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Jougleux C, Joly H, Brissard H, Lenne B, François S, Hamelin F, Derache N, Morin J, Reuter F, Colamarino R, Ruet A. French consensus procedure for neuropsychological assessment in multiple sclerosis. Rev Neurol (Paris) 2024:S0035-3787(24)00558-7. [PMID: 39003098 DOI: 10.1016/j.neurol.2024.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 05/23/2024] [Accepted: 06/20/2024] [Indexed: 07/15/2024]
Abstract
Cognitive impairment is one of the invisible symptoms of Multiple sclerosis (MS), which could be associated with depression, unemployment, reduced social interaction, inability to drive, and compromised quality of life. Moreover, the presence of cognitive impairment can be considered as a long-term prognostic factor and in the follow-up of disability. So, cognitive assessment is a crucial element in clinical follow-up of patients with MS (pwMS). International recommendations mention the use of the Brief International Cognitive Assessment in MS (BICAMS). The BICAMS, that has been recently validated in French is a brief non-exhaustive assessment, developed as a short screening battery, hence needing other supplemented tests. The present paper aims to propose a consensus, approved by expert French consensus from the Cognition group of the SF-SEP (http://sfsep.org [Société Francophone de la Sclérose en Plaques]), for cognitive assessment of pwMS suggesting the tools that should be used in order to apprehend the other cognitive impairments that could appear in MS.
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Affiliation(s)
- C Jougleux
- Service de neurologie et pathologies neuro-inflammatoires, Clinique neurologique, CRC SEP, CHU de Lille, Lille, France.
| | - H Joly
- Service de neurologie, CHU Pasteur 2, CRC SEP, Nice, France; UR2CA-URRIS, université Nice Côte d'Azur, Nice, France; CNRS, IMoPA, université de Lorraine, Nancy, France
| | - H Brissard
- CNRS, IMoPA, université de Lorraine, Nancy, France; Service de neurologie, CHRU de Nancy, Nancy, France
| | - B Lenne
- Groupement des hôpitaux de l'institut catholique de Lille (GHICL), Neurology Department, Lille, France
| | - S François
- Service de neurologie, CHU de Nantes, Nantes, France
| | - F Hamelin
- Structure régionale NeuroSEP Synapse, Le Vésinet, France
| | - N Derache
- Department of Neurology, centre hospitalier universitaire de Caen Normandie, Caen, France
| | - J Morin
- Service de neurologie pathologie inflammatoire du système nerveux central, CRC SEP, CHU Pellegrin, CHU de Bordeaux, Bordeaux, France
| | - F Reuter
- Service de neurologie, hôpital de la Timone, AP-HM, pôle de neurosciences cliniques, Marseille, France; CEMEREM, Aix Marseille université, CNRS, CRMBM, UMR 7339, Marseille, France
| | - R Colamarino
- Service de neurologie, CH d'Antibes, Antibes, France
| | - A Ruet
- Service de neurologie pathologie inflammatoire du système nerveux central, CRC SEP, CHU Pellegrin, CHU de Bordeaux, Bordeaux, France; Inserm U1215, Neurocentre Magendie, université de Bordeaux, Bordeaux, France
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VanNostrand M, Monaghan PG, Daugherty AM, Fritz NE. Study protocol of a randomized controlled trial comparing backward walking to forward walking training on balance in multiple sclerosis: The TRAIN-MS trial. Contemp Clin Trials 2024; 144:107621. [PMID: 38971304 DOI: 10.1016/j.cct.2024.107621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Revised: 06/11/2024] [Accepted: 07/03/2024] [Indexed: 07/08/2024]
Abstract
Balance impairment and accidental falls are a pervasive challenge faced by persons with multiple sclerosis (PwMS), significantly impacting their quality of life. While exercise has proven to be an effective intervention for improving mobility and functioning in PwMS, current exercise approaches predominantly emphasize forward walking (FW) and balance training, with variable improvements in balance and fall rates. Backward walking (BW) has emerged as a promising intervention modality for enhancing mobility and strength outcomes; however, significant gaps remain. Specifically, there is limited knowledge about the efficacy of BW interventions on outcomes such as static, anticipatory, and reactive balance, balance confidence, falls, and cognition. This randomized controlled trial aims to determine the feasibility, acceptability, and impact of 8-weeks of backward walking training (TRAIN-BW) as compared to forward walking training (TRAIN-FW). Ninety individuals with MS with self-reported walking dysfunction or ≥ 2 falls in the past 6 months will be randomized in blocks, stratified by sex and disease severity to either the TRAIN-BW or TRAIN-FW intervention groups. Adherence and retention rates will be used to determine feasibility and the Client Satisfaction Questionnaire will be used to assess acceptability. The primary outcomes will be static, anticipatory, and reactive balance. Secondary outcomes include walking velocity, balance confidence, concern about falling, cognition, physical activity, and fall rates measured prospectively for 6 months after post-testing. Additionally, the extent to which cognitive functioning influences response to intervention will be examined. Backward walking training may be an innovative intervention to address balance impairments and falls in persons with MS.
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Affiliation(s)
- Michael VanNostrand
- Neuroimaging and Neurorehabilitation Laboratory, Wayne State University, Detroit, MI, USA; Department of Health Care Sciences, Wayne State University, Detroit, MI, USA.
| | - Patrick G Monaghan
- Neuroimaging and Neurorehabilitation Laboratory, Wayne State University, Detroit, MI, USA; Department of Health Care Sciences, Wayne State University, Detroit, MI, USA
| | - Ana M Daugherty
- Translational Neuroscience Program, Wayne State University, Detroit, MI, USA; Department of Psychology, Wayne State University, Detroit, MI, USA; Institute of Gerontology, Wayne State University, Detroit, MI, USA
| | - Nora E Fritz
- Neuroimaging and Neurorehabilitation Laboratory, Wayne State University, Detroit, MI, USA; Department of Health Care Sciences, Wayne State University, Detroit, MI, USA; Department of Neurology, Wayne State University, Detroit, MI, USA
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Ontaneda D, Chitnis T, Rammohan K, Obeidat AZ. Identification and management of subclinical disease activity in early multiple sclerosis: a review. J Neurol 2024; 271:1497-1514. [PMID: 37864717 PMCID: PMC10972995 DOI: 10.1007/s00415-023-12021-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 09/22/2023] [Accepted: 09/24/2023] [Indexed: 10/23/2023]
Abstract
IMPORTANCE Early treatment initiation in multiple sclerosis (MS) is crucial in preventing irreversible neurological damage and disability progression. The current assessment of disease activity relies on relapse rates and magnetic resonance imaging (MRI) lesion activity, but inclusion of other early, often "hidden," indicators of disease activity may describe a more comprehensive picture of MS. OBSERVATIONS Early indicators of MS disease activity other than relapses and MRI activity, such as cognitive impairment, brain atrophy, and fatigue, are not typically captured by routine disease monitoring. Furthermore, silent progression (neurological decline not clearly captured by standard methods) may occur undetected by relapse and MRI lesion activity monitoring. Consequently, patients considered to have no disease activity actually may have worsening disease, suggesting a need to revise MS management strategies with respect to timely initiation and escalation of disease-modifying therapy (DMT). Traditionally, first-line MS treatment starts with low- or moderate-efficacy therapies, before escalating to high-efficacy therapies (HETs) after evidence of breakthrough disease activity. However, multiple observational studies have shown that early initiation of HETs can prevent or reduce disability progression. Ongoing randomized clinical trials are comparing escalation and early HET approaches. CONCLUSIONS AND RELEVANCE There is an urgent need to reassess how MS disease activity and worsening are measured. A greater awareness of "hidden" indicators, potentially combined with biomarkers to reveal silent disease activity and neurodegeneration underlying MS, would provide a more complete picture of MS and allow for timely therapeutic intervention with HET or switching DMTs to address suboptimal treatment responses.
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Affiliation(s)
- Daniel Ontaneda
- Mellen Center for Multiple Sclerosis, Department of Neurology, Cleveland Clinic, Cleveland, OH, USA.
| | - Tanuja Chitnis
- Brigham Multiple Sclerosis Center, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Kottil Rammohan
- Division of Multiple Sclerosis, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Ahmed Z Obeidat
- Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, USA
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Piri Cinar B, Baba C, Demir S, Uzunkopru C, Seferoglu M, Gungor Dogan I, Cilingir V, Acikgoz M, Bulbul NG, Sivaci AO, Cekic S, Yigit P, Eroglu S, Beckmann Y, Ozakbas S. Cognition as a parameter in monitoring the effect of multiple sclerosis relapse treatment: A prospective controlled study. Clin Neurol Neurosurg 2024; 238:108173. [PMID: 38430729 DOI: 10.1016/j.clineuro.2024.108173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 02/11/2024] [Accepted: 02/12/2024] [Indexed: 03/05/2024]
Abstract
BACKGROUND Cognitive evaluation was considered to be very important in the relapse period, on the basis of the presence of isolated cognitive attacks and the necessity of monitoring the patient both physically and cognitively. MATERIALS AND METHODS People with MS (pwMS) who were hospitalized during relapse were included in the study. All MS patients were evaluated by the neurologist with Expanded Disability Status Scale (EDSS), The 9 Hole Peg Test (9HPT) and the Timed 25-Foot Walk Test (T25-FWT). Additionally, all participants were examined cognitively with the Turkish version of the Brief International Cognitive Assessment for MS (BICAMS) battery. Also, schedules were indicated as during relapse before the treatment (pre-treatment) and the first month after relapse (1-month follow-up). RESULTS A total of 140 MS patients (mean age; 34.98±10.09, mean disease duration; 6.05±5.29 years) and 86 healthy controls (mean age; 36.94±10.83) were included to the present study. The mean EDSS scores in pre-treatment in MS patients was 2.74±1.14 and decreased significantly in the 1-month follow-up (1.74±1.24; p<0.001). The mean SDMT score was lower by 8.76 points in MS patients than in HCs) in pre-treatment and 7.66 points in 1-month follow-up (p<0.001). The mean SDMT scores of all participants increased with measurement time gradually (p<0.001). CONCLUSION In this study, it was detected which cognitive domains were affected after relapse treatment and cognitive changes in pwMS during relapse and remission periods compared to the healthy controls. All three BICAMS test scores significantly increased in one-month follow-up than the pre-treatment period. The results showed that CVLT-II and BVMT-R scores improved more in pwMS than in HCs, and also SDMT scores of pwMS showed a trend of increase, but was not a significant improvement.
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Affiliation(s)
- B Piri Cinar
- Samsun University Medical Faculty Department of Neurology, Turkey.
| | - C Baba
- Institute of Health Scienes, Dokuz Eylul University, Izmir, Turkey
| | - S Demir
- University of Health Sciences Sehit Prof. Dr. İlhan Varank Sancaktepe Research and Training Hospital, Department of Neurology, İstanbul, Turkey
| | - C Uzunkopru
- İzmir Katip Çelebi University, Department of Neurology, İzmir, Turkey
| | - M Seferoglu
- Bursa Yüksek İhtisas Education and Research Hospital, Department of Neurology, Bursa, Turkey
| | - I Gungor Dogan
- University of Health Sciences Sehit Prof. Dr. İlhan Varank Sancaktepe Research and Training Hospital, Department of Neurology, İstanbul, Turkey
| | - V Cilingir
- Faculty of Medicine, Yuzuncu Yil University, Department of Neurology, Van, Turkey
| | - M Acikgoz
- Zonguldak Bülent Ecevit University Medical Faculty, Department of Neurology, Zonguldak, Turkey
| | - N G Bulbul
- Sultan 2. Abdulhamit Han Training and Research Hospital, Department of Neurology, Istanbul, Turkey
| | - A O Sivaci
- Bursa Yüksek İhtisas Education and Research Hospital, Department of Neurology, Bursa, Turkey
| | - S Cekic
- Zonguldak Bülent Ecevit University Medical Faculty, Department of Neurology, Zonguldak, Turkey
| | - P Yigit
- Graduate School of Health Sciences Dokuz Eylul University, Izmir, Turkey
| | - S Eroglu
- Graduate School of Health Sciences Dokuz Eylul University, Izmir, Turkey
| | - Y Beckmann
- İzmir Katip Çelebi University, Department of Neurology, İzmir, Turkey
| | - S Ozakbas
- Dokuz Eylul University Medical Faculty Neurology Department, Turkey
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Schaeffer MJ, Reaume N, Wang M, Aftab A, Pan A, Tariq S, Reid M, Smith EE, D'Esterre C, Barber PA. Visualization of atrophy of medial temporal lobes and the septal nuclei in patients with transient ischaemic attack and controls. CEREBRAL CIRCULATION - COGNITION AND BEHAVIOR 2023; 5:100177. [PMID: 37519344 PMCID: PMC10372167 DOI: 10.1016/j.cccb.2023.100177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 06/28/2023] [Accepted: 07/06/2023] [Indexed: 08/01/2023]
Abstract
Introduction Transient ischaemic attack (TIA) is associated with increased risk of cognitive decline and dementia as early as one-year post-event. Regional brain atrophy measurements may predict future cognitive decline. Aims: 1) To determine whether Medial Temporal Atrophy (MTA) scores and interseptal distance (ISD) measurements are greater in patients with TIA compared to controls; and 2) To determine whether MTA and ISD predicts cognitive change one year after TIA. Methods Baseline demographic, vascular risk factors, structural imaging and cognitive tests scores were compared between 103 Patients with TIA and 103 age-and-sex-matched controls from the Predementia Neuroimaging of Transient Ischaemic Attack (PREVENT) Study. MTA was assessed using the Schelten's Scale, and ISD was calculated as the distance between the septal nucleus of each hemisphere. Multiple linear regression models were used to evaluate how MTA and ISD related to cognitive change after adjusting for covariates. Results Patients with TIA had larger ISD measurements (1.4 mm [SD=1.2] vs. 0.9 mm [SD=1.0]); p < 0.001) and higher right/left MTA scores (both p < 0.05) compared to controls. At baseline, controls performed significantly better on the RAVLT (total recall), BVMT (total and delayed recall) and the Trail Making Task (A and B) compared to patients with TIA. However, at one-year follow-up there was no evidence of decline in the patients with TIA compared with controls. Higher MTA and ISD scores were not associated with cognitive decline. Conclusions Patients with TIA had higher MTA scores and ISD measurements than controls, but neither were predictors of cognitive decline at one year. Future studies with longer follow-up periods will be required to determine whether higher MTA scores and ISD predict risk of cognitive decline in patients with TIA.
