Slowed articulation rate is associated with information processing speed decline in multiple sclerosis: A pilot study

2019 ◽  
Vol 65 ◽  
pp. 28-33 ◽  
Author(s):  
Lucie Friedova ◽  
Jan Rusz ◽  
Jiri Motyl ◽  
Barbora Srpova ◽  
Karolina Vodehnalova ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Information Processing ◽  
Pilot Study ◽  
Processing Speed ◽  
Articulation Rate ◽  
Information Processing Speed

scholarly journals Design, Development, and Testing of an App for Dual-Task Assessment and Training Regarding Cognitive-Motor Interference (CMI-APP) in People With Multiple Sclerosis: Multicenter Pilot Study

10.2196/15344 ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. e15344 ◽  
Author(s):  
Andrea Tacchino ◽  
Renee Veldkamp ◽  
Karin Coninx ◽  
Jens Brulmans ◽  
Steven Palmaers ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Working Memory ◽  
Information Processing ◽  
Pilot Study ◽  
Processing Speed ◽  
Perceived Exertion ◽  
Rehabilitation Program ◽  
Information Processing Speed ◽  
Motor Tasks ◽  
Assessment Tests

Background Interest toward dual-task training (DTT) is increasing as traditional interventions may not prepare patients to adequately face the challenges of most activities of daily living. These usually involve simultaneous cognitive and motor tasks, and they often show a decline in performance. Cognitive-motor interference (CMI) has been investigated in different neurological populations, but limited evidence is present for people with multiple sclerosis (MS). The use of computerized tools is mandatory to allow the application of more standardized assessment and rehabilitation intervention protocols and easier implementation of multicenter and multilanguage studies. Objective To describe the design and development of CMI-APP, an adaptive and interactive technology tablet-based app, and to present the preliminary results of a multicenter pilot study involving people with MS performed in several European centers for evaluating the feasibility of and adherence to a rehabilitation program based on CMI-APP. Methods CMI-APP includes user-friendly interfaces for personal data input and management, assessment of CMI, and DTT. A dedicated team developed CMI-APP for Android tablets above API level 14 (version 4.0), using C# as the programming language and Unity and Visual Studio as development tools. Three cognitive assessment tests for working memory, information processing speed, and sustained attention and four motor assessment tests for walking at different difficulty levels were implemented. Dual cognitive-motor tasks were performed by combining single cognitive and motor tasks. CMI-APP implements exercises for DTT involving the following 12 cognitive functions: sustained attention, text comprehension, verbal fluency, auditory discrimination, visual discrimination, working memory, information processing speed, auditory memory, visual memory, verbal analog reasoning, visual analog reasoning, and visual spatial planning, which can be performed during walking or stepping on the spot. Fifteen people with MS (mean age 52.6, SD 8.6 years; mean disease duration 9.4, SD 8.4 years; mean Expanded Disability Status Scale score 3.6, SD 1.1) underwent DTT (20 sessions). Adherence to the rehabilitation program was evaluated according to the percentage of performed sessions, perceived exertion during the training (Borg 15-point Ratings of Perceived Exertion [RPE] Scale), and subjective experience of the training (Intrinsic Motivation Inventory [IMI]). Results The adherence rate was 91%. DTT was perceived as “somewhat difficult” (mean RPE Scale score 12.6, SD 1.9). IMI revealed that participants enjoyed the training and felt that it was valuable and, to some extent, important, without feelings of pressure. They felt competent, although they did not always feel they could choose the exercises, probably because the therapist chose the exercises and many exercises had few difficulty levels. Conclusions CMI-APP is safe, highly usable, motivating, and well accepted for DTT by people with MS. The findings are fundamental for the preparation of future large-sample studies examining CMI and the effectiveness of DTT interventions with CMI-APP in people with MS.

scholarly journals Influence of Cognitive Function on Speech and Articulation Rate in Multiple Sclerosis

2012 ◽  
Vol 19 (2) ◽  
pp. 173-180 ◽  
Author(s):  
Jonathan D. Rodgers ◽  
Kris Tjaden ◽  
Lynda Feenaughty ◽  
Bianca Weinstock-Guttman ◽  
Ralph H. B. Benedict
Keyword(s):  
Multiple Sclerosis ◽  
Information Processing ◽  
Cognitive Function ◽  
Oral Reading ◽  
Processing Speed ◽  
Speech Rate ◽  
Cognitive Tests ◽  
Articulation Rate ◽  
Information Processing Speed ◽  
Syllable Repetition

