Impact of Cognitive Impairment and Dysarthria on Spoken Language in Multiple Sclerosis

2020 ◽  
pp. 1-11
Author(s):  
Lynda Feenaughty ◽  
Ling-Yu Guo ◽  
Bianca Weinstock-Guttman ◽  
Meredith Ray ◽  
Ralph H.B. Benedict ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
Speech Rate ◽  
Spoken Language ◽  
Pause Duration ◽  
Control Group ◽  
Acoustic Measures ◽  
Perceptual Judgments ◽  
Speech Timing ◽  
The Impact

Abstract Objective: To investigate the impact of cognitive impairment on spoken language produced by speakers with multiple sclerosis (MS) with and without dysarthria. Method: Sixty speakers comprised operationally defined groups. Speakers produced a spontaneous speech sample to obtain speech timing measures of speech rate, articulation rate, and silent pause frequency and duration. Twenty listeners judged the overall perceptual severity of the samples using a visual analog scale that ranged from no impairment to severe impairment (speech severity). A 2 × 2 factorial design examined main and interaction effects of dysarthria and cognitive impairment on speech timing measures and speech severity in individuals with MS. Each speaker group with MS was further compared to a healthy control group. Exploratory regression analyses examined relationships between cognitive and biopsychosocial variables and speech timing measures and perceptual judgments of speech severity, for speakers with MS. Results: Speech timing was significantly slower for speakers with dysarthria compared to speakers with MS without dysarthria. Silent pause durations also significantly differed for speakers with both dysarthria and cognitive impairment compared to MS speakers without either impairment. Significant interactions between dysarthria and cognitive factors revealed comorbid dysarthria and cognitive impairment contributed to slowed speech rates in MS, whereas dysarthria alone impacted perceptual judgments of speech severity. Speech severity was strongly related to pause duration. Conclusions: The findings suggest the nature in which dysarthria and cognitive symptoms manifest in objective, acoustic measures of speech timing and perceptual judgments of severity is complex.

MHealth Applications for People with Cognitive Impairment and Their Caregivers: A Scoping Review (Preprint)

2020 ◽  
Author(s):  
Qing Zhao ◽  
Pei Chen ◽  
Yu Zhang ◽  
Haining Liu ◽  
Xianwen Li
Keyword(s):  
Cognitive Impairment ◽  
Sample Size ◽  
Research Design ◽  
Scoping Review ◽  
Life Support ◽  
Small Sample ◽  
Mobile Technologies ◽  
Control Group ◽  
Caregiver Support ◽  
The Impact

BACKGROUND Mobile health application has become an important tool for healthcare systems. One such tool is the delivery of assisting in people with cognitive impairment and their caregivers. OBJECTIVE This scoping review aims to explore and evaluate the existing evidence and challenges on the use of mHealth applications that assisting in people with cognitive impairment and their caregivers. METHODS Nine databases, including PubMed, EMBASE, Cochrane, PsycARTICLES, CINAHL, Web of Science, Applied Science & Technology Source, IEEE Xplore and the ACM Digital Library were searched from inception through June 2020 for the studies of mHealth applications on people with cognitive impairment and their caregivers. Two reviewers independently extracted, checked synthesized data independently. RESULTS Of the 6101 studies retrieved, 64 studies met the inclusion criteria. Three categories emerged from this scoping review. These categories are ‘application functionality’, ‘evaluation strategies’, ‘barriers and challenges’. All the included studies were categorized into 7 groups based on functionality: (1) cognitive assessment; (2) cognitive training; (3) life support; (4) caregiver support; (5) symptom management; (6) reminiscence therapy; (7) exercise intervention. The included studies were broadly categorized into four types: (1) Usability testing; (2) Pilot and feasibility studies; (3) Validation studies; and (4) Efficacy or Effectiveness design. These studies had many defects in research design such as: (1) small sample size; (2) deficiency in active control group; (3) deficiency in analyzing the effectiveness of intervention components; (4) lack of adverse reactions and economic evaluation; (5) lack of consideration about the education level, electronic health literacy and smartphone proficiency of the participants; (6) deficiency in assessment tool; (7) lack of rating the quality of mHealth application. Some progress should be improved in the design of smartphone application functionality, such as: (1) the design of cognitive measurements and training game need to be differentiated; (2) reduce the impact of the learning effect. Besides this, few studies used health behavior theory and performed with standardized reporting. CONCLUSIONS Preliminary results show that mobile technologies facilitate the assistance in people with cognitive impairment and their caregivers. The majority of mHealth application interventions incorporated usability outcome and health outcomes. However, these studies have many defects in research design that limit the extrapolation of research. The content of mHealth application is urgently improved to adapt to demonstrate the real effect. In addition, further research with strong methodological rigor and adequate sample size are needed to examine the feasibility, effectiveness, and cost-effectiveness of mHealth applications for people with cognitive impairment and their caregivers.