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Affiliation(s)
- Morgan J. Schaeffer
- Department of Psychology, University of Victoria, Victoria, British Columbia, Canada
| | - Noaah Reaume
- Department of Clinical Neurosciences, University of Calgary, 1403 29th Street NW, Calgary, Alberta, Canada
| | - Meng Wang
- Department of Community Health Sciences, University of Calgary, 3280 Hospital Drive NW Alberta, Calgary, Canada
| | - Arooj Aftab
- Department of Clinical Neurosciences, University of Calgary, 1403 29th Street NW, Calgary, Alberta, Canada
| | - Alexander Pan
- Department of Clinical Neurosciences, University of Calgary, 1403 29th Street NW, Calgary, Alberta, Canada
| | - Sana Tariq
- Calgary Stroke Program, Department of Clinical Neurosciences, Foothills Medical Centre, 1403 - 29 Street NW, Calgary, Alberta, Canada
- Seaman Family MR Center, Foothills Medical Centre, 1403 29th Street NW, Calgary, Alberta, Canada
| | - Meaghan Reid
- Calgary Stroke Program, Department of Clinical Neurosciences, Foothills Medical Centre, 1403 - 29 Street NW, Calgary, Alberta, Canada
- Seaman Family MR Center, Foothills Medical Centre, 1403 29th Street NW, Calgary, Alberta, Canada
| | - Eric E. Smith
- Department of Clinical Neurosciences, University of Calgary, 1403 29th Street NW, Calgary, Alberta, Canada
- Department of Community Health Sciences, University of Calgary, 3280 Hospital Drive NW Alberta, Calgary, Canada
- Department of Radiology, University of Calgary, 1403 29th Street NW, Calgary, Alberta, Canada
- Calgary Stroke Program, Department of Clinical Neurosciences, Foothills Medical Centre, 1403 - 29 Street NW, Calgary, Alberta, Canada
- Cumming School of Medicine, Hotchkiss Brain Institute, 3330 Hospital Drive NW, Calgary, Alberta, Canada
| | - Chris D'Esterre
- Department of Clinical Neurosciences, University of Calgary, 1403 29th Street NW, Calgary, Alberta, Canada
| | - Philip A. Barber
- Department of Clinical Neurosciences, University of Calgary, 1403 29th Street NW, Calgary, Alberta, Canada
- Department of Community Health Sciences, University of Calgary, 3280 Hospital Drive NW Alberta, Calgary, Canada
- Department of Radiology, University of Calgary, 1403 29th Street NW, Calgary, Alberta, Canada
- Calgary Stroke Program, Department of Clinical Neurosciences, Foothills Medical Centre, 1403 - 29 Street NW, Calgary, Alberta, Canada
- Seaman Family MR Center, Foothills Medical Centre, 1403 29th Street NW, Calgary, Alberta, Canada
- Cumming School of Medicine, Hotchkiss Brain Institute, 3330 Hospital Drive NW, Calgary, Alberta, Canada
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Radial diffusivity reflects general decline rather than specific cognitive deterioration in multiple sclerosis. Sci Rep 2022; 12:21771. [PMID: 36526708 PMCID: PMC9758146 DOI: 10.1038/s41598-022-26204-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 12/12/2022] [Indexed: 12/23/2022] Open
Abstract
Advanced structural brain imaging techniques, such as diffusion tensor imaging (DTI), have been used to study the relationship between DTI-parameters and cognitive scores in multiple sclerosis (MS). In this study, we assessed cognitive function in 61 individuals with MS and a control group of 35 healthy individuals with the Symbol Digit Modalities Test, the California Verbal Learning Test-II, the Brief Visuospatial Memory Test-Revised, the Controlled Oral Word Association Test, and Stroop-test. We also acquired diffusion-weighted images (b = 1000; 32 directions), which were processed to obtain the following DTI scalars: fractional anisotropy, mean, axial, and radial diffusivity. The relation between DTI scalars and cognitive parameters was assessed through permutations. Although fractional anisotropy and axial diffusivity did not correlate with any of the cognitive tests, mean and radial diffusivity were negatively correlated with all of these tests. However, this effect was not specific to any specific white matter tract or cognitive test and demonstrated a general effect with only low to moderate individual voxel-based correlations of <0.6. Similarly, lesion and white matter volume show a general effect with medium to high voxel-based correlations of 0.5-0.8. In conclusion, radial diffusivity is strongly related to cognitive impairment in MS. However, the strong associations of radial diffusivity with both cognition and whole brain lesion volume suggest that it is a surrogate marker for general decline in MS, rather than a marker for specific cognitive functions.
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Fuchs TA, Gillies J, Jaworski MG, Wilding GE, Youngs M, Weinstock-Guttman B, Benedict RH. Repeated forms, testing intervals, and SDMT performance in a large multiple sclerosis dataset. Mult Scler Relat Disord 2022; 68:104375. [PMID: 36544304 DOI: 10.1016/j.msard.2022.104375] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 10/21/2022] [Accepted: 10/23/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND The Symbol Digit Modalities Test (SDMT), the most reliable and sensitive measure of cognition in people with multiple sclerosis (PwMS), is increasingly used in clinical trials and care. OBJECTIVES We aimed to establish how SDMT performance is influenced by repeating forms and frequency of use in PwMS. METHODS A retrospective analysis was completed on a large database of PwMS (n = 740) with multiple SDMT administrations. Change in SDMT performance was analyzed, accounting for frequency of tests and utilization of alternate- versus same-form conditions. RESULTS SDMT administrations ranged from 2 to 14 per subject over a mean (SD) of 5.9 (4.5) years. Accounting for demographics, the mixed effects model revealed a significant main effect of SDMT exposures (1.8 point improvement per repetition, p = 0.001) and an interaction between time since previous SDMT and whether the same test form was administered in the previous administration (estimate=-1.1, p = 0.037). As well, SDMT decline is observed when testing intervals exceed two years (F = 9.69, p<0.001). CONCLUSION Improvements in SDMT performance with repeated exposure, likely reflecting practice effects, were greatest when repeating the same SDMT form over briefer intervals. We recommend the use of alternate forms or analogous versions of timed symbol-digit coding particularly where samples are saturated with many administrations.
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Affiliation(s)
- Tom A Fuchs
- Jacobs Multiple Sclerosis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, 1001 Main Street, Buffalo, NY 14203, United States of America; Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, NY, United States of America
| | - John Gillies
- Jacobs Multiple Sclerosis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, 1001 Main Street, Buffalo, NY 14203, United States of America
| | - Michael G Jaworski
- Jacobs Multiple Sclerosis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, 1001 Main Street, Buffalo, NY 14203, United States of America
| | - Gregory E Wilding
- Department of Biostatistics, University at Buffalo, The State University of New York, Buffalo, NY, United States of America
| | - Margaret Youngs
- Jacobs Multiple Sclerosis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, 1001 Main Street, Buffalo, NY 14203, United States of America
| | - Bianca Weinstock-Guttman
- Jacobs Multiple Sclerosis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, 1001 Main Street, Buffalo, NY 14203, United States of America
| | - Ralph Hb Benedict
- Jacobs Multiple Sclerosis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, 1001 Main Street, Buffalo, NY 14203, United States of America.
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Holm SP, Wolfer AM, Pointeau GH, Lipsmeier F, Lindemann M. Practice effects in performance outcome measures in patients living with neurologic disorders – A systematic review. Heliyon 2022; 8:e10259. [PMID: 36082322 PMCID: PMC9445299 DOI: 10.1016/j.heliyon.2022.e10259] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 03/05/2021] [Accepted: 08/05/2022] [Indexed: 10/26/2022] Open
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Rogers F, Bane E, Dwyer CP, Alvarez-Iglesias A, Joyce RA, Hynes SM. Remote administration of BICAMS measures and the Trail-Making Test to assess cognitive impairment in multiple sclerosis. Neuropsychol Rehabil 2022; 33:903-926. [PMID: 35297748 DOI: 10.1080/09602011.2022.2052324] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Reliable remote cognitive testing could provide a safer assessment of cognitive impairment in multiple sclerosis (MS) during the COVID-19 pandemic and thereafter. Here we aimed to investigate the reliability and feasibility of administering Brief International Cognitive Assessment for MS (BICAMS) and the Trail-Making Test (TMT) to people with MS online. Between-group differences on BICAMS and the TMT were examined in a sample of 68 participants. Group 1 (N = 34) was tested in-person pre-pandemic. Group 2 was tested remotely. Within-group differences for in-person and virtual administrations were examined for Group 1. No significant differences between virtual and in-person administrations of the CVLT-II and SDMT were detected. BVMT-R scores were significantly higher for virtual administrations (M = 20.59, SD = 6.65) compared to in-person administrations (M = 16.35, SD = 6.05), possibly indicating inter-rater differences. Strong positive correlations were found for in-person and virtual scores within Group 1 on the CVLT-II (r = .84), SDMT (r = .85), TMT-A (r = .88), TMT-B (r = .76) and BVMT-R (r = .72). No significant differences between in-person and remote administrations of CVLT-II and SDMT in people living with MS were detected. Recommendations for future studies employing the TMT and BVMT-R online are provided.
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Affiliation(s)
| | - Eimear Bane
- Student Counselling and Wellbeing, University of Limerick, Limerick, Ireland
| | - Christopher P Dwyer
- School of Social Science, Technological University of the Shannon IE, Athlone, Ireland
| | - Alberto Alvarez-Iglesias
- Health Research Board Clinical Research Facility, National University of Ireland Galway, Galway, Ireland
| | - Robert A Joyce
- Discipline of Occupational Therapy, School of Health Sciences, National University of Ireland Galway, Galway, Ireland
| | - Sinéad M Hynes
- Discipline of Occupational Therapy, School of Health Sciences, National University of Ireland Galway, Galway, Ireland
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Seebacher B, Helmlinger B, Pinter D, Ehling R, Hegen H, Ropele S, Reishofer G, Enzinger C, Brenneis C, Deisenhammer F. Effects of actual and imagined music-cued gait training on motor functioning and brain activity in people with multiple sclerosis: protocol of a randomised parallel multicentre trial. BMJ Open 2022; 12:e056666. [PMID: 35131834 PMCID: PMC8823210 DOI: 10.1136/bmjopen-2021-056666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Motor imagery (MI) refers to the mental rehearsal of a physical action without muscular activity. Our previous studies showed that MI combined with rhythmic-auditory cues improved walking, fatigue and quality of life (QoL) in people with multiple sclerosis (pwMS). Largest improvements were seen after music and verbally cued MI. It is unclear whether actual cued gait training achieves similar effects on walking as cued MI in pwMS. Furthermore, in pwMS it is unknown whether any of these interventions leads to changes in brain activation. The purpose of this study is therefore to compare the effects of imagined and actual cued gait training and a combination thereof on walking, brain activation patterns, fatigue, cognitive and emotional functioning in pwMS. METHODS AND ANALYSIS A prospective double-blind randomised parallel multicentre trial will be conducted in 132 pwMS with mild to moderate disability. Randomised into three groups, participants will receive music, metronome and verbal cueing, plus MI of walking (1), MI combined with actual gait training (2) or actual gait training (3) for 30 min, 4× per week for 4 weeks. Supported by weekly phone calls, participants will practise at home, guided by recorded instructions. Primary endpoints will be walking speed (Timed 25-Foot Walk) and distance (2 min Walk Test). Secondary endpoints will be brain activation patterns, fatigue, QoL, MI ability, anxiety, depression, cognitive functioning, music-induced motivation-to-move, pleasure, arousal and self-efficacy. Data will be collected at baseline, postintervention and 3-month follow-up. MRI reference values will be generated using 15 matched healthy controls. ETHICS AND DISSEMINATION This study follows the Standard Protocol Items: Recommendations for Interventional Trials-PRO Extension. Ethical approval was received from the Ethics Committees of the Medical Universities of Innsbruck (1347/2020) and Graz (33-056 ex 20/21), Austria. Results will be disseminated via national and international conferences and published in peer-reviewed journals. TRIAL REGISTRATION NUMBER DRKS00023978.
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Affiliation(s)
- Barbara Seebacher
- Clinical Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
- Karl Landsteiner Institute for Interdisciplinary Rehabilitation Research, Münster, Austria
| | - Birgit Helmlinger
- Department of Neurology, Medical University of Graz, Graz, Austria
- Department of Neurology, Research Unit for Neuronal Plasticity and Repair, Medical University of Graz, Graz, Austria
| | - Daniela Pinter
- Department of Neurology, Medical University of Graz, Graz, Austria
- Department of Neurology, Research Unit for Neuronal Plasticity and Repair, Medical University of Graz, Graz, Austria
| | - Rainer Ehling
- Karl Landsteiner Institute for Interdisciplinary Rehabilitation Research, Münster, Austria
- Department of Neurology, Clinic for Rehabilitation Münster, Münster, Austria
| | - Harald Hegen
- Clinical Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Stefan Ropele
- Department of Neurology, Medical University of Graz, Graz, Austria
| | - Gernot Reishofer
- Department of Radiology, Division of Neuroradiology, Vascular and Interventional Radiology, Medical University of Graz, Graz, Austria
| | - Christian Enzinger
- Department of Neurology; Division of Neuroradiology; Department of Radiology, Medical University of Graz, Graz, Austria
| | - Christian Brenneis
- Karl Landsteiner Institute for Interdisciplinary Rehabilitation Research, Münster, Austria
- Department of Neurology, Clinic for Rehabilitation Münster, Münster, Austria
| | - Florian Deisenhammer
- Clinical Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
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11
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Landrigan J, Bessenyei K, Leitner D, Yakovenko I, Fisk JD, Prentice JL. A systematic review of the effects of cannabis on cognition in people with multiple sclerosis. Mult Scler Relat Disord 2022; 57:103338. [DOI: 10.1016/j.msard.2021.103338] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 10/05/2021] [Accepted: 10/15/2021] [Indexed: 02/07/2023]
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The Brief International Cognitive Assessment in Multiple Sclerosis (BICAMS): Validation in Arabic and Lebanese Normative Values. J Int Neuropsychol Soc 2022; 28:94-103. [PMID: 33563350 DOI: 10.1017/s1355617721000102] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Multiple sclerosis (MS) is often associated with cognitive deficits. Accurate evaluation of the MS patients' cognitive performance is essential for diagnosis and treatment recommendation. The Brief International Cognitive Assessment in Multiple Sclerosis (BICAMS), widely used cognitive testing battery, examines processing speed, verbal and visuospatial learning, and memory. Our study aims to examine the psychometric properties of an Arabic version of the BICAMS and to provide normative values in a Lebanese sample. METHOD The BICAMS, comprised of the Symbol Digit Modalities Test (SDMT), Brief Visuospatial Memory Test-Revised (BVMT-R), and a newly developed verbal learning/memory test, the Verbal Memory Arabic Test (VMAT), were administered on healthy subjects and MS patients. The sample consisted of 180 healthy individuals, of whom 63 were retested after 2-3 weeks. Forty-three MS patients matched with 43 healthy subjects based on age, sex, and years of education were assessed. A sample of 10 MS patients was also examined on two occasions. Test-retest reliability and criterion-related validity were examined, and regression-based norms were derived. RESULTS The test-retest correlations showed good evidence of reliability with coefficients ranging between 0.64 and 0.73 in the healthy sample, and between 0.43 and 0.92 in the MS sample. The BICAMS was able to discriminate between MS patients and matched healthy participants on the SDMT and BVMT-R. Normative data were comparable to other studies. CONCLUSIONS This new Arabic version of the BICAMS shows initial good psychometric properties. While good evidence of VMAT's reliability was shown in the healthy participants, less test-retest reliability in this tool was seen in the MS group, and partial criterion-related validity was evident. This renders further examination of the VMAT. We provide regression-based norms for a Lebanese sample and encourage the use of this battery in both research and clinical settings.
