Hospital, NHS Foundation Trust , Sheffield , UK
| | - Annalena Venneri
- Department of Neuroscience, University of Sheffield , Sheffield , UK
| |
Collapse
|
15
|
Jelinek PL, Simpson S, Brown CR, Jelinek GA, Marck CH, De Livera AM, O'Kearney E, Taylor KL, Neate SL, Weiland TJ. Self-reported cognitive function in a large international cohort of people with multiple sclerosis: associations with lifestyle and other factors. Eur J Neurol 2018; 26:142-154. [PMID: 30133057 PMCID: PMC6585853 DOI: 10.1111/ene.13784] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 08/16/2018] [Indexed: 01/19/2023]
Abstract
Background and purpose We aimed to estimate the prevalence of perceived cognitive impairment (PCI) and explore its associations with lifestyle and disease characteristics in a large international cohort of people with multiple sclerosis (MS). Methods This study was a cross‐sectional analysis. Participants rated their cognitive function over the preceding 4 weeks using four questions in a subscale within the Multiple Sclerosis Quality of Life questionnaire (MSQOL‐54). These questions assessed perceived concentration, attention and memory by the patient and family/friends. Four definitions of PCI were derived, ranging from lowest to highest specificity. Associations with PCI were assessed by log‐binomial regression. Results The prevalence of PCI in our sample ranged from 41.0% (95% confidence interval, 39.0–43.0) using the least‐specific definition to 11.6% (95% confidence interval, 10.3–12.9) using the most specific definition. A number of factors were associated with PCI, increasing in magnitude as the definition specificity increased, including positive associations for smoking and body mass index, whereas physical activity, dietary quality and use of vitamin D/omega‐3 supplements were inversely associated with PCI. Conclusions Our study reports associations between healthy lifestyle behaviours and PCI in people with MS. Although reverse causality is a potential explanation for our findings, previous studies have shown comparable associations with healthy lifestyle and MS onset and progression. Subject to external validation, these results suggest benefits realized from a healthy lifestyle in people with MS.
Collapse
Affiliation(s)
- P L Jelinek
- Neuroepidemiology Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC.,Sir Charles Gairdner Hospital, Nedlands, WA
| | - S Simpson
- Neuroepidemiology Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC.,Menzies Institute for Medical Research, University of Tasmania, Tasmania
| | - C R Brown
- Neuroepidemiology Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC
| | - G A Jelinek
- Neuroepidemiology Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC
| | - C H Marck
- Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC
| | - A M De Livera
- Neuroepidemiology Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC.,Biostatistics Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC
| | - E O'Kearney
- Neuroepidemiology Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC
| | - K L Taylor
- Neuroepidemiology Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC.,Department of Psychiatry and Psychosocial Cancer Care, St Vincent's Hospital, Melbourne, VIC, Australia
| | - S L Neate
- Neuroepidemiology Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC
| | - T J Weiland
- Neuroepidemiology Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC
| |
Collapse
|
16
|
The association between pre-pregnancy overweight/obesity and offspring's behavioral problems and executive functioning. Early Hum Dev 2018; 122:32-41. [PMID: 29864728 DOI: 10.1016/j.earlhumdev.2018.05.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Revised: 05/15/2018] [Accepted: 05/19/2018] [Indexed: 11/24/2022]
Abstract
The prevalence of obesity among women of childbearing age has been rising dramatically over the last decades. Pre-pregnancy obesity may have negative neurodevelopmental consequences for the offspring. The present study examined the association of maternal pre-pregnancy overweight and obesity with child behavior problems and executive functioning at age 5 years. Data of 4094 mother-child pairs of the Amsterdam Born Children and their Development birth cohort study was used. Child behavioral problems were assessed with the maternal and teacher version of the Strengths and Difficulties Questionnaire. Two executive functioning constructs, inhibitory control and cognitive flexibility, were measured with the Response Organization Objects task of the Amsterdam Neuropsychological Tasks test battery. Increased maternal pre-pregnancy BMI was associated with an increase in children's behavioral problems (OR total behavioral problems reported by mothers pre-pregnancy obesity versus normal weight: 1.78 [95% CI 1.17 to 2.69] and reported by teachers for pre-pregnancy overweight versus normal weight: 1.32 [1.00 to 1.74]). Maternal pre-pregnancy obesity was associated with an increase in peer relationship problems reported by teachers (OR: 1.77 [1.18 to 2.64]). It was also associated with a small decrease in cognitive flexibility (increased Reaction Time in ms: B = 67.59 [5.88 to 129.30] and Within Subject Standard Deviation in ms: B = 76.46 [32.00 to 120.92]), but not with inhibitory control. Cognitive flexibility did not mediate the association between maternal pre-pregnancy BMI and children's behavioral problems.
Collapse
|
17
|
McNicholas N, O'Connell K, Yap SM, Killeen RP, Hutchinson M, McGuigan C. Cognitive dysfunction in early multiple sclerosis: a review. QJM 2018; 111:359-364. [PMID: 28371862 DOI: 10.1093/qjmed/hcx070] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Indexed: 11/14/2022] Open
Abstract
Cognitive impairment is a common and disabling feature of Multiple Sclerosis (MS), including early MS, and may even pre-date any physical symptoms. It contributes even more to withdrawal from work than physical disability. Here, we provide an overview of cognitive impairment in MS, particularly in early MS where it is most commonly under-reported and under-treated. We address the presenting features of CI, its impact on quality of life, and its validated assessments (in particular the use of Brief International Cognitive Assessment in MS for use in a clinical setting). We review the insights radiology has given us into the pathogenesis of cognitive impairment in MS, particularly in early CI and in cognitively preserved MS patients. We review current treatments for cognitive impairment, primarily cognitive rehabilitation. We address the evidence for its associated co-morbidities, which may exacerbate or trigger CI, and should therefore be addressed early in the disease course (smoking, alcohol, mood, fatigue and potential co-existing sleep disorders, exercise, and vitamin D). The article supports the importance for early recognition and management of cognitive impairment in MS, before it becomes an established and irreversible entity.
Collapse
Affiliation(s)
- N McNicholas
- Department of Neurology, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - K O'Connell
- Department of Neurology, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - S M Yap
- Department of Neurology, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - R P Killeen
- Department of Neuroradiology, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - M Hutchinson
- Department of Neurology, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - C McGuigan
- Department of Neurology, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| |
Collapse
|
18
|
Alias H, Lau SCD, Schuitema I, de Sonneville LMJ. Neuropsychological Consequences for Survivors of Childhood Brain Tumor in Malaysia. Front Psychol 2018; 9:703. [PMID: 29896137 PMCID: PMC5986920 DOI: 10.3389/fpsyg.2018.00703] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Accepted: 04/23/2018] [Indexed: 01/06/2023] Open
Abstract
Objective: This study aimed to evaluate neuropsychological consequences in survivors of childhood brain tumor. Method: A case-control study was conducted over a period of 4 months in a tertiary referral center in Kuala Lumpur, Malaysia. Fourteen survivors of childhood brain tumor aged 7–18 years, who were off-treatment for at least 1 year and were in remission, and 31 unrelated healthy controls were recruited. The median age at diagnosis was 8.20 years (range: 0.92–12.96 years). The diagnoses of brain tumors were medulloblastoma, germ cell tumor, pineocytoma, pilocystic astrocytoma, suprasellar germinoma, and ependymoma. Eleven survivors received central nervous system irradiation. Seven tasks were selected from the Amsterdam Neuropsychological Tasks program to evaluate alertness (processing speed), and major aspects of executive functioning, such as working memory capacity, inhibition, cognitive flexibility, and sustained attention. Speed, stability and accuracy of responses were the main outcome measures. Results: Survivors of childhood brain tumor showed statistically significant poorer performance on all tasks compared to healthy controls. Both processing speed and accuracy were impaired in the survivors, in particular under more complex task conditions. The survivors demonstrated deficits in alertness, sustained attention, working memory capacity, executive visuomotor control, and cognitive flexibility. Longer duration off treatment appeared to be correlated with poorer alertness, memory capacity, and inhibition. Conclusion: Survivors of childhood brain tumor in our center showed impaired neuropsychological functioning. Development of less toxic treatment protocols is important to prevent late effects of cognitive deficits in survivors of childhood brain tumor.
