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Kademli M, Ertan-Kaya Ö, Salman F, Cangöz-Tavat B, Baran Z. The Auditory Consonant Trigram (ACT) Test: A norm updating study for university students. APPLIED NEUROPSYCHOLOGY. ADULT 2024; 31:10-18. [PMID: 34672893 DOI: 10.1080/23279095.2021.1986509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The Auditory Consonant Trigram (ACT) Test is accepted as a pure measurement of verbal working memory, but its norm study and psychometric properties have not been sufficiently researched. This study aims to update the norm data of the ACT, validity and reliability studies of which have been previously conducted on an adult Turkish sample, on a broader young sample and in a way that would end some methodological limitations. For this purpose, the data is collected from 304 voluntary healthy young adults (aged 18-26, 152 females-152 males). According to the results, a difference is found among all delay intervals. While the test scores decrease in females as delay interval increases, there is no difference in males between the delay intervals of 9 and 18 sec. While there is no difference between the genders for very short delay intervals (0-3 sec), males show a more successful performance than females as the delay interval increases (9-18 sec). Males are also more successful than females in terms of total test scores of the ACT. In this respect, it is concluded that the ACT measurement of working memory with a total score reliability coefficient of 0.75 is reliable.
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Affiliation(s)
- Müge Kademli
- Department of Psychology, Suleyman Demirel University, Isparta, Turkey
| | - Özlem Ertan-Kaya
- Department of Psychology, Ankara Medipol University, Ankara, Turkey
| | - Funda Salman
- Department of Psychology, Ankara Science University, Ankara, Turkey
| | | | - Zeynel Baran
- Department of Psychology, Hacettepe University, Ankara, Turkey
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Fatigue scores correlate with other self-assessment data, but not with clinical and biomarker parameters, in CIS and RRMS. Mult Scler Relat Disord 2019; 36:101424. [PMID: 31586802 DOI: 10.1016/j.msard.2019.101424] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 08/07/2019] [Accepted: 09/30/2019] [Indexed: 01/08/2023]
Abstract
BACKGROUND Fatigue is common in multiple sclerosis and is associated with reduced quality of life. This study aimed to assess the correlation between fatigue scores and data from other self-assessment questionnaires, neuropsychological tests and neuroimaging, as well as data on neuroimmunological markers in cerebrospinal fluid (CSF) and serum/plasma, in clinically isolated syndrome (CIS) and relapsing remitting MS (RRMS). METHODS Modified fatigue impact scale (MFIS) scores were determined in 38 patients with newly diagnosed CIS or RRMS at baseline and after one year in a prospective longitudinal cohort study. Non-parametric correlation analyses were used to assess associations between MFIS scores and other self-assessment questionnaire data (Hospital Anxiety and Depression scale (HAD), Multiple Sclerosis Impact Scale 29 (MSIS-29) and Short Form 36 (SF-36)), as well as with neuropsychological test performances (e.g. Auditory Consonant Trigram Test (ACTT)), clinical parameters (e.g. disease duration and expanded disability status scale (EDSS)), magnetic resonance imaging (MRI) data (number of T2 lesions in brain MRI and total brain volume) and several neurodegenerative/neuroinflammatory markers in CSF and serum/plasma (IL-1β, IL-6, CXCL1, CXCL10, CXCL13, CCL-22 in plasma; neurofilament light chain (NFL) in serum; IL-6, CXCL1, CXCL10, CXCL13, CCL22, NFL and chitinase-3-like-1 (CHI3L1) in CSF. CSF and serum/plasma from 21 age- and sex-matched healthy controls were available for comparison. RESULTS At both baseline and one-year follow-up, fatigue scores correlated significantly with HAD, MSIS-29 and SF-36 scores and ACTT performance (Spearman´s rho 0.45-0.78, all p ≤ 0.01) but not with the other neuropsychological test results, disease duration, EDSS ratings, number of T2 lesions, total brain volume or neurodegenerative/neuroinflammatory markers, including neurofilament light chain levels in CSF and serum. In group comparisons, MFIS scores were similar in patients fulfilling no evidence of disease activity-3 (NEDA-3) (n = 18) and patients not fulfilling NEDA-3 (n = 20) during one year of follow-up (p > 0.01). CONCLUSIONS In this cohort of patients with newly diagnosed CIS and RRMS, fatigue scores were associated with mood, disease impact on daily life and quality of life as well as with alterations of attentive functions. Study results indicate that subjective fatigue scores are not well reflected by some commonly used and objectively measurable disease parameters like EDSS, T2 lesions and NFL levels.
