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Vaheb S, Mokary Y, Yazdan Panah M, Shaygannejad A, Afshari-Safavi A, Ghasemi M, Shaygannejad V, Moases Ghaffary E, Mirmosayyeb O. Multiple sclerosis and personality traits: associations with depression and anxiety. Eur J Med Res 2024; 29:171. [PMID: 38475891 DOI: 10.1186/s40001-024-01772-0] [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: 12/13/2023] [Accepted: 03/06/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Depression and anxiety are commonly observed in people with multiple sclerosis (pwMS). There is a growing body of literature supporting the hypothesis that personality traits can influence the mood disorders. This study aimed to investigate the personality traits and their relationships with depression and anxiety among pwMS. METHODS 234 pwMS were involved in this cross-sectional study. Personality traits, depression, and anxiety were assessed using the NEO Five-Factor Inventory (NEO-FFI) and Hospital Anxiety and Depression Scale (HADS), respectively. Pearson's correlation coefficient and generalized linear model were employed to evaluate the relationships between demographic and clinical characteristics, NEO-FFI, and HADS subscales. RESULTS In pwMS, longer disease duration was significantly associated with lower level of conscientiousness (β = - 0.23, p = 0.008) and agreeableness (β = - 0.2, p = 0.01). Moreover, higher expanded disability status scale (EDSS) of pwMS had a significant relationship with higher level of neuroticism (β = 0.89, p = 0.01). Increased level of neuroticism was significantly correlated with lower level of extraversion (r = - 0.28, p < 0.001), openness (r = - 0.37, p < 0.001), agreeableness (r = - 0.31, p < 0.001), and conscientiousness (r = - 0.45, p < 0.001). PwMS with higher level of conscientiousness showed more extraversion (r = 0.23, p < 0.001), openness (r = 0.61, p < 0.001), and agreeableness (r = 0.41, p < 0.001). Elevated level of neuroticism was significantly associated with higher level of anxiety (β = 0.47, p < 0.001) and depression (β = 0.11, p < 0.001) among pwMS. CONCLUSION The co-occurrence of depression and anxiety is probably associated with neuroticism among pwMS. Additionally, the impact of personality traits extends to influencing key disease aspects such as physical disability and disease duration in MS.
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Affiliation(s)
- Saeed Vaheb
- Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Yousef Mokary
- Students Research Committee, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Mohammad Yazdan Panah
- Students Research Committee, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Aysa Shaygannejad
- Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Alireza Afshari-Safavi
- Department of Biostatistics and Epidemiology, Faculty of Health, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Majid Ghasemi
- Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Neurology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Vahid Shaygannejad
- Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
- Department of Neurology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Elham Moases Ghaffary
- Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Omid Mirmosayyeb
- Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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2
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Chu L, Casserly C, Rosehart H, Morrow SA. Is there a multiple sclerosis personality? Personality characteristics in newly diagnosed multiple sclerosis and association with mood and cognition. J Neurol Sci 2022; 434:120145. [DOI: 10.1016/j.jns.2022.120145] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 12/03/2021] [Accepted: 01/03/2022] [Indexed: 01/25/2023]
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3
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Cognitive rehabilitation outcomes in patients with Multiple sclerosis: Preliminary data about the potential role of personality traits. Mult Scler Relat Disord 2022; 58:103533. [DOI: 10.1016/j.msard.2022.103533] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 12/22/2021] [Accepted: 01/14/2022] [Indexed: 02/06/2023]
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4
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“Nothing to see here”: No structural brain differences as a function of the Big Five personality traits from a systematic review and meta-analysis. PERSONALITY NEUROSCIENCE 2022; 5:e8. [PMID: 35991756 PMCID: PMC9379932 DOI: 10.1017/pen.2021.5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 10/03/2021] [Accepted: 10/20/2021] [Indexed: 11/24/2022]
Abstract
Personality reflects social, affective, and cognitive predispositions that emerge from genetic and environmental influences. Contemporary personality theories conceptualize a Big Five Model of personality based on the traits of neuroticism, extraversion, agreeableness, conscientiousness, and openness to experience. Starting around the turn of the millennium, neuroimaging studies began to investigate functional and structural brain features associated with these traits. Here, we present the first study to systematically evaluate the entire published literature of the association between the Big Five traits and three different measures of brain structure. Qualitative results were highly heterogeneous, and a quantitative meta-analysis did not produce any replicable results. The present study provides a comprehensive evaluation of the literature and its limitations, including sample heterogeneity, Big Five personality instruments, structural image data acquisition, processing, and analytic strategies, and the heterogeneous nature of personality and brain structures. We propose to rethink the biological basis of personality traits and identify ways in which the field of personality neuroscience can be strengthened in its methodological rigor and replicability.