Collapse
Affiliation(s)
- Hamidah Alias
- Department of Pediatrics, UKM Medical Center, Faculty of Medicine, The National University of Malaysia, Kuala Lumpur, Malaysia
| | - Sie Chong D Lau
- Department of Pediatrics, UKM Medical Center, Faculty of Medicine, The National University of Malaysia, Kuala Lumpur, Malaysia
| | - Ilse Schuitema
- Department of Clinical Child and Adolescent Studies, Faculty of Social Sciences, Leiden University, Leiden, Netherlands
| | - Leo M J de Sonneville
- Department of Clinical Child and Adolescent Studies, Faculty of Social Sciences, Leiden University, Leiden, Netherlands
| |
Collapse
|
19
|
Machine Learning EEG to Predict Cognitive Functioning and Processing Speed Over a 2-Year Period in Multiple Sclerosis Patients and Controls. Brain Topogr 2018; 31:346-363. [PMID: 29380079 DOI: 10.1007/s10548-018-0620-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Accepted: 01/15/2018] [Indexed: 12/29/2022]
Abstract
Event-related potentials (ERPs) show promise to be objective indicators of cognitive functioning. The aim of the study was to examine if ERPs recorded during an oddball task would predict cognitive functioning and information processing speed in Multiple Sclerosis (MS) patients and controls at the individual level. Seventy-eight participants (35 MS patients, 43 healthy age-matched controls) completed visual and auditory 2- and 3-stimulus oddball tasks with 128-channel EEG, and a neuropsychological battery, at baseline (month 0) and at Months 13 and 26. ERPs from 0 to 700 ms and across the whole scalp were transformed into 1728 individual spatio-temporal datapoints per participant. A machine learning method that included penalized linear regression used the entire spatio-temporal ERP to predict composite scores of both cognitive functioning and processing speed at baseline (month 0), and months 13 and 26. The results showed ERPs during the visual oddball tasks could predict cognitive functioning and information processing speed at baseline and a year later in a sample of MS patients and healthy controls. In contrast, ERPs during auditory tasks were not predictive of cognitive performance. These objective neurophysiological indicators of cognitive functioning and processing speed, and machine learning methods that can interrogate high-dimensional data, show promise in outcome prediction.
Collapse
|
20
|
Boys with Oppositional Defiant Disorder/Conduct Disorder Show Impaired Adaptation During Stress: An Executive Functioning Study. Child Psychiatry Hum Dev 2018; 49:298-307. [PMID: 28755013 PMCID: PMC5856866 DOI: 10.1007/s10578-017-0749-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Evidence for problems in executive functioning (EF) in children with oppositional defiant disorder/conduct disorder (ODD/CD) is mixed and the impact stress may have on EF is understudied. Working memory, sustained attention, inhibition and cognitive flexibility of boys with ODD/CD (n = 65) and non-clinical controls (n = 32) were examined under typical and stressful test conditions. Boys with ODD/CD showed impaired working memory under typical testing conditions, and impairments in working memory and sustained attention under stressful conditions. In contrast to controls, performance on sustained attention, cognitive flexibility and inhibition was less influenced by stress in boys with ODD/CD. These results suggest that boys with ODD/CD show impairments in adaptation to the environment whereas typically developing boys show adaptive changes in EF.
Collapse
|
21
|
Hansen S, Lautenbacher S. Neuropsychological Assessment in Multiple Sclerosis. ZEITSCHRIFT FUR NEUROPSYCHOLOGIE 2017. [DOI: 10.1024/1016-264x/a000197] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Abstract. Neuropsychological deficits in multiple sclerosis (MS) are common. Over the past decades, many different procedures have been employed in diagnosing these deficits. Even though certain aspects of cognitive performance such as information processing speed and working memory may be affected more frequently than other cognitive functions, no specific deficit profile has been established in MS. This article provides an overview of the neuropsychological diagnostic procedures in MS and allows the reader to reach an informed decision on the applicability of specific procedures and the availability of study data in the context of MS. Additionally, it makes recommendations on the compilation of both screening procedures and extensive test batteries.
Collapse
Affiliation(s)
- Sascha Hansen
- Klinikum Bayreuth GmbH, Betriebsstätte Hohe Warte, Department of Neurology, Bayreuth, Germany
- Otto-Friedrich-University, Department of Physiological Psychology, Bamberg, Germany
| | - Stefan Lautenbacher
- Otto-Friedrich-University, Department of Physiological Psychology, Bamberg, Germany
| |
Collapse
|
22
|
Fetal Growth Restriction with Brain Sparing: Neurocognitive and Behavioral Outcomes at 12 Years of Age. J Pediatr 2017; 188:103-109.e2. [PMID: 28693788 DOI: 10.1016/j.jpeds.2017.06.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Revised: 04/25/2017] [Accepted: 06/01/2017] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To study neurocognitive functions and behavior in children with a history of fetal growth restriction (FGR) with brain sparing. We hypothesized that children with FGR would have poorer outcomes on these domains. STUDY DESIGN Subjects were 12-year-old children with a history of FGR born to mothers with severe early-onset hypertensive pregnancy disorders (n = 96) compared with a normal functioning full term comparison group with a birth weight ≥2500 g (n = 32). Outcome measures were neurocognitive outcomes (ie, intelligence quotient, executive function, attention) and behavior. RESULTS For the FGR group, the mean ratio of the pulsatility index for the umbilical artery/middle cerebral artery (UC-ratio = severity of brain sparing) was 1.42 ± 0.69. The mean gestational age was 31-6/7 ± 2-2/7 weeks. The mean birth weight was 1341 ± 454 g, and the mean birth weight ratio 0.68 ± 0.12. Neurocognitive outcomes were comparable between groups. Parents of children with FGR reported more social problems (mean T-score 56.6 ± 7.7; comparison 52.3 ± 4.3, P < .001, effect size = 1, 95% CI 0.52-1.46) and attention problems (mean T-score 57.3 ± 6.9; comparison 53.6 ± 4.2, P = .004, effect size = 0.88, 95% CI 0.42-1.33). UC-ratio was not associated with any of the outcomes, but low parental education and lower birth weight ratio were. CONCLUSIONS In this prospective follow-up study of 12-year-old children with a history of FGR and confirmed brain sparing, neurocognitive functions were comparable with the comparison group, but parent-reported social and attention problem scores were increased.
Collapse
|
23
|
Classen S, Krasniuk S, Morrow SA, Alvarez L, Monahan M, Danter T, Rosehart H. Visual Correlates of Fitness to Drive in Adults With Multiple Sclerosis. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2017; 38:15-27. [DOI: 10.1177/1539449217718841] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
| | | | | | | | - Miriam Monahan
- Driver Rehabilitation Institute, Santa Rosa, California, USA
| | - Tim Danter
- All Dominion Driver Training & Traffic Education Centres, Oakville, Ontario, Canada
| | | |
Collapse
|
24
|
Gouveia A, Dias SP, Santos T, Rocha H, Coelho CR, Ruano L, Galego O, Diogo MC, Seixas D, Sá MJ, Batista S. Cognitive impairment and magnetic resonance imaging correlates in primary progressive multiple sclerosis. Acta Neurol Scand 2017; 136:109-115. [PMID: 27778334 DOI: 10.1111/ane.12702] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/04/2016] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To characterize cognitive impairment in primary progressive multiple sclerosis (PPMS) and to correlate the pattern of cognitive deficits with brain magnetic resonance imaging (MRI) volumetric data. MATERIALS AND METHODS In a multicenter cross-sectional study, we recruited consecutive patients with PPMS as well as age, sex, and education level-matched healthy controls (HC). All participants underwent neuropsychological (NP) assessment, and brain MRI was performed in patients with PPMS for analysis of lesion load, subcortical GM volumes, and regional cortical volumes. RESULTS We recruited 55 patients with PPMS and 36 HC. Thirty-six patients were included in the MRI analysis. Patients with PPMS performed significantly worse than HC in all NP tests. Subcortical GM volume was significantly correlated with all NP tests, except for Stroop Test, with the largest effect for the thalamus (r=-.516 [BVMT-R DR, P=.016 FDR-corrected] to r=.664 [SDMT, P<.001 FDR-corrected]). In the stepwise linear regression model, thalamic volume was the only predictor of performance in all NP tests. CONCLUSION Cognitive impairment is common in PPMS and affects all evaluated cognitive domains. Subcortical GM volume, particularly of the thalamus, is a strong predictor of cognitive performance, suggesting it has a central role in the pathophysiology of PPMS-related cognitive dysfunction.
