Stroke and dementia, leading causes of neurological disability and death, potential for prevention

Abstract Background MRI is the method of choice in the diagnosis of MS as well as in monitoring the disease activity. MRI volumetry is used to assess whole or regional brain volume loss which reflects neurodegenerative aspect of the disease and plays an important role in all stages of disease. The aim of this work is to study MRI volumetry in the evaluation of cerebellum and brain stem volume loss in RRMS patients and its correlation with neurological disability score and number of relapses. Results Volumes of whole brainstem, medulla, and pons showed a significant decrease in RRMS cases compared to controls (p < 0.05). Brainstem volume had a mean volume of 22.17 and 25.09 cm3 in cases and controls, respectively. However, midbrain volume showed no significant difference between cases and controls (p = 0.134). Volume of left cerebellar cortex showed a significant decrease in RRMS cases compared to controls (p < 0.001). It had mean volumes of 81.64 and 92.14 ml in cases and controls, respectively, at left cerebellar hemisphere, while right cerebellar hemisphere cortex volumes were 80.37 and 91.97 ml in cases and controls, respectively. Cerebellar white matter showed no significant volume decrease in cases and controls. Conclusion Volumetric MR imaging is an important tool for quantifying the MS disease, assesses MS activity, progression, and tissue loss. The degree and the pattern of atrophy on MRI images correlate significantly with the neurological disability score and number of relapses.

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Psychometrics and normative data for the Multiple Sclerosis Functional Composite: replacing the PASAT with the Symbol Digit Modalities Test

Multiple Sclerosis Journal ◽

10.1177/1352458509354552 ◽

2009 ◽

Vol 16 (2) ◽

pp. 228-237 ◽

Cited By ~ 150

Author(s):

AS Drake ◽

B. Weinstock-Guttman ◽

SA Morrow ◽

D. Hojnacki ◽

FE Munschauer ◽

...

Keyword(s):

Multiple Sclerosis ◽

Work Disability ◽

Task Force ◽

Neurological Disability ◽

Promising Alternative ◽

Functional Composite ◽

Continuous Scale ◽

Serial Addition ◽

Composite Scores ◽

Normal Controls

The MS Functional Composite (MSFC) is a continuous scale of neurological disability for patients with multiple sclerosis (MS). Cognition is represented by the Paced Auditory Serial Addition Test (PASAT), although the Symbol Digit Modalities Test (SDMT) has been proposed as a promising alternative. MSFC scores were calculated using either the PASAT or the SDMT with the following reference populations: National Multiple Sclerosis Society (NMSS) Task Force, 400 MS patients, and 100 normal controls. A subgroup of 115 patients was followed longitudinally, with a test—retest interval of 2.3 ± 1.2 years. Pearson correlations were calculated and analyses of variance (ANOVAs) were used to assess relationships among the MSFC components and composite scores, and differences in performance between patients and controls. Longitudinal changes were also assessed. Logistic regression was performed to determine which MSFC scores are most predictive of diagnosis, course, and work disability. All MSFCs had similar test—retest reliability and correlations with other measures including neurological disability, depression, and fatigue. The SDMT showed slightly better validity with respect to predicting diagnosis, course, and work disability, although the amount of variance accounted for was similar for each version of the MSFC. Our data, derived from a large sample of MS patients and normal controls, supports the validity of both PASAT and SDMT versions of the MSFC. Because the SDMT has slightly better predictive validity and has a relatively easier administration procedure, some clinicians and researchers may wish to replace the PASAT with the SDMT in future calculations of the MSFC using the calculation methods provided in this manuscript.

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Ten Million and One—Neurological Disability as a National Problem

PEDIATRICS ◽

10.1542/peds.21.5.871b ◽

1958 ◽

Vol 21 (5) ◽

pp. 871-872

Author(s):

ERIC DENHOFF

Keyword(s):

Spinal Cord ◽

New York ◽

Nervous System ◽

Highly Qualified ◽

Neurological Disability ◽

The Brain

This monograph summarizes the results of the Conference on Neurological Disability as a National Problem held at Arden House, Harriman, New York, in December, 1955. It was attended by more than 50 highly qualified specialists with various interests in the field who met to explore the realistic possibilities of meeting the problems posed by more than 10 million patients suffering from more than 300 clinical entities loosely grouped together as "neurologic disabilities." Neurologic disabilities are defined as those disorders which are associated demonstrably with dysfunction, disease, or injury of the nervous system, the brain, the spinal cord, and the peripheral neuromuscular connections.