scholarly journals Effect of Whole-Body Cryotherapy on Morphological, Rheological and Biochemical Indices of Blood in People with Multiple Sclerosis

2021 ◽  
Vol 10 (13) ◽  
pp. 2833
Author(s):  
Bartłomiej Ptaszek ◽  
Aneta Teległów ◽  
Justyna Adamiak ◽  
Jacek Głodzik ◽  
Szymon Podsiadło ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Neurological Diseases ◽  
Venous Blood ◽  
Whole Body ◽  
Controlled Study ◽  
Control Group ◽  
Blood Indices ◽  
Rheological Indices ◽  
Whole Body Cryotherapy ◽  
The Impact

The aim of this study was to examine and assess the impact of a series of 20 whole-body cryotherapy (WBC) treatments on the biochemical and rheological indices of blood in people with multiple sclerosis. In this prospective controlled study, the experimental group consisted of 15 women aged 34–55 (mean age, 41.53 ± 6.98 years) with diagnosed multiple sclerosis who underwent a series of whole-body cryotherapy treatments. The first control group consisted of 20 women with diagnosed multiple sclerosis. This group had no intervention in the form of whole-body cryotherapy. The second control group consisted of 15 women aged 30–49 years (mean age, 38.47 ± 6.0 years) without neurological diseases and other chronic diseases who also underwent the whole-body cryotherapy treatment. For the analysis of the blood indices, venous blood was taken twice (first, on the day of initiation of whole-body cryotherapy treatments and, second, after a series of 20 cryotherapy treatments). The blood counts were determined using an ABX MICROS 60 hematological analyzer (USA). The LORCA analyzer (Laser–Optical Rotational Cell Analyzer, RR Mechatronics, the Netherlands) was used to study the aggregation and deformability of erythrocytes. The total protein serum measurement was performed using a Cobas 6000 analyzer, Roche and a Proteinogram-Minicap Sebia analyzer. Fibrinogen determinations were made using a Bio-Ksel, Chrom-7 camera. Statistically significant differences and changes after WBC in the levels of red blood cells (RBC), hemoglobin (HGB), hematocrit (HCT), elongation index, total extend of aggregation (AMP), and proteins (including fibrinogen) were observed. However, there was no significant effect of a series of 20 WBC treatments on changes in blood counts, rheology, and biochemistry in women with multiple sclerosis. Our results show that the use of WBC has a positive effect on the rheological properties of the blood of healthy women.

scholarly journals Validation and cross-cultural adaptation of sexual dysfunction modified scale in multiple sclerosis for Brazilian population

2015 ◽  
Vol 73 (8) ◽  
pp. 681-687 ◽  
Author(s):  
Raquel Ataíde Peres da Silva ◽  
Guilherme Sciascia do Olival ◽  
Lívia Palma Stievano ◽  
Vania Balardin Toller ◽  
Sergio Semeraro Jordy ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Sexual Dysfunction ◽  
Cultural Adaptation ◽  
Chronic Inflammatory Disease ◽  
Cross Cultural ◽  
Brazilian Population ◽  
Control Group ◽  
Cross Cultural Adaptation ◽  
The Central