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5
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Characteristic Personality Traits of Multiple Sclerosis Patients—An Unicentric Prospective Observational Cohort Study. J Clin Med 2021; 10:jcm10245932. [PMID: 34945228 PMCID: PMC8708716 DOI: 10.3390/jcm10245932] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 12/13/2021] [Accepted: 12/15/2021] [Indexed: 11/30/2022] Open
Abstract
Background and objectives: Multiple sclerosis (MS) patients tend to present peculiar personality traits that highly impact their quality of life. Our study aimed to determine which personality traits are more common in MS patients compared to a sex- and age-matched control group. Methods and materials: Patients with relapsing–remitting MS along with a sex- and age-matched control group were included. All subjects completed the DECAS Personality Inventory and an additional form including demographic characteristics. Data (including descriptive statistics and univariate and multivariate analysis) were analyzed using SPSS. Results: 122 subjects were included, out of which 61 were in the patient group, mostly females (71.31%) with a mean age of 42.06 ± 10.46 years. Mean duration of disease was 10.18 ± 5.53 years and mean EDSS score was 2.09; 36% of patients were treated with Interferon-beta 1a. Subjects in the patient group presented significantly lower scores for extraversion (p = 0.036), specifically those with higher EDSS score, even after adjusting for possible confounders (age, sex, marital status, early retirement, alcohol, and tobacco consumption). Additionally, regarding orientation in life, MS patients were more often philosophers (p = 0.001), especially young males, whereas the dominant emotional feeling was less common, the actor profile (p = 0.022). Regarding task involvement, MS patients were often passive and compassionate concerning other people. Higher EDSS score also correlated with avoidant (p = 0.006) and melancholic (p = 0.043) personality traits. Subjects with higher education associated more often pragmatic, experimenter, popular, and optimist traits, whereas the elderly had actor, authoritarian, and experimenter profiles. Conclusions: Some MS patients may have reduced levels of extraversion and specific personality traits compared to age- and sex-matched subjects. Determining the exact personality profile might help the neurologist to establish a better therapeutic alliance and to apply specific interventions.
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van der Hiele K, van Gorp DAM, van Egmond EEA, Jongen PJ, Reneman MF, van der Klink JJL, Arnoldus EPJ, Beenakker EAC, van Eijk JJJ, Frequin STFM, de Gans K, Hengstman GJD, Hoitsma E, Gerlach OHH, Verhagen WIM, Heerings MAP, Middelkoop HAM, Visser LH. Self-reported occupational functioning in persons with relapsing-remitting multiple sclerosis: Does personality matter? J Neurol Sci 2021; 427:117561. [PMID: 34216973 DOI: 10.1016/j.jns.2021.117561] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 06/24/2021] [Accepted: 06/26/2021] [Indexed: 01/10/2023]
Abstract
BACKGROUND Multiple sclerosis (MS) poses a major threat to sustainable employability. Identifying conditions and factors that promote work participation is of great importance. Our objective was to explore the contribution of personality traits in explaining occupational functioning in MS. METHODS 241 participants with relapsing-remitting MS (78% female, median age: 42.0 years, median EDSS: 2.0) and 60 healthy controls (70% female, median age: 45.0 years) underwent neuropsychological and neurological examinations and completed questionnaires. Multivariate logistic and linear regression analyses were conducted to examine relations between personality traits and self-reported occupational functioning, while accounting for known correlates. RESULTS Personality traits were not associated with self-reported occupational functioning when correcting for known correlates. A higher impact of fatigue (B = -0.05, p = .005 and B = -0.04, p = .009) and depression (B = -0.22, p = .008 and B = -0.21, p = .01) were associated with no paid job (R2 = 0.13) and considering to reduce work hours (R2 = 0.12). A higher impact of fatigue (B = -0.05, p = .008, β = 0.46, p = .001 and β = -0.36, p = .001) was associated with absenteeism from work (R2 = 0.15), more presenteeism (R2 = 0.35) and lower work ability (R2 = 0.25). A higher impact of fatigue (β = 0.46, p = .001) and anxiety (β = 0.25, p = .001) were associated with more work difficulties (R2 = 0.54). CONCLUSION Personality traits did not explain additional variance in self-reported occupational functioning in persons with relapsing-remitting MS with mild disability. The impact of fatigue was the main and most consistent correlate of occupational functioning, often combined with depression or anxiety. Total explained variance of the models was limited, emphasizing the need to additionally examine other (contextual) factors when considering occupational challenges in MS.
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Affiliation(s)
- K van der Hiele
- Leiden University, Institute of Psychology, Health, Medical and Neuropsychology Unit, Leiden, the Netherlands.
| | - D A M van Gorp
- University of Humanistic Studies, Utrecht, the Netherlands
| | - E E A van Egmond
- Leiden University, Institute of Psychology, Health, Medical and Neuropsychology Unit, Leiden, the Netherlands; University of Humanistic Studies, Utrecht, the Netherlands; National Multiple Sclerosis Foundation, Rotterdam, the Netherlands; Elisabeth-TweeSteden Hospital, Department of Neurology, Tilburg, the Netherlands
| | - P J Jongen
- MS4 Research Institute, Nijmegen, the Netherlands; University of Groningen, University Medical Centre Groningen, Department of Community & Occupational Medicine, Groningen, the Netherlands
| | - M F Reneman
- University of Groningen, University Medical Centre Groningen, Centre for Rehabilitation, Haren, the Netherlands
| | - J J L van der Klink
- Tilburg University, Department of Social and Behavioral Sciences, Tranzo Scientific Center for Care and Welfare, Tilburg, the Netherlands; Optentia, North West University of South Africa, Vanderbijlspark, South Africa
| | - E P J Arnoldus
- Elisabeth-TweeSteden Hospital, Department of Neurology, Tilburg, the Netherlands
| | - E A C Beenakker
- Medical Centre Leeuwarden, Department of Neurology, Leeuwarden, the Netherlands