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13
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Lam KH, van Oirschot P, den Teuling B, Hulst HE, de Jong BA, Uitdehaag BMJ, de Groot V, Killestein J. Reliability, construct and concurrent validity of a smartphone-based cognition test in multiple sclerosis. Mult Scler 2021; 28:300-308. [PMID: 34037472 PMCID: PMC8795217 DOI: 10.1177/13524585211018103] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Background: Early detection and monitoring of cognitive dysfunction in multiple sclerosis (MS) may be enabled with smartphone-adapted tests that allow frequent measurements in the everyday environment. Objectives: The aim of this study was to determine the reliability, construct and concurrent validity of a smartphone-adapted Symbol Digit Modalities Test (sSDMT). Methods: During a 28-day follow-up, 102 patients with MS and 24 healthy controls (HC) used the MS sherpa® app to perform the sSDMT every 3 days on their own smartphone. Patients performed the Brief International Cognitive Assessment for MS at baseline. Test–retest reliability (intraclass correlation coefficients, ICC), construct validity (group analyses between cognitively impaired (CI), cognitively preserved (CP) and HC for differences) and concurrent validity (correlation coefficients) were assessed. Results: Patients with MS and HC completed an average of 23.2 (SD = 10.0) and 18.3 (SD = 10.2) sSDMT, respectively. sSDMT demonstrated high test–retest reliability (ICCs > 0.8) with a smallest detectable change of 7 points. sSDMT scores were different between CI patients, CP patients and HC (all ps < 0.05). sSDMT correlated modestly with the clinical SDMT (highest r = 0.690), verbal (highest r= 0.516) and visuospatial memory (highest r= 0.599). Conclusion: Self-administered smartphone-adapted SDMT scores were reliable and different between patients who were CI, CP and HC and demonstrated concurrent validity in assessing information processing speed.
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Affiliation(s)
- KH Lam
- KH Lam Department of Neurology, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, MS Center Amsterdam, Amsterdam Neuroscience, De Boelelaan, 1117 Amsterdam, The Netherlands.
| | - P van Oirschot
- Orikami Digital Health Products, Nijmegen, The Netherlands
| | - B den Teuling
- Orikami Digital Health Products, Nijmegen, The Netherlands
| | - HE Hulst
- Department of Anatomy and Neurosciences, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - BA de Jong
- Department of Neurology, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - BMJ Uitdehaag
- Department of Neurology, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - V de Groot
- Department of Rehabilitation Medicine, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - J Killestein
- Department of Neurology, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam, The Netherlands
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14
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Kheloui S, Rossi M, Jacmin-Park S, Larocque O, Vallée M, Kerr P, Bourdon O, Juster RP. Psychoneuroendocrine protocol to comprehensively study sexually dimorphic cognition. COMPREHENSIVE PSYCHONEUROENDOCRINOLOGY 2021; 6:100050. [PMID: 35757359 PMCID: PMC9216706 DOI: 10.1016/j.cpnec.2021.100050] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Revised: 03/15/2021] [Accepted: 03/15/2021] [Indexed: 12/23/2022] Open
Abstract
Background A large body of research provides evidence for sex differences in cognitive abilities. These sex differences stem from the interplay between biological sex (e.g., birth-assigned sex, sex hormones) and psychosocial gender (e.g., gender identity, gender-roles, sexual orientation). Literature remains rather mixed with regards to the magnitude of sex and gender effects on cognitive abilities and mental health. Growing evidence shows that sex hormone assessment combined with measures of psychosocial gender may be fundamental to comprehensively understand individual differences in sexually dimorphic cognitive abilities. Objectives This study protocol describes a sexually dimorphic cognitive battery to assess the influence of sex hormones on performance. In parallel, we aim to assess the inter-related effects that biological sex and psychosocial gender-based factors exert on cognition and mental health. Methods Our projected sample includes 180 adult participants who are at least 18 years old. Sub-groups will be recruited based on birth-assigned sex, gender identity, and sexual orientation. Biological measures will be collected via salivary samples throughout testing to include sex hormones (testosterone, estradiol and progesterone) and stress hormones (cortisol). Demographic and psychosocial variables will be measured through self-report questionnaires. Participants will be required to complete eight classic cognitive tasks that assess a variety of cognitive domains in a 2-h testing session. Results and future directions Results from this study provides unique insights into the correlates of cognitive sex differences and gender diversity. This will give us solid ground to further investigate these influences in clinical populations in which sex hormones and cognitive functioning are often altered. Cognition is modulated by multiple sex and gender factors. Cognitive abilities will be assessed among 180 adults representing diverse sexual orientations and gender identities. This protocol aims to nuance the effects of sex hormones in contrast to those of socio-cultural gender.
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Affiliation(s)
- Sarah Kheloui
- Department of Psychiatry and Addiction, University of Montreal, Montreal, Quebec, Canada
- Centre de recherche de l’Institut universitaire en santé mentale de Montréal, Canada
- Center on Sex∗Gender, Allostasis and Resilience, Canada
| | - Mathias Rossi
- Department of Psychiatry and Addiction, University of Montreal, Montreal, Quebec, Canada
- Centre de recherche de l’Institut universitaire en santé mentale de Montréal, Canada
- Center on Sex∗Gender, Allostasis and Resilience, Canada
| | - Silke Jacmin-Park
- Department of Psychology, University of Montreal, Montreal, Quebec, Canada
- Centre de recherche de l’Institut universitaire en santé mentale de Montréal, Canada
- Center on Sex∗Gender, Allostasis and Resilience, Canada
| | - Ophélie Larocque
- Department of Psychology, University of Montreal, Montreal, Quebec, Canada
- Centre de recherche de l’Institut universitaire en santé mentale de Montréal, Canada
- Center on Sex∗Gender, Allostasis and Resilience, Canada
| | - Morgan Vallée
- Department of Sociology, Université du Québec à Montréal, Montreal, Quebec, Canada
- Centre de recherche de l’Institut universitaire en santé mentale de Montréal, Canada
- Center on Sex∗Gender, Allostasis and Resilience, Canada
| | - Philippe Kerr
- Department of Psychiatry and Addiction, University of Montreal, Montreal, Quebec, Canada
- Centre de recherche de l’Institut universitaire en santé mentale de Montréal, Canada
- Center on Sex∗Gender, Allostasis and Resilience, Canada
| | - Olivier Bourdon
- Department of Psychology, Université du Québec à Montréal, Montreal, Quebec, Canada
- Centre de recherche de l’Institut universitaire en santé mentale de Montréal, Canada
- Center on Sex∗Gender, Allostasis and Resilience, Canada
| | - Robert-Paul Juster
- Department of Psychiatry and Addiction, University of Montreal, Montreal, Quebec, Canada
- Centre de recherche de l’Institut universitaire en santé mentale de Montréal, Canada
- Center on Sex∗Gender, Allostasis and Resilience, Canada
- Corresponding author. Department of Psychiatry and Addiction, Faculty of Medicine, Université de Montréal Centre de recherche de l’Institut universitaire en santé mentale de Montréal 7331 Hochelaga Street, H1N 3V2, Montreal, Quebec, Canada.
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15
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Abbott CC, Quinn D, Miller J, Ye E, Iqbal S, Lloyd M, Jones TR, Upston J, De Deng Z, Erhardt E, McClintock SM. Electroconvulsive Therapy Pulse Amplitude and Clinical Outcomes. Am J Geriatr Psychiatry 2021; 29:166-178. [PMID: 32651051 PMCID: PMC7744398 DOI: 10.1016/j.jagp.2020.06.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Revised: 06/09/2020] [Accepted: 06/10/2020] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Electroconvulsive therapy (ECT) pulse amplitude, which determines the induced electric field magnitude in the brain, is currently set at 800-900 milliamperes (mA) on modern ECT devices without any clinical or scientific rationale. The present study assessed differences in depression and cognitive outcomes for three different pulse amplitudes during an acute ECT series. We hypothesized that the lower amplitudes would maintain the antidepressant efficacy of the standard treatment and reduce the risk of neurocognitive impairment. METHODS This double-blind investigation randomized subjects to three treatment arms: 600, 700, and 800 mA (active comparator). Clinical, cognitive, and imaging assessments were conducted pre-, mid- and post-ECT. Subjects had a diagnosis of major depressive disorder, age range between 50 and 80 years, and met clinical indication for ECT. RESULTS The 700 and 800 mA arms had improvement in depression outcomes relative to the 600 mA arm. The amplitude groups showed no differences in the primary cognitive outcome variable, the Hopkins Verbal Learning Test-Revised (HVLT-R) retention raw score. However, secondary cognitive outcomes such as the Delis Kaplan Executive Function System Letter and Category Fluency measures demonstrated cognitive impairment in the 800 mA arm. DISCUSSION The results demonstrated a dissociation of depression (higher amplitudes better) and cognitive (lower amplitudes better) related outcomes. Future work is warranted to elucidate the relationship between amplitude, electric field, neuroplasticity, and clinical outcomes.
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Affiliation(s)
- Christopher C Abbott
- Department of Psychiatry (CCA, DQ, JM, EY, SI, ML, TRJ, JU), University of New Mexico, Albuquerque, NM.
| | - Davin Quinn
- Department of Psychiatry, University of New Mexico, Albuquerque, NM
| | - Jeremy Miller
- Department of Psychiatry, University of New Mexico, Albuquerque, NM
| | - Enstin Ye
- Department of Psychiatry, University of New Mexico, Albuquerque, NM
| | - Sulaiman Iqbal
- Department of Psychiatry, University of New Mexico, Albuquerque, NM
| | - Megan Lloyd
- Department of Psychiatry, University of New Mexico, Albuquerque, NM
| | - Thomas R Jones
- Department of Psychiatry, University of New Mexico, Albuquerque, NM
| | - Joel Upston
- Department of Psychiatry, University of New Mexico, Albuquerque, NM
| | - Zhi De Deng
- Noninvasive Neuromodulation Unit, Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD,Division of Brain Stimulation and Neurophysiology, Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC
| | - Erik Erhardt
- Department of Mathematics and Statistics, University of New Mexico, Albuquerque, NM
| | - Shawn M McClintock
- Division of Psychology, Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX,Division of Brain Stimulation and Neurophysiology, Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC
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16
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Abstract
BACKGROUND Although episodic memory impairment is one of the hallmarks of Alzheimer's disease (AD), the relative decline in the components of episodic memory (What, Where, and When) and the effects of cognitive training on each of them are still unknown. OBJECTIVE We aimed to independently assess the impairment in each component of episodic memory in early to moderate AD and address whether it can be enhanced through active, spatiotemporal episodic training. METHODS A non-verbal scene-based episodic memory task was developed to assess the ability to remember What, Where, and When information. Experiment 1 tested whether this task can differentiate AD subjects (N = 16) from healthy controls (N = 16). In Experiment 2, 13 AD subjects underwent 16 training sessions, followed by a re-administration of the scene-based memory task. Experiment 3 tested 42 healthy older adults and 51 younger adults on the same task to investigate the effects of normal aging. RESULTS Of the three components, When memory had the highest predictive power in distinguishing AD from normal aging. Following training of AD subjects, only Where memory improved. Only What memory revealed a significant decline in healthy subjects from 65-85 years of age. CONCLUSION These findings shed new light on the importance of the temporal component of episodic memory as a behavioral marker of AD. The selective improvement of spatial but not temporal memory through training further demonstrates the fragility of temporal memory even in early AD. Neuroscientific research is needed to distinguish whether the Where component was enhanced by improvements in hippocampal spatial representation or by other compensatory mechanisms.
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Affiliation(s)
- Jin-Hyuck Park
- Department of Occupational Therapy, College of Medical Science, Soonchunhyang University, Asan, Korea
| | - Sang Ah Lee
- Department of Bio and Brain Engineering, Korea Advanced Institute of Science and Technology, Daejeon, Korea
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17
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Walø-Syversen G, Kvalem IL, Kristinsson J, Eribe IL, Rø Ø, Brunborg C, Dahlgren CL. Visual, Verbal and Everyday Memory 2 Years After Bariatric Surgery: Poorer Memory Performance at 1-Year Follow-Up. Front Psychol 2021; 11:607834. [PMID: 33488469 PMCID: PMC7820680 DOI: 10.3389/fpsyg.2020.607834] [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: 09/21/2020] [Accepted: 12/07/2020] [Indexed: 11/13/2022] Open
Abstract
Severe obesity has been associated with reduced performance on tests of verbal memory in bariatric surgery candidates. There is also some evidence that bariatric surgery leads to improved verbal memory, yet these findings need further elucidation. Little is known regarding postoperative memory changes in the visual domain and how patients subjectively experience their everyday memory after surgery. The aim of the current study was to repeat and extend prior findings on postoperative memory by investigating visual, verbal, and self-reported everyday memory following surgery, and to examine whether weight loss and somatic comorbidity predict memory performance. The study was a prospective, observational study in which participants (n = 48) underwent cognitive testing at baseline, 1 and 2 years after bariatric surgery. Repeated measures analyses of variance revealed significantly poorer visual and verbal memory performance at the 1-year follow-up, with performance subsequently returning to baseline levels after 2 years. Verbal learning and self-reported everyday memory did not show significant postoperative changes. Memory performance at 1 year was not significantly predicted by weight loss, changes in C-reactive protein levels or postoperative somatic comorbidity (Type 2 diabetes, sleep apnea, and hypertension). The study demonstrated poorer visual and verbal memory performance at 1-year follow-up that returned to baseline levels after 2 years. These findings are in contrast to most previous studies and require further replication, however, the results indicate that postoperative memory improvements following bariatric surgery are not universal. Findings suggest that treatment providers should also be aware of patients potentially having poorer memory at 1 year following surgery.