Collapse
Affiliation(s)
- A. Gouveia
- Department of Neurology; Centro Hospitalar e Universitário de Coimbra; Coimbra Portugal
| | - S. P. Dias
- Department of Neurology; Centro Hospitalar de Lisboa Central; Lisboa Portugal
| | - T. Santos
- Department of Neurology; Centro Hospitalar Vila Nova de Gaia/Espinho; Vila Nova de Gaia Portugal
| | - H. Rocha
- Department of Neurology; Centro Hospitalar de São João; Porto Portugal
- Faculty of Medicine; Department of Clinical Neuroscience and Mental Health; University of Porto; Porto Portugal
| | - C. R. Coelho
- Department of Neurology; Centro Hospitalar de Setúbal; Setúbal Portugal
| | - L. Ruano
- Department of Neurology; Centro Hospitalar Entre Douro e Vouga; Santa Maria da Feira Portugal
- EPIUnit - Epidemiology Research Unit; Institute of Public Health; University of Porto; Porto Portugal
| | - O. Galego
- Department of Neuroradiology; Centro Hospitalar e Universitário de Coimbra; Coimbra Portugal
| | - M. C. Diogo
- Department of Neuroradiology; Centro Hospitalar de Lisboa Central; Lisboa Portugal
| | - D. Seixas
- Department of Imaging Diagnosis; Centro Hospitalar de Vila Nova de Gaia/Espinho; Vila Nova de Gaia Portugal
- Faculty of Medicine; Department of Experimental Biology; Porto University; Porto Portugal
| | - M. J. Sá
- Department of Neurology; Centro Hospitalar de São João; Porto Portugal
- Faculty of Health Sciences; University Fernando Pessoa; Porto Portugal
| | - S. Batista
- Department of Neurology; Centro Hospitalar e Universitário de Coimbra; Coimbra Portugal
- Faculty of Medicine; University of Coimbra; Coimbra Portugal
| |
Collapse
|
25
|
Zeng Q, Dong X, Ruan C, Hu B, Zhou B, Xue Y, Liu Y, Yang H. Cognitive impairment in Chinese IIDDs revealed by MoCA and P300. Mult Scler Relat Disord 2017; 16:1-7. [DOI: 10.1016/j.msard.2017.05.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Revised: 04/25/2017] [Accepted: 05/11/2017] [Indexed: 10/19/2022]
|
26
|
Azcárraga-Guirola E, Rodríguez-Agudelo Y, Velázquez-Cardoso J, Rito-García Y, Solís-Vivanco R. Electrophysiological correlates of decision making impairment in multiple sclerosis. Eur J Neurosci 2016; 45:321-329. [DOI: 10.1111/ejn.13465] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2016] [Revised: 10/18/2016] [Accepted: 11/02/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Elisa Azcárraga-Guirola
- Neuropsychology Department; Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez (INNNMVS); Insurgentes Sur 3877, Col. La Fama, Tlalpan. C.P. 14269 Mexico City Mexico
| | - Yaneth Rodríguez-Agudelo
- Neuropsychology Department; Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez (INNNMVS); Insurgentes Sur 3877, Col. La Fama, Tlalpan. C.P. 14269 Mexico City Mexico
| | - Julia Velázquez-Cardoso
- Neuropsychology Department; Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez (INNNMVS); Insurgentes Sur 3877, Col. La Fama, Tlalpan. C.P. 14269 Mexico City Mexico
| | | | - Rodolfo Solís-Vivanco
- Neuropsychology Department; Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez (INNNMVS); Insurgentes Sur 3877, Col. La Fama, Tlalpan. C.P. 14269 Mexico City Mexico
| |
Collapse
|
27
|
Burkhardt L, Lobitz S, Koustenis E, Rueckriegel SM, Hernáiz Driever P. Cognitive and fine motor deficits in a pediatric sickle cell disease cohort of mixed ethnic origin. Ann Hematol 2016; 96:199-213. [DOI: 10.1007/s00277-016-2861-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Accepted: 10/18/2016] [Indexed: 11/24/2022]
|
28
|
Lubrini G, Ríos Lago M, Periañez JA, Tallón Barranco A, De Dios C, Fernández-Fournier M, Diez Tejedor E, Frank García A. The contribution of depressive symptoms to slowness of information processing in relapsing remitting multiple sclerosis. Mult Scler 2016; 22:1607-1615. [DOI: 10.1177/1352458516661047] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2016] [Accepted: 07/03/2016] [Indexed: 11/16/2022]
Abstract
Background: Slowness of information processing has been suggested as a fundamental factor modulating cognitive impairment in multiple sclerosis (MS). However, the contribution of depressive symptoms (DS) to slowness remains unclear. One of the most accepted hypotheses on the impact of depression on the general population suggests that depression interferes only with tasks requiring high cognitive demands. However, no studies have investigated if the same pattern occurs in MS. Objective: The aim of this study was to determine the profile of the contribution of DS to slowness. Methods: Four Reaction Time (RT) tasks requiring an increasing level of cognitive demands were administered to 35 relapsing remitting MS patients with DS, 33 MS patients without DS, 17 depressed non-MS patients and 27 controls. Results: MS patients without DS obtained longer RTs than controls in all the tasks. On the contrary, depressed non-MS patients were slower than controls only in the most demanding task. Finally, MS patients with DS were slower than MS patients without DS not only in the most demanding task but also in the task requiring a lower level of cognitive demands. Conclusion: The contribution of DS to slowness depends on the level of cognitive demands. However, its impact on MS is more deleterious than on the general population.