| | - J J J van Eijk
- Jeroen Bosch Hospital, Department of Neurology's-Hertogenbosch, the Netherlands
| | - S T F M Frequin
- St. Antonius Hospital, Department of Neurology, Nieuwegein, the Netherlands
| | - K de Gans
- Groene Hart Hospital, Department of Neurology, Gouda, the Netherlands
| | | | - E Hoitsma
- Alrijne Hospital Leiden, Department of Neurology, Leiden, the Netherlands
| | - O H H Gerlach
- Zuyderland Medical Centre, Department of Neurology, Sittard-Geleen, the Netherlands
| | - W I M Verhagen
- Canisius-Wilhelmina Hospital, Department of Neurology, Nijmegen, the Netherlands
| | - M A P Heerings
- Department of Human Genetics, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, the Netherlands
| | - H A M Middelkoop
- Leiden University, Institute of Psychology, Health, Medical and Neuropsychology Unit, Leiden, the Netherlands; Leiden University Medical Centre, Department of Neurology, Leiden, the Netherlands
| | - L H Visser
- University of Humanistic Studies, Utrecht, the Netherlands; Elisabeth-TweeSteden Hospital, Department of Neurology, Tilburg, the Netherlands
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7
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Liu X, Lai H, Li J, Becker B, Zhao Y, Cheng B, Wang S. Gray matter structures associated with neuroticism: A meta-analysis of whole-brain voxel-based morphometry studies. Hum Brain Mapp 2021; 42:2706-2721. [PMID: 33704850 PMCID: PMC8127153 DOI: 10.1002/hbm.25395] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Revised: 01/28/2021] [Accepted: 02/22/2021] [Indexed: 02/05/2023] Open
Abstract
Neuroticism is major higher-order personality trait and has been robustly associated with mental and physical health outcomes. Although a growing body of studies have identified neurostructural markers of neuroticism, the results remained highly inconsistent. To characterize robust associations between neuroticism and variations in gray matter (GM) structures, the present meta-analysis investigated the concurrence across voxel-based morphometry (VBM) studies using the anisotropic effect size signed differential mapping (AES-SDM). A total of 13 studies comprising 2,278 healthy subjects (1,275 females, 29.20 ± 14.17 years old) were included. Our analysis revealed that neuroticism was consistently associated with the GM structure of a cluster spanning the bilateral dorsal anterior cingulate cortex and extending to the adjacent medial prefrontal cortex (dACC/mPFC). Meta-regression analyses indicated that the neuroticism-GM associations were not confounded by age and gender. Overall, our study is the first whole-brain meta-analysis exploring the brain structural correlates of neuroticism, and the findings may have implications for the intervention of high-neuroticism individuals, who are at risk of mental disorders, by targeting the dACC/mPFC.
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Affiliation(s)
- Xiqin Liu
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China.,State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | - Han Lai
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Jingguang Li
- College of Teacher Education, Dali University, Dali, China
| | - Benjamin Becker
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
| | - Yajun Zhao
- School of Education and Psychology, Southwest Minzu University, Chengdu, China
| | - Bochao Cheng
- Department of Radiology, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Song Wang
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China.,Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
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8
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Caregiver strain among life partners of persons with mild disability due to relapsing-remitting multiple sclerosis. Mult Scler Relat Disord 2019; 31:5-11. [DOI: 10.1016/j.msard.2019.03.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 01/18/2019] [Accepted: 03/05/2019] [Indexed: 11/20/2022]
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9
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Fuchs TA, Dwyer MG, Kuceyeski A, Choudhery S, Carolus K, Li X, Mallory M, Weinstock-Guttman B, Jakimovski D, Ramasamy D, Zivadinov R, Benedict RHB. White matter tract network disruption explains reduced conscientiousness in multiple sclerosis. Hum Brain Mapp 2018; 39:3682-3690. [PMID: 29740964 DOI: 10.1002/hbm.24203] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2017] [Revised: 04/11/2018] [Accepted: 04/23/2018] [Indexed: 12/22/2022] Open
Abstract
Quantifying white matter (WM) tract disruption in people with multiple sclerosis (PwMS) provides a novel means for investigating the relationship between defective network connectivity and clinical markers. PwMS exhibit perturbations in personality, where decreased Conscientiousness is particularly prominent. This trait deficit influences disease trajectory and functional outcomes such as work capacity. We aimed to identify patterns of WM tract disruption related to decreased Conscientiousness in PwMS. Personality assessment and brain MRI were obtained in 133 PwMS and 49 age- and sex-matched healthy controls (HC). Lesion maps were applied to determine the severity of WM tract disruption between pairs of gray matter regions. Next, the Network-Based-Statistics tool was applied to identify structural networks whose disruption negatively correlates with Conscientiousness. Finally, to determine whether these networks explain unique variance above conventional MRI measures and cognition, regression models were applied controlling for age, sex, brain volume, T2-lesion volume, and cognition. Relative to HCs, PwMS exhibited lower Conscientiousness and slowed cognitive processing speed (p = .025, p = .006). Lower Conscientiousness in PwMS was significantly associated with WM tract disruption between frontal, frontal-parietal, and frontal-cingulate pathways in the left (p = .02) and right (p = .01) hemisphere. The mean disruption of these pathways explained unique additive variance in Conscientiousness, after accounting for conventional MRI markers of pathology and cognition (ΔR2 = .049, p = .029). Damage to WM tracts between frontal, frontal-parietal, and frontal-cingulate cortical regions is significantly correlated with reduced Conscientiousness in PwMS. Tract disruption within these networks explains decreased Conscientiousness observed in PwMS as compared with HCs.