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Affiliation(s)
- Gro Walø-Syversen
- Regional Department for Eating Disorders, Oslo University Hospital, Oslo, Norway
| | | | - Jon Kristinsson
- Centre for Morbid Obesity and Bariatric Surgery, Oslo University Hospital, Oslo, Norway
| | - Inger L Eribe
- Centre for Morbid Obesity and Bariatric Surgery, Oslo University Hospital, Oslo, Norway
| | - Øyvind Rø
- Regional Department for Eating Disorders, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Cathrine Brunborg
- Oslo Centre for Biostatistics and Epidemiology, Research Support Services, Oslo University Hospital, Oslo, Norway
| | - Camilla Lindvall Dahlgren
- Regional Department for Eating Disorders, Oslo University Hospital, Oslo, Norway.,Department of Psychology, Bjørknes University College, Oslo, Norway
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18
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Grigorescu C, Chalah MA, Lefaucheur JP, Kümpfel T, Padberg F, Ayache SS, Palm U. Effects of Transcranial Direct Current Stimulation on Information Processing Speed, Working Memory, Attention, and Social Cognition in Multiple Sclerosis. Front Neurol 2020; 11:545377. [PMID: 33178103 PMCID: PMC7593675 DOI: 10.3389/fneur.2020.545377] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 08/26/2020] [Indexed: 01/17/2023] Open
Abstract
Multiple Sclerosis (MS) is a chronic inflammatory disease of the central nervous system. Cognitive impairment occurs in 40-65% of patients and could drastically affect their quality of life. Deficits could involve general cognition (e.g., attention and working memory) as well as social cognition. Transcranial direct current stimulation (tDCS), is a novel brain stimulation technique that has been assessed in the context of several neuropsychiatric symptoms, including those described in the context of MS. However, very rare trials have assessed tDCS effects on general cognition in MS, and none has tackled social cognition. The aim of this work was to assess tDCS effects on general and social cognition in MS. Eleven right-handed patients with MS received two blocks (bifrontal tDCS and sham, 2 mA, 20 min, anode/cathode over left/right prefrontal cortex) of 5 daily stimulations separated by a 3-week washout interval. Working memory and attention were, respectively, measured using N-Back Test (0-Back, 1-Back, and 2-Back) and Symbol Digit Modalities Test (SDMT) at the first and fifth day of each block and 1 week later. Social cognition was evaluated using Faux Pas Test and Eyes Test at baseline and 1 week after each block. Interestingly, accuracy of 1-Back test improved following sham but not active bifrontal tDCS. Therefore, active bifrontal tDCS could have impaired working memory via cathodal stimulation of the right prefrontal cortex. No significant tDCS effects were observed on social cognitive measures and SDMT. Admitting the small sample size and the learning (practice) effect that might arise from the repetitive administration of each task, the current results should be considered as preliminary and further investigations in larger patient samples are needed to gain a closer understanding of tDCS effects on cognition in MS.
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Affiliation(s)
- Christina Grigorescu
- Department of Psychiatry and Psychotherapy, Klinikum der Universität München, Munich, Germany
| | - Moussa A Chalah
- EA 4391, Excitabilité nerveuse et thérapeutique, Université Paris-Est-Créteil, Créteil, France.,Service de Physiologie-Explorations Fonctionnelles, Hôpital Henri-Mondor, Assistance Publique-Hôpitaux de Paris, Créteil, France
| | - Jean-Pascal Lefaucheur
- EA 4391, Excitabilité nerveuse et thérapeutique, Université Paris-Est-Créteil, Créteil, France.,Service de Physiologie-Explorations Fonctionnelles, Hôpital Henri-Mondor, Assistance Publique-Hôpitaux de Paris, Créteil, France
| | - Tania Kümpfel
- Institute for Clinical Neuroimmunology, Klinikum der Universität München, Munich, Germany
| | - Frank Padberg
- Department of Psychiatry and Psychotherapy, Klinikum der Universität München, Munich, Germany
| | - Samar S Ayache
- EA 4391, Excitabilité nerveuse et thérapeutique, Université Paris-Est-Créteil, Créteil, France.,Service de Physiologie-Explorations Fonctionnelles, Hôpital Henri-Mondor, Assistance Publique-Hôpitaux de Paris, Créteil, France
| | - Ulrich Palm
- Department of Psychiatry and Psychotherapy, Klinikum der Universität München, Munich, Germany.,Medical Park Chiemseeblick, Bernau, Germany
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19
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Alboudi A, Hadid A, Ali AR, Alshaikh F, Aqleh H. Normative values of the Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) in an Arab population: Corrected for age, sex and education. Mult Scler Relat Disord 2020; 44:102305. [PMID: 32570183 DOI: 10.1016/j.msard.2020.102305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 06/01/2020] [Accepted: 06/12/2020] [Indexed: 11/30/2022]
Abstract
Background Cognitive impairment is common in multiple sclerosis (MS) patients with 43-70% of patients being affected. The international cognitive assessment for MS BICAMS is a new battery for cognitive assessment in MS patients. It was suggested in 2012 that international validation efforts be undertaken. Objective To utilize regression to provide normative values for the BICAMS while correcting for age, gender and education, as well as assess test-retest reliability, in an Arab population. Methods Healthy subjects were recruited from different areas in Dubai. Corrections for demographics were calculated using multiple linear regression. Test-retest reliability was assessed using the Pearson correlation coefficient. Results Two hundred eighty-one healthy subjects were enrolled (174 women, mean age 30±10.3 years, mean education 17.8±3.7 years). Test re-test results showed significant correlation between baseline and retest scores. Regression-based equations were derived for the BICAMS. Conclusion This large-scale validation study provides evidence to support the facilitation of international implementation of the BICAMS assessment by focusing on the Arab population. Next steps include validation efforts in an Arab MS patient population to further support the use of the BICAMS in day to day practice and for longitudinal patient assessment.
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Affiliation(s)
- Ayman Alboudi
- Mercy Health Saint Mary, Grand Rapids, Michgan, US; Rashid hospital, Dubai, UAE.
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20
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Khaligh-Razavi SM, Sadeghi M, Khanbagi M, Kalafatis C, Nabavi SM. A self-administered, artificial intelligence (AI) platform for cognitive assessment in multiple sclerosis (MS). BMC Neurol 2020; 20:193. [PMID: 32423386 PMCID: PMC7236354 DOI: 10.1186/s12883-020-01736-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 04/20/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cognitive impairment is common in patients with multiple sclerosis (MS). Accurate and repeatable measures of cognition have the potential to be used as markers of disease activity. METHODS We developed a 5-min computerized test to measure cognitive dysfunction in patients with MS. The proposed test - named the Integrated Cognitive Assessment (ICA) - is self-administered and language-independent. Ninety-one MS patients and 83 healthy controls (HC) took part in Substudy 1, in which each participant took the ICA test and the Brief International Cognitive Assessment for MS (BICAMS). We assessed ICA's test-retest reliability, its correlation with BICAMS, its sensitivity to discriminate patients with MS from the HC group, and its accuracy in detecting cognitive dysfunction. In Substudy 2, we recruited 48 MS patients, 38 of which had received an 8-week physical and cognitive rehabilitation programme and 10 MS patients who did not. We examined the association between the level of serum neurofilament light (NfL) in these patients and their ICA scores and Symbol Digit Modalities Test (SDMT) scores pre- and post-rehabilitation. RESULTS The ICA demonstrated excellent test-retest reliability (r = 0.94), with no learning bias, and showed a high level of convergent validity with BICAMS. The ICA was sensitive in discriminating the MS patients from the HC group, and demonstrated high accuracy (AUC = 95%) in discriminating cognitively normal from cognitively impaired participants. Additionally, we found a strong association (r = - 0.79) between ICA score and the level of NfL in MS patients before and after rehabilitation. CONCLUSIONS The ICA has the potential to be used as a digital marker of cognitive impairment and to monitor response to therapeutic interventions. In comparison to standard cognitive tools for MS, the ICA is shorter in duration, does not show a learning bias, and is independent of language.
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Affiliation(s)
- Seyed-Mahdi Khaligh-Razavi
- Cognetivity Ltd, London, UK. .,Department of Brain and Cognitive Sciences, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran.
| | | | - Mahdiyeh Khanbagi
- Department of Brain and Cognitive Sciences, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran
| | - Chris Kalafatis
- Cognetivity Ltd, London, UK.,South London & Maudsley NHS Foundation Trust, London, UK.,Department of Old Age Psychiatry, King's College London, London, UK
| | - Seyed Massood Nabavi
- Department of Brain and Cognitive Sciences, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran
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21
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Alarcón AN, Ayala OD, García JR, Montañés P. Validation of the Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) in a Colombian Population. Mult Scler Relat Disord 2020; 42:102072. [PMID: 32330844 DOI: 10.1016/j.msard.2020.102072] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 03/21/2020] [Accepted: 03/24/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Cognitive impairment has been recognized as an important factor in multiple sclerosis (MS) in the past few years. One brief, reliable and valid tool to assess cognition in MS is the BICAMS, which encompasses the Symbol Digit Modalities Test (SDMT), the California Verbal Learning Test (CVLT II), and the Brief Visuospatial Memory Test - Revised (BVMT-R). Continuing with the international initiative to validate the BICAMS in different countries, here we present the results obtained from the efforts in validating such test in the Colombian population. METHOD 100 healthy controls and 50 MS patients participated in the study, group matched for age, education and gender. Subjects completed all three tests of the BICAMS. Instead of the CVLT-II, the Colombian validated form PAMCL (Prueba de Aprendizaje y Memoria con Codificación Libre) was used. Test-retest measures were obtained for 16 patients in order to test for reliability. RESULTS Evidence of criterion validity was obtained, MS group performing significantly worse than HC group in all three tests (SDMT: p= .001, d= 0.59; PAMCL: p= .03, d= 0.38; BVMT-R: p<.001, d= 0.58). Test-retest was also obtained, finding significant correlations for all three tests (SDMT: r=0.932, p<.00; BVMT-R: r=0.863, p<.001; PAMCL: r=0.889, p<.001). Standardization of raw scores to uncontrolled scaled scores was done and these scores were then adjusted for age and years of schooling using a multiple linear regression. CONCLUSIONS The BICAMS proved to be a valid and sensitive tool to screen for cognitive impairment in MS patients.
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Affiliation(s)
- Andrea N Alarcón
- Departamento de Psicología, Universidad Nacional de Colombia, Bogotá, Colombia
| | - Oscar D Ayala
- Departamento de Psicología, Universidad Nacional de Colombia, Bogotá, Colombia
| | | | - Patricia Montañés
- Departamento de Psicología, Universidad Nacional de Colombia, Bogotá, Colombia
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Beier M, Alschuler K, Amtmann D, Hughes A, Madathil R, Ehde D. iCAMS: Assessing the Reliability of a Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) Tablet Application. Int J MS Care 2020; 22:67-74. [PMID: 32410901 DOI: 10.7224/1537-2073.2018-108] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background This study aimed to develop a Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) tablet application, "iCAMS," and examine equivalency between the original paper-based and the tablet-based assessments. Methods This study enrolled 100 participants with physician-confirmed multiple sclerosis (MS). Interrater reliability, parallel forms reliability, and concurrent validity were evaluated by incorporating two test administrators in each session: one scoring participant responses with the original paper assessments and the other with iCAMS. Although the participant was exposed to the material only once, responses were recorded on both administration methods. In addition to the standard test procedures, each research assistant used a stopwatch to measure the amount of time required to administer and score each version of BICAMS. Results Pearson correlation coefficients (r) revealed strong and significant correlations for all three tests. Excellent agreement was observed between iCAMS and paper versions of the BICAMS tests, with all intraclass correlation coefficients exceeding 0.93. The scores from all the cognitive tests were not statistically significantly different, indicating no proportional bias. Including scoring, administration of the iCAMS application saved approximately 10 minutes over the paper version. Conclusions Preliminary findings suggest that the tablet application iCAMS is a reliable and fast method for administering BICAMS.
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Cognitive impairment and CSF proteome modification after oral bacteriotherapy in HIV patients. J Neurovirol 2019; 26:95-106. [PMID: 31677067 DOI: 10.1007/s13365-019-00801-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 08/22/2019] [Accepted: 08/27/2019] [Indexed: 01/01/2023]
Abstract
OBJECTIVE To investigate whether a probiotic supplementation to cART patients modifies the cerebrospinal fluid (CSF) proteome and improves neurocognitive impairment. METHODS 26 CSF samples from 13 HIV-positive patients [six patients living with HIV (PLHIV) and seven patients with a history of AIDS (PHAIDS)] were analyzed. All patients underwent to neurocognitive evaluation and blood sampling at baseline and after 6 months of oral bacteriotherapy. Immune phenotyping and activation markers (CD38 and HLA-DR) were evaluated on peripheral blood mononuclear cells (PBMC). Plasma levels of IL-6, sCD14, and MIP-1β were detected, by enzyme-linked immunosorbent assay (ELISA). Functional proteomic analysis of CSF sample was conducted by two-dimensional electrophoresis; a multivariate analysis was performed by principal component analysis (PCA) and data were enriched by STRING software. RESULTS Oral bacteriotherapy leads to an improvement on several cognitive test and neurocognitive performance in both groups of HIV-positive subjects. A reduction in the percentage of CD4+CD38+HLA-DR+ T cells was also observed at peripheral level after the probiotic intake (p = 0.008). In addition, the probiotic supplementation to cART significantly modifies protein species composition and abundance at the CSF level, especially those related to inflammation (β2-microglobulin p = 0.03; haptoglobin p = 0.06; albumin p = 0.003; hemoglobin p = 0.003; immunoglobulin heavy chains constant region p = 0.02, transthyretin p = 0.02) in PLHIV and PHAIDS. CONCLUSIONS Our results suggest that oral bacteriotherapy as a supplement to cART could exert a role in the amelioration of inflammation state at peripheral and CNS level.
