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Wong D, Pike K, Stolwyk R, Allott K, Ponsford J, McKay A, Longley W, Bosboom P, Hodge A, Kinsella G, Mowszowski L. Delivery of Neuropsychological Interventions for Adult and Older Adult Clinical Populations: An Australian Expert Working Group Clinical Guidance Paper. Neuropsychol Rev 2023:10.1007/s11065-023-09624-0. [PMID: 38032472 DOI: 10.1007/s11065-023-09624-0] [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: 04/12/2022] [Accepted: 10/16/2023] [Indexed: 12/01/2023]
Abstract
Delivery of neuropsychological interventions addressing the cognitive, psychological, and behavioural consequences of brain conditions is increasingly recognised as an important, if not essential, skill set for clinical neuropsychologists. It has the potential to add substantial value and impact to our role across clinical settings. However, there are numerous approaches to neuropsychological intervention, requiring different sets of skills, and with varying levels of supporting evidence across different diagnostic groups. This clinical guidance paper provides an overview of considerations and recommendations to help guide selection, delivery, and implementation of neuropsychological interventions for adults and older adults. We aimed to provide a useful source of information and guidance for clinicians, health service managers, policy-makers, educators, and researchers regarding the value and impact of such interventions. Considerations and recommendations were developed by an expert working group of neuropsychologists in Australia, based on relevant evidence and consensus opinion in consultation with members of a national clinical neuropsychology body. While the considerations and recommendations sit within the Australian context, many have international relevance. We include (i) principles important for neuropsychological intervention delivery (e.g. being based on biopsychosocial case formulation and person-centred goals); (ii) a description of clinical competencies important for effective intervention delivery; (iii) a summary of relevant evidence in three key cohorts: acquired brain injury, psychiatric disorders, and older adults, focusing on interventions with sound evidence for improving activity and participation outcomes; (iv) an overview of considerations for sustainable implementation of neuropsychological interventions as 'core business'; and finally, (v) a call to action.
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Affiliation(s)
- Dana Wong
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia.
| | - Kerryn Pike
- School of Psychology and Public Health & John Richards Centre for Rural Ageing Research, La Trobe University, Melbourne, Australia
- School of Applied Psychology, Griffith University, Gold Coast, Australia
| | - Rene Stolwyk
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
- Monash-Epworth Rehabilitation Research Centre, Melbourne, Australia
| | - Kelly Allott
- , Orygen, Parkville, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia
| | - Jennie Ponsford
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
- Monash-Epworth Rehabilitation Research Centre, Melbourne, Australia
| | - Adam McKay
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
- MERRC, Rehabilitation and Mental Health Division, Epworth HealthCare, Richmond, Australia
| | - Wendy Longley
- Rehabilitation Studies Unit, Sydney Medical School, University of Sydney, Sydney, Australia
- The Uniting War Memorial Hospital, Waverley, Sydney, Australia
| | - Pascalle Bosboom
- MindLink Psychology, West Perth, Australia
- School of Psychological Science, University of Western Australia, Crawley, Australia
| | | | - Glynda Kinsella
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Loren Mowszowski
- Faculty of Science, School of Psychology & Brain and Mind Centre, The University of Sydney, Sydney, Australia
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Taylor LA, Mhizha-Murira JR, Smith L, Potter KJ, Wong D, Evangelou N, Lincoln NB, das Nair R. Memory rehabilitation for people with multiple sclerosis. Cochrane Database Syst Rev 2021; 10:CD008754. [PMID: 34661282 PMCID: PMC8521643 DOI: 10.1002/14651858.cd008754.pub4] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Problems with cognition, particularly memory, are common in people with multiple sclerosis (MS) and can affect their ability to complete daily activities and can negatively affect quality of life. Over the last few years, there has been considerable growth in the number of randomised controlled trials (RCTs) of memory rehabilitation in MS. To guide clinicians