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Affiliation(s)
- Tom A Fuchs
- Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York (SUNY), Buffalo, New York.,Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York (SUNY), Buffalo, New York
| | - Michael G Dwyer
- Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York (SUNY), Buffalo, New York.,Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York (SUNY), Buffalo, New York
| | - Amy Kuceyeski
- Weill Cornell Medicine, Department of Radiology, The Feil Family Brain and Mind Research Institute, 407 East 61st St, RR-115, New York, New York
| | - Sanjeevani Choudhery
- Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York (SUNY), Buffalo, New York.,Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York (SUNY), Buffalo, New York
| | - Keith Carolus
- Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York (SUNY), Buffalo, New York.,Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York (SUNY), Buffalo, New York
| | - Xian Li
- Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York (SUNY), Buffalo, New York.,Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York (SUNY), Buffalo, New York
| | - Matthew Mallory
- Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York (SUNY), Buffalo, New York.,Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York (SUNY), Buffalo, New York
| | - Bianca Weinstock-Guttman
- Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York (SUNY), Buffalo, New York
| | - Dejan Jakimovski
- Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York (SUNY), Buffalo, New York.,Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York (SUNY), Buffalo, New York
| | - Deepa Ramasamy
- Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York (SUNY), Buffalo, New York.,Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York (SUNY), Buffalo, New York.,Center for Biomedical Imaging, Clinical Translational Science Institute, University at Buffalo, State University of New York (SUNY), Buffalo, New York
| | - Robert Zivadinov
- Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York (SUNY), Buffalo, New York.,Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York (SUNY), Buffalo, New York.,Center for Biomedical Imaging, Clinical Translational Science Institute, University at Buffalo, State University of New York (SUNY), Buffalo, New York
| | - Ralph H B Benedict
- Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York (SUNY), Buffalo, New York
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10
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Roy S, Drake A, Fuchs T, Dwyer MG, Zivadinov R, Chapman BP, Weinstock-Guttman B, Benedict RH. Longitudinal personality change associated with cognitive decline in multiple sclerosis. Mult Scler 2018; 24:1352458517753720. [PMID: 29363385 DOI: 10.1177/1352458517753720] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We previously reported that personality and cognition were stable over 3 years in patients with multiple sclerosis (MS). This study examined whether a longer duration would reveal evidence of emerging personality dysfunction. The NEO Five-Factor Inventory and Brief International Cognitive Assessment for MS was used to assess personality and cognition, respectively. Patients were classified as "Cog Stable" or "Cog Decline" based on cognitive deterioration over 5 years. Extraversion and Conscientiousness declined across pooled groups. Follow-up of a group by time interaction found that decline in these traits was more evident in the Cog Decline group, demonstrating a link between personality and cognitive change.
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Affiliation(s)
- Shumita Roy
- Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York (SUNY), Buffalo, NY, USA
| | - Allison Drake
- Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York (SUNY), Buffalo, NY, USA
| | - Tom Fuchs
- Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York (SUNY), Buffalo, NY, USA/Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York (SUNY), Buffalo, NY, USA
| | - Michael G Dwyer
- Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York (SUNY), Buffalo, NY, USA/Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York (SUNY), Buffalo, NY, USA/Center for Biomedical Imaging at Clinical Translational Science Institute, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York (SUNY), Buffalo, NY, USA
| | - Robert Zivadinov
- Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York (SUNY), Buffalo, NY, USA/Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York (SUNY), Buffalo, NY, USA/Center for Biomedical Imaging at Clinical Translational Science Institute, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York (SUNY), Buffalo, NY, USA
| | - Benjamin P Chapman
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA
| | - Bianca Weinstock-Guttman
- Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York (SUNY), Buffalo, NY, USA
| | - Ralph Hb Benedict
- Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York (SUNY), Buffalo, NY, USA
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Poletti B, Carelli L, Lafronza A, Solca F, Faini A, Ciammola A, Grobberio M, Raimondi V, Pezzati R, Ardito RB, Silani V. Cognitive-constructivist Approach in Medical Settings: The Use of Personal Meaning Questionnaire for Neurological Patients' Personality Investigation. Front Psychol 2017; 8:582. [PMID: 28443057 PMCID: PMC5387101 DOI: 10.3389/fpsyg.2017.00582] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Accepted: 03/29/2017] [Indexed: 01/04/2023] Open
Abstract
Objective: The cognitive-constructivist psychotherapy approach considers the self as a continuous regulation process between present and past experience, in which attributions of meaning is characterized by the use of internal rules. In this conception, everyone would be driven by a specific inner coherence called Personal Meaning Organization (PMO). Such approach has never been applied to neurological patients by means of ad hoc developed tools. We performed an explorative study aimed to characterize personality styles in different neurological conditions within the theoretical framework of cognitive-constructivist model. Materials and Methods: Three groups of neurological patients (Amyotrophic Lateral Sclerosis, Multiple Sclerosis, Primary Headache) and a sample of healthy participants, each composed by 15 participants, for a total of 60 participants, were recruited. The Personal Meaning Questionnaire (PMQ), an Italian questionnaire assessing PMOs construct, and other clinical tools for psychological and quality of life assessment were administered to all subjects. Results: The main finding concerned the detection, across all clinical conditions, of a higher prevalence of phobic personality style, with Amyotrophic Lateral Sclerosis showing a relevant prevalence of such PMO with respect to all other neurological conditions and controls. However, with respect to controls, in all clinical conditions, PMQ highlighted a tendency, even if not statistically significant, to codify experience by means of specific cognitive and emotional patterns. Conclusion: Our findings represent the first contribution towards understanding the personality profiles of patients affected by neurological conditions according to cognitive-constructivist theory.