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The Norwegian translation of the brief international cognitive assessment for multiple sclerosis (BICAMS). Mult Scler Relat Disord 2019; 36:101408. [PMID: 31610403 DOI: 10.1016/j.msard.2019.101408] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 09/17/2019] [Accepted: 09/19/2019] [Indexed: 11/23/2022]
Abstract
BACKGROUND Cognitive impairment is a common symptom in all stages of multiple sclerosis (MS), yet it is underreported and not routinely evaluated. The Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) is a short and easily administered test battery for screening of cognitive impairment in MS that can be completed within 15 min and incorporated into routine clinical practice. The test battery consists of the oral version of the Symbols Digit Modalities Test (SDMT) and the initial learning trials of the California Verbal Learning Test 2nd edition (CVLT-II) and the Brief Visuospatial Memory Test Revised (BVMT-R). OBJECTIVE To investigate if the Norwegian version of the BICAMS could identify cognitive impairment in early stages of MS and be used as part of routine follow-up procedures. METHODS A total of 65 relapsing-remitting MS (RRMS) patients and 68 healthy controls were examined with the BICAMS test battery. A randomly selected subset of 29 controls were retested 1-4 weeks after baseline. All participants were screened for anxiety and depression using the Hospital Anxiety and Depression Scale (HADS). RESULTS There were statistically significant differences between the patients with MS and the healthy controls on all three subtests, and the differences remained significant for the CVLT-II (p = 0.003) and BVMT-R (p = 0.011) after adjusting for education. There were no statistically significant correlations between BICAMS scores and anxiety and depression. SDMT and BVMT-R results in the control group at baseline and re-test were strongly correlated (r ≥ 0.70, p < 0.001), and CVLT-II achieved an adequate value of r = 0.60 (p = 0.001). On the SDMT, there was a statistically significant improvement between the two test-sessions. Cognitive impairment, defined as an abnormal test score on ≥1 subtest, was identified in 46.2% of the patient sample, whereas 15.4% were considered cognitively impaired on ≥2 subtests. CONCLUSION This study supports that the Norwegian version of the BICAMS should be included as a screening procedure for cognitive impairment in Norwegian MS patients.
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The association between executive functioning, coping styles and depressive symptoms in patients with Multiple Sclerosis. Mult Scler Relat Disord 2019; 36:101392. [PMID: 31526983 DOI: 10.1016/j.msard.2019.101392] [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] [Received: 11/17/2018] [Revised: 08/24/2019] [Accepted: 09/07/2019] [Indexed: 11/20/2022]
Abstract
OBJECTIVES To investigate the direct, mediated and moderated relationships between executive functioning, coping and depressive symptoms in patients with multiple sclerosis (MS). METHODS Cross-sectional cohort study of routine follow-up visits, including a standardized (neuro)psychological evaluation of 68 MS patients. Coping was measured with the Coping Inventory for Stressful Situations; Depressive symptoms with the subscale depression of the Hospital Anxiety and Depression Scale. Cognitive tests were reduced to a single 'executive function' factor by means of confirmatory factor analysis. Path analyses tested mediating and moderating effects of coping on the relation between executive functioning and depressive symptoms. RESULTS Consistently, the executive functioning factor was not related to task-oriented and emotion-oriented coping. Better executive functioning, however, and less reliance on avoidance coping, was related to more depressive symptoms. Testing of the mediating path showed that executive dysfunctioning was indeed significantly related to more depressive symptoms by less reliance on avoidance coping. There was no additional direct effect of executive functioning on depressive symptoms and also no moderating effect of any coping style on the association between cognition and depressive symptoms. CONCLUSION Our findings suggest that task-oriented and emotion-oriented coping do not influence the relationship between executive functioning and depression in MS patients, but their mental health might benefit from more reliance on avoidance coping.
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Rogers CM, Saway B, Busch CM, Simonds GR. The Effects of 24-Hour Neurosurgical Call on Fine Motor Dexterity, Cognition, and Mood. Cureus 2019; 11:e5687. [PMID: 31720156 PMCID: PMC6822998 DOI: 10.7759/cureus.5687] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: Concerns regarding the effects of fatigue on physician performance and quality of life lead to the implementation of duty hour restrictions for residents by the Accreditation Council for Graduate Medical Education (ACGME). These restrictions have been met by strong criticism from the neurosurgical community. This is partly due to a lack of objective evidence that fatigue results in decrements in professional function in neurological surgeons. There is also concern that the restrictions have diminished clinical and operative experience as well as the development of professional responsibility in residency. Objective: To evaluate whether 24-hour neurosurgical call has an objective impact on fine motor dexterity, cognitive thinking skills, and mental well-being. Methods: Subjects were tested before and after taking 24 hours of neurosurgical call. We evaluated fine motor dexterity using the Vienna Test System Motor Performance Series, cognitive thinking abilities using a battery of paper-pencil neuropsychological tests, and mental well-being using the Profile of Mood States. Results: A total of 27 subjects were included in this study, 12 seasoned to neurosurgical call and 15 naive to neurosurgical call. The seasoned subjects demonstrated no statistically significant change in performance after call on any of the tests for fine motor dexterity or cognitive thinking abilities. The nonseasoned subjects demonstrated multiple decrements in fine motor dexterity and cognitive thinking abilities after taking call. In the Motor Performance Series, they had a statistically significant decrease in the speed of untargeted movements in the nondominant hand during the tapping test (p = 0.002), and a decline in the precision of fine motor movements and information processing as evidenced by an increase in the number of errors of the dominant hand in the line tracking test (p = 0.014). There was a statistically significant decline in their immediate memory during Hopkins Verbal Learning Test (p = 0.025), and complex attention, mental flexibility, and visual-motor speed in the Trail Making Test (p = 0.03). The Profile of Mood States found no difference in feelings of anger (p = 0.54), tension (p = 0.358), or depression (p = 0.65). There were increased feelings of confusion (p < 0.001) and decreased feelings of vigor (p < 0.001) and friendliness (p = 0.001). Nonseasoned subjects had an increase in total mood disturbance (p = 0.012) but seasoned subjects did not (p = 0.083). Conclusion: Our results suggest that fatigue-induced decrements in professional function can be ameliorated by experience with prolonged duty hours. In contrast to nonseasoned subjects, those who were conditioned to 24-hour neurosurgical call demonstrated resilience in fine motor dexterity and cognitive thinking skills, and exhibited no change in total mood disturbance. An argument can be made that we are turning the neurosurgical training paradigm upside down with the current ACGME duty hour restrictions.
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Affiliation(s)
- Cara M Rogers
- Department of Surgery, Division of Neurological Surgery, Virginia Tech Carilion School of Medicine and Fralin Biomedical Research Institute, Roanoke, USA
| | - Brian Saway
- Department of Surgery, Division of Neurological Surgery, Virginia Tech Carilion School of Medicine and Fralin Biomedical Research Institute, Roanoke, USA
| | - Christopher M Busch
- Department of Surgery, Division of Neurological Surgery, Virginia Tech Carilion School of Medicine and Fralin Biomedical Research Institute, Roanoke, USA
| | - Gary R Simonds
- Department of Surgery, Division of Neurological Surgery, Virginia Tech Carilion School of Medicine and Fralin Biomedical Research Institute, Roanoke, USA
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Snow NJ, Wadden KP, Chaves AR, Ploughman M. Transcranial Magnetic Stimulation as a Potential Biomarker in Multiple Sclerosis: A Systematic Review with Recommendations for Future Research. Neural Plast 2019; 2019:6430596. [PMID: 31636661 PMCID: PMC6766108 DOI: 10.1155/2019/6430596] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Accepted: 08/31/2019] [Indexed: 12/23/2022] Open
Abstract
Multiple sclerosis (MS) is a demyelinating disorder of the central nervous system. Disease progression is variable and unpredictable, warranting the development of biomarkers of disease status. Transcranial magnetic stimulation (TMS) is a noninvasive method used to study the human motor system, which has shown potential in MS research. However, few reviews have summarized the use of TMS combined with clinical measures of MS and no work has comprehensively assessed study quality. This review explored the viability of TMS as a biomarker in studies of MS examining disease severity, cognitive impairment, motor impairment, or fatigue. Methodological quality and risk of bias were evaluated in studies meeting selection criteria. After screening 1603 records, 30 were included for review. All studies showed high risk of bias, attributed largely to issues surrounding sample size justification, experimenter blinding, and failure to account for key potential confounding variables. Central motor conduction time and motor-evoked potentials were the most commonly used TMS techniques and showed relationships with disease severity, motor impairment, and fatigue. Short-latency afferent inhibition was the only outcome related to cognitive impairment. Although there is insufficient evidence for TMS in clinical assessments of MS, this review serves as a template to inform future research.
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Affiliation(s)
- Nicholas J. Snow
- Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, Canada
| | - Katie P. Wadden
- Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, Canada
| | - Arthur R. Chaves
- Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, Canada
| | - Michelle Ploughman
- Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, Canada
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Effect of Various OR Noise on Fine Motor Skills, Cognition, and Mood. Surg Res Pract 2019; 2019:5372174. [PMID: 31355326 PMCID: PMC6637681 DOI: 10.1155/2019/5372174] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 05/29/2019] [Accepted: 06/26/2019] [Indexed: 11/18/2022] Open
Abstract
Background The amalgam of noises inherent to the modern-day operating room has the potential of diluting surgeon concentration, which could affect surgeon performance and mood and have implications on quality of care and surgeon resilience. Objective Evaluate the impact of operating room environmental noises on surgeon performance including fine motor dexterity, cognition, and mood. Methods 37 subjects were tested under three different environmental noise conditions including silence, a prerecorded soundtrack of a loud bustling operating room, and with background music of their choosing. We used the Motor Performance Series to test motor dexterity, neuropsychological tests to evaluate cognitive thinking, and Profile of Mood States to test mental well-being. Results Our results showed that typical operating room noise had no impact on motor dexterity but music improved the speed and precision of movements and information processing skills. Neurocognitive testing showed a significant decrement from operating room noise on verbal learning and delayed memory, whereas music improved complex attention and mental flexibility. The Profile of Mood States found that music resulted in a significant decrease in feelings of anger, confusion, fatigue, and tension along with decreased total mood disturbance, which is a measure of psychological distress. Loud operating room noise had a negative impact on feelings of vigor but no increase in total mood disturbance. Conclusion Our results suggest that loud and unnecessary environmental noises can be distracting to a surgeon, so every effort should be taken to minimize these. Music of the surgeons' choosing does not negatively affect fine motor dexterity or cognition and has an overall positive impact on mood and can therefore be safely practiced if desired.
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Goverover Y, Toglia J, DeLuca J. The weekly calendar planning activity in multiple sclerosis: A top-down assessment of executive functions. Neuropsychol Rehabil 2019; 30:1372-1387. [PMID: 30810484 DOI: 10.1080/09602011.2019.1584573] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Deficits in executive functioning are detrimental to employment, daily functioning and quality of life, however their precise nature in multiple sclerosis (MS) remains underspecified. The aims of this study were to: (1) describe the executive processes affected in MS, using a top-down (Weekly Calendar Planning Activity; WCPA) and bottom-up (Delis-Kaplan Executive Function System; DKEFS) assessment tools; (2) explore relationships between performance on the WCPA and DKEFS with a test of everyday functional performance, Actual RealityTM (AR). Methods: Sixty two participants with MS with and without cognitive impairments (n = 21 and 41, respectively) and 38 Healthy Controls (HC) completed the WCPA, two selected subtests of the DKEFS, and AR. Results: The MS group with cognitive impairments performed worse compared with the MS with no cognitive impairments and HC on both the WCPA and DKEFS. Better scores on the DKEFS were associated with better performance of the WCPA. WCPA was a significant predictor of three of the four AR variables. The DKEFS was a significant predictor of time to perform the AR. The results support the use of the WCPA as an assessment of executive functions in persons with MS. It embodies processes such as environmental monitoring, planning and problem solving, and self-regulation.
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Affiliation(s)
- Yael Goverover
- Department of Occupational Therapy, New York University, New York, NY, USA.,Kessler Foundation, West Orange, NJ, USA
| | - Joan Toglia
- School of Health and Natural Sciences, Mercy College, Dobbs Ferry, NY, USA
| | - John DeLuca
- Kessler Foundation, West Orange, NJ, USA.,Department of Physical Medicine and Rehabilitation, New Jersey Medical School, Rutgers University, Newark, NJ, USA
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de Caneda MAG, Cuervo DLM, Marinho NE, de Vecino MCA. The Reliability of the Brief Visuospatial Memory Test - Revised in Brazilian multiple sclerosis patients. Dement Neuropsychol 2018; 12:205-211. [PMID: 29988357 PMCID: PMC6022983 DOI: 10.1590/1980-57642018dn12-020014] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Cognitive Impairment (CI) is a common and distressing problem in Multiple Sclerosis (MS). Its identification is complicated and sometimes omitted in the routine evaluation by neurologists. The BICAMS (Brief International Cognitive Assessment for Multiple Sclerosis) is a promising tool to overcome this difficulty. However, there is some concern regarding the subjectivity in scoring of the BVMT-R (Brief Visuospatial Memory Test - Revised), one of its components. Objective To evaluate the reliability of the BVMT-R in a sample of Brazilian MS patients, with the measure being administered and scored by neurologists. Methods BICAMS was applied to seventy subjects comprising forty patients diagnosed with MS and thirty healthy controls. In the MS patients group, the coefficients of agreement between three different raters, using the same protocols, and the internal consistency of the BVMT-R were assessed. Also, the coefficients of correlation of the BVMT-R with the other tests of the BICAMS, CVLT II (California Verbal Learning Test II) and SDMT (Symbol Digit Modalities Test), and their respective effect sizes were calculated. Results the BVMT-R presented a moderate inter-rater coefficient of agreement (k=0.62), an excellent Intraclass Correlation Coefficient (ICC=0.85), and high internal consistency (α=0.92). The correlation between the BVMT-R and CVLT II was moderate (ρ=0.36; p<0.025), but strong with the SDMT (ρ=0.60; p<0.01), with a large effect size. Conclusion The BVMT-R is a reliable instrument for assessing CI in patients with MS, having a significant association with information processing speed, an aspect which should be considered when evaluating its score.