and researchers, this review provides an overview of the effectiveness of memory rehabilitation for people with MS. OBJECTIVES To determine whether people with MS who received memory rehabilitation compared to those who received no treatment, or an active control showed better immediate, intermediate, or longer-term outcomes in their: 1. memory functions, 2. other cognitive abilities, and 3. functional abilities, in terms of activities of daily living, mood, and quality of life. SEARCH METHODS We searched CENTRAL which includes Clinicaltrials.gov, World Health Organization (The Whoqol) International Clinical Trials Registry Portal, Embase and PubMed (MEDLINE), and the following electronic databases (6 September 2020): CINAHL, LILACS, the NIHR Clinical Research Network Portfolio database, The Allied and Complementary Medicine Database, PsycINFO, and CAB Abstracts. SELECTION CRITERIA We selected RCTs or quasi-RCTs of memory rehabilitation or cognitive rehabilitation for people with MS in which a memory rehabilitation treatment group was compared with a control group. Selection was conducted independently first and then confirmed through group discussion. We excluded studies that included participants whose memory deficits were the result of conditions other than MS, unless we could identify a subgroup of participants with MS with separate results. DATA COLLECTION AND ANALYSIS Eight review authors were involved in this update in terms of study selection, quality assessment, data extraction and manuscript review. We contacted investigators of primary studies for further information where required. We conducted data analysis and synthesis in accordance with Cochrane methods. We performed a 'best evidence' synthesis based on the methodological quality of the primary studies included. Outcomes were considered separately for 'immediate' (within the first month after completion of intervention), 'intermediate' (one to six months), and 'longer-term' (more than six months) time points. MAIN RESULTS We added 29 studies during this update, bringing the total to 44 studies, involving 2714 participants. The interventions involved various memory retraining techniques, such as computerised programmes and training on using internal and external memory aids. Control groups varied in format from assessment-only groups, discussion and games, non-specific cognitive retraining, and attention or visuospatial training. The risk of bias amongst the included studies was generally low, but we found eight studies to have high risk of bias related to certain aspects of their methodology. In this abstract, we are only reporting outcomes at the intermediate timepoint (i.e., between one and six months). We found a slight difference between groups for subjective memory (SMD 0.23, 95% CI 0.11 to 0.35; 11 studies; 1045 participants; high-quality evidence) and quality of life (SMD 0.30, 95% CI 0.02 to 0.58; 6 studies; 683 participants; high-quality evidence) favoring the memory rehabilitation group. There was a small difference between groups for verbal memory (SMD 0.25, 95% CI 0.11 to 0.40; 6 studies; 753 participants; low-quality evidence) and information processing (SMD 0.27, 95% CI 0.00 to 0.54; 8 studies; 933 participants; low-quality evidence), favoring the memory rehabilitation group. We found little to no difference between groups for visual memory (SMD 0.20, 95% CI -0.11 to 0.50; 6 studies; 751 participants; moderate-quality evidence), working memory (SMD 0.16, 95% CI -0.09 to 0.40; 8 studies; 821 participants; moderate-quality evidence), or activities of daily living (SMD 0.06, 95% CI -0.36 to 0.24; 4 studies; 400 participants; high-quality evidence). AUTHORS' CONCLUSIONS: There is evidence to support the effectiveness of memory rehabilitation on some outcomes assessed in this review at intermediate follow-up. The evidence suggests that memory rehabilitation results in between-group differences favoring the memory rehabilitation group at the intermediate time point for subjective memory, verbal memory, information processing, and quality of life outcomes, suggesting that memory rehabilitation is beneficial and meaningful to people with MS. There are differential effects of memory rehabilitation based on the quality of the trials, with studies of high risk of bias inflating (positive) outcomes. Further robust, large-scale, multi-centre RCTs, with better quality reporting, using ecologically valid outcome assessments (including health economic outcomes) assessed at longer-term time points are still needed to be certain about the effectiveness of memory rehabilitation in people with MS.
