Cognitive functioning in children with multiple sclerosis

2008 ◽  
Vol 15 (2) ◽  
pp. 266-268 ◽  
Author(s):  
C Montiel-Nava ◽  
JA Peña ◽  
S González-Pernía ◽  
E Mora-La Cruz
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Functioning ◽  
Cognitive Performance ◽  
Cognitive Deficits ◽  
Neuropsychological Test ◽  
Common Occurrence ◽  
Neuropsychological Test Battery ◽  
Verbal Skills ◽  
Iq Scores ◽  
The Moment

Objective To examine the cognitive functioning of children with multiple sclerosis (MS). Methods Six children with a diagnosis of clinically definite MS were evaluated using a neuropsychological test battery. Results The majority of the children showed deficits in at least two of the administered subtests, with IQ scores within the deficient classification. Conclusions Verbal and non-verbal skills were equally impaired, and patients who were older at the moment of the onset of the disease had a better cognitive performance. Cognitive deficits should be regarded as a common occurrence in the course of MS in children.

scholarly journals Cognitive functioning and predictors thereof in patients with 1–10 brain metastases selected for stereotactic radiosurgery

2019 ◽  
Vol 145 (2) ◽  
pp. 265-276 ◽  
Author(s):  
Wietske C. M. Schimmel ◽  
Karin Gehring ◽  
Patrick E. J. Hanssens ◽  
Margriet M. Sitskoorn
Keyword(s):  
Information Processing ◽  
Brain Metastases ◽  
Cognitive Functioning ◽  
Cognitive Performance ◽  
Cognitive Flexibility ◽  
Verbal Memory ◽  
Test Performance ◽  
Neuropsychological Test ◽  
Cognitive Outcome ◽  
Individual Level

Abstract Purpose Information on predictive factors of cognitive functioning in patients with (multiple) brain metastases (BM) selected for radiosurgery may allow for more individual care and may play a role in predicting cognitive outcome after radiosurgery. The aim of this study was to evaluate cognitive performance, and predictors thereof, in patients with 1–10 BM before radiosurgery. Methods Cognition was measured before radiosurgery using a standardized neuropsychological test battery in patients with 1–10 BM (expected survival > 3 months; KPS ≥ 70; no prior BM treatment). Regression formulae were constructed to calculate sociodemographically corrected z scores. Group and individual cognitive functioning was analyzed. Multivariable regression was used to explore potential predictors. Results Patients (N = 92) performed significantly worse than controls (N = 104) on all 11 test variables (medium-large effect sizes for 8 variables). Percentages of impairment were highest for information processing (55.3%), dexterity (43.2%) and cognitive flexibility (28.7%). 62% and 46% of patients had impairments in at least two, or three test variables, respectively. Models including combinations of clinical and psychological variables were predictive of verbal memory, psychomotor speed, information processing and dexterity. Neither number nor volume of metastases predicted patients’ test performance. Conclusions Already before radiosurgery, almost half of the patients suffered from severe cognitive deficits in at least three test variables. At group and individual level, information processing, cognitive flexibility, and dexterity were most affected. These cognitive impairments may impair daily functioning and patients’ ability to make (shared) treatment decisions. Both clinical (symptomatic BM; timing of BM diagnosis) and psychological (mental fatigue) characteristics influenced cognitive performance. Clinical trial information Cognition and Radiation Study A (CAR-Study A; ClinicalTrials.gov Identifier: NCT02953756; Medical Ethics Committee file number: NL53472.028.15/P1515).