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Affiliation(s)
- Barbara Poletti
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico ItalianoMilan, Italy
| | - Laura Carelli
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico ItalianoMilan, Italy
| | - Annalisa Lafronza
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico ItalianoMilan, Italy
| | - Federica Solca
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico ItalianoMilan, Italy
| | - Andrea Faini
- Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico ItalianoMilan, Italy
| | - Andrea Ciammola
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico ItalianoMilan, Italy
| | - Monica Grobberio
- Laboratory of Clinical Neuropsychology, Department of Neurology - ASST LarianaComo, Italy
| | - Vanessa Raimondi
- Department of Neurology and Clinical Psychology Services, ASST CremaCrema, Italy
| | - Rita Pezzati
- University of Applied Sciences and Arts of Southern SwitzerlandManno, Switzerland.,Centro Terapia CognitivaComo, Italy
| | - Rita B Ardito
- Center for Cognitive Science, Department of Psychology, University of TurinTurin, Italy
| | - Vincenzo Silani
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico ItalianoMilan, Italy.,Department of Pathophysiology and Transplantation and "Dino Ferrari" Center, University of Milan Medical SchoolMilan, Italy
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Roy S, Drake AS, Eizaguirre MB, Zivadinov R, Weinstock-Guttman B, Chapman BP, Benedict RHB. Trait neuroticism, extraversion, and conscientiousness in multiple sclerosis: Link to cognitive impairment? Mult Scler 2017; 24:205-213. [DOI: 10.1177/1352458517695467] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Previous research suggests that patients with multiple sclerosis (MS) have higher neuroticism, lower extraversion, and lower conscientiousness relative to healthy controls (HCs). However, the prevalence of this maladaptive profile in MS and its relation to cognition is unknown. Objective: Determine prevalence of maladaptive personality among MS patients, compared to HCs, and examine how it relates to cognitive dysfunction. Methods: A sample of 275 MS patients and 55 HCs completed neuroperformance measures of information processing speed and memory. Self and informant ratings were obtained on the NEO Five-Factor Inventory. Results: MS patients had higher neuroticism and lower extraversion than HCs. Cognitively impaired patients were also lower in conscientiousness. Cluster analysis revealed a configuration of these same three traits, representing a maladaptive profile. This profile was found in 50% of the overall MS sample, compared to 24% of HCs. However, only cognitively impaired MS patients had a higher prevalence of maladaptive personality compared to HCs. Among cognitively impaired patients, those with maladaptive traits were impaired in more cognitive domains than those with more adaptive traits. Conclusion: Cognitively impaired MS patients have a higher prevalence of seemingly maladaptive traits compared to HCs, demonstrating an association between cognition and personality in MS.
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Affiliation(s)
- Shumita Roy
- Department of Neurology, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York (SUNY), Buffalo, NY, USA
| | - Allison S Drake
- Department of Neurology, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York (SUNY), Buffalo, NY, USA
| | | | - Robert Zivadinov
- Department of Neurology, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York (SUNY), Buffalo, NY, USA/Buffalo Neuroimaging Analysis Center and Department of Neurology, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York (SUNY), Buffalo, NY, USA/MR Imaging Clinical Translational Research Center, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York (SUNY), Buffalo, NY, USA
| | - Bianca Weinstock-Guttman
- Department of Neurology, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York (SUNY), Buffalo, NY, USA
| | - Benjamin P Chapman
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA
| | - Ralph HB Benedict
- Department of Neurology, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York (SUNY), Buffalo, NY, USA/Department of Neurology, Buffalo General Hospital, Buffalo, NY, USA
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Leavitt VM, Buyukturkoglu K, Inglese M, Sumowski JF. Protective personality traits: High openness and low neuroticism linked to better memory in multiple sclerosis. Mult Scler 2017; 23:1786-1790. [PMID: 28067603 DOI: 10.1177/1352458516685417] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Memory impairment in multiple sclerosis (MS) is common, although few risk/protective factors are known. OBJECTIVE To examine relationships of personality to memory/non-memory cognition in MS. METHOD 80 patients completed a cognitive battery and a personality scale measuring the "Big 5" traits: openness, neuroticism, agreeableness, extraversion, and conscientiousness. RESULTS Memory was most related to openness, with higher openness linked to better memory and lower risk for memory impairment, controlling for age, atrophy, education, and intelligence quotient (IQ). Lower neuroticism was also related to better memory, and lower conscientiousness to memory impairment. Non-memory cognition was unrelated to personality. CONCLUSION Personality may inform predictive models of memory impairment in MS.
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Affiliation(s)
- Victoria M Leavitt
- Department of Neurology, Columbia University Medical Center, New York, NY, USA
| | - Korhan Buyukturkoglu
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Matilde Inglese
- Departments of Neurology, Radiology and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA/Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
| | - James F Sumowski
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Roy S, Frndak S, Drake AS, Irwin L, Zivadinov R, Weinstock-Guttman B, Benedict RH. Differential effects of aging on motor and cognitive functioning in multiple sclerosis. Mult Scler 2016; 23:1385-1393. [PMID: 27885064 DOI: 10.1177/1352458516679036] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Multiple sclerosis (MS) patients are impaired in motor and cognitive performance, but the extent to which these deficits are magnified by aging is unknown. In one prior study, differences in cognitive processing speed between MS patients and healthy individuals were of similar magnitude across the lifespan. Here, we have improved on this work by expanding assessment to multiple cognitive domains and motor functioning. OBJECTIVE To determine whether the degree of cognitive and motor dysfunction in MS is magnified with increasing age. METHODS In all, 698 MS patients (aged 29-71 years) and 226 healthy controls (HCs; aged 18-72 years) completed neuroperformance tests covering ambulation, upper extremity function, information processing speed, and memory. RESULTS Linear regression models predicting cognitive and motor function revealed main effects of MS/HC diagnosis, age, and education across all measures. There was also an interaction between age and diagnosis on measures of motor function, but not on cognitive outcomes. CONCLUSION The progression of motor decline is amplified by aging in MS. However, the degree of cognitive impairment does not vary across the lifespan. Thus, evidence of accelerated cognitive impairment in older adults with MS may signal the presence of other age-related cognitive pathologies.