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Affiliation(s)
- Lauren A Taylor
- Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, UK
| | | | - Laura Smith
- Division of Psychiatry and Applied Psychology, University of Nottingham, Nottingham, UK
| | - Kristy-Jane Potter
- Division of Psychiatry & Applied Psychology, University of Nottingham, Nottingham, UK
| | - Dana Wong
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Nikos Evangelou
- Faculty of Medicine & Health Sciences, University of Nottingham, Nottingham, UK
| | - Nadina B Lincoln
- Division of Rehabilitation and Ageing, University of Nottingham, Nottingham, UK
| | - Roshan das Nair
- Division of Psychiatry & Applied Psychology, University of Nottingham, Nottingham, UK
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Colin C, Martin A, Bonneviot F, Brangier E. Unravelling future thinking: a valuable concept for prospective ergonomics. THEORETICAL ISSUES IN ERGONOMICS SCIENCE 2021. [DOI: 10.1080/1463922x.2021.1943045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Clement Colin
- Université de Lorraine, PERSEUS EA7312, Metz, France
- Total S.E., Corporate R&D, F-92078 Paris, France
| | | | - Flavie Bonneviot
- Université de Lorraine, PERSEUS EA7312, Metz, France
- Vedecom Institute, Versailles, France
| | - Eric Brangier
- Université de Lorraine, PERSEUS EA7312, Metz, France
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Ernst A, Bertrand JMF, Voltzenlogel V, Souchay C, Moulin CJA. The Proust Machine: What a Public Science Event Tells Us About Autobiographical Memory and the Five Senses. Front Psychol 2021; 11:623910. [PMID: 33551934 PMCID: PMC7854910 DOI: 10.3389/fpsyg.2020.623910] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 12/18/2020] [Indexed: 11/13/2022] Open
Abstract
Our senses are constantly stimulated in our daily lives but we have only a limited understanding of how they affect our cognitive processes and, especially, our autobiographical memory. Capitalizing on a public science event, we conducted the first empirical study that aimed to compare the relative influence of the five senses on the access, temporal distribution, and phenomenological characteristics of autobiographical memories in a sample of about 400 participants. We found that the access and the phenomenological features of memories varied as a function of the type of sensory cues, but not their temporal distribution. With regard to their influence on autobiographical memory, an overlap between some senses was found, with on one hand, olfaction and taste and, on the other, vision, audition, and touch. We discuss these findings in the light of theories of perception, memory, and the self, and consider methodological implications of the sensory cuing technique in memory research, as well as clinical implications for research in psychopathological and neuropsychological populations.
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Affiliation(s)
- Alexandra Ernst
- Laboratoire de Psychopathologie et de Neuropsychologie (EA 2027), Université Paris 8 Vincennes, Saint-Denis, France
| | - Julie M F Bertrand
- Laboratoire de Psychologie (EA 3188), Université de Franche-Comté, Besançon, France
| | | | - Céline Souchay
- LPNC (CNRS UMR 5015), Université Grenoble Alpes, Grenoble, France
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Treatment and management of cognitive dysfunction in patients with multiple sclerosis. Nat Rev Neurol 2020; 16:319-332. [PMID: 32372033 DOI: 10.1038/s41582-020-0355-1] [Citation(s) in RCA: 97] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/30/2020] [Indexed: 01/19/2023]
Abstract
Cognitive impairment is a common and devastating manifestation of multiple sclerosis (MS). Although disease-modifying therapies have been efficacious for reducing relapse rates in MS, such treatments are ineffective for treating cognitive dysfunction. Alternative treatment approaches for mitigating cognitive problems are greatly needed in this population. To date, cognitive rehabilitation and exercise training have been identified as possible candidates for treating MS-related cognitive impairment; however, cognitive dysfunction is still often considered to be poorly managed in patients with MS. This Review provides a comprehensive overview of recent developments in the treatment and management of cognitive impairment in people with MS. We describe the theoretical rationales, current states of the science, field-wide challenges and recent advances in cognitive rehabilitation and exercise training for treating MS-related cognitive impairment. We also discuss future directions for research into the treatment of cognitive impairment in MS that should set the stage for the inclusion of cognitive rehabilitation and exercise training into clinical practice within the next decade.
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The measurement of episodic foresight: A systematic review of assessment instruments. Cortex 2019; 117:351-370. [DOI: 10.1016/j.cortex.2018.08.018] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 06/05/2018] [Accepted: 08/20/2018] [Indexed: 01/07/2023]
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Purkart R, Versace R, Vallet GT. "Does It Improve the Mind's Eye?": Sensorimotor Simulation in Episodic Event Construction. Front Psychol 2019; 10:1403. [PMID: 31244746 PMCID: PMC6581725 DOI: 10.3389/fpsyg.2019.01403] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 05/29/2019] [Indexed: 11/13/2022] Open
Abstract
Memories are not frozen in the past. Instead, they can be dynamically combined to allow individuals to adapt to the present or even imagine the future. This recombination, called event construction, also means that it might be possible to improve memory through specific interventions such as episodic specificity induction (ESI). ESI provides brief training in recollecting the details of a past event that boosts the retrieval of specific details in subsequent tasks if these tasks involve the recombination of memories. However, very little is known about how event construction is accomplished, and this is essential if we are (1) to understand how episodic memory might work and (2) to promote a specific mechanism that will help people remember the past better. The present study assesses the sensorimotor simulation hypothesis, which has been proposed within the embodied approaches to cognition. According to these approaches, access to and the recombination of memories occur through the simulation of the sensory and motor propreties of our past experiences. This hypothesis was tested using a sensory interference paradigm. In a first phase, the participants watched videos and then received a specificity or a control induction. In a second phase, they described their memories of the videos while simultaneously viewing an interfering stimulus (dynamic visual noise; DVN) or a gray control screen. In line with a sensorimotor simulation account, the presentation of a DVN during the description of the videos led to a decrease in the number of internal details (details specific to the event) only after the specificity induction rather than the control induction. The findings provide evidence that the specificity induction targets and facilitates the sensorimotor simulation mechanism, thus confirming the crucial involvement of a mechanism of this sort in the constructive functioning of memory.