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Shura RD, Rowland JA, Miskey HM. Auditory Consonant Trigrams: A Psychometric Update†. Arch Clin Neuropsychol 2015; 31:47-57. [PMID: 26645315 DOI: 10.1093/arclin/acv083] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2015] [Indexed: 11/15/2022] Open
Abstract
The Auditory Consonant Trigrams (ACT) test was developed to evaluate immediate memory in the absence of rehearsal. There are few psychometric studies of the measure and a lack of normative data using samples from the United States or Veterans. ACT data were examined for 184 participants who passed the Word Memory Test, denied a history of moderate to severe traumatic brain injury (TBI), and consented for research purposes only. Reliability and construct validity were examined and normative data developed using a healthy subsample. Cronbach's α for the ACT total score was 0.79. Regression analyses suggested that years of education, estimated premorbid IQ, psychomotor speed, working memory, and impulsivity had the strongest relationships with performance on the ACT. Performance was unrelated to posttraumatic stress disorder and remote mild TBI, but the presence of major depressive disorder was associated with lower total scores. These results demonstrate the ACT has adequate psychometric properties.
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Affiliation(s)
- Robert D Shura
- Mid-Atlantic Mental Illness Research, Education, and Clinical Center (MA-MIRECC), W.G. "Bill" Hefner Veterans Affairs Medical Center, Salisbury, NC 28144, USA Department of Psychiatry and Behavioral Sciences, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA
| | - Jared A Rowland
- Mid-Atlantic Mental Illness Research, Education, and Clinical Center (MA-MIRECC), W.G. "Bill" Hefner Veterans Affairs Medical Center, Salisbury, NC 28144, USA Department of Psychiatry and Behavioral Sciences, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA Department of Neurobiology and Anatomy, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Holly M Miskey
- Mid-Atlantic Mental Illness Research, Education, and Clinical Center (MA-MIRECC), W.G. "Bill" Hefner Veterans Affairs Medical Center, Salisbury, NC 28144, USA Department of Psychiatry and Behavioral Sciences, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA
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Utility of the INECO frontal screening (IFS) in the detection of executive dysfunction in patients with relapsing-remitting multiple sclerosis (RRMS). Neurol Sci 2015; 36:2035-41. [DOI: 10.1007/s10072-015-2299-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Accepted: 06/16/2015] [Indexed: 10/23/2022]
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Perceived cognitive difficulties and cognitive test performance as predictors of employment outcomes in people with multiple sclerosis. J Int Neuropsychol Soc 2015; 21:156-68. [PMID: 25727930 DOI: 10.1017/s1355617715000053] [Citation(s) in RCA: 73] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Perceived cognitive difficulties and cognitive impairment are important determinants of employment in people with multiple sclerosis (pwMS). However, it is not clear how they are related to adverse work outcomes and whether the relationship is influenced by depressive symptoms. Thus, this study examined perceived and actual general cognitive and prospective memory function, and cognitive appraisal accuracy, in relation to adverse work outcomes. The possible mediating and/or moderating role of depression was also examined. A cross-sectional community-based sample of 111 participants (33 males, 78 females) completed the Multiple Sclerosis Work Difficulties Questionnaire (MSWDQ), Beck Depression Inventory - Fast Screen (BDI-FS), and questions related to their current or past employment. They then underwent cognitive testing using the Screening Examination for Cognitive Impairment, Auditory Consonant Trigrams test, Zoo Map Test, and Cambridge Prospective Memory Test. Perceived general cognitive and prospective memory difficulties in the workplace and performance on the respective cognitive tests were found to predict unemployment and reduced work hours since MS diagnosis due to MS. Depression was also related to reduced work hours, but it did not explain the relationship between perceived cognitive difficulties and the work outcomes. Nor was it related to cognitive test performance. The results highlight a need to address the perceptions of cognitive difficulties together with cognitive impairment and levels of depression in vocational rehabilitation programs in pwMS.
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Uysal U, Idiman F, Idiman E, Ozakbas S, Karakas S, Bruce J. Contingent negative variation is associated with cognitive dysfunction and secondary progressive disease course in multiple sclerosis. J Clin Neurol 2014; 10:296-303. [PMID: 25324878 PMCID: PMC4198710 DOI: 10.3988/jcn.2014.10.4.296] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2014] [Revised: 07/23/2014] [Accepted: 07/25/2014] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND AND PURPOSE The relationship between contingent negative variation (CNV), which is an event-related potential, and cognition in multiple sclerosis (MS) has not been examined previously. The primary objective of the present study was thus to determine the association between CNV and cognition in a sample of MS patients. METHODS The subjects of this study comprised 66 MS patients [50 with relapsing-remitting MS (RRMS) and 16 with secondary progressive MS (SPMS)] and 40 matched healthy volunteers. A neuropsychological battery was administered to all of the subjects; CNV recordings were made from the Cz, Fz, and Pz electrodes, and the amplitude and area under the curve (AUC) were measured at each electrode. RESULTS RRMS patients exhibited CNVs with lower amplitudes and smaller AUCs than the controls at Pz. SPMS patients exhibited CNVs with lower amplitudes and smaller AUCs than the controls, and CNVs with a smaller amplitude than the RRMS patients at both Cz and Pz. After correcting for multiple comparisons, a lower CNV amplitude at Pz was significantly associated with worse performance on measures of speed of information processing, verbal fluency, verbal learning, and verbal recall. CONCLUSIONS CNV may serve as a marker for disease progression and cognitive dysfunction in MS. Further studies with larger samples and wider electrode coverage are required to fully assess the value of CNV in these areas.