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Affiliation(s)
- Marco Aurélio G de Caneda
- Multiple Sclerosis Center, Department of Neurology, Hospital Moinhos de Vento, Porto Alegre, RS, Brazil
| | | | - Nathércia Estevam Marinho
- Multiple Sclerosis Center, Department of Neurology, Hospital Moinhos de Vento, Porto Alegre, RS, Brazil
| | - Maria Cecília A de Vecino
- Multiple Sclerosis Center, Department of Neurology, Hospital Moinhos de Vento, Porto Alegre, RS, Brazil
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Beier M, Gromisch ES, Hughes AJ, Alschuler KN, Madathil R, Chiaravalloti N, Foley FW. Proposed cut scores for tests of the Brief International Cognitive Assessment of Multiple Sclerosis (BICAMS). J Neurol Sci 2017; 381:110-116. [DOI: 10.1016/j.jns.2017.08.019] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2017] [Revised: 08/11/2017] [Accepted: 08/14/2017] [Indexed: 11/16/2022]
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Andryszak P, Wiłkość M, Żurawski B, Izdebski P. Verbal fluency in breast cancer patients treated with chemotherapy. Breast Cancer 2017; 24:376-383. [PMID: 27435227 PMCID: PMC5395589 DOI: 10.1007/s12282-016-0713-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Accepted: 07/13/2016] [Indexed: 01/13/2023]
Abstract
BACKGROUND Cognitive decline caused by chemotherapy used in the treatment of malignant diseases was reported in several studies. ICCTF recommends the diagnosis of cognitive function in patient treated with chemotherapy. One of the suggested method is Verbal Fluency Test (VFT). METHODS Study was carried out on a group of 30 women with early breast cancer treated with adjuvant chemotherapy and 29 healthy controls. The patients underwent neuropsychological assessment using VFT at three time points: T1: before chemotherapy, T2: mid-chemotherapy and T3: post-chemotherapy. The examination in healthy controls was conducted at the same time intervals. RESULTS In phonetic fluency task patients produced more words at T2 compared to T1 (Z = 2.02; p < 0.05) and at T3 compared to T1, both patients (Z = 2.36; p < 0.05) and controls (Z = 2.57; p < 0.01). The patients scored lower than controls (Z = -2.04; p < 0.05) as well as on average cluster size in the same task (Z = -2.38; p < 0.05) at T3, while they scored higher on the number of phonetic switches at T2 compared to T1 (Z = 2.62; p < 0.01) and at T3 compared to T1 (Z = 2.50; p < 0.01). In semantic task controls produced more words at T3 than at T1 (Z = 2.62; p < 0.01) and at T3 compared to T2 (Z = 2.89; p < 0.01) and semantic clusters at T3 compared to T2 (Z = 2.43; p < 0.05). In patients, number of clusters was smaller at T3 compared to T2 (Z = -2.85; p < 0.05), while number of semantic switches was higher at T3 than at T2 (Z = 3.05; p < 0.01). Patients scored also lower than controls on number of semantic switches at T2 (Z = -2.05; p < 0.05). CONCLUSIONS Chemotherapy does not decrease verbal fluency, but it has a negative impact on semantic memory.
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Affiliation(s)
- Paulina Andryszak
- Institute of Psychology, Kazimierz Wielki University, Staffa 1, 85-867, Bydgoszcz, Poland.
| | - Monika Wiłkość
- Institute of Psychology, Kazimierz Wielki University, Staffa 1, 85-867, Bydgoszcz, Poland
- Department of Psychiatry, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Bydgoszcz, Poland
| | - Bogdan Żurawski
- The Franciszek Lukaszczyk Oncology Center in Bydgoszcz, Bydgoszcz, Poland
| | - Paweł Izdebski
- Institute of Psychology, Kazimierz Wielki University, Staffa 1, 85-867, Bydgoszcz, Poland
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Alioto AG, Kramer JH, Borish S, Neuhaus J, Saloner R, Wynn M, Foley JM. Long-term test-retest reliability of the California Verbal Learning Test - second edition. Clin Neuropsychol 2017; 31:1449-1458. [PMID: 28387582 DOI: 10.1080/13854046.2017.1310300] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Aging is often associated with declines in episodic memory. Reliable tracking of memory requires assessment instruments that are stable over time to better understand changes potentially attributable to neurodegenerative disease. While prior studies support the test-retest reliability of memory instruments over brief intervals, follow-up testing in clinical settings typically occurs at least one-year later. The present study evaluated the long-term test-retest reliability of the California Verbal Learning Test - second edition (CVLT-2), a widely used measure of episodic learning and memory. METHOD One hundred and fifty seven healthy older adults (mean age = 68.47 years; education = 17.28 years) underwent repeat assessment at an average of 1.30 years apart. Participants underwent repeat assessment using either parallel or alternate forms at follow-up. We utilized a standardized regression-based (SRB) approach to determine statistically significant changes in test scores over time. RESULTS This study revealed modest 1-year test-retest correlation coefficients for the primary CVLT-2 measures (range = .57-.69) Results of SRB formulae are provided to assist clinicians with defining clinically relevant cognitive change on the CVLT-2 while controlling for confounding factors. CONCLUSIONS Findings from this study support repeat test administration of the CVLT-2 over longer periods, and may enhance its applicability in determining longitudinal change in memory performance.
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Affiliation(s)
- Andrea G Alioto
- a Department of Neurology , University of California, San Francisco (UCSF) , San Francisco , CA , USA
| | - Joel H Kramer
- a Department of Neurology , University of California, San Francisco (UCSF) , San Francisco , CA , USA
| | - Sarah Borish
- a Department of Neurology , University of California, San Francisco (UCSF) , San Francisco , CA , USA
| | - John Neuhaus
- a Department of Neurology , University of California, San Francisco (UCSF) , San Francisco , CA , USA
| | - Rowan Saloner
- a Department of Neurology , University of California, San Francisco (UCSF) , San Francisco , CA , USA
| | - Matthew Wynn
- a Department of Neurology , University of California, San Francisco (UCSF) , San Francisco , CA , USA
| | - Jessica M Foley
- a Department of Neurology , University of California, San Francisco (UCSF) , San Francisco , CA , USA
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Benedict RH, DeLuca J, Phillips G, LaRocca N, Hudson LD, Rudick R. Validity of the Symbol Digit Modalities Test as a cognition performance outcome measure for multiple sclerosis. Mult Scler 2017; 23:721-733. [PMID: 28206827 PMCID: PMC5405816 DOI: 10.1177/1352458517690821] [Citation(s) in RCA: 521] [Impact Index Per Article: 74.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Cognitive and motor performance measures are commonly employed in multiple sclerosis (MS) research, particularly when the purpose is to determine the efficacy of treatment. The increasing focus of new therapies on slowing progression or reversing neurological disability makes the utilization of sensitive, reproducible, and valid measures essential. Processing speed is a basic elemental cognitive function that likely influences downstream processes such as memory. The Multiple Sclerosis Outcome Assessments Consortium (MSOAC) includes representatives from advocacy organizations, Food and Drug Administration (FDA), European Medicines Agency (EMA), National Institute of Neurological Disorders and Stroke (NINDS), academic institutions, and industry partners along with persons living with MS. Among the MSOAC goals is acceptance and qualification by regulators of performance outcomes that are highly reliable and valid, practical, cost-effective, and meaningful to persons with MS. A critical step for these neuroperformance metrics is elucidation of clinically relevant benchmarks, well-defined degrees of disability, and gradients of change that are deemed clinically meaningful. This topical review provides an overview of research on one particular cognitive measure, the Symbol Digit Modalities Test (SDMT), recognized as being particularly sensitive to slowed processing of information that is commonly seen in MS. The research in MS clearly supports the reliability and validity of this test and recently has supported a responder definition of SDMT change approximating 4 points or 10% in magnitude.
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Affiliation(s)
- Ralph Hb Benedict
- Department of Neurology and Buffalo General Medical Center, University at Buffalo, Buffalo, NY, USA
| | - John DeLuca
- Kessler Foundation, West Orange, NJ, USA; Rutgers New Jersey Medical School, Newark, NJ, USA
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- Multiple Sclerosis Outcome Assessments Consortium (MSOAC), Critical Path Institute, Tucson, AZ, USA
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Barcellos LF, Bellesis KH, Shen L, Shao X, Chinn T, Frndak S, Drake A, Bakshi N, Marcus J, Schaefer C, Benedict RH. Remote assessment of verbal memory in MS patients using the California Verbal Learning Test. Mult Scler 2017; 24:354-357. [PMID: 28273777 DOI: 10.1177/1352458517694087] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We used the California Verbal Learning Test, Second Edition (CVLT-II), one component of the Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS), to determine feasibility of a remote assessment protocol. We compared telephone-administered CVLT-II data from MS patients to data acquired in person from an independent sample of patients and healthy controls. Mixed factor analyses of variance (ANOVAs) showed no significant differences between patient groups, but between-group effects comparing patients and healthy controls were significant. In this study, CVLT-II assessment by conventional in-person and remote telephone assessment yielded indistinguishable results. The findings indicate that telephone-administered CVLT-II is feasible. Further validation studies are underway.
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Affiliation(s)
- Lisa F Barcellos
- Genetic Epidemiology and Genomics Laboratory, Division of Epidemiology, School of Public Health, University of California, Berkeley, CA, USA/Kaiser Permanente Division of Research, Oakland, CA, USA
| | | | - Ling Shen
- Kaiser Permanente Division of Research, Oakland, CA, USA
| | - Xiaorong Shao
- Genetic Epidemiology and Genomics Laboratory, Division of Epidemiology, School of Public Health, University of California, Berkeley, CA, USA
| | - Terrence Chinn
- Kaiser Permanente Division of Research, Oakland, CA, USA
| | - Seth Frndak
- Department of Neurology, University of Buffalo, Buffalo, NY, USA
| | - Allison Drake
- Department of Neurology, University of Buffalo, Buffalo, NY, USA
| | - Nandini Bakshi
- Kaiser Permanente-Permanente Medical Group, Walnut Creek, CA, USA
| | - Jackie Marcus
- Kaiser Permanente-Permanente Medical Group, San Francisco, CA, USA
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Gomes-Osman J, Cabral DF, Hinchman C, Jannati A, Morris TP, Pascual-Leone A. The effects of exercise on cognitive function and brain plasticity - a feasibility trial. Restor Neurol Neurosci 2017; 35:547-556. [PMID: 28984621 PMCID: PMC5839170 DOI: 10.3233/rnn-170758] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Exercise-mediated cognitive improvements can be at least partly attributed to neuroplastic changes in the nervous system, and may be influenced by the Val66Met polymorphism of the brain-derived neurotrophic factor (BDNF) gene. Transcranial magnetic stimulation (TMS) can be used to assess mechanisms of plasticity in humans noninvasively. OBJECTIVES To assess the feasibility of evaluating the effects of short-term regular exercise on cognitive performance, and to evaluate the relationship between these effects, TMS measures of plasticity, and BDNF Met carrier status in young healthy sedentary adults. METHODS Of the 19 participants who enrolled in the study, 14 sedentary adults (12 females, age mean±SD, 27±12.3 yr), with less than two sessions of physical exercise in the preceding 2 months, completed an aerobic exercise regimen including four 30-min daily sessions per week for 4 weeks (for a total of 16 sessions) delivered at 55-64% of age-predicted maximal heart rate. Prior to and following the exercise regimen, participants performed a neuropsychological test battery and an intermittent theta-burst TMS plasticity protocol. RESULTS All participants completed the various measures and adhered to the exercise regimen. There were no complications and the results obtained were reliable. The feasibility of the approach is thus well established. Between-group comparisons of pre-post change revealed trends toward increased performance on the Stroop and faster reaction times in the CPT detectability in the Val66Val subgroup (p = 0.07 and p = 0.08), and a reduction in TBS-induced modulation of TMS responses in Met carriers (p = 0.07). CONCLUSION Acute exercise interventions in sedentary adults can be meaningfully conducted along with cognitive and neurophysiologic measures to assess behavioral and neurobiological effects and assessment of BDNF polymorphism. TMS measures of plasticity can be used to evaluate the effects of exercise on brain plasticity, and relate them to neuropsychological measures of cognition.
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Affiliation(s)
- Joyce Gomes-Osman
- Berenson-Allen Center for Noninvasive Brain Stimulation and Division of Cognitive Neurology, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
- Department of Physical Therapy, University of Miami Miller School of Medicine, Coral Gables, FL, USA
| | - Danylo F. Cabral
- Department of Physical Therapy, University of Miami Miller School of Medicine, Coral Gables, FL, USA
| | - Carrie Hinchman
- Berenson-Allen Center for Noninvasive Brain Stimulation and Division of Cognitive Neurology, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Ali Jannati
- Berenson-Allen Center for Noninvasive Brain Stimulation and Division of Cognitive Neurology, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Timothy P. Morris
- Berenson-Allen Center for Noninvasive Brain Stimulation and Division of Cognitive Neurology, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Alvaro Pascual-Leone
- Berenson-Allen Center for Noninvasive Brain Stimulation and Division of Cognitive Neurology, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
- Institut Guttman de Neurorehabilitació, Universitat Autónoma de Barcelona, Badalona, Barcelona, Spain
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Abstract
Due to the heterogeneous nature of the disease, it is a challenge to capture disease activity of multiple sclerosis (MS) in a reliable and valid way. Therefore, it can be difficult to assess the true efficacy of interventions in clinical trials. In phase III trials in MS, the traditionally used primary clinical outcome measures are the Expanded Disability Status Scale and the relapse rate. Secondary outcome measures in these trials are the number or volume of T2 hyperintense lesions and gadolinium-enhancing T1 lesions on magnetic resonance imaging (MRI) of the brain. These secondary outcome measures are often primary outcome measures in phase II trials in MS. Despite several limitations, the traditional clinical measures are still the mainstay for assessing treatment efficacy. Newer and potentially valuable outcome measures increasingly used or explored in MS trials are, clinically, the MS Functional Composite and patient-reported outcome measures, and on MRI, brain atrophy and the formation of persisting black holes. Several limitations of these measures have been addressed and further improvements will probably be proposed. Major improvements are the coverage of additional functional domains such as cognitive functioning and assessment of the ability to carry out activities of daily living. The development of multidimensional measures is promising because these measures have the potential to cover the full extent of MS activity and progression. In this review, we provide an overview of the historical background and recent developments of outcome measures in MS trials. We discuss the advantages and limitations of various measures, including newer assessments such as optical coherence tomography, biomarkers in body fluids and the concept of 'no evidence of disease activity'.