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Affiliation(s)
- Rudy Purkart
- EA 3082, Laboratoire d’Étude des Mécanismes Cognitifs, Université Lumière Lyon 2, Lyon, France
| | - Rémy Versace
- EA 3082, Laboratoire d’Étude des Mécanismes Cognitifs, Université Lumière Lyon 2, Lyon, France
| | - Guillaume T. Vallet
- CNRS UMR 6024, Laboratoire de Psychologie Sociale et Cognitive, Université Clermont Auvergne, Clermont-Ferrand, France
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Purkart R, T. Vallet G, Versace R. Améliorer la remémoration d’évènements autobiographiques et l’imagination d’évènements futurs grâce à l’Induction de spécificité épisodique : adaptation et validation en Français. ANNEE PSYCHOLOGIQUE 2019. [DOI: 10.3917/anpsy1.191.0025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Cognitive Deficits in Multiple Sclerosis: Recent Advances in Treatment and Neurorehabilitation. Curr Treat Options Neurol 2018; 20:53. [PMID: 30345468 DOI: 10.1007/s11940-018-0538-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
PURPOSE OF REVIEW This article highlights recent progress in research on treatment and neurorehabilitation of cognitive impairment in multiple sclerosis (MS) including pharmacological interventions, physical exercise, and neuropsychological rehabilitation, both in conventional and technology-assisted settings. RECENT FINDINGS The most consistent evidence in terms of improvement or preservation of circumscribed cognitive scores in MS patients comes from moderately sampled randomized clinical trials on multimodal approaches that combine conventional or computerized neuropsychological training with psychoeducation or cognitive behavioral therapy. Disease-modifying treatments also appear to have beneficial effects in preventing or attenuating cognitive decline, whereas there is little evidence for agents such as donepezil or stimulants. Finally, physical exercise may yield some cognitive improvement in MS patients. Despite substantial and often promising research efforts, there is a lack of validated and widely accepted clinical procedures for cognitive neurorehabilitation in MS. Development of such approaches will require collaborative efforts towards the design of interventions that are fundamentally inspired by cognitive neuroscience, potentially guided by neuroimaging, and composed of conventional neuropsychological training and cognitive behavioral therapy as well as physical exercise and therapeutic video games. Subsequently, large-scale validation will be needed with meaningful outcome measures reflecting transfer to everyday cognitive function and maintenance of training effects.
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Mhizha-Murira JR, Drummond A, Klein OA, dasNair R. Reporting interventions in trials evaluating cognitive rehabilitation in people with multiple sclerosis: a systematic review. Clin Rehabil 2017; 32:243-254. [PMID: 28828902 DOI: 10.1177/0269215517722583] [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: 11/17/2022]
Abstract
OBJECTIVE To determine the quantity and quality of description of cognitive rehabilitation for cognitive deficits in people with multiple sclerosis, using a variety of published checklists, and suggest ways of improving the reporting of these interventions. DATA SOURCES A total of 10 electronic databases were searched, including MEDLINE, EMBASE, CINAHL and PsycINFO, from inception to May 2017. Grey literature databases, trial registers, reference lists and author citations were also searched. REVIEW METHODS Papers were included if participants were people with multiple sclerosis aged 18 years and over and if the effectiveness of cognitive rehabilitation in improving functional ability for memory, attention or executive dysfunction, with or without a control group, was being evaluated. RESULTS A total of 54 studies were included in this review. The reporting of a number of key aspects of cognitive rehabilitation was poor. This was particularly in relation to content of interventions (reported completely in 26 of the 54 studies), intervention procedures (reported completely in 16 of the 54 studies), delivery mode (reported completely in 24 of the 54 studies) and intervention mechanism of action (reported completely in 21 of the 54 studies). CONCLUSION The quality of reporting of cognitive rehabilitation for memory, attention and executive function for multiple sclerosis, across a range of study designs, is poor. Existing reporting checklists do not adequately cover aspects relevant to cognitive rehabilitation, such as the approaches used to address cognitive deficits. Future checklists could consider these aspects we have identified in this review.