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Affiliation(s)
- Shumita Roy
- Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo-The State University of New York (SUNY), Buffalo, NY, USA
| | - Seth Frndak
- Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo-The State University of New York (SUNY), Buffalo, NY, USA
| | - Allison S Drake
- Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo-The State University of New York (SUNY), Buffalo, NY, USA
| | - Lauren Irwin
- Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo-The State University of New York (SUNY), Buffalo, NY, USA
| | - Robert Zivadinov
- Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo-The State University of New York (SUNY), Buffalo, NY, USA/Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo-The State University of New York (SUNY), Buffalo, NY, USA/MR Imaging Clinical Translational Research Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo-The State University of New York (SUNY), Buffalo, NY, USA
| | - Bianca Weinstock-Guttman
- Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo-The State University of New York (SUNY), Buffalo, NY, USA
| | - Ralph Hb Benedict
- Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo-The State University of New York (SUNY), Buffalo, NY, USA/Department of Neurology, Buffalo General Hospital, Buffalo, NY, USA
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Abstract
OBJECTIVES Cognitive reserve moderates the effects of gray matter (GM) atrophy on cognitive function in neurological disease. Broadly speaking, Reserve explains how persons maintain function in the face of cerebral injury in cognitive and other functional domains (e.g., physical, social). Personality, as operationalized by the Five Factor Model (FFM), is also implicated as a moderator of this relationship. It is conceivable that these protective mechanisms are related. Prior studies suggest links between Reserve and personality, but the degree to which these constructs overlap and buffer the clinical effects of neuropathology is unclear. METHODS We evaluated Reserve and FFM traits-Neuroticism, Extraversion, Openness, Agreeableness, and Conscientiousness-in a cohort of 67 multiple sclerosis (MS) patients. We also examined the extent to which FFM traits and aspects of Reserve interact in predicting cognitive processing speed. RESULTS Retrospectively reported educational/occupational achievement was associated with higher Openness, and childhood social engagement was associated with higher Extraversion, Agreeableness, and Conscientiousness. Current involvement in exercise activities and social activities was associated with Extraversion, current involvement in hobbies was associated with Neuroticism, and current receptive behaviors were associated with Agreeableness and Conscientiousness. When tested as predictors, Conscientiousness and childhood enrichment activities interacted in predicting cognitive processing speed after accounting for age, disease duration, disability, and GM volume. CONCLUSIONS Childhood enrichment activities and Conscientiousness have a synergistic effect on cognitive processing speed. Current findings have implications for using psychological interventions to foster both Reserve and adaptive personality characteristics to stave off clinical symptoms in MS. (JINS, 2016, 22, 920-927).
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Benedict RH, Drake AS, Irwin LN, Frndak SE, Kunker KA, Khan AL, Kordovski VM, Motl RW, Weinstock-Guttman B. Benchmarks of meaningful impairment on the MSFC and BICAMS. Mult Scler 2016; 22:1874-1882. [PMID: 26920379 DOI: 10.1177/1352458516633517] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Revised: 01/24/2016] [Accepted: 01/27/2016] [Indexed: 11/17/2022]
Abstract
BACKGROUND Cognitive and motor abilities in multiple sclerosis (MS) are typically quantified using reliable, consensus standard tests validated in the MS population. While these performance measures are associated with vocational disability in parametric analyses, translation of raw scores into anchors reflecting clinically relevant, functional impairment requires further research. OBJECTIVE To examine performance-based motor and cognitive outcomes among definitive anchors that designate varying degrees of functional impairment, thereby establishing benchmarks for score interpretation. METHODS We evaluated MS patients and healthy controls, all undergoing a brief test battery. Outcomes were derived from the MS Functional Composite (MSFC) and the Brief International Cognitive Assessment for MS (BICAMS). Functional impairment anchors were (1) disability benefits, (2) employed with negative work events, and (3) employed without problems. RESULTS All measures yielded statistically significant differences across all levels of work status, after accounting for the effects of age and education. Benchmark values distinguished the functional impairment groups. When evaluated in combination, the Timed 25-Foot Walk and the Symbol Digit Modalities Test were the most robust predictors of functional decline. CONCLUSION We have established benchmark scores for popular motor and cognitive tests that are associated with specific degrees of impairment in work status.