Collapse
Affiliation(s)
- Genny Lubrini
- Department of Neurology, La Paz University Hospital, IdiPAZ Health Research Institute, Autónoma University of Madrid, Madrid, Spain
| | - Marcos Ríos Lago
- Brain Damage Service, Hospital Beata Maria Ana, Madrid, Spain; Department of Basic Psychology II, UNED, Madrid, Spain
| | - Jose A Periañez
- Department of Basic Psychology II, Complutense University of Madrid, Madrid, Spain
| | - Antonio Tallón Barranco
- Department of Neurology, La Paz University Hospital, IdiPAZ Health Research Institute, Autónoma University of Madrid, Madrid, Spain
| | - Consuelo De Dios
- Department of Psychiatry, La Paz University Hospital, IdiPAZ Health Research Institute, Autónoma University of Madrid, Madrid, Spain
| | - Mireya Fernández-Fournier
- Department of Neurology, La Paz University Hospital, IdiPAZ Health Research Institute, Autónoma University of Madrid, Madrid, Spain
| | - Exuperio Diez Tejedor
- Department of Neurology, La Paz University Hospital, IdiPAZ Health Research Institute, Autónoma University of Madrid, Madrid, Spain
| | - Ana Frank García
- Department of Neurology, La Paz University Hospital, IdiPAZ Health Research Institute, Autónoma University of Madrid, Madrid, Spain
| |
Collapse
|
29
|
Guxens M, Vermeulen R, van Eijsden M, Beekhuizen J, Vrijkotte TGM, van Strien RT, Kromhout H, Huss A. Outdoor and indoor sources of residential radiofrequency electromagnetic fields, personal cell phone and cordless phone use, and cognitive function in 5-6 years old children. ENVIRONMENTAL RESEARCH 2016; 150:364-374. [PMID: 27348251 DOI: 10.1016/j.envres.2016.06.021] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Revised: 06/06/2016] [Accepted: 06/12/2016] [Indexed: 05/20/2023]
Abstract
BACKGROUND Little is known about the exposure of young children to radiofrequency electromagnetic fields (RF-EMF) and potentially associated health effects. We assessed the relationship between residential RF-EMF exposure from mobile phone base stations, residential presence of indoor sources, personal cell phone and cordless phone use, and children's cognitive function at 5-6 years of age. METHODS Cross-sectional study on children aged 5-6 years from the Amsterdam Born Children and their Development (ABCD) study, the Netherlands (n=2354). Residential RF-EMF exposure from mobile phone base stations was estimated with a 3D geospatial radio wave propagation model. Residential presence of indoor sources (cordless phone base stations and Wi-Fi) and children's cell phone and cordless phone use was reported by the mother. Speed of information processing, inhibitory control, cognitive flexibility, and visuomotor coordination was assessed using the Amsterdam Neuropsychological Tasks. RESULTS Residential presence of RF-EMF indoor sources was associated with an improved speed of information processing. Higher residential RF-EMF exposure from mobile phone base stations and presence of indoor sources was associated with an improved inhibitory control and cognitive flexibility whereas we observed a reduced inhibitory control and cognitive flexibility with higher personal cordless phone use. Higher residential RF-EMF exposure from mobile phone base stations was associated with a reduced visuomotor coordination whereas we observed an improved visuomotor coordination with residential presence of RF-EMF indoor sources and higher personal cell phone use. CONCLUSIONS We found inconsistent associations between different sources of RF-EMF exposure and cognitive function in children aged 5-6 years.
Collapse
Affiliation(s)
- Mònica Guxens
- Institute for Risk Assessment Sciences, Division of Environmental Epidemiology, Utrecht University, PO Box 80178, 3508 TD Utrecht, The Netherlands; Center for Research in Environmental Epidemiology, C/ Doctor Aiguader 88, 08003 Barcelona, Spain; Pompeu Fabra University, C/ Doctor Aiguader 88, 08003 Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Avenue de Monforte de Lemos, 5, 28029 Madrid, Spain; Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Centre-Sophia Children's Hospital, PO Box 2060, 3000 CB Rotterdam, The Netherlands.
| | - Roel Vermeulen
- Institute for Risk Assessment Sciences, Division of Environmental Epidemiology, Utrecht University, PO Box 80178, 3508 TD Utrecht, The Netherlands; Julius Centre for Public Health Sciences and Primary Care, University Medical Centre, PO Box 85500, 3508 GA Utrecht, The Netherlands.
| | - Manon van Eijsden
- Department of Epidemiology and Health Promotion, Public Health Service of Amsterdam (GGD), PO Box 2200, 1000 CE Amsterdam, The Netherlands.
| | - Johan Beekhuizen
- Institute for Risk Assessment Sciences, Division of Environmental Epidemiology, Utrecht University, PO Box 80178, 3508 TD Utrecht, The Netherlands.
| | - Tanja G M Vrijkotte
- Department of Public Health, Academic Medical Center, University of Amsterdam, Meidergdreef 9, 1105 AZ Amsterdam, The Netherlands.
| | - Rob T van Strien
- Department of Environmental Health, Public Health Service of Amsterdam (GGD), PO Box 2200, 1000 CE Amsterdam, The Netherlands.
| | - Hans Kromhout
- Institute for Risk Assessment Sciences, Division of Environmental Epidemiology, Utrecht University, PO Box 80178, 3508 TD Utrecht, The Netherlands.
| | - Anke Huss
- Institute for Risk Assessment Sciences, Division of Environmental Epidemiology, Utrecht University, PO Box 80178, 3508 TD Utrecht, The Netherlands; Institute for Social and Preventive Medicine, University of Bern, Finkenhubelweg 9, 3012 Bern, Switzerland.
| |
Collapse
|
30
|
de Sonneville LMJ, Hidding E, van Engeland H, Vorstman JAS, Sijmens-Morcus MEJ, Swaab H. [Formula: see text]Executive functioning and its relation to ASD and ADHD symptomatology in 22q11.2 deletion syndrome. Child Neuropsychol 2016; 24:1-19. [PMID: 27608887 DOI: 10.1080/09297049.2016.1221064] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Children with 22q11.2 deletion syndrome (22q11DS; velo-cardio-facial-syndrome) are at risk for the developmental disorders, attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). In this study, the relation between executive functioning (EF) and the severity of ADHD and ASD symptoms is examined, since EF is known to be important in relation to emotional and behavioral problems. The participants consist of 58 children (38 females) with a mean age of 13.5 years (SD 2.6). Standardized assessment was used to evaluate the severity of ASD and ADHD symptomatology. The major aspects of EF, i.e., cognitive flexibility, inhibition, sustained attention, distractibility, working memory and reaction speed, were evaluated. The profile of EF in 22q11DS was found to be characterized by weaker performance compared to the norms on all subdomains of EF. Poor cognitive flexibility and inhibition, as well as high distractibility, were found to be related to more severe ASD symptoms, while poor quality of sustained attention and high distractibility were found to be related to more severe ADHD symptoms. It is concluded that children with 22q11DS experience impairments in EF, and that the degree of impairment on specific EF subdomains is related to the severity of ASD and/or ADHD symptomatology. These results may help in defining the mediating role of neurocognitive dysfunctions in the development of social and behavioral problems in 22q11DS.
Collapse
Affiliation(s)
- Leo M J de Sonneville
- a Department of Clinical Child and Adolescent Studies , Leiden University , Leiden , The Netherlands.,b Leiden Institute for Brain and Cognition , Leiden , The Netherlands
| | - Elske Hidding
- a Department of Clinical Child and Adolescent Studies , Leiden University , Leiden , The Netherlands
| | - Herman van Engeland
- c Department of Psychiatry, Brain Center Rudolph Magnus , University Medical Centre Utrecht , Utrecht , The Netherlands
| | - Jacob A S Vorstman
- c Department of Psychiatry, Brain Center Rudolph Magnus , University Medical Centre Utrecht , Utrecht , The Netherlands
| | | | - Hanna Swaab
- a Department of Clinical Child and Adolescent Studies , Leiden University , Leiden , The Netherlands.,b Leiden Institute for Brain and Cognition , Leiden , The Netherlands
| |
Collapse
|
31
|
Lazeron RHC, de Sonneville LMJ, Scheltens P, Polman CH, Barkhof F. Cognitive slowing in multiple sclerosis is strongly associated with brain volume reduction. Mult Scler 2016; 12:760-8. [PMID: 17263004 DOI: 10.1177/1352458506070924] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Introduction In this study, we investigated the influence of in vivo disease pathology (measured as magnetic resonance imaging (MRI) lesion load and brain volume reduction) on cognitive functioning, especially the speed of processing, in multiple sclerosis (MS) patients. Since MS is characterized by cognitive slowing rather than impaired accuracy, we used the Amsterdam Neuropsychological Tasks (ANT) program, a computerized test proven to be very sensitive to cognitive slowing in MS patients. Methods Thirty-two patients performed the ANT and underwent MRI scanning. Using the ANT computerized tests, we investigated focused, divided, sustained attention, executive function and psychomotor function, and examined associations of speed, speed fluctuation and accuracy of performance of these tests with MRI lesion load and brain volume parameters. Results A decrease in the speed of processing and response speed stability, and a decrease in psychomotor accuracy and stability were clearly associated with less brain volume, and with higher lesion loads, in particular at frontal and occipital areas. Correlations with brain volume reduction were found for all domains, except for visuo-spatial processing. In particular, speed and speed fluctuation scores correlated with brain volume reduction, while accuracy of performance, in general, did not correlate. Only some test speed scores and speed fluctuation scores correlated with lesion load measurements. Conclusion This study shows that, in MS patients, accuracy of processing is not compromised unless high working memory demands are involved. Problems in neurocognitive functioning in MS are mainly modulated by speed and stability of speed processing, in particular when attention-demanding controlled information processing is required. Abnormalities in these domains are most strongly associated with brain volume loss, confirming that pathology beyond focal lesions is important in MS.