Neuropsychological rehabilitation does not improve cognitive performance but reduces perceived cognitive deficits in patients with multiple sclerosis: a randomised, controlled, multi-centre trial

2013 ◽  
Vol 20 (1) ◽  
pp. 99-107 ◽  
Author(s):  
Anu Mäntynen ◽  
Eija Rosti-Otajärvi ◽  
Keijo Koivisto ◽  
Arja Lilja ◽  
Heini Huhtala ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Performance ◽  
Cognitive Deficits ◽  
Intervention Group ◽  
Preliminary Evidence ◽  
Control Group ◽  
Neuropsychological Rehabilitation ◽  
Attentional Deficits ◽  
Positive Effects ◽  
Randomised Controlled

Background: There is preliminary evidence on the positive effects of neuropsychological rehabilitation on cognition in multiple sclerosis (MS), but the generalisability of the findings is limited by methodological problems. Objective: The aim of the present study was to determine the effects of strategy-oriented neuropsychological rehabilitation on MS. Methods: A total of 102 relapsing–remitting MS patients with subjective and objective attentional deficits were randomised into an intervention and a control group. Neuropsychological assessments were performed at baseline, at three months immediately after the intervention, and at six months. Patients in the intervention group received neuropsychological rehabilitation once a week in 60-minute sessions for 13 consecutive weeks. The control group received no intervention. Results: Neuropsychological rehabilitation including computer-based attention and working memory retraining, psychoeducation, strategy learning and psychological support did not improve cognitive performance but had a positive effect on perceived cognitive deficits. The intervention group perceived significantly fewer deficits than the control group both immediately after the intervention and at six months. The personal rehabilitation goals were also well achieved. Conclusions: Strategy-oriented neuropsychological rehabilitation did not improve cognitive performance but reduced perceived cognitive deficits in MS.

The effects of heat stress on cognition in persons with multiple sclerosis

2011 ◽  
Vol 18 (4) ◽  
pp. 489-497 ◽  
Author(s):  
P Hämäläinen ◽  
A Ikonen ◽  
A Romberg ◽  
H Helenius ◽  
J Ruutiainen
Keyword(s):  
Multiple Sclerosis ◽  
Heat Stress ◽  
Body Temperature ◽  
Cognitive Functioning ◽  
Cognitive Deficits ◽  
Core Body Temperature ◽  
Heat Exposure ◽  
Heat Sensitivity ◽  
Serial Addition ◽  
Core Body

Background: Heat sensitivity and cognitive deficits are typical manifestations of multiple sclerosis (MS). Although cognitive deficits are quite well characterized, practically no data exist on the effects of heat on cognitive performances in MS. Objective: To assess the effects of short-term heat stress on cognitive functioning in subjects with MS. Methods: A total of 23 heat-sensitive MS and 19 healthy control (HC) subjects participated. Moderate heat exposure took place in a Finnish sauna. Cognitive functioning was measured with tests of sustained attention and processing speed, the Paced Auditory Serial Addition Test (PASAT 3” and 2”) and the computerized visual vigilance test, before, during and after heat exposure. Results: During the heat exposure, the core body temperature of the MS group rose significantly more ( p = 0.002) than that of the HC group. The heat stress worsened the performance of the MS group in the PASAT 3” ( p = 0.025) but not in the other cognitive measures. The performance in the PASAT 3” was reversed almost to the baseline level only 1- h after the heat exposure. Conclusions: A significant increase in core body temperature during heat stress is associated with a mild and reversible worsening of the PASAT 3” performance, while visual vigilance performance seems to remain almost unaffected.

Strengthening Mental Abilities with Relational Training (SMART) in Multiple Sclerosis (MS): Study Protocol for a Feasibility Randomised Controlled Trial

2021 ◽  
Author(s):  
Nima Moghaddam ◽  
David L Dawson ◽  
Nikos Evangelou ◽  
James Turton ◽  
Annie Hawton ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Functioning ◽  
Cognitive Deficits ◽  
Cognitive Rehabilitation ◽  
Retention Rates ◽  
Feasibility Trial ◽  
Trial Participant ◽  
Attention And Memory ◽  
Definitive Trial ◽  
Brain Functions