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Affiliation(s)
| | - Avril Drummond
- 1 School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Olga A Klein
- 1 School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Roshan dasNair
- 2 Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, UK
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Abstract
The study of the self in neuropsychological patients raises not only theoretical questions on the relationships between the self, autobiographical memory (AM), and episodic future thinking but also clinical issues for patients' daily life and care. We addressed this issue in Parkinson's disease patients for whom AM and future thinking impairments have been documented. All patients and controls generated and dated up past and future self-images and provided associated past and future events. Our findings suggest a subtle pattern of preservation/impairment of different dimensions (quantitative and qualitative) of self-images, which rely partially on the episodic quality of past and future events.
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Affiliation(s)
- Alexandra Ernst
- a Department of Psychology, Psychology and Neuroscience of Cognition Unit , University of Liege , Liege , Belgium
| | - Joanne Allen
- b Institute of Psychological Sciences , University of Leeds , Leeds , UK
| | - Lydia Dubourg
- c Developmental Imaging and Psychopathology Lab, Department of Psychiatry, School of Medicine , University of Geneva , Geneva , Switzerland
| | - Céline Souchay
- d Laboratoire de Psychologie et Neurocognition, LPNC UMR CNRS 5105 , University of Grenoble , Grenoble , France
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Ernst A, Sourty M, Roquet D, Noblet V, Gounot D, Blanc F, de Seze J, Manning L. Benefits from an autobiographical memory facilitation programme in relapsing-remitting multiple sclerosis patients: a clinical and neuroimaging study. Neuropsychol Rehabil 2016; 28:1110-1130. [PMID: 27718890 DOI: 10.1080/09602011.2016.1240697] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
While the efficacy of mental visual imagery (MVI) to alleviate autobiographical memory (AM) impairment in multiple sclerosis (MS) patients has been documented, nothing is known about the brain changes sustaining that improvement. To explore this issue, 20 relapsing-remitting MS patients showing AM impairment were randomly assigned to two groups, experimental (n = 10), who underwent the MVI programme, and control (n = 10), who followed a sham verbal programme. Besides the stringent AM assessment, the patients underwent structural and functional MRI sessions, consisting in retrieving personal memories, within a pre-/post-facilitation study design. Only the experimental group showed a significant AM improvement in post-facilitation, accompanied by changes in brain activation (medial and lateral frontal regions), functional connectivity (posterior brain regions), and grey matter volume (parahippocampal gyrus). Minor activations and functional connectivity changes were observed in the control group. The MVI programme improved AM in MS patients leading to functional and structural changes reflecting (1) an increase reliance on brain regions sustaining a self-referential process; (2) a decrease of those reflecting an effortful research process; and (3) better use of neural resources in brain regions sustaining MVI. Functional changes reported in the control group likely reflected ineffective attempts to use the sham strategy in AM.
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Affiliation(s)
- Alexandra Ernst
- a Cognitive Neuropsychology and Physiopathology of Schizophrenia (INSERM UMR 1114) , University of Strasbourg , Strasbourg , France
| | - Marion Sourty
- b ICube (CNRS UMR 7357) , University of Strasbourg, Fédération de Médecine Translationnelle de Strasbourg (FMTS) , Strasbourg , France
| | - Daniel Roquet
- b ICube (CNRS UMR 7357) , University of Strasbourg, Fédération de Médecine Translationnelle de Strasbourg (FMTS) , Strasbourg , France
| | - Vincent Noblet
- b ICube (CNRS UMR 7357) , University of Strasbourg, Fédération de Médecine Translationnelle de Strasbourg (FMTS) , Strasbourg , France
| | - Daniel Gounot
- b ICube (CNRS UMR 7357) , University of Strasbourg, Fédération de Médecine Translationnelle de Strasbourg (FMTS) , Strasbourg , France
| | - Frédéric Blanc
- b ICube (CNRS UMR 7357) , University of Strasbourg, Fédération de Médecine Translationnelle de Strasbourg (FMTS) , Strasbourg , France.,c Department of Neurology and Centre Mémoire de Ressources et de Recherche (CMRR) , University Hospital of Strasbourg , Strasbourg , France.,d Clinical Investigation Centre (CIC, INSERM 1434) , University Hospital of Strasbourg , Strasbourg , France