Collapse
Affiliation(s)
- R H C Lazeron
- Department of Neurology, Vrije Universiteit Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands.
| | | | | | | | | |
Collapse
|
32
|
Olivares T, Nieto A, Sánchez MP, Wollmann T, Hernández MA, Barroso J. Pattern of neuropsychological impairment in the early phase of relapsing-remitting multiple sclerosis. Mult Scler 2016; 11:191-7. [PMID: 15794394 DOI: 10.1191/1352458505ms1139oa] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
To investigate the neuropsychological profile in the first few years post-onset of relapsing-remitting multiple sclerosis (MS) we carried out a comprehensive neuropsychological evaluation of 33 patients characterized by very short evolution of this disease, minimal levels of neurological disability and preserved general cognition. Thirty-three individually pair-matched controls were also evaluated. Patients performed as well as controls on many of the cognitive exploration measures. Nevertheless, the group of patients evinced a general slowness that affected motor execution and cognitive processing. Memory functions were characterized by preservation of working memory, retrieval or storage of information and a deficit at the acquisition phase in (verbal and visual) supraspan tasks. In addition, significant correlations were observed between some measures of information processing speed and memory. These results highlight the importance of studying cognitive deficits not only in the different subtypes of MS but also in different phases of the disease.
Collapse
Affiliation(s)
- T Olivares
- Facultad de Psicología, Universidad de La Laguna, La Laguna 38205, Tenerife, Islas Canarias, Spain
| | | | | | | | | | | |
Collapse
|
33
|
Lynch SG, Parmenter BA, Denney DR. The association between cognitive impairment and physical disability in multiple sclerosis. Mult Scler 2016; 11:469-76. [PMID: 16042232 DOI: 10.1191/1352458505ms1182oa] [Citation(s) in RCA: 81] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Background: The association between cognitive impairment and physical disability was examined in a larger, more representative sample of patients with multiple sclerosis (MS) than in previous studies. Method: Two hundred and fifty-three patients attending an MS clinic were assessed with respect to physical disability using the Expanded Disability Status Scale and cognitive impairment using a battery of neuropsychological tests. Results: Physical disability correlated with duration of disease; cognitive impairment did not. Virtually all measures derived from the cognitive battery were significantly correlated with physical disability. Three measures of speeded information processing and one involving delayed recall of verbal material were unique predictors of disability status. The relationship between cognitive impairment and physical disability was equivalent for patients with shorter (<3 years) versus longer (>10 years) disease duration. Cognitive impairment correlated with the rate of disability progression as reflected by the progression index. Conclusion: Cognitive impairment is more closely associated with physical disability than most previous studies indicate. This relationship appears to be stable throughout the duration of MS, although this conclusion is qualified by the cross-sectional design of the study. Further attention should be paid to cognitive impairment as a possible predictor of the rate of patients’ physical decline.
Collapse
Affiliation(s)
- Sharon G Lynch
- Department of Neurology, University of Kansas Medical Center, Kansas City, KS 66160, USA
| | | | | |
Collapse
|
34
|
Hidding E, Swaab H, de Sonneville LMJ, van Engeland H, Vorstman JAS. The role of COMT and plasma proline in the variable penetrance of autistic spectrum symptoms in 22q11.2 deletion syndrome. Clin Genet 2016; 90:420-427. [PMID: 26919535 DOI: 10.1111/cge.12766] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Revised: 02/10/2016] [Accepted: 02/22/2016] [Indexed: 12/16/2022]
Abstract
This paper examines how COMT158 genotypes and plasma proline levels are associated with variable penetrance of social behavioural and social cognitive problems in 22q11.2 deletion syndrome (22q11DS). Severity of autistic spectrum symptoms of 45 participants with 22q11DS was assessed using the Autism Diagnostic Interview Revised. Face and facial emotion recognition was evaluated using standardized computer-based test-paradigms. Associations with COMT158 genotypes and proline levels were examined. High proline levels and poor face recognition in individuals with the COMTMET allele, and poor facial emotion recognition, explained almost 50% of the variance in severity of autism symptomatology in individuals with 22q11DS. High proline levels and a decreased capacity to break down dopamine as a result of the COMTMET variant are both relevant in the expression of the social phenotype in patients. This epistatic interaction effect between the COMT158 genotype and proline on the expression of social deficits in 22q11DS shows how factors other than the direct effects of the deletion itself can modulate the penetrance of associated cognitive and behavioural outcomes. These findings are not only relevant to our insight into 22q11DS, but also provide a model to better understand the phenomenon of variable penetrance in other pathogenic genetic variants.
Collapse
Affiliation(s)
- E Hidding
- Department of Clinical Child and Adolescent Studies, Faculty of Social and Behavioural Sciences, Leiden University, Leiden, The Netherlands
| | - H Swaab
- Department of Clinical Child and Adolescent Studies, Faculty of Social and Behavioural Sciences, Leiden University, Leiden, The Netherlands.,Leiden Institute of Brain and Cognition, Leiden, The Netherlands
| | - L M J de Sonneville
- Department of Clinical Child and Adolescent Studies, Faculty of Social and Behavioural Sciences, Leiden University, Leiden, The Netherlands. .,Leiden Institute of Brain and Cognition, Leiden, The Netherlands .
| | - H van Engeland
- Department of Psychiatry, Brain Center Rudolph Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - J A S Vorstman
- Department of Psychiatry, Brain Center Rudolph Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| |
Collapse
|
35
|
D'Amico E, Leone C, Hayrettin T, Patti F. Can we define a rehabilitation strategy for cognitive impairment in progressive multiple sclerosis? A critical appraisal. Mult Scler 2016; 22:581-9. [PMID: 26920381 DOI: 10.1177/1352458516632066] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Accepted: 01/17/2016] [Indexed: 01/25/2023]
Abstract
Cognitive impairment (CI) has been shown to be severe in patients with progressive forms of multiple sclerosis (MS), and the most frequently impaired domains are sustained attention, information processing speed, memory, and executive functions. In contrast to relapsing forms of MS, where studies have shown favorable results from cognitive rehabilitation, there is a lack of data on cognitive rehabilitation in progressive forms of MS. A specific approach in assessing CI and in designing and administering rehabilitation training for patients with progressive forms of MS is needed.
Collapse
Affiliation(s)
| | | | - Tumani Hayrettin
- Klinik und PoliklinikfürNeurologie der Universität Ulm, Ulm, Germany
| | | |
Collapse
|
36
|
Koustenis E, Hernáiz Driever P, de Sonneville L, Rueckriegel SM. Executive function deficits in pediatric cerebellar tumor survivors. Eur J Paediatr Neurol 2016; 20:25-37. [PMID: 26631949 DOI: 10.1016/j.ejpn.2015.11.001] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2014] [Revised: 10/30/2015] [Accepted: 11/01/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND AIMS Besides motor function the cerebellum subserves frontal lobe functions. Thus, we investigated executive functions in pediatric posterior fossa tumor survivors. METHODS We tested information processing, aspects of attention, planning and intelligence in 42 pediatric posterior fossa tumor survivors (mean age 14.63 yrs, SD 5.03). Seventeen low-grade tumor patients (LGCT) were treated with surgery only and 25 high-grade tumors patients (HGCT) received postsurgical adjuvant treatment. We evaluated simple reaction time, executive functioning, i.e. visuospatial memory, inhibition, and mental flexibility using the Amsterdam Neuropsychological Tasks program, whereas forward thinking was assessed with the Tower of London-test. Intelligence was determined using the Wechsler Intelligence Scale. Ataxia was assessed with the International Cooperative Ataxia Rating Scale. RESULTS About one third of each patient group showed forward thinking scores below one standard deviation of the norm. Impaired forward thinking correlated significantly with degree of ataxia (r = -0.39, p = 0.03) but not with fluid intelligence. Both patient groups exhibited executive function deficits in accuracy and reaction speed in more difficult tasks involving information speed and attention flexibility. Still, HGCT patients were significantly slower and committed more errors. Working memory was inferior in HGCT patients. CONCLUSION Pediatric cerebellar tumor survivors with different disease and treatment related brain damage exhibit similar patterns of impairment in executive functioning, concerning forward thinking, inhibition and mental flexibility. The deficits are larger in high-grade tumor patients. The pattern of function loss seen in both groups is most probably due to comparable lesions to cerebro-cerebellar circuits that are known to modulate critical executive functions.