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Biomedical Variables and Adaptation to Disease and Health-Related Quality of Life in Polish Patients with MS

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph15122678 ◽

2018 ◽

Vol 15 (12) ◽

pp. 2678 ◽

Cited By ~ 2

Author(s):

Joanna Dymecka ◽

Mariola Bidzan

Keyword(s):

Quality Of Life ◽

Multiple Sclerosis ◽

Mood Disorders ◽

Upper Limb ◽

Lower Limb ◽

Health Related Quality ◽

Neurological Disability ◽

Related Quality ◽

Health Related

The aim of this research was to assess the level of adaptation to multiple sclerosis (Sclerosis multiplex; MS) and health-related quality of life (HRQoL) of the study population as well as to determine the relationship between biomedical factors related to the course of multiple sclerosis, adaptation to the disease, and HRQoL. Analysis of medical records, clinical and psychological interviews, the Extended Disability Status Scale (EDSS), Guy’s Neurological Disability Scale (GNDS), the Acceptance of Illness Scale (AIS), and the Multiple Sclerosis Impact Scale 29 (MSIS-29) were collected from 137 patients with MS. It was found that there was a relation between motor impairment, neurological disability, adaptation to illness, and HRQoL; it was also found that there were negative correlations between adaptation to illness and the severity of lower-limb disability, fatigue, mood disorders, other problems related to MS, and upper-limb disability. Of all the symptoms, lower-limb disability, fatigue, and mood disorders had the strongest relation with adaptation. All of the analysed symptoms were found to correlate with HRQoL. Of all the symptoms, HRQoL was most affected by lower- and upper-limb disability, fatigue, other MS problems, and mood disorders.

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Neurological disability and pregnancy

Neurology and Pregnancy ◽

10.1201/b14988-51 ◽

2012 ◽

pp. 250-253

Keyword(s):

Neurological Disability

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Factor structure of Guy’s Neurological Disability Scale in a sample of Dutch patients with multiple sclerosis

Multiple Sclerosis Journal ◽

10.1177/1352458511413098 ◽

2011 ◽

Vol 17 (12) ◽

pp. 1498-1503 ◽

Cited By ~ 10

Author(s):

LB Mokkink ◽

DL Knol ◽

BMJ Uitdehaag

Keyword(s):

Multiple Sclerosis ◽

Factor Structure ◽

General Factor ◽

Cronbach’S Alpha ◽

Neurological Disability ◽

Structural Validity ◽

Cronbach's Alpha ◽

Disability Scale ◽

Scale Scores ◽

Item Factor Analysis

Background: Guy’s Neurological Disability Scale (GNDS) is designed to assess disability (i.e. activity limitations) in patients with multiple sclerosis. It contains 12 functional domains, each indicating a level of disability. Four domain scores and a total score can be calculated. Objective: The aim of this study was to evaluate the structural validity of the GNDS in a Dutch population who were definitely diagnosed as having multiple sclerosis. Methods: Data of 974 patients were available. The structural validity of the GNDS was evaluated by confirmatory item factor analysis (CIFA). Two first-order models and two bifactor models were investigated. Results: The best fitted model was a bifactor model with a general factor underlying all items, and 10 items loading on 3 group factors. Cronbach’s alpha on the general factor (0.78) and on the group factor spinal-plus (0.74) were satisfying. Cronbach’s alpha on the group factors mental (0.56) and bulbar (0.48) were low. Reliability based on CIFA was 0.85. Conclusion: Results showed a clear factor structure of the GNDS. It justifies the use of the total score of the GNDS. In addition, three sub-scale scores could be used.

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