| | - Jérôme de Seze
- c Department of Neurology and Centre Mémoire de Ressources et de Recherche (CMRR) , University Hospital of Strasbourg , Strasbourg , France.,d Clinical Investigation Centre (CIC, INSERM 1434) , University Hospital of Strasbourg , Strasbourg , France
| | - Liliann Manning
- a Cognitive Neuropsychology and Physiopathology of Schizophrenia (INSERM UMR 1114) , University of Strasbourg , Strasbourg , France
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Voltzenlogel V, Ernst A, de Sèze J, Brassat D, Manning L, Berna F. Giving meaning to illness: An investigation of self-defining memories in patients with relapsing-remitting multiple sclerosis patients. Conscious Cogn 2016; 45:200-209. [DOI: 10.1016/j.concog.2016.09.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Revised: 08/30/2016] [Accepted: 09/13/2016] [Indexed: 10/21/2022]
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Allé MC, d'Argembeau A, Schneider P, Potheegadoo J, Coutelle R, Danion JM, Berna F. Self-continuity across time in schizophrenia: An exploration of phenomenological and narrative continuity in the past and future. Compr Psychiatry 2016; 69:53-61. [PMID: 27423345 DOI: 10.1016/j.comppsych.2016.05.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Accepted: 05/02/2016] [Indexed: 10/21/2022] Open
Abstract
BACKGROUND Disorders of the self, such as a reduced sense of personal continuity in time, are a core symptom of schizophrenia, but one that is still poorly understood. In the present study, we investigated two complementary aspects of self-continuity, namely phenomenological and narrative continuity, in 27 patients with schizophrenia, and compared them with 27 control participants. METHODS Participants were asked to identify important past events and to narrate a story from their life that included these events. They were also asked to imagine important events that might happen in their personal future and to build a narrative of their future life. The vividness of these important life events and the proportion of self-event connections in the narratives were used as a measure of phenomenological and narrative continuity, respectively. RESULTS Our study showed patients with schizophrenia experienced less vivid representations of personally significant events (p = .02) for both temporal directions (past and future) (p < .001). In addition, their ability to make explicit connections between personal events and self-attributes in life narratives was also impaired (p = .03), but only in the case of past narratives (p < .001). CONCLUSIONS These results shed new light on the cognitive mechanisms underlying self-disorders in schizophrenia. The clinical and therapeutic implications of these findings are discussed.
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Affiliation(s)
- M C Allé
- INSERM U-1114, 1 place de l'Hôpital, Clinique Psychiatrique, Strasbourg Cedex, France; Université de Strasbourg, Strasbourg, France; FMTS: Fédération de Médecine Translationnelle de Strasbourg, Strasbourg, France
| | - A d'Argembeau
- Department of Psychology - Cognition and Behavior, University of Liège, Liège, Belgium; Cyclotron Research Centre, University of Liège, Liège, Belgium
| | - P Schneider
- Hôpitaux Universitaires de Strasbourg, 1 place de l'Hôpital, Strasbourg Cedex, France; Fondation FondaMental, Créteil, France
| | - J Potheegadoo
- INSERM U-1114, 1 place de l'Hôpital, Clinique Psychiatrique, Strasbourg Cedex, France; Université de Strasbourg, Strasbourg, France; FMTS: Fédération de Médecine Translationnelle de Strasbourg, Strasbourg, France
| | - R Coutelle
- INSERM U-1114, 1 place de l'Hôpital, Clinique Psychiatrique, Strasbourg Cedex, France; Université de Strasbourg, Strasbourg, France; FMTS: Fédération de Médecine Translationnelle de Strasbourg, Strasbourg, France; Hôpitaux Universitaires de Strasbourg, 1 place de l'Hôpital, Strasbourg Cedex, France
| | - J-M Danion
- INSERM U-1114, 1 place de l'Hôpital, Clinique Psychiatrique, Strasbourg Cedex, France; Université de Strasbourg, Strasbourg, France; FMTS: Fédération de Médecine Translationnelle de Strasbourg, Strasbourg, France; Hôpitaux Universitaires de Strasbourg, 1 place de l'Hôpital, Strasbourg Cedex, France; Fondation FondaMental, Créteil, France
| | - F Berna
- INSERM U-1114, 1 place de l'Hôpital, Clinique Psychiatrique, Strasbourg Cedex, France; Université de Strasbourg, Strasbourg, France; FMTS: Fédération de Médecine Translationnelle de Strasbourg, Strasbourg, France; Hôpitaux Universitaires de Strasbourg, 1 place de l'Hôpital, Strasbourg Cedex, France; Fondation FondaMental, Créteil, France.