Collapse
Affiliation(s)
- Elisabeth Koustenis
- Department of Pediatric Oncology and Hematology, Charité-Universitätsmedizin Berlin, Germany
| | - Pablo Hernáiz Driever
- Department of Pediatric Oncology and Hematology, Charité-Universitätsmedizin Berlin, Germany.
| | - Leo de Sonneville
- Leiden Institute for Brain and Cognition, Department of Clinical Child and Adolescent Studies, Leiden University, The Netherlands
| | - Stefan M Rueckriegel
- Department of Pediatric Oncology and Hematology, Charité-Universitätsmedizin Berlin, Germany; Department of Neurosurgery, University Hospital Würzburg, Germany
| |
Collapse
|
37
|
Jonkman LE, Rosenthal DM, Sormani MP, Miles L, Herbert J, Grossman RI, Inglese M. Gray Matter Correlates of Cognitive Performance Differ between Relapsing-Remitting and Primary-Progressive Multiple Sclerosis. PLoS One 2015; 10:e0129380. [PMID: 26485710 PMCID: PMC4616346 DOI: 10.1371/journal.pone.0129380] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Accepted: 05/07/2015] [Indexed: 11/29/2022] Open
Abstract
Multiple Sclerosis (MS) is a chronic inflammatory/demyelinating and neurodegenerative disease of the central nervous system (CNS). Most patients experience a relapsing-remitting (RR) course, while about 15–20% of patients experience a primary progressive (PP) course. Cognitive impairment affects approximately 40–70% of all MS patients and differences in cognitive impairment between RR-MS and PP-MS have been found. We aimed to compare RR-MS and PP-MS patients in terms of cognitive performance, and to investigate the MRI correlates of cognitive impairment in the two groups using measures of brain volumes and cortical thickness. Fifty-seven patients (42 RR-MS, 15 PP-MS) and thirty-eight matched controls underwent neuropsychological (NP) testing and MRI. PP-MS patients scored lower than RR-MS patients on most of the NP tests in absence of any specific pattern. PP-MS patients showed significantly lower caudate volume. There was no significant difference in MRI correlates of cognitive impairment between the two groups except for a prevalent association with MRI measures of cortical GM injury in RR-MS patients and with MRI measures of subcortical GM injury in PP-MS patients. This suggests that although cognitive impairment results from several factors, cortical and subcortical GM injury may play a different role depending on the disease course.
Collapse
Affiliation(s)
- Laura E. Jonkman
- Department of Neurology, Mount Sinai School of Medicine, New York, New York, United States of America
- Department of Anatomy and Neurosciences, VU University Medical Center, Amsterdam, the Netherlands
| | - Diana M. Rosenthal
- Department of Radiology, New York University School of Medicine, New York, New York, United States of America
- Department of Population Health, New York University School of Medicine, New York, New York, United States of America
| | | | - Laura Miles
- Department of Radiology, New York University School of Medicine, New York, New York, United States of America
| | - Joseph Herbert
- Department of Neurology, New York University School of Medicine, New York, New York, United States of America
| | - Robert I. Grossman
- Department of Radiology, New York University School of Medicine, New York, New York, United States of America
| | - Matilde Inglese
- Department of Neurology, Mount Sinai School of Medicine, New York, New York, United States of America
- Department of Radiology, Mount Sinai School of Medicine, New York, New York, United States of America
- Department of Neuroscience, Mount Sinai School of Medicine, New York, New York, United States of America
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
- * E-mail:
| |
Collapse
|
38
|
Executive Dysfunction 25 Years after Treatment with Cranial Radiotherapy for Pediatric Lymphoid Malignancies. J Int Neuropsychol Soc 2015; 21:657-69. [PMID: 26391667 DOI: 10.1017/s1355617715000788] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The first cohorts to survive childhood lymphoid malignancies treated with cranial irradiation are now aging into adulthood, and concerns are growing about the development of radiotherapy-induced cognitive deficits in the aging brain. These deficits are hypothesized to increase over time. Their impact on daily functioning of older survivors, and the accompanying need for interventions, should be anticipated. By describing a detailed profile of executive function deficits and their associations with age, specific targets for neuropsychological intervention can be identified. Fifty survivors of childhood lymphoid malignancies and 58 related controls were assessed with the Amsterdam Neuropsychological Tasks program. The survivors were on average 31.1 (4.9) years old, treated with 22.5 (6.8) Gy cranial irradiation, and examined on average 25.5 (3.1) years after diagnosis. The survivors showed significantly decreased response speed, irrespective of the task at hand. Furthermore, we found deficits in working memory capacity, inhibition, cognitive flexibility, executive visuomotor control, attentional fluctuations, and sustained attention. Older age was associated with poorer performance on executive visuomotor control and inhibition. On executive visuomotor control, 50% of female survivors performed more than 1.5 SD below average, versus 15.4% of male survivors. The combination of visuospatial working memory problems and decreasing executive visuomotor control could result in difficulty with learning new motor skills at older ages, like walking with a cane. Deterioration of executive control and inhibition may result in decreased behavioral and emotional regulation in aging survivors. Especially the deficiency in executive visuomotor control in female survivors should be considered for (prophylactic) intervention.
Collapse
|
39
|
Atteinte de la mémoire épisodique verbale dans la sclérose en plaques : revue critique des processus cognitifs concernés et de leur exploration. Rev Neurol (Paris) 2015; 171:624-45. [DOI: 10.1016/j.neurol.2015.02.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2014] [Revised: 02/01/2015] [Accepted: 02/13/2015] [Indexed: 11/22/2022]
|
40
|
Wolkorte R, Heersema DJ, Zijdewind I. Reduced Voluntary Activation During Brief and Sustained Contractions of a Hand Muscle in Secondary-Progressive Multiple Sclerosis Patients. Neurorehabil Neural Repair 2015; 30:307-16. [DOI: 10.1177/1545968315593809] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Background. Secondary-progressive multiple sclerosis (SPMS) patients have structural cortical damage resulting in increased compensatory cortical activity during (submaximal) performance. However, functional effects of changed cortical output are difficult to measure. The interpolated-twitch technique allows for measurement of voluntary activation (VA) necessary for force production. This study aimed to determine VA, force, and muscle fatigue during brief and sustained contractions in SPMS patients. Because fatigue effects are not confined to the motor system, we additionally examined fatiguing effects on cognitive performance. Methods. Twenty-five SPMS and 25 sex-, age-, and education-matched participants performed brief (5 seconds) and sustained (2 minutes) maximal index finger abductions. To evaluate VA, double-pulse twitches were evoked before, during, and after contractions. Additionally, data were compared with data obtained in relapsing–remitting multiple sclerosis (RRMS) patients. Subjects also performed choice-reaction time tasks before and after the sustained contraction. Results. During brief contractions, VA (85% vs 94%, P = .004) and force (25 N vs 32 N, P = .011) were lower for SPMS patients than controls. During sustained contractions, VA ( P = .001) was also lower, resulting in greater force decline (73% vs 63%, P < .001) and reduced peripheral fatigue (19% vs 50%, P < .001). Comparisons with RRMS resulted in lower VA, greater force decline, and greater estimated central fatigue in SPMS. SPMS patients were slower ( P < .001) and made more errors ( P < .001) than controls, but neither group reduced their performance after the sustained contraction. Conclusion. SPMS patients had lower VA than RRMS patients and controls. The importance of voluntary activation for muscle force and fatigability warrants targeted rehabilitation strategies.