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Affiliation(s)
- Ralph Hb Benedict
- Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
| | - Allison S Drake
- Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
| | - Lauren N Irwin
- Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
| | - Seth E Frndak
- Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
| | - Katrina A Kunker
- Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
| | - Anjum L Khan
- Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
| | - Victoria M Kordovski
- Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
| | - Robert W Motl
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Bianca Weinstock-Guttman
- Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
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Fernández-Muñoz JJ, Morón-Verdasco A, Cigarán-Méndez M, Muñoz-Hellín E, Pérez-de-Heredia-Torres M, Fernández-de-las-Peñas C. Disability, quality of life, personality, cognitive and psychological variables associated with fatigue in patients with multiple sclerosis. Acta Neurol Scand 2015; 132:118-24. [PMID: 25644133 DOI: 10.1111/ane.12370] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2014] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To examine the associations between function, quality of life, personality, cognitive and psychological outcomes with fatigue in patients with MS. METHODS One hundred and eight patients (54% women) with definite MS participated. MS-related fatigue was assessed with the Fatigue Impact Scale (FIS). Demographic and clinical data (weight, height, medication and history of pain), specific disease outcomes (Functional Assessment of Multiple Sclerosis/FAMS), general disease outcomes (Beck Depression Inventory/BDI-II, and Short-Form Health Survey 36/SF-36) and personality (NEO Five-Factor Inventory/NEOFFI) were assessed. Correlation and regression analyses were performed to determine associations between variables. RESULTS A significant positive correlation existed between the FIS and EDSS (r=0.190; P<0.05). Significant negative correlations between the FIS with specific disease (FAMS mobility: r=-0.333, P<0.01; FAMS symptoms: r=-0.443, P<0.01; FAMS emotional well-being: r=-0.412, P<0.01; FAMS general contentment: r=-0.325, P<. 01; and, FAMS thinking/fatigue: r=-0.706, P<0.01); general disease (all domains SF36: -0.508<r<-0.302; P<0.01); and personality (NEOFFI neuroticism: r=-0.39, P<0.01; agreeableness: r=-0.206, P<0.05; conscientiousness: r=-0.279, P<0.01) were also observed. Stepwise regression analyses revealed that FAMS thinking/fatigue, physical function (SF-36) and FAMS emotional well-being explained 62.5% of the variance in fatigue (r2=0.652; r2 adjusted=0.625; F=23.774; P<0.001). CONCLUSIONS This study indicates that MS-related fatigue shows an impact on physical, cognitive and emotional aspects in this population.
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Affiliation(s)
| | - A. Morón-Verdasco
- Department of Psychology; Universidad Rey Juan Carlos; Alcorcón Spain
| | - M. Cigarán-Méndez
- Department of Psychology; Universidad Rey Juan Carlos; Alcorcón Spain
| | - E. Muñoz-Hellín
- Department of Physical Therapy; Occupational Therapy; Rehabilitation and Physical Medicine; Universidad Rey Juan Carlos; Alcorcón Spain
| | - M. Pérez-de-Heredia-Torres
- Department of Physical Therapy; Occupational Therapy; Rehabilitation and Physical Medicine; Universidad Rey Juan Carlos; Alcorcón Spain
| | - C. Fernández-de-las-Peñas
- Department of Physical Therapy; Occupational Therapy; Rehabilitation and Physical Medicine; Universidad Rey Juan Carlos; Alcorcón Spain
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Concetta Incerti C, Magistrale G, Argento O, Pisani V, Di Battista G, Ferraro E, Caltagirone C, Benedict RHB, Nocentini U. Occupational stress and personality traits in multiple sclerosis: A preliminary study. Mult Scler Relat Disord 2015. [DOI: 10.1016/j.msard.2015.06.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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Lima ABD, Paes RA, Alvarenga RMP. Personality factors in recently diagnosed multiple sclerosis patients: a preliminary investigation with the NEO-FFI scale. ARQUIVOS DE NEURO-PSIQUIATRIA 2015; 73:200-4. [PMID: 25807124 DOI: 10.1590/0004-282x20140234] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Accepted: 11/19/2014] [Indexed: 11/21/2022]
Abstract
This article describes some prevalent personality dimensions of recently diagnosed multiple sclerosis patients. A sample of 33 female recently diagnosed with relapsing-remitting multiple sclerosis (RRMS) was assessed with the NEO-FFI personality scale. Beck depression (BDI) and anxiety (BAI) scales were also used. No significant levels of anxiety or depression were identified in this group. As for personality factors, conscientiousness was the most common factor found, whereas openness to experience was the least observed. Literature on the relationship between personality and MS is scarce and there are no Brazilian studies on this subject. Some personality traits might complicate or facilitate the experience of living with a chronic, disabling and uncertain neurological condition such as MS.
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Affiliation(s)
- Aline Braz de Lima
- Divisão de Neurologia, Hospital Universitário Gafrée & Guinle, Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Renata Alves Paes
- Divisão de Neurologia, Hospital Universitário Gafrée & Guinle, Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Regina Maria Papais Alvarenga
- Divisão de Neurologia, Hospital Universitário Gafrée & Guinle, Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
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Cambil-Martín J, Galiano-Castillo N, Muñoz-Hellín E, Díaz-Rodríguez L, Laguarta-Val S, Fernández-de-Las-Peñas C, Arroyo-Morales M. Influence of body mass index on psychological and functional outcomes in patients with multiple sclerosis: a cross-sectional study. Nutr Neurosci 2014; 19:79-85. [PMID: 25225836 DOI: 10.1179/1476830514y.0000000156] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVES To analyze the effect of weight on psychological and functional outcomes in multiple sclerosis (MS) patients, including self-perception, depression, functional level, fatigue, and self-rated health status. METHODS One hundred and one (n = 101) patients with MS participated in this cross-sectional study. Outcomes were scores in the Beck Depression Inventory, NEO Five-Factor Inventory (NEOFFI), Functional Assessment of Multiple Sclerosis (FAMS), Fatigue Impact Scale, and Quality Short-Form Health Survey 36 (SF-36). Patients were classified as normal weight (18.5 < BMI < 24.9 kg/m(2)) or overweight (25.0 > BMI > 29.9 kg/m(2)). One-way analysis of covariance was conducted with gender, age, and years with disease as covariates. RESULTS Depression levels were significantly higher in overweight versus normal-weight MS patients (F = 6.381; P = 0.013). NEOFFI scores were significantly higher in overweight versus normal-weight MS patients for extraversion (F = 6.331; P = 0.014), conscientiousness (F = 4.794; P = 0.034), and neuroticism (F = 5.422; P = 0.022) but not for openness (F = 2.174; P = 0.109) or agreeableness (F = 0.047; P = 0.829). The two groups did not significantly differ in fatigue (P > 00.5). Scores in general (F = 4.708; P = 0.032) and mental health (F = 4.583; P = 0.035) SF-36 domains were significantly lower in overweight versus normal-weight patients. Scores for FAMS domains of emotional well-being (F = 8.050; P = 0.006), general contentment (F = 7.967; P = 0.006), and family/social well-being (F = 7.662; P = 0.007) were significantly lower in overweight versus normal-weight patients. CONCLUSIONS Overweight MS patients evidenced higher depression levels, lower functional capacity, and worse self-rated health status in comparison to normal-weight MS patients. These results suggest that weight control programs should be incorporated into the management of patients with MS.