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Salter A, Tyry T, Wang G, Fox RJ, Cutter G, Marrie RA. Examining the joint effect of disability, health behaviors, and comorbidity on mortality in MS. Neurol Clin Pract 2016; 6:397-408. [PMID: 27847682 DOI: 10.1212/cpj.0000000000000269] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND In multiple sclerosis (MS), comorbidities have been associated with disability progression and an increased risk of mortality. We investigated the association between comorbidities and mortality in MS after accounting for disability and health behaviors. METHODS We followed North American Research Committee on Multiple Sclerosis (NARCOMS) Registry participants who completed the Fall 2006 survey on comorbidities until death (reported or matched in the National Death Index) or date of last follow-up in 2014. We used proportional hazards regression to investigate the association between comorbidities and mortality, controlling for demographic, clinical, health behavior, and disability factors. RESULTS Of 9,496 participants meeting the inclusion criteria, 502 (5.3%) were deceased. Most participants reported having ≤3 comorbid conditions (70.9% survivors, 76.9% decedents). In individual regression models, vascular, visual, and mental comorbidities were associated with increased mortality risk after adjustment for factors associated with survival. When combined into a single model, vascular (hazard ratio 1.269; 1.041-1.547), visual (1.490; 1.199-1.852), and mental comorbidities (excluding anxiety, 1.239; 1.024-1.499) remained independently associated with an increased risk of mortality. CONCLUSIONS Presence of comorbidities was independently associated with an increased risk of mortality as compared to absence of comorbidities after adjusting for factors associated with survival. Specifically, vascular, visual, and mental comorbidities increased the risk of mortality. This highlights the need for clinicians to attend to these comorbidities, which can be modified by treatments or other interventions, and potentially reduce the risk of mortality in persons with MS who have these conditions.
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Affiliation(s)
- Amber Salter
- Division of Biostatistics (AS, GW), Washington University in St. Louis, MO; Division of Neurology (TT), Dignity Health, St. Joseph's Hospital and Medical Center, Phoenix, AZ; Department of Neurology and Neurological Institute (RJF), Cleveland Clinic, OH; Department of Biostatistics (GC), University of Alabama at Birmingham; and Departments of Internal Medicine and Community Health Sciences (RAM), University of Manitoba, Winnipeg, Canada
| | - Tuula Tyry
- Division of Biostatistics (AS, GW), Washington University in St. Louis, MO; Division of Neurology (TT), Dignity Health, St. Joseph's Hospital and Medical Center, Phoenix, AZ; Department of Neurology and Neurological Institute (RJF), Cleveland Clinic, OH; Department of Biostatistics (GC), University of Alabama at Birmingham; and Departments of Internal Medicine and Community Health Sciences (RAM), University of Manitoba, Winnipeg, Canada
| | - Guoqiao Wang
- Division of Biostatistics (AS, GW), Washington University in St. Louis, MO; Division of Neurology (TT), Dignity Health, St. Joseph's Hospital and Medical Center, Phoenix, AZ; Department of Neurology and Neurological Institute (RJF), Cleveland Clinic, OH; Department of Biostatistics (GC), University of Alabama at Birmingham; and Departments of Internal Medicine and Community Health Sciences (RAM), University of Manitoba, Winnipeg, Canada
| | - Robert J Fox
- Division of Biostatistics (AS, GW), Washington University in St. Louis, MO; Division of Neurology (TT), Dignity Health, St. Joseph's Hospital and Medical Center, Phoenix, AZ; Department of Neurology and Neurological Institute (RJF), Cleveland Clinic, OH; Department of Biostatistics (GC), University of Alabama at Birmingham; and Departments of Internal Medicine and Community Health Sciences (RAM), University of Manitoba, Winnipeg, Canada
| | - Gary Cutter
- Division of Biostatistics (AS, GW), Washington University in St. Louis, MO; Division of Neurology (TT), Dignity Health, St. Joseph's Hospital and Medical Center, Phoenix, AZ; Department of Neurology and Neurological Institute (RJF), Cleveland Clinic, OH; Department of Biostatistics (GC), University of Alabama at Birmingham; and Departments of Internal Medicine and Community Health Sciences (RAM), University of Manitoba, Winnipeg, Canada
| | - Ruth Ann Marrie