Collapse
Affiliation(s)
- Ria Wolkorte
- Department of Neuroscience, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Dorothea J. Heersema
- Department of Neurology, University Medical Center Groningen, Groningen, Netherlands
| | - Inge Zijdewind
- Department of Neuroscience, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| |
Collapse
|
41
|
Rueckriegel SM, Bruhn H, Thomale UW, Hernáiz Driever P. Cerebral white matter fractional anisotropy and tract volume as measured by MR imaging are associated with impaired cognitive and motor function in pediatric posterior fossa tumor survivors. Pediatr Blood Cancer 2015; 62:1252-8. [PMID: 25850573 DOI: 10.1002/pbc.25485] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2014] [Accepted: 02/02/2015] [Indexed: 01/18/2023]
Abstract
BACKGROUND Disease and therapy cause brain damage and subsequent functional loss in pediatric patients with posterior fossa tumors. Treatment-related toxicity factors are resection in patients with pilocytic astrocytoma (PA) and, additionally, cranio-spinal irradiation together with chemotherapy in patients with medulloblastoma (MB). We tested whether damage to white matter (WM) as revealed by diffusion tensor MR imaging (DTI) correlated with specific cognitive and motor impairments in survivors of pediatric posterior fossa tumors. PROCEDURES Eighteen MB (mean age ± SD, 15.2 ± 4.9 y) and 14 PA (12.6 ± 5.0 y) survivors were investigated with DTI on a 3-Tesla-MR system. We identified fractional anisotropy (FA) of WM, the volume ratio of WM to gray matter and cerebrospinal fluid (WM/GM + CSF), and volume of specific frontocerebellar tracts. Ataxia was assessed using the International Cooperative Ataxia Rating Scale (ICARS), while the Wechsler Intelligence Scale for Children determined full-scale intelligence quotients (FSIQ). Amsterdam Neuropsychological Tasks (ANT) was used to assess processing speed. Handwriting automation was analyzed using a digitizing graphic tablet. RESULTS The WM/GM + CSF ratio correlated significantly with cognitive measures (IQ, P = 0.002; ANT baseline speed, P = 0.04; ANT shifting attention, P = 0.004). FA of skeletonized tracts correlated significantly with FSIQ (P = 0.008), ANT baseline speed (P = 0.028) and ANT shifting attention (P = 0.045). Moreover, frontocerebellar tract volumes correlated with both the FSIQ (P = 0.011) and ICARS (P = 0.007). CONCLUSION DTI provides a method for quantification of WM damage by tumor and by therapy-associated effects in survivors of pediatric posterior fossa tumors. DTI-derived WM integrity may be a representative marker for cognitive and motor deterioration.
Collapse
Affiliation(s)
- Stefan M Rueckriegel
- Pediatric Neurooncology Program, Department of Pediatric Oncology and Hematology, Charité-CVK, Berlin, Germany.,Department of Neurosurgery, University Hospital Würzburg, Würzburg, Germany
| | - Harald Bruhn
- Department of Radiology, Charité-CVK, Berlin, Germany
| | - Ulrich W Thomale
- Section of Pediatric Neurosurgery, Charité- CVK, Berlin, Germany
| | - Pablo Hernáiz Driever
- Pediatric Neurooncology Program, Department of Pediatric Oncology and Hematology, Charité-CVK, Berlin, Germany
| |
Collapse
|
42
|
Roth AK, Denney DR, Lynch SG. Information processing speed and attention in multiple sclerosis: Reconsidering the Attention Network Test (ANT). J Clin Exp Neuropsychol 2015; 37:518-29. [PMID: 26010017 DOI: 10.1080/13803395.2015.1037252] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE The Attention Network Test (ANT) assesses attention in terms of discrepancies between response times to items that differ in the burden they place on some facet of attention. However, simple arithmetic difference scores commonly used to capture these discrepancies fail to provide adequate control for information processing speed, leading to distorted findings when patient and control groups differ markedly in the speed with which they process and respond to stimulus information. This study examined attention networks in patients with multiple sclerosis (MS) using simple difference scores, proportional scores, and residualized scores that control for processing speed through statistical regression. METHOD Patients with relapsing-remitting (N = 20) or secondary progressive (N = 20) MS and healthy controls (N = 40) of similar age, education, and gender completed the ANT. RESULTS Substantial differences between patients and controls were found on all measures of processing speed. Patients exhibited difficulties in the executive control network, but only when difference scores were considered. When deficits in information processing speed were adequately controlled using proportional or residualized score, deficits in the alerting network emerged. The effect sizes for these deficits were notably smaller than those for overall information processing speed and were also limited to patients with secondary progressive MS. CONCLUSIONS Deficits in processing speed are more prominent in MS than those involving attention, and when the former are properly accounted for, differences in the latter are confined to the alerting network.
Collapse
Affiliation(s)
- Alexandra K Roth
- a Department of Psychology , University of Kansas , Lawrence , KS , USA
| | | | | |
Collapse
|
43
|
Denney DR, Hughes AJ, Elliott JK, Roth AK, Lynch SG. Incidental Learning During Rapid Information Processing on the Symbol-Digit Modalities Test. Arch Clin Neuropsychol 2015; 30:322-8. [DOI: 10.1093/arclin/acv019] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/19/2015] [Indexed: 11/12/2022] Open
|
44
|
van Rijn S, Swaab H. Executive dysfunction and the relation with behavioral problems in children with 47,XXY and 47,XXX. GENES BRAIN AND BEHAVIOR 2015; 14:200-8. [DOI: 10.1111/gbb.12203] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Revised: 01/16/2015] [Accepted: 01/20/2015] [Indexed: 10/24/2022]
Affiliation(s)
- S. van Rijn
- Clinical Child and Adolescent Studies; Leiden University; Leiden The Netherlands
- Leiden Institute for Brain and Cognition; Leiden The Netherlands
| | - H. Swaab
- Clinical Child and Adolescent Studies; Leiden University; Leiden The Netherlands
- Leiden Institute for Brain and Cognition; Leiden The Netherlands
| |
Collapse
|
45
|
Cabib C, Llufriu S, Casanova-Molla J, Saiz A, Valls-Solé J. Defective sensorimotor integration in preparation for reaction time tasks in patients with multiple sclerosis. J Neurophysiol 2015; 113:1462-9. [DOI: 10.1152/jn.00591.2014] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Slowness of voluntary movements in patients with multiple sclerosis (MS) may be due to various factors, including attentional and cognitive deficits, delays in motor conduction time, and impairment of specific central nervous system circuits. In 13 healthy volunteers and 20 mildly disabled, relapsing-remitting MS patients, we examined simple reaction time (SRT) tasks requiring sensorimotor integration in circuits involving the corpus callosum and the brain stem. A somatosensory stimulus was used as the imperative signal (IS), and subjects were requested to react with either the ipsilateral or the contralateral hand (uncrossed vs. crossed SRT). In 33% of trials, a startling auditory stimulus was presented together with the IS, and the percentage reaction time change with respect to baseline SRT trials was measured (StartReact effect). The difference between crossed and uncrossed SRT, which requires interhemispheric conduction, was significantly larger in patients than in healthy subjects ( P = 0.021). The StartReact effect, which involves activation of brain stem motor pathways, was reduced significantly in patients with respect to healthy subjects (uncrossed trials: P = 0.015; crossed trials: P = 0.005). In patients, a barely significant correlation was found between SRT delay and conduction abnormalities in motor and sensory pathways ( P = 0.02 and P = 0.04, respectively). The abnormalities found specifically in trials reflecting interhemispheric transfer of information, as well as the evidence for reduced subcortical motor preparation, indicate that a delay in reaction time execution in MS patients cannot be explained solely by conduction slowing in motor and sensory pathways but suggest, instead, defective sensorimotor integration mechanisms in at least the two circuits examined.