Abstract Background Multiple Sclerosis (MS) is a chronic condition of the central nervous system, affecting around 1 in every 600 people in the UK, with 130 new diagnoses every week. Cognitive difficulties are common amongst people with MS, with up to 70% experiencing deficits in higher-level brain functions – such as planning and problem-solving, attention, and memory. Cognitive deficits make it difficult for people with MS to complete everyday tasks and limit their abilities to work, socialise, and live independently. There is a clear need – and recognised research priority – for treatments that can improve cognitive functioning in people with MS. The absence of effective cognitive interventions exacerbates burdens on the services accessed by people with MS – requiring these services to manage sequelae of untreated cognitive deficits, including reduced quality of life, greater disability and dependence, and poorer adherence to disease-modifying treatments. Our planned research will fill the evidence gap through developing – and examining the feasibility of trialling – a novel online cognitive rehabilitation programme for people with MS (SMART). Methods The primary objective of this study aims to conduct a feasibility study to inform development of a definitive trial of SMART for improving cognitive functioning in people with MS. Secondary objectives include accessing the acceptability to participants of the intervention, delivery format, inclusion/exclusion criteria, baselines and outcome measures, randomisation protocol, and the study procedures. It will further assess the framework for a cost-effectiveness analysis alongside a definitive trial; participant recruitment and retention rates, sample-size needed for a fully powered trial, and signal of efficacy. Discussion As a feasibility trial, outcomes are unlikely to immediately effect changes to NHS practice. However, this is a necessary step towards developing a definitive trial – and will give us a signal of efficacy, a prerequisite for progression to a definitive trial. If found to be clinically- and cost-effective, the latter trial could create a step-change in MS cognitive rehabilitation – improving service-delivery and optimising support with limited additional resources. Trial Registration: Registration ID: ClnicalTrials.gov: NCT04975685 – registered on July 23rd, 2021 Protocol version: 2.0, 25 November 2021

scholarly journals Cognitive outcomes in meningioma patients undergoing surgery: individual changes over time and predictors of late cognitive functioning

2019 ◽  
Vol 21 (7) ◽  
pp. 911-922 ◽  
Author(s):  
Sophie J M Rijnen ◽  
Ikram Meskal ◽  
Marjan Bakker ◽  
Wouter De Baene ◽  
Geert-Jan M Rutten ◽  
...  
Keyword(s):  
Cognitive Functioning ◽  
Cognitive Performance ◽  
Cognitive Deficits ◽  
Cognitive Rehabilitation ◽  
Cognitive Outcomes ◽  
Cognitive Outcome ◽  
Normative Sample ◽  
Before And After ◽  
Preoperative Predictors ◽  
Over Time

Abstract Background Meningioma patients are known to face cognitive deficits before and after surgery. We examined individual changes in cognitive performance over time and identified preoperative predictors of cognitive functioning 12 months after surgery in a large sample of meningioma patients. Methods Patients underwent neuropsychological assessment (NPA) using CNS Vital Signs 1 day before (T0) and 3 (T3) and 12 (T12) months after surgery. Patients’ sociodemographically corrected scores on 7 cognitive domains were compared with performance of a normative sample using one-sample z tests and chi-square tests of independence. Reliable change indices with correction for practice effects were calculated for individual patients. Linear mixed effects models were used to identify preoperative predictors of performance at T12. Results At T0, 261 patients were assessed, and 229 and 82 patients were retested at T3 and T12, respectively. Patients showed impaired cognitive performance before and after surgery, and although performance improved on the group level, cognitive scores remained significantly lower than in the normative sample up to T12. On the individual level, performance remained stable in the majority of patients. Better preoperative performance, younger age, male sex, and higher educational level predicted better late cognitive performance. Conclusions Meningioma patients face serious and persistent pre- and postsurgical cognitive deficits. A preoperative NPA together with sociodemographic characteristics may provide valuable information on the late cognitive outcome of individual meningioma patients. These results can help to inform patients and clinicians on late cognitive outcomes at an early stage, and emphasizes the importance of presurgical NPA and timely cognitive rehabilitation.

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