- Division of Biostatistics (AS, GW), Washington University in St. Louis, MO; Division of Neurology (TT), Dignity Health, St. Joseph's Hospital and Medical Center, Phoenix, AZ; Department of Neurology and Neurological Institute (RJF), Cleveland Clinic, OH; Department of Biostatistics (GC), University of Alabama at Birmingham; and Departments of Internal Medicine and Community Health Sciences (RAM), University of Manitoba, Winnipeg, Canada
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Ernst A, Sourty M, Roquet D, Noblet V, Gounot D, Blanc F, De Seze J, Manning L. Functional and structural cerebral changes in key brain regions after a facilitation programme for episodic future thought in relapsing-remitting multiple sclerosis patients. Brain Cogn 2016; 105:34-45. [DOI: 10.1016/j.bandc.2016.03.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Revised: 03/22/2016] [Accepted: 03/25/2016] [Indexed: 11/16/2022]
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17
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Mattioli F, Bellomi F, Stampatori C, Provinciali L, Compagnucci L, Uccelli A, Pardini M, Santuccio G, Fregonese G, Pattini M, Allegri B, Clerici R, Lattuada A, Montomoli C, Corso B, Gallo P, Riccardi A, Ghezzi A, Roscio M, Tola MR, Calanca C, Baldini D, Trafficante D, Capra R. Two Years Follow up of Domain Specific Cognitive Training in Relapsing Remitting Multiple Sclerosis: A Randomized Clinical Trial. Front Behav Neurosci 2016; 10:28. [PMID: 26941630 PMCID: PMC4763055 DOI: 10.3389/fnbeh.2016.00028] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2015] [Accepted: 02/08/2016] [Indexed: 12/02/2022] Open
Abstract
Cognitive rehabilitation in multiple sclerosis (MS) has been reported to induce neuropsychological improvements, but the persistence of these effects has been scarcely investigated over long follow ups. Here, the results of a multicenter randomized clinical trial are reported, in which the efficacy of 15 week domain specific cognitive training was evaluated at 2 years follow up in 41 patients. Included patients were randomly assigned either to domain specific cognitive rehabilitation, or to aspecific psychological intervention. Patients who still resulted to be cognitively impaired at 1 year follow up were resubmitted to the same treatment, whereas the recovered ones were not. Neuropsychological tests and functional scales were administered at 2 years follow up to all the patients. Results revealed that both at 1 and at 2 years follow up more patients in the aspecific group (18/19, 94% and 13/17, 76% respectively) than in the specific group (11/22, 50% and 5/15, 33% respectively) resulted to be cognitively impaired. Furthermore patients belonging to the specific group showed significantly less impaired tests compared with the aspecific group ones (p = 0.02) and a significant amelioration in the majority of the tests. On the contrary patients in the aspecific group did not change. The specific group subjects also perceived a subjective improvement in their cognitive performance, while the aspecific group patients did not. These results showed that short time domain specific cognitive rehabilitation is a useful treatment for patients with MS, shows very long lasting effects, compared to aspecific psychological interventions. Also subjective cognitive amelioration was found in patients submitted to domain specific treatment after 2 years.
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Affiliation(s)
- Flavia Mattioli
- Neuropsychology Unit, Spedali Civili of Brescia Brescia, Italy
| | - Fabio Bellomi
- Neuropsychology Unit, Spedali Civili of Brescia Brescia, Italy
| | | | | | | | - Antonio Uccelli
- Clinica Neurologica, MS Center, University of Genova Genova, Italy
| | - Matteo Pardini
- Clinica Neurologica, MS Center, University of Genova Genova, Italy
| | - Giuseppe Santuccio
- Neurology Unit, Azienda Ospedaliera Valtellina Valchiavenna Sondrio, Italy
| | - Giuditta Fregonese
- Neurology Unit, Azienda Ospedaliera Valtellina Valchiavenna Sondrio, Italy
| | | | | | | | | | - Cristina Montomoli
- Biostatistics Unit, Department of Public Health, Experimental and Forensic Medicine, Pavia University Pavia, Italy
| | - Barbara Corso
- National Research Council, Neuroscience Institute Padova, Italy
| | - Paolo Gallo
- Clinica Neurologica, University of Padova Padova, Italy
| | | | - Angelo Ghezzi
- UO Neurologia, MS Center, Gallarate Hospital Gallarate, Italy
| | - Marco Roscio
- UO Neurologia, MS Center, Gallarate Hospital Gallarate, Italy
| | | | | | | | | | - Ruggero Capra
- Multiple Sclerosis Center, Spedali Civili of Brescia Brescia, Italy
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