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Affiliation(s)
- Caspar E. P. van Munster
- Department of Neurology, Amsterdam Neuroscience, VUmc MS Center Amsterdam, VU University Medical Center, De Boelelaan 1117, 1081 Amsterdam, The Netherlands
| | - Bernard M. J. Uitdehaag
- Department of Neurology, Amsterdam Neuroscience, VUmc MS Center Amsterdam, VU University Medical Center, De Boelelaan 1117, 1081 Amsterdam, The Netherlands
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Jaywant A, Barredo J, Ahern DC, Resnik L. Neuropsychological assessment without upper limb involvement: a systematic review of oral versions of the Trail Making Test and Symbol-Digit Modalities Test. Neuropsychol Rehabil 2016; 28:1055-1077. [PMID: 27756192 DOI: 10.1080/09602011.2016.1240699] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The Trail Making Test (TMT) and written version of the Symbol Digit Modalities Test (SDMT) assess attention, processing speed, and executive functions but their utility is limited in populations with upper limb dysfunction. Oral versions of the TMT and SDMT exist, but a systematic review of their psychometric properties and clinical utility has not been conducted, which was the goal of this study. Searches were conducted in PubMed and PsycINFO, test manuals, and the reference lists of included articles. Four measures were identified: the SDMT-oral, oral TMT-A, oral TMT-B, and the Mental Alternation Test (MAT). Two investigators independently reviewed abstracts to identify peer-reviewed articles that reported on these measures in adult populations. From each article, one investigator extracted information on reliability, validity, responsiveness, minimum detectable change, normative data, and demographic influences. A second investigator verified the accuracy of the data in a random selection of 10% of papers. The quality of the evidence for each psychometric property was rated on a 4-point scale (unknown, poor, adequate, excellent). Results showed excellent evidence for the SDMT-oral, adequate evidence for the oral TMT-B and MAT, and adequate to poor evidence for the oral TMT-A. These findings inform the clinical assessment of attention, processing speed, and executive functions in individuals with upper limb disability.
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Affiliation(s)
- Abhishek Jaywant
- a Center of Excellence for Neurorestoration and Neurotechnology , Providence VA Medical Center , Providence , RI , USA.,b Department of Psychiatry and Human Behavior , Warren Alpert Medical School of Brown University , Providence , RI , USA
| | - Jennifer Barredo
- a Center of Excellence for Neurorestoration and Neurotechnology , Providence VA Medical Center , Providence , RI , USA.,c Brown Institute for Brain Science , Brown University , Providence , RI , USA
| | - David C Ahern
- b Department of Psychiatry and Human Behavior , Warren Alpert Medical School of Brown University , Providence , RI , USA.,d The Miriam Hospital , Providence , RI , USA
| | - Linda Resnik
- a Center of Excellence for Neurorestoration and Neurotechnology , Providence VA Medical Center , Providence , RI , USA
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Gavett BE, Gurnani AS, Saurman JL, Chapman KR, Steinberg EG, Martin B, Chaisson CE, Mez J, Tripodis Y, Stern RA. Practice Effects on Story Memory and List Learning Tests in the Neuropsychological Assessment of Older Adults. PLoS One 2016; 11:e0164492. [PMID: 27711147 PMCID: PMC5053775 DOI: 10.1371/journal.pone.0164492] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Accepted: 09/26/2016] [Indexed: 11/18/2022] Open
Abstract
Two of the most commonly used methods to assess memory functioning in studies of cognitive aging and dementia are story memory and list learning tests. We hypothesized that the most commonly used story memory test, Wechsler's Logical Memory, would generate more pronounced practice effects than a well validated but less common list learning test, the Neuropsychological Assessment Battery (NAB) List Learning test. Two hundred eighty-seven older adults, ages 51 to 100 at baseline, completed both tests as part of a larger neuropsychological test battery on an annual basis. Up to five years of recall scores from participants who were diagnosed as cognitively normal (n = 96) or with mild cognitive impairment (MCI; n = 72) or Alzheimer's disease (AD; n = 121) at their most recent visit were analyzed with linear mixed effects regression to examine the interaction between the type of test and the number of times exposed to the test. Other variables, including age at baseline, sex, education, race, time (years) since baseline, and clinical diagnosis were also entered as fixed effects predictor variables. The results indicated that both tests produced significant practice effects in controls and MCI participants; in contrast, participants with AD declined or remained stable. However, for the delayed-but not the immediate-recall condition, Logical Memory generated more pronounced practice effects than NAB List Learning (b = 0.16, p < .01 for controls). These differential practice effects were moderated by clinical diagnosis, such that controls and MCI participants-but not participants with AD-improved more on Logical Memory delayed recall than on delayed NAB List Learning delayed recall over five annual assessments. Because the Logical Memory test is ubiquitous in cognitive aging and neurodegenerative disease research, its tendency to produce marked practice effects-especially on the delayed recall condition-suggests a threat to its validity as a measure of new learning, an essential construct for dementia diagnosis.
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Affiliation(s)
- Brandon E. Gavett
- Department of Psychology, University of Colorado Colorado Springs, Colorado Springs, Colorado, United States of America
| | - Ashita S. Gurnani
- Department of Psychology, University of Colorado Colorado Springs, Colorado Springs, Colorado, United States of America
| | - Jessica L. Saurman
- Department of Psychology, University of Colorado Colorado Springs, Colorado Springs, Colorado, United States of America
| | - Kimberly R. Chapman
- Alzheimer's Disease Center, Boston University School of Medicine, Boston, Massachusetts, United States of America
| | - Eric G. Steinberg
- Alzheimer's Disease Center, Boston University School of Medicine, Boston, Massachusetts, United States of America
| | - Brett Martin
- Boston University School of Public Health, Boston, Massachusetts, United States of America
| | - Christine E. Chaisson
- Boston University School of Public Health, Boston, Massachusetts, United States of America
| | - Jesse Mez
- Alzheimer's Disease Center, Boston University School of Medicine, Boston, Massachusetts, United States of America
| | - Yorghos Tripodis
- Boston University School of Public Health, Boston, Massachusetts, United States of America
| | - Robert A. Stern
- Alzheimer's Disease Center, Boston University School of Medicine, Boston, Massachusetts, United States of America
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Samaan Z, McDermid Vaz S, Bawor M, Potter TH, Eskandarian S, Loeb M. Neuropsychological Impact of West Nile Virus Infection: An Extensive Neuropsychiatric Assessment of 49 Cases in Canada. PLoS One 2016; 11:e0158364. [PMID: 27352145 PMCID: PMC4924871 DOI: 10.1371/journal.pone.0158364] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Accepted: 06/14/2016] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND West Nile virus emerged as an important human pathogen in North America and continues to pose a risk to public health. It can cause a highly variable range of clinical manifestations ranging from asymptomatic to severe illness. Neuroinvasive disease due to West Nile virus can lead to long-term neurological deficits and psychological impairment. However, these deficits have not been well described. The objective of this study was to characterize the neuropsychological manifestations of West Nile virus infection with a focus on neuroinvasive status and time since infection. METHODS Patients from Ontario Canada with a diagnosis of neuroinvasive disease (meningitis, encephalitis, or acute flaccid paralysis) and non-neuroinvasive disease who had participated in a cohort study were enrolled. Clinical and laboratory were collected, as well as demographics and medical history. Cognitive functioning was assessed using a comprehensive battery of neuropsychological tests. RESULTS Data from 49 individuals (32 with West Nile fever and 17 with West Nile neuroinvasive disease) were included in the present cross-sectional analysis. Patterns of neuropsychological impairment were comparable across participants with both neuroinvasive and non-neuroinvasive West Nile virus infection on all cognitive measures. Neuropsychiatric impairment was also observed more frequently at two to four years post-infection compared to earlier stages of illness. CONCLUSIONS Our data provide objective evidence for cognitive difficulties among patients who were infected with West Nile virus; these deficits appear to manifest regardless of severity of West Nile virus infection (West Nile fever vs. West Nile neuroinvasive disease), and are more prevalent with increasing illness duration (2-4 years vs. 1 month). Data from this study will help inform patients and healthcare providers about the expected course of recovery, as well as the need to implement effective treatment strategies that include neuropsychological interventions.
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Affiliation(s)
- Zainab Samaan
- Department of Psychiatry & Behavioral Neurosciences, McMaster University, Hamilton, Ontario, Canada
- Department of Clinical Epidemiology & Biostatistics, McMaster University, Hamilton, Ontario, Canada
- Population Genomics Program, Chanchlani Research Centre, McMaster University, Hamilton, Ontario, Canada
| | - Stephanie McDermid Vaz
- Department of Psychiatry & Behavioral Neurosciences, McMaster University, Hamilton, Ontario, Canada
- Cleghorn Early Intervention in Psychosis Program, St. Joseph’s Healthcare, Hamilton, Ontario, Canada
| | - Monica Bawor
- Population Genomics Program, Chanchlani Research Centre, McMaster University, Hamilton, Ontario, Canada
- MiNDS Neuroscience Graduate Program, McMaster University, Hamilton, Ontario, Canada
| | - Tammy Hlywka Potter
- Division of Infectious Diseases, McMaster University, Hamilton, Ontario, Canada
| | - Sasha Eskandarian
- Department of Clinical Epidemiology & Biostatistics, McMaster University, Hamilton, Ontario, Canada
| | - Mark Loeb
- Department of Clinical Epidemiology & Biostatistics, McMaster University, Hamilton, Ontario, Canada
- Division of Infectious Diseases, McMaster University, Hamilton, Ontario, Canada
- Department of Pathology & Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
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Migliore S, Ghazaryan A, Simonelli I, Pasqualetti P, Landi D, Palmieri MG, Moffa F, Rinaldi P, Vernieri F, Filippi MM. Validity of the minimal assessment of cognitive function in multiple sclerosis (MACFIMS) in the Italian population. Neurol Sci 2016; 37:1261-70. [PMID: 27095052 DOI: 10.1007/s10072-016-2578-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2015] [Accepted: 04/07/2016] [Indexed: 01/21/2023]
Abstract
Cognitive dysfunction involves 40-65 % of multiple sclerosis (MS) patients. It can be detected in all MS phenotypes from the early stages of the disease, and it tends to progress over time. Minimal Assessment of Cognitive Function in MS (MACFIMS) has been proved to be the most sensitive and comprehensive battery available for MS cognitive assessment in the English population. In Italy, MACFIMS applicability is limited in everyday clinical practice since the overall validity of this battery in the Italian MS population has never been demonstrated. The aim of this study was to translate/cross-culturally adapt and validate an Italian version of the MACFIMS. A total of 130 MS patients and 60 healthy controls (HCs) were enrolled and evaluated with an Italian version of the MACFIMS. All tests discriminated MS patients from HCs; according to the literature, approximately more than half of MS patients (70.8 %) exhibit cognitive impairment. Principal component analysis showed four distinct components: visual-spatial memory/processing speed, working memory, executive functions and verbal memory. Our study is the first to validate an Italian version of the MACFIMS. Several aspects of validity have been demonstrated: criterion and, partially, construct. Future work will investigate the longitudinal course of neuropsychological dysfunction in Italian MS patients using these measures.
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Affiliation(s)
- Simone Migliore
- Clinical Psychology Service, University Campus Bio-Medico, Via Alvaro de Portillo 200, Rome, RM, Italy.
- LIRH Foundation, Via dei Mille 41, Rome, Italy.
| | - Anna Ghazaryan
- Department of Neuroscience, Fatebenefratelli Hospital-Isola Tiberina, Rome, Italy
| | - Ilaria Simonelli
- Department of Neuroscience, Fatebenefratelli Hospital-Isola Tiberina, Rome, Italy
- Neurodegeneration Lab and Department of Imaging, IRCCS San Raffaele Pisana, Rome, Italy
| | - Patrizio Pasqualetti
- Department of Neuroscience, Fatebenefratelli Hospital-Isola Tiberina, Rome, Italy
- Neurodegeneration Lab and Department of Imaging, IRCCS San Raffaele Pisana, Rome, Italy
| | - Doriana Landi
- Department of Neuroscience, Policlinico "Tor Vergata", Rome, Italy
| | | | - Filomena Moffa
- Department of Neuroscience, Fatebenefratelli Hospital-Isola Tiberina, Rome, Italy
| | - Pasquale Rinaldi
- Institute of Cognitive Sciences and Technologies, National Research Council of Italy, Rome, Italy
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Neuropsychological Practice Effects in the Context of Cognitive Decline: Contributions from Learning and Task Novelty. J Int Neuropsychol Soc 2016; 22:453-66. [PMID: 26790693 DOI: 10.1017/s1355617715001332] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Although cognitive decline is typically associated with decreasing practice effects (PEs) (presumably due to declining memory), some studies show increased PEs with declines in cognition. One explanation for these inconsistencies is that PEs reflect not only memory, but also rebounds from adapting to task novelty (i.e., novelty effect), leading to increased PEs. We examined a theoretical model of relationships among novelty effects, memory, cognitive decline, and within-session PEs. Sixty-six older adults ranging from normal to severely impaired completed measures of memory, novelty effects, and two trials each of Wechsler Adult Intelligence Scale, 4 th Edition Symbol Search and Coding. Interrelationships among variables were examined using regression analyses. PEs for Symbol Search and Coding (a) were related to different proposed PE components (i.e., memory and novelty effects), such that novelty effect predicted Symbol Search PE (R2 =.239, p<.001) and memory predicted Coding PE (R2 =.089, p=.015), and (b) showed different patterns across stages of cognitive decline, such that the greatest cognitive decline was associated with smallest Coding PE (R2 =.125, p=.004), whereas intermediate cognitive decline was associated with the greatest Symbol Search PE (R2 =.097, p=.040). The relationship between cognitive decline and PE for Symbol Search was partially mediated by novelty effect among older adults with abnormal cognitive decline (model R2 =.286, p<.001). These findings (a) suggest that PE is not a unitary construct, (b) offer an explanation for contradictory findings in the literature, and (c) highlight the need for a better understanding of component processes of PE across different neuropsychological measures.