Collapse
Affiliation(s)
- Christopher Cabib
- EMG Unit, Neurology Department, Hospital Clinic, and Institut d'Investigació Augustí Pi i Sunyer, Facultat de Medicina, University of Barcelona, Barcelona, Spain; and
| | - Sara Llufriu
- Center for Neuroimmunology, Neurology Department, Hospital Clínic, and Institut d'Investigació August Pi i Sunyer, Universitat de Barcelona, Barcelona, Spain
| | - Jordi Casanova-Molla
- EMG Unit, Neurology Department, Hospital Clinic, and Institut d'Investigació Augustí Pi i Sunyer, Facultat de Medicina, University of Barcelona, Barcelona, Spain; and
| | - Albert Saiz
- Center for Neuroimmunology, Neurology Department, Hospital Clínic, and Institut d'Investigació August Pi i Sunyer, Universitat de Barcelona, Barcelona, Spain
| | - Josep Valls-Solé
- EMG Unit, Neurology Department, Hospital Clinic, and Institut d'Investigació Augustí Pi i Sunyer, Facultat de Medicina, University of Barcelona, Barcelona, Spain; and
| |
Collapse
|
46
|
Retraction notice: Language abilities of patients with primary progressive multiple sclerosis: a preliminary group and case investigation. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2015; 17:96. [PMID: 24766406 DOI: 10.3109/17549507.2014.907673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
|
47
|
Samyn V, Roeyers H, Bijttebier P, Rosseel Y, Wiersema JR. Assessing effortful control in typical and atypical development: Are questionnaires and neuropsychological measures interchangeable? A latent-variable analysis. RESEARCH IN DEVELOPMENTAL DISABILITIES 2015; 36C:587-599. [PMID: 25462519 DOI: 10.1016/j.ridd.2014.10.018] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2014] [Revised: 08/20/2014] [Accepted: 10/13/2014] [Indexed: 06/04/2023]
Abstract
OBJECTIVE Effortful control (EC), the self-regulation component of temperament, is traditionally measured using questionnaires. Through the years, several neuropsychological measures originating from the cognitive psychology and the executive function (EF) literature have been introduced in the domain of temperament research to tap EC. Although this is not particularly surprising, given the conceptual overlap between EC and EF, it remains unclear whether EC questionnaires and neuropsychological EF tasks can really be used interchangeably when measuring EC. The current study addressed two important aspects in evaluating the interchangeability of both types of measures, that is: (a) do they measure the same construct? and (b) do they give the same results when comparing clinical populations? METHOD Three EC questionnaires, two inhibitory control tasks, and two attentional control tasks were administered in 148 typically developing children, 30 children with attention-deficit/hyperactivity disorder (ADHD), and 31 children with autism spectrum disorder (ASD). All children were between 10 and 15 years of age and had a full scale IQ of 80 or higher. RESULTS Confirmatory factor analyses revealed that the questionnaires and EF tasks do not capture the same underlying latent variable(s). Groups could not be differentiated from each other based on their performance on EF tasks, whereas significant group differences were found for all EC-reports. CONCLUSIONS Overall, our findings show more differences than commonalities between the EC questionnaires and EF tasks and, consequently, suggest that both types of measures should not be used interchangeably.
Collapse
Affiliation(s)
- Vicky Samyn
- Ghent University, Henri Dunantlaan 2, 9000 Ghent, Belgium.
| | | | | | - Yves Rosseel
- Ghent University, Henri Dunantlaan 2, 9000 Ghent, Belgium.
| | - Jan R Wiersema
- Ghent University, Henri Dunantlaan 2, 9000 Ghent, Belgium.
| |
Collapse
|
48
|
Abnormalities of motor imagery and relationship with depressive symptoms in mildly disabling relapsing-remitting multiple sclerosis. J Neurol Phys Ther 2014; 38:111-8. [PMID: 24531344 DOI: 10.1097/npt.0000000000000033] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND PURPOSE The effectiveness of motor imagery (MI) as an adjunct to physical rehabilitation has previously been shown. Motor imagery ability can be affected by neurologic disorders that affect motor and cognitive function. This study was designed to assess MI ability in persons with mildly disabling relapsing-remitting multiple sclerosis (RRMS) based on the functional and cognitive dysfunctions. METHODS Twenty-two participants with RRMS and 23 age-, gender-, and education-matched comparison subjects were evaluated by a battery of MI tasks, including a kinesthetic and visual imagery questionnaire, a mental hand rotation task, and a visual guided pointing task. RESULTS There was no significant difference in MI vividness between the participants with MS and the comparison group, but the accuracy and temporal correspondence of MI in the participants with MS differed significantly from those in the comparison group. Depression scores were significantly higher in participants with MS (P < 0.001), and depression was significantly correlated with disability (r = 0.4; P < 0.05). The correlation between accuracy of MI in the participants with MS and their cognitive ability was significant (r = 0.57; P < 0.05). The MI duration of participants with MS was significantly correlated with their disability (r = 0.59; P < 0.05) and their cognitive ability (r = -0.38; P = 0.009). DISCUSSION The preservation of MI ability was observed in participants with RRMS; however, abnormalities in accuracy and temporal aspects of MI were observed even in the participants with mild disease. Abnormalities in temporal aspects and accuracy of MI were related to disability and cognitive ability, respectively. In participants with MS, depression should be considered as a confounding factor for the MI task results. CONCLUSIONS Our finding could be considered in the application of MI during the rehabilitation of persons with MS.
Collapse
|
49
|
Abstract
OBJECTIVES To assess decision-making under explicit risk conditions in relapsing-remitting multiple sclerosis patients and its relationship to decisions made under conditions of ambiguity. To assess cognitive functions related to decision-making performance in patients with multiple sclerosis (MS). SETTING MS center in Buenos Aires, Argentina. PARTICIPANTS 27 patients with relapsing-remitting multiple sclerosis and 27 sex-matched, age-matched and education-matched healthy controls. INTERVENTION Neuropsychological assessment and decision-making evaluation using the Game of Dice Task and the Iowa Gambling Task. OUTCOMES Game of Dice Task and the Iowa Gambling Task scores. RESULTS Patients with MS showed significantly poorer performance on the Game of Dice Task, choosing disadvantageous dice more often (p=0.019), as well as significantly lower overall scores in the Iowa Gambling Task (p=0.007). Block analysis showed that patients with MS and controls had scores that were comparable for blocks 1 and 2 (p=0.15 and p=0.24, respectively). Conversely, patients with MS scored poorly on blocks 4 (p=0.003) and 5 (p=0.023), the last two of the test, corresponding to decision-making under conditions of risk. Finally, the Game of Dice Task performance together with the last three blocks of the Iowa Gambling Task were correlated with visuospatial learning, processing speed and working memory but not with executive functioning. CONCLUSIONS Patients with MS showed deficits in decision-making under risk conditions, which might be related to deficits in visuospatial learning, processing speed and working memory.
Collapse
Affiliation(s)
- Mauricio F Farez
- Department of Neurology, Raúl Carrea Institute for Neurological Research (FLENI), Buenos Aires, Argentina
| | - Lucía Crivelli
- Department of Neurology, Raúl Carrea Institute for Neurological Research (FLENI), Buenos Aires, Argentina
| | - Ramón Leiguarda
- Department of Neurology, Raúl Carrea Institute for Neurological Research (FLENI), Buenos Aires, Argentina
| | - Jorge Correale
- Department of Neurology, Raúl Carrea Institute for Neurological Research (FLENI), Buenos Aires, Argentina
| |
Collapse
|
50
|
Cognitive dysfunction in patients with multiple sclerosis treated with different types of interferon beta: A randomized clinical trial. J Neurol Sci 2014; 342:16-20. [DOI: 10.1016/j.jns.2014.01.038] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2013] [Revised: 01/13/2014] [Accepted: 01/27/2014] [Indexed: 11/24/2022]
|