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Modica CM, Zivadinov R, Dwyer MG, Bergsland N, Weeks AR, Benedict RHB. Iron and volume in the deep gray matter: association with cognitive impairment in multiple sclerosis. AJNR Am J Neuroradiol 2014; 36:57-62. [PMID: 24948507 DOI: 10.3174/ajnr.a3998] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE There is a well-established correlation between deep gray matter atrophy and cognitive dysfunction in MS. However, the cause of these signs of neurodegeneration is poorly understood. Iron accumulation in the deep gray matter is higher in patients with MS compared with age- and sex-matched healthy controls, and could contribute to disease progression. Our objective was to evaluate the relationship between iron and cognition in several deep gray matter structures while accounting for the influence of volume loss. MATERIALS AND METHODS Eighty-five patients with MS and 27 healthy volunteers underwent 3T MR imaging and neuropsychological examination. We used SWI filtered phase to analyze the mean phase of low-phase voxels, indicative of abnormal iron accumulation. RESULTS Correlations between mean phase of low-phase voxels and cognitive tests were found in the caudate nucleus (r = 0.240 and 0.232), putamen (r = 0.368, 0.252, and 0.238), globus pallidus (r = 0.235), and pulvinar nucleus of thalamus (r = 0.244, 0.255, and 0.251) (P < .05). However, correlations between structure volume and cognition were more robust. Furthermore, the introduction of structure volume into hierarchical regression analyses after iron metrics significantly improved most models, and mean phase of low-phase voxels did not account for significant variance after volume. CONCLUSIONS These findings suggest that iron accumulation plays a significant, if minor, role in MS cognitive decline.
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Affiliation(s)
- C M Modica
- From the Neuroscience Program (C.M.M.) Buffalo Neuroimaging Analysis Center (C.M.M., R.Z., M.G.D., N.B., R.H.B.B.)
| | - R Zivadinov
- Buffalo Neuroimaging Analysis Center (C.M.M., R.Z., M.G.D., N.B., R.H.B.B.) MR Imaging Clinical Translational Research Center (R.Z.) Department of Neurology (R.Z., R.H.B.B.), School of Medicine and Biomedical Sciences
| | - M G Dwyer
- Buffalo Neuroimaging Analysis Center (C.M.M., R.Z., M.G.D., N.B., R.H.B.B.)
| | - N Bergsland
- Buffalo Neuroimaging Analysis Center (C.M.M., R.Z., M.G.D., N.B., R.H.B.B.) IRCCS (N.B.), "S. Maria Nascente," Don Gnocchi Foundation, Milan, Italy
| | - A R Weeks
- School of Public Health and Health Professions (A.R.W.), University at Buffalo, State University of New York, Buffalo, New York
| | - R H B Benedict
- Buffalo Neuroimaging Analysis Center (C.M.M., R.Z., M.G.D., N.B., R.H.B.B.) Department of Neurology (R.Z., R.H.B.B.), School of Medicine and Biomedical Sciences
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Abstract
OBJECTIVE A nighttime dip in blood pressure is associated with decreased risk of cardiovascular morbidity and mortality. We examined whether personality traits predict nighttime dipping blood pressure. METHODS A community-based sample of 2848 adults from Sardinia (Italy) completed the Revised NEO Personality Inventory and 7 years later were examined with 24-hour ambulatory blood pressure monitoring. The primary analyses examined the associations of personality traits with continuous and categorical measures of mean arterial, systolic, and diastolic blood pressure nighttime dipping. RESULTS Agreeableness and conscientiousness were associated with more nocturnal blood pressure dipping (β = .05 [p = .025] and β = .07 [p < .001], respectively) and lower systolic blood pressure at night (β = -.05 [p = .018] and β = -.03 [p = .072], respectively). Nondippers were particularly more impulsive (p = .009), less trusting (p = .004), and less self-disciplined (p = .001), but there was no significant association between nocturnal dipping blood pressure and trait anxiety (p = .78) or depression (p = .59). The associations were stronger when comparing extreme dippers (nighttime drop ≥ 20%) to reverse dippers (nighttime increase in blood pressure). Indeed, scoring 1 standard deviation higher on conscientiousness was associated with approximately 40% reduced risk of reverse dipping (odds ratio = 1.43, confidence interval = 1.08-1.91). CONCLUSIONS We found evidence that reduced nighttime blood pressure dipping is associated with antagonism and impulsivity-related traits but not with measures of emotional vulnerability. The strongest associations were found with conscientiousness, a trait that may have a broad impact on cardiovascular health.
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