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43
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Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS): Canadian contribution to the international validation project. J Neurol Sci 2016; 362:147-52. [DOI: 10.1016/j.jns.2016.01.040] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2015] [Revised: 01/08/2016] [Accepted: 01/20/2016] [Indexed: 11/22/2022]
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Bouman Z, Hendriks MPH, Aldenkamp AP, Kessels RPC. Temporal Stability of the Dutch Version of the Wechsler Memory Scale-Fourth Edition (WMS-IV-NL). Clin Neuropsychol 2016; 29 Suppl 1:30-46. [PMID: 26911865 DOI: 10.1080/13854046.2015.1137354] [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
OBJECTIVE The Wechsler Memory Scale-Fourth Edition (WMS-IV) is one of the most widely used memory batteries. We examined the test-retest reliability, practice effects, and standardized regression-based (SRB) change norms for the Dutch version of the WMS-IV (WMS-IV-NL) after both short and long retest intervals. METHOD The WMS-IV-NL was administered twice after either a short (M = 8.48 weeks, SD = 3.40 weeks, range = 3-16) or a long (M = 17.87 months, SD = 3.48, range = 12-24) retest interval in a sample of 234 healthy participants (M = 59.55 years, range = 16-90; 118 completed the Adult Battery; and 116 completed the Older Adult Battery). RESULTS The test-retest reliability estimates varied across indexes. They were adequate to good after a short retest interval (ranging from .74 to .86), with the exception of the Visual Working Memory Index (r = .59), yet generally lower after a long retest interval (ranging from .56 to .77). Practice effects were only observed after a short retest interval (overall group mean gains up to 11 points), whereas no significant change in performance was found after a long retest interval. Furthermore, practice effect-adjusted SRB change norms were calculated for all WMS-IV-NL index scores. CONCLUSIONS Overall, this study shows that the test-retest reliability of the WMS-IV-NL varied across indexes. Practice effects were observed after a short retest interval, but no evidence was found for practice effects after a long retest interval from one to two years. Finally, the SRB change norms were provided for the WMS-IV-NL.
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Affiliation(s)
- Zita Bouman
- a Academic Centre for Epileptology, Kempenhaeghe , Heeze , the Netherlands.,b Donders Institute for Brain, Cognition and Behaviour , Radboud University , Nijmegen , the Netherlands
| | - Marc P H Hendriks
- a Academic Centre for Epileptology, Kempenhaeghe , Heeze , the Netherlands.,b Donders Institute for Brain, Cognition and Behaviour , Radboud University , Nijmegen , the Netherlands
| | - Albert P Aldenkamp
- a Academic Centre for Epileptology, Kempenhaeghe , Heeze , the Netherlands.,c Department of Neurology and School for Mental Health and Neuroscience , Maastricht University Medical Centre , Maastricht , the Netherlands.,d Department of Neurology , University Hospital Gent , Gent , Belgium.,e Faculty of Electrical Engineering, Signal Processing System Group , Technical University Eindhoven , Eindhoven , the Netherlands
| | - Roy P C Kessels
- b Donders Institute for Brain, Cognition and Behaviour , Radboud University , Nijmegen , the Netherlands.,f Department of Medical Psychology , Radboud University Medical Center , Nijmegen , the Netherlands
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Goverover Y, Strober L, Chiaravalloti N, DeLuca J. Factors That Moderate Activity Limitation and Participation Restriction in People With Multiple Sclerosis. Am J Occup Ther 2015; 69:6902260020p1-9. [PMID: 26122682 DOI: 10.5014/ajot.2015.014332] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
We examined the variables most associated with activity limitation (i.e., cooking) and participation restriction (i.e., employment) in 72 people with multiple sclerosis (MS). Participants underwent a comprehensive neuropsychological test battery assessing memory, executive functions, visual perception, and processing speed and completed questionnaires assessing activity, participation, fatigue, and affective symptoms. Results showed that processing speed was the only variable consistently significantly related to both activity and participation. When examining specific aspects of activity and participation in isolation, employment status was significantly associated with education level, visual memory, fatigue, and processing speed. Cooking ability was associated with performance on tasks of working memory, verbal memory, and processing speed. These findings suggest that processing speed is a primary cognitive factor in MS influencing quality of both activity and participation in everyday life.
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Affiliation(s)
- Yael Goverover
- Yael Goverover, PhD, is Associate Professor, New York University, New York, NY, and Visiting Scientist, Kessler Foundation, West Orange, NJ;
| | - Lauren Strober
- Lauren Strober, PhD, is Senior Research Scientist, Neuropsychology and Neuroscience Laboratory, Kessler Foundation, West Orange, NJ
| | - Nancy Chiaravalloti
- Nancy Chiaravalloti, PhD, is Director, Neuropsychology and Neuroscience Laboratory and Traumatic Brain Injury Laboratory, Kessler Foundation, West Orange, NJ
| | - John DeLuca
- John DeLuca, PhD, is Senior Vice President for Research, Kessler Foundation, West Orange, NJ
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46
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Goverover Y, Chiaravalloti N, DeLuca J. Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) and performance of everyday life tasks: Actual Reality. Mult Scler 2015; 22:544-50. [PMID: 26163071 DOI: 10.1177/1352458515593637] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Accepted: 06/04/2015] [Indexed: 11/16/2022]
Abstract
BACKGROUND Recently, a brief cognitive assessment (Brief International Cognitive Assessment for Multiple Sclerosis: BICAMS) has been recommended for use with patients diagnosed with multiple sclerosis (MS) to screen for cognitive impairments. However, the relationship between the BICAMS and everyday life activity has not been examined. The aim of this study was to examine whether the BICAMS can predict performance of activities of daily living using Actual Reality(TM) (AR) in persons with MS. METHOD A between-subjects design was utilized to compare 41 individuals with MS and 32 healthy controls (HC) performing BICAMS and an AR task. Participants were asked to access the internet to purchase a flight ticket or cookies, and were administered the BICAMS and questionnaires to assess quality of life (QOL), affect symptomatology, and prior internet experience. RESULTS Participants with MS performed significantly worse than HC on the BICAMS and the AR. Additionally, better BICAMS performance was associated with more independent AR performance. Self-reports of QOL were not correlated with AR or BICAMS performance. CONCLUSIONS Individuals with MS have greater problems with actual everyday life tasks as compared to HC. The BICAMS is a promising cognitive screening tool to predict actual functional performance in participants with MS.
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Affiliation(s)
- Yael Goverover
- Department of Occupational Therapy, Steinhardt School of Culture, Education, and Human Development, New York University, USA
| | - Nancy Chiaravalloti
- Kessler Foundation, West Orange, NJ, USA Department of Physical Medicine and Rehabilitation, New Jersey Medical School, Rutgers University, USA
| | - John DeLuca
- Kessler Foundation, West Orange, NJ USA; Department of Physical Medicine and Rehabilitation, New Jersey Medical School, Rutgers University, USA
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The Hungarian validation of the Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) battery and the correlation of cognitive impairment with fatigue and quality of life. Mult Scler Relat Disord 2015; 4:499-504. [PMID: 26590654 DOI: 10.1016/j.msard.2015.07.006] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2015] [Revised: 06/30/2015] [Accepted: 07/03/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND Multiple Sclerosis (MS) causes not only somatic, but also cognitive impairment regardless of the patients׳ age or the course of the disease. The Brief International Cognitive Assessment for MS (BICAMS) test, published in 2011, is a short cognitive questionnaire: a fast, reliable, sensitive and specific tool for the evaluation of the patients׳ cognitive state. OBJECTIVES Our primary objective was to assess the validity of the Hungarian version of the BICAMS test. Our secondary objective was to evaluate the impact of the cognitive impairment on the patient׳s quality of life and fatigue׳s impact on the patients׳ cognitive state. METHODS 65 RR-MS patients and 65 age, sex and education matched healthy control (HC) subjects completed the test and were retested after 3 weeks. The patients also completed the MS Quality of Life 54 (MSQoL54) and the Fatigue Impact Scale (FIS) assessments. Group differences were calculated by paired sample T-tests. The test-retest reliability was measured by intraclass correlation coefficients. To analyze the difference between the test-retest performances of the two groups we used two-way repeated measures ANOVA where the BICAMS battery was the single composite outcome and one-way repeated measures ANOVA. To assess the impact of the cognitive decline on the patients׳ quality of life and fatigue׳s impact on the cognitive state, we examined the correlations between results in the BICAMS and the MSQoL54 and FIS. RESULTS We found significant difference (p ≤ 0.001, p = 0.017 in the first CVLT-II assessment) between MS patients and members of the HC group in all four evaluated parameters of BICAMS test in both sessions. The correlation coefficients were very strong between the tests and retests (r > 0.8; p < 0.001; r = 0.678, p < 0.001 between the CVLT-II assessments). We found that the HC group performed significantly (p = 0.020) better in the retest sessions as compared to their original performance than the patients did and this difference is solely due to the difference between the CVLT-II performances. We have found significant negative correlation between the patients׳ cognitive function and the fatigue score (r < -0.3, p < 0.05). Seven of the MSQoL-54 subscales correlated with the BICAMS performance (r > 0.3; < 0 .05). CONCLUSIONS The Hungarian version of the BICAMS test is a valid and reliable method for the evaluation of MS patients׳ cognitive function. It seems that because of the short retest period, the members of the HC group remembered the CVLT-II words thus performed better than the patients did. Also apparently fatigue can have a negative impact on the patients׳ cognitive state, and cognitive impairment could worsen the patients׳ quality of life.
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Kane KD, Yochim BP. Construct validity and extended normative data for older adults for the Brief Visuospatial Memory Test, Revised. Am J Alzheimers Dis Other Demen 2014; 29:601-6. [PMID: 24604892 PMCID: PMC10852821 DOI: 10.1177/1533317514524812] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE This study examined the construct validity of a visual memory test (Brief Visuospatial Memory Test, Revised [BVMT-R]) in a sample of older adults and provided normative data for adults aged 80+ years. METHOD The sample included 109 community-dwelling individuals (mean [M] age = 74.9 years, M education = 15.0 years, 62.4% female, and 97.2% European American). PROCEDURES Measures administered included the BVMT-R, California Verbal Learning Test, 2nd edition, and subtests of the Delis-Kaplan Executive Function System and Neuropsychological Assessment Battery. RESULTS The BVMT-R correlated highly with another measure of memory and less so with unrelated measures (e.g., verbal fluency). Age and education were significantly correlated with BVMT-R Total and Delayed Recall scores, with education as the strongest predictor. No significant differences were found for sex. Normative data were provided for adults aged 80 to 88 years (n = 29). CONCLUSIONS Adequate evidence was found for convergent validity and only partial support for discriminant validity. Normative data should continue to be stratified by age and also by formal education level.
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Affiliation(s)
- Katherine D Kane
- Department of Psychology, University of Colorado at Colorado Springs, Colorado Springs, CO, USA
| | - Brian P Yochim
- Department of Psychiatry and Behavioral Sciences, VA Palo Alto Healthcare System, Stanford University School of Medicine, Stanford, CA, USA
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The Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS): normative values with gender, age and education corrections in the Italian population. BMC Neurol 2014; 14:171. [PMID: 25204350 PMCID: PMC4172942 DOI: 10.1186/s12883-014-0171-6] [Citation(s) in RCA: 92] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2014] [Accepted: 08/28/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND BICAMS (Brief International Cognitive Assessment for Multiple Sclerosis) has been recently developed as brief, practical and universal assessment tool for cognitive impairment in MS subjects. It includes the Symbol Digit Modalities Test (SDMT), the California Verbal Learning Test-2 (CVLT2) and the Brief Visuospatial Memory Test-Revised (BVMT-R) . In this study we aimed at gathering regression based normative data for the BICAMS battery in the Italian population. METHODS Healthy subjects were consecutively recruited among patient friends and relatives. Corrections for demographics were calculated using multivariable linear regression models. Test-retest reliability was assessed using the Pearson correlation coefficient. RESULTS The BICAMS battery was administered to 273 healthy subjects (180 women, mean age 38.9 ± 13.0 years, mean education 14.9 ± 3.0 years). Test-retest reliability was good for all the tests. CONCLUSIONS The study provided normative data of the BICAMS for the Italian population confirming good test-retest reliability which can facilitate the use of the battery in clinical practice, also for longitudinal patient assessments.
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Benedict RH, Morrow S, Rodgers J, Hojnacki D, Bucello MA, Zivadinov R, Weinstock-Guttman B. Characterizing cognitive function during relapse in multiple sclerosis. Mult Scler 2014; 20:1745-52. [PMID: 24842959 DOI: 10.1177/1352458514533229] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
OBJECTIVE To characterize neuropsychological (NP) test performance during multiple sclerosis (MS) relapse and recovery. METHODS Clinical status was assessed with NP testing and Expanded Disability Status Scale (EDSS) in 24 relapsing patients, and 24 individually-matched, stable controls. All presented with cognitive symptoms as indicated by patient, clinician or caregiver perceived decline, but were free of optic neuritis, ataxia and upper extremity weakness that could compromise NP testing. The presence of enhancing magnetic resonance imaging (MRI) lesions was considered confirmatory of relapse. Relapsing patients were treated with corticosteroids. NP testing and EDSS were compared to pre-relapse baseline levels, and three-month, post-relapse, follow-up. RESULTS Analyses revealed significant decline on the Symbol Digit Modalities Test (SDMT) (p=0.005) and worsening on EDSS (p=0.019). Impairment was observed at the point of relapse in cases but not controls. The groups were no longer different at three-month follow-up. The increment of decline on SDMT was 3.5 raw score points, or roughly 6%. CONCLUSIONS This is the first study to assess NP status changes during MS relapse using well established, reliable metrics. The presence of a clinically meaningful event is substantiated by decline in NP testing, observed or reported cognitive change, and in a subset of patients, gadolinium-enhancing MRI lesions.
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Affiliation(s)
- Ralph Hb Benedict
- Buffalo General Hospital, Suite E2, 100 High Street, Buffalo, New York, 14203, USA
| | | | | | - David Hojnacki
- University at Buffalo, State University of New York, USA
| | | | - Robert Zivadinov
- State University of New York, USA/Buffalo Neuroimaging Analysis Center, State University of New York, USA/MRI Clinical Translational Research Center, State University of New York, USA
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