AbstractWe examined cognitive predictors of speech and articulation rate in 50 individuals with multiple sclerosis (MS) and 23 healthy controls. We measured speech and articulation rate from audio-recordings of participants reading aloud and talking extemporaneously on a topic of their choice (i.e., self-generated speech). Articulation rate was calculated for each speech sample by removing lexically irrelevant vocalizations and pauses of >200 ms. Speech rate was similarly calculated including pauses. Concurrently, the Minimal Assessment of Cognitive Function in Multiple Sclerosis (MACFIMS) battery, as well as standardized tests of sentence intelligibility and syllable repetition were administered. Analysis of variance showed that MS patients were slower on three of the four rate measures. Greater variance in rate measures was accounted for by cognitive variables for the MS group than controls. An information processing speed composite, as measured by the Symbol Digit Modalities Test (SDMT) and the Paced Auditory Serial Addition Test (PASAT), was the strongest predictor among cognitive tests. A composite of memory tests related to self-generated speech, above and beyond information processing speed, but not to oral reading. Self-generated speech, in this study, was not found to relate more strongly to cognitive tests than simple reading. Implications for further research are discussed. (JINS, 2012, 18, 1–8)

scholarly journals Design, Development, and Testing of an App for Dual-Task Assessment and Training Regarding Cognitive-Motor Interference (CMI-APP) in People With Multiple Sclerosis: Multicenter Pilot Study (Preprint)

2019 ◽  
Author(s):  
Andrea Tacchino ◽  
Renee Veldkamp ◽  
Karin Coninx ◽  
Jens Brulmans ◽  
Steven Palmaers ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Working Memory ◽  
Information Processing ◽  
Pilot Study ◽  
Processing Speed ◽  
Perceived Exertion ◽  
Rehabilitation Program ◽  
Information Processing Speed ◽  
Motor Tasks ◽  
Assessment Tests

BACKGROUND Interest toward dual-task training (DTT) is increasing as traditional interventions may not prepare patients to adequately face the challenges of most activities of daily living. These usually involve simultaneous cognitive and motor tasks, and they often show a decline in performance. Cognitive-motor interference (CMI) has been investigated in different neurological populations, but limited evidence is present for people with multiple sclerosis (MS). The use of computerized tools is mandatory to allow the application of more standardized assessment and rehabilitation intervention protocols and easier implementation of multicenter and multilanguage studies. OBJECTIVE To describe the design and development of CMI-APP, an adaptive and interactive technology tablet-based app, and to present the preliminary results of a multicenter pilot study involving people with MS performed in several European centers for evaluating the feasibility of and adherence to a rehabilitation program based on CMI-APP. METHODS CMI-APP includes user-friendly interfaces for personal data input and management, assessment of CMI, and DTT. A dedicated team developed CMI-APP for Android tablets above API level 14 (version 4.0), using C# as the programming language and Unity and Visual Studio as development tools. Three cognitive assessment tests for working memory, information processing speed, and sustained attention and four motor assessment tests for walking at different difficulty levels were implemented. Dual cognitive-motor tasks were performed by combining single cognitive and motor tasks. CMI-APP implements exercises for DTT involving the following 12 cognitive functions: sustained attention, text comprehension, verbal fluency, auditory discrimination, visual discrimination, working memory, information processing speed, auditory memory, visual memory, verbal analog reasoning, visual analog reasoning, and visual spatial planning, which can be performed during walking or stepping on the spot. Fifteen people with MS (mean age 52.6, SD 8.6 years; mean disease duration 9.4, SD 8.4 years; mean Expanded Disability Status Scale score 3.6, SD 1.1) underwent DTT (20 sessions). Adherence to the rehabilitation program was evaluated according to the percentage of performed sessions, perceived exertion during the training (Borg 15-point Ratings of Perceived Exertion [RPE] Scale), and subjective experience of the training (Intrinsic Motivation Inventory [IMI]). RESULTS The adherence rate was 91%. DTT was perceived as “somewhat difficult” (mean RPE Scale score 12.6, SD 1.9). IMI revealed that participants enjoyed the training and felt that it was valuable and, to some extent, important, without feelings of pressure. They felt competent, although they did not always feel they could choose the exercises, probably because the therapist chose the exercises and many exercises had few difficulty levels. CONCLUSIONS CMI-APP is safe, highly usable, motivating, and well accepted for DTT by people with MS. The findings are fundamental for the preparation of future large-sample studies examining CMI and the effectiveness of DTT interventions with CMI-APP in people with MS.

