A mixed-methods study of cognitive performance in persons with multiple sclerosis: Association between neuropsychological test performance and interviews about daily cognitive functioning

2021 ◽  
pp. 102911
Author(s):  
Nadine Akbar ◽  
Marcia Finlayson
Keyword(s):  
Multiple Sclerosis ◽  
Mixed Methods ◽  
Cognitive Functioning ◽  
Cognitive Performance ◽  
Test Performance ◽  
Neuropsychological Test ◽  
Mixed Methods Study

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).

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 Challenges in multiple sclerosis care: Results from an international mixed-methods study

2021 ◽  
Vol 50 ◽  
pp. 102854
Author(s):  
Sophie Péloquin ◽  
Klaus Schmierer ◽  
Thomas P. Leist ◽  
Jiwon Oh ◽  
Suzanne Murray ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Mixed Methods ◽  
Mixed Methods Study

Trajectories of Symbol Digit Modalities Test performance in individuals with multiple sclerosis

2020 ◽  
pp. 135245852091343 ◽  
Author(s):  
Brian C Healy ◽  
Lindsay Barker ◽  
Rohit Bakshi ◽  
Ralph H B Benedict ◽  
Cindy T Gonzalez ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Functioning ◽  
Test Performance ◽  
Disease Duration ◽  
Longitudinal Change ◽  
Latent Trajectory ◽  
Lower Baseline ◽  
Term Change ◽  
Baseline Values ◽  
Trajectory Models

Background: Although cognitive problems have been identified in people with multiple sclerosis (PwMS), few studies have investigated the long-term change in cognitive functioning. Objective: To identify trajectories of change in cognitive functioning for PwMS. Methods: Participants enrolled in the quality-of-life subgroup from the Comprehensive Longitudinal Investigation of Multiple Sclerosis at Brigham and Women’s Hospital (CLIMB) were eligible for our analysis. In 2006, participants in this group began to complete the Symbol Digit Modalities Test (SDMT) annually. Latent trajectory models were used to identify groups of participants with similar longitudinal change in SDMT scores. Linear and quadratic trajectory models were fit, and the models were compared. Latent trajectory models were also fit adjusting for baseline age and disease duration as well as using normalized SDMT scores. The groups identified across the approaches were compared. Results: We found that classes with higher-than-average baseline values improved, classes with average baseline values remained relatively constant, and classes with lower baseline values experienced cognitive worsening. Similar results were observed in the alternative latent trajectory models accounting for other variables. Conclusion: Our models show that subjects with higher SDMT scores at baseline showed improvement, while subjects with lower SDMT scores at baseline showed worsening. Baseline age and disease duration were also associated with SDMT performance.

scholarly journals The Impact of Disease-Modifying Therapy Access Barriers on People With Multiple Sclerosis: Mixed-Methods Study

10.2196/11168 ◽  
2018 ◽  
Vol 20 (10) ◽  
pp. e11168 ◽  
Author(s):  
Kristina F Simacek ◽  
John J Ko ◽  
Debbie Moreton ◽  
Stefan Varga ◽  
Kristen Johnson ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Mixed Methods ◽  
Mixed Methods Study ◽  
Access Barriers ◽  
Disease Modifying Therapy ◽  
Disease Modifying ◽  
The Impact

scholarly journals Neuropsychological Test Performance of Cognitively Healthy Centenarians: Normative data from the Dutch 100-plus Study

2018 ◽  
Author(s):  
Nina Beker ◽  
Sietske A.M. Sikkes ◽  
Marc Hulsman ◽  
Ben Schmand ◽  
Philip Scheltens ◽  
...  
Keyword(s):  
Cognitive Functioning ◽  
Test Performance ◽  
Normative Data ◽  
Neuropsychological Test ◽  
Cognitive Testing ◽  
Hearing Impairments ◽  
Age Related ◽  
Dementia Incidence ◽  
Sensory Impairments ◽  
Linear Regressions

ABSTRACTBackgroundThe population who reaches the extreme age of 100 years is growing. At this age, dementia incidence is high and cognitive functioning is variable and influenced by sensory impairments. Appropriate cognitive testing requires normative data generated specifically for this group. Currently, these are lacking. We set out to generate norms for neuropsychological tests in cognitively healthy centenarians while taking sensory impairments into account.MethodsWe included 235 centenarians (71.5% female) from the 100-plus Study, who self-reported to be cognitively healthy, which was confirmed by an informant and a trained researcher. Normative data were generated for 15 tests that evaluate global cognition, pre-morbid intelligence, attention, language, memory, executive and visuo-spatial functions by multiple linear regressions and/or percentiles. Centenarians with vision and/or hearing impairments were excluded for tests that required these faculties.ResultsSubjects scored on average 25.6±3.1 (range 17-30, interquartile-range 24-28) points on the MMSE. Vision problems and fatigue often complicated the ability to complete tests, and these problems explained 41% and 22% of the missing test scores respectively, whereas hearing problems (4%) and task incomprehension (6%) only rarely did. Sex and age showed a limited association with test performance, whereas educational level was associated with performance on the majority of the tests.ConclusionsNormative data for the centenarian population is provided, while taking age-related sensory impairments into consideration. Results indicate that, next to vision impairments, fatigue and education level should be taken into account when assessing cognitive functioning in centenarians.

scholarly journals How is and how should healthcare for people with multiple sclerosis in Germany be designed?–The rationale and protocol for the mixed-methods study Multiple Sclerosis–Patient-Oriented Care in Lower Saxony (MS-PoV)

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0259855
Author(s):  
Kathrin Krüger ◽  
Lara Marleen Fricke ◽  
Elise-Marie Dilger ◽  
Annett Thiele ◽  
Kristina Schaubert ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Health Insurance ◽  
Mixed Methods ◽  
Focus Groups ◽  
Statutory Health Insurance ◽  
Mixed Methods Study ◽  
Health Insurance Company ◽  
Insurance Company ◽  
Lower Saxony ◽  
Healthcare Process

Background Multiple sclerosis (MS) is the most common autoimmune inflammatory disease of the central nervous system in Europe, often causing severe physical, cognitive and emotional impairments. Currently, it is unclear whether the healthcare provisions of people with MS (PwMS) are in line with the recommendations for treatment based on guidelines or patients’ needs. The main objectives of the study are as follows: (a) to investigate how well PwMS are treated; and (b) to develop a needs-oriented, patient-centred care model. Methods This mixed-methods study focuses on adult PwMS living in Lower Saxony, a federal state in Germany. The qualitative study comprises focus groups with PwMS, physicians and people involved in the healthcare process as well as a future workshop. The quantitative study comprises a cross-sectional online survey and addresses the patient-relevant outcomes and needs, as previously determined by literature searches and focus groups. It will be administered to all PwMS who are insured by the statutory health insurance company involved in the project (n~7,000). The survey data will be linked to the longitudinal secondary data from the statutory health insurance company and data from the German MS registry where available. The linked and single data sources will be statistically analysed. Discussion By comprehensively comparing the current healthcare provisions with the needs and requirements of PwMS, the strengths and weaknesses of the overall healthcare process and provision of assistive devices can be identified. The barriers and facilitators of the health service providers and their impact on daily life will be explored (qualitative analyses). Reliable recommendations for improvements will be given based on a study population drawn from the largest statutory health insurance company in Lower Saxony (quantitative analyses). However, the inherent advantages and limitations of the qualitative and quantitative research approaches need to be considered. Trial registration The study is registered at German Clinical Trials Register DRKS00021741.

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