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Affiliation(s)
- Utku Uysal
- Department of Neurology, Dokuz Eylul University, Izmir, Turkey
| | - Fethi Idiman
- Department of Neurology, Dokuz Eylul University, Izmir, Turkey
| | - Egemen Idiman
- Department of Neurology, Dokuz Eylul University, Izmir, Turkey
| | - Serkan Ozakbas
- Department of Neurology, Dokuz Eylul University, Izmir, Turkey
| | - Sirel Karakas
- Department of Psychology, Cyprus International University, Lefkosa, Republic of Cyprus, Turkey
| | - Jared Bruce
- Department of Psychology, University of Missouri-Kansas City, Kansas City, MO, USA
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Piri Cinar B, Ozakbas S, Idiman E. Evaluation of clinical parameters during and after treatment of attack in patients with clinically isolated syndrome: comparison of the results with that of multiple sclerosis patients. Clin Neurol Neurosurg 2013; 115:2432-7. [PMID: 24140010 DOI: 10.1016/j.clineuro.2013.09.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2012] [Revised: 08/30/2013] [Accepted: 09/08/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVES The aim of the present study was to examine the changes in the measurement of functions during and after pulse methylprednisolone (MP) treatment during a clinically isolated syndrome (CIS) attack, using the multiple sclerosis functional composite (MSFC) and Expanded Disability Status Scale (EDSS), and to compare the results with that of MS patients. PATIENTS AND METHOD The present study included 44 patients with CIS and 26 patients with clinically definite multiple sclerosis (MS), as the control group. All patients were having an acute attack and were treated with 1000-mg intravenous methylprednisolone. The scales were administered before-and after-treatment, and at 30 days after treatment. RESULTS A 5-days treatment was adequate in 36.9% of CIS patients and 62.5% of MS patients (p=0.003). A moderate correlation was found between Auditory Consonant Trigram Test (ACT) and paced auditory serial addition test in CIS patients before-treatment. A poor correlation was found between EDSS scores and ACT in CIS patients at all measurement periods. The level of correlation between EDSS and ACT scores was similar in MS patients. CONCLUSION Although MS and CIS patients show similar response to corticosteroid treatment and had similar fatigue characteristics, overall cognitive functioning was better in CIS patients.
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Early onset multiple sclerosis has worse prognosis than adult onset multiple sclerosis based on cognition and magnetic resonance imaging. Autoimmune Dis 2012. [PMID: 23193441 PMCID: PMC3502763 DOI: 10.1155/2012/563989] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Objectives. In the present study, we aimed to compare the childhood and adult onset multiple sclerosis patients prospectively in their adulthood on the basis of clinical and magnetic resonance imaging (MRI) findings and cognitive impairment, which have not been performed before.
Patients and Methods. Forty-six patients in whom the disease onset occurred before 16 years of age were included in the present study. Study subjects were compared with 64 randomly included adult onset patients.
Results. Mean disease duration, clinical course, and female to male ratio did not differ in the groups. Cerebellar/brainstem and spinal involvement at onset were significantly higher in EOMS than in AOMS. Difference in MSFC between baseline and at the end of the 5th year was significantly worse in EOMS population (P = 0.02). The most significant difference was found in Paced Auditory Serial Addition Test (PASAT) (P = 0.008). Differences between baseline and at the end of the 5th year on the basis of T1 hypointense lesions were significantly higher in early onset MS than in adult onset MS patients (P = 0.02).
Conclusions. Early onset MS seems to have worse prognosis than that of adult onset MS on the basis of clinical manifestation, cognitive impairment, and MRI parameters.