Difficulties in Planning Among Patients with Multiple Sclerosis: A Relative Consequence of Deficits in Information Processing Speed

2013 ◽  
Vol 19 (5) ◽  
pp. 613-620 ◽  
Author(s):  
Emily M. Owens ◽  
Douglas R. Denney ◽  
Sharon G. Lynch
Keyword(s):  
Multiple Sclerosis ◽  
Information Processing ◽  
Processing Speed ◽  
Healthy Controls ◽  
Problem Difficulty ◽  
Sufficient Time ◽  
Information Processing Speed ◽  
Tower Of London ◽  
Planning Ability

AbstractPrevious studies show that MS patients take longer than healthy controls to plan their solutions to Tower of London (TOL) problems but yield conflicting results regarding the quality of their solutions. The present study evaluated performance under untimed or timed conditions to assess the possibility that differences in planning ability only occur when restrictions in solution times are imposed. MS patients (n = 39) and healthy controls (n = 43) completed a computerized version of the TOL under one of two conditions. In the untimed condition, participants were allowed as much time as needed on each problem. In the timed condition, limits were imposed on solution times and time remaining was displayed with each problem. Patients exhibited longer planning times than controls, and the disparity between groups increased with problem difficulty. Planning performance depended upon condition. In the untimed condition, patients and controls performed equally well. When solution times were restricted, however, patients solved fewer problems than controls. MS patients’ planning ability is intact when permitted sufficient time to formulate the required plan. Deficiencies in planning are only evident when time is restricted, and, therefore, are more accurately considered a relative consequence of disease-related problems in information processing speed. (JINS, 2013, 19, 1–8)

Effect of dalfampridine on information processing speed impairment in multiple sclerosis

Neurology ◽  
2019 ◽  
Vol 93 (8) ◽  
pp. e733-e746 ◽  
Author(s):  
Laura De Giglio ◽  
Francesca De Luca ◽  
Flavia Gurreri ◽  
Ilaria Ferrante ◽  
Luca Prosperini ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Information Processing ◽  
Processing Speed ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Controlled Trial ◽  
Information Processing Speed ◽  
Effective Treatment Option ◽  
Double Blind ◽  
To Receive

ObjectiveTo test a possible benefit of dalfampridine on information processing speed (IPS), a key function for cognitive impairment (CogIm) in multiple sclerosis (MS).MethodsIn this randomized, double-blind, placebo-controlled trial, we included patients with a score on the Symbol Digit Modalities Test (SDMT) under the 10th percentile of the reference value. Patients were randomized in a 2:1 ratio to receive dalfampridine 10 mg or placebo twice daily for 12 weeks. They underwent a comprehensive neuropsychological evaluation at screening (T0), at the end of treatment (T1), and after a 4-week follow-up (T2). The primary endpoint was improvement in SDMT.ResultsOut of 208 patients screened, 120 were randomized to receive either dalfampridine (n = 80) or placebo (n = 40). At T1, the dalfampridine group presented an increase of SDMT scores vs placebo group (mean change 9.9 [95% confidence interval (CI) 8.5–11.4] vs 5.2 [95% CI 2.8–7.6], p = 0.0018; d = 0.60 for raw score; and 0.8 [95% CI 0.6–1] vs 0.3 [95% CI 0.0–0.5], p = 0.0013; d = 0.61 for z scores; by linear mixed model with robust standard error). The improvement was not sustained at T2. A beneficial effect of dalfampridine was observed in the Paced Auditory Serial Addition Test and in cognitive fatigue.ConclusionDalfampridine could be considered as an effective treatment option for IPS impairment in MS.Trial registration2013-002558-64 EU Clinical Trials Register.Classification of evidenceThis study provides Class I evidence that for patients with MS with low scores on the SDMT, dalfampridine improves IPS.

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