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Vision in multiple sclerosis: the story, structure-function correlations, and models for neuroprotection. J Neuroophthalmol 2012; 31:362-73. [PMID: 22089500 DOI: 10.1097/wno.0b013e318238937f] [Citation(s) in RCA: 103] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
Visual dysfunction is one of the most common clinical manifestations of multiple sclerosis (MS). Just over a decade ago, MS clinical trials did not include visual outcomes, but experts recognized the need for more sensitive measures of visual function. Low-contrast letter acuity emerged as the leading candidate to measure visual disability in MS, and subsequent studies found low-contrast acuity testing to correlate well with brain MRI lesion burden, visual-evoked potentials, quality of life (QOL), and retinal nerve fiber layer (RNFL) loss, as measured by optical coherence tomography (OCT). OCT in MS has allowed for assessment of structure-function correlations that make the anterior visual pathway and acute optic neuritis (ON) ideal models for testing novel agents for neuroprotection and repair. New therapies that reduce axonal loss by neuroprotective or myelin repair mechanisms can now be assessed noninvasively by OCT and coupled with visual function data. Based on OCT studies in MS, RNFL thickness is reduced significantly among patients (92 μm) vs controls (105 μm) and is particularly reduced in MS eyes with a history of ON (85 μm). Worsening of visual function by a clinically significant ≥ 7 letters or approximately 1.5 lines for low-contrast acuity is associated with approximately 4.5 μm reductions in RNFL thickness in MS eyes. Longitudinal studies of OCT have also shown RNFL axonal loss over time that occurs even in the absence of acute ON and that correlates with clinically meaningful worsening of vision and QOL, even in patients with benign MS. The latest OCT investigations involve high-resolution spectral-domain (SD) OCT with segmentation and measurement of specific retinal layers using computerized algorithms. These methods allow quantitation of ganglion cell (neuronal) layer loss and axonal degeneration in MS in vivo. In this review, we examine the data from these studies and ongoing trials that highlight the entity of ON as a model to investigate neuroprotection and neurorepair. In doing so, we also present representative group data from studies that have examined visual function, OCT measures, and QOL scales in patients with MS and ON and disease-free controls. These data, and those from recent meta-analyses, may be used to provide reference values for the development of clinical trial protocols.
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Achiron A, Doniger GM, Harel Y, Appleboim-Gavish N, Lavie M, Simon ES. Prolonged response times characterize cognitive performance in multiple sclerosis. Eur J Neurol 2007; 14:1102-8. [PMID: 17880565 DOI: 10.1111/j.1468-1331.2007.01909.x] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Cognitive impairment is amongst the main symptoms affecting multiple sclerosis (MS) and should be comprehensively and accurately assessed. To study the added value of a computerized neuropsychological battery enabling the measurement of response times in the cognitive domains, 58 randomly selected MS patients and 71 age-, gender- and education-matched healthy subjects were evaluated. Construct and discriminant validity were assessed for the standard Neuropsychological Screening Battery for Multiple Sclerosis (NSBMS) and the Mindstreams Computerized Cognitive Battery (MCCB). The MCCB demonstrated good construct validity in comparison with the NSBMS in memory (P < 0.001), executive function (P < 0.001), attention (P < 0.05) and information processing (P < 0.05) domains. In addition, it showed high discriminant validity most prominently for executive function, attention and motor skills (P < 0.001). Response times measured by the computerized battery were longer in all cognitive domains and varied with cognitive load, demonstrating that response time deficits in MS are associated with particular task demands. We conclude that in MS prolonged response times on a range of cognitive tasks signify abnormal conduction within demyelinative tracts.
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Affiliation(s)
- A Achiron
- Multiple Sclerosis Center, Sheba Medical Center, Tel-Hashomer, Israel.
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Rogers JM, Panegyres PK. Cognitive impairment in multiple sclerosis: evidence-based analysis and recommendations. J Clin Neurosci 2007; 14:919-27. [PMID: 17659875 DOI: 10.1016/j.jocn.2007.02.006] [Citation(s) in RCA: 138] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2006] [Accepted: 02/05/2007] [Indexed: 11/25/2022]
Abstract
Cognitive impairment is common in multiple sclerosis (MS), occurring at all stages of the disease, and can be a major source of vocational disability, social impairment, and impoverished quality of life. Dysfunction in free recall from long-term memory, speed of information processing, working memory, and abstract reasoning are frequently observed in MS. Despite weak correlation with disease duration and physical disability status, the degree of cognitive impairment in MS has been related to the extent of topographically specific neuronal tissue damage and loss. Additional clinical factors including disease course, fatigue, affective disturbance, and medication can impact on the degree of MS-related cognitive impairment. We suggest that the symbol digits modalities test, paced auditory serial addition task, the clock drawing test and the MS neuropsychological screening questionnaire be considered as valid and relevant screening tests for cognitive impairment in MS.
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Affiliation(s)
- Jeffrey M Rogers
- Neurosciences Unit, Health Department of Western Australia, Perth, Western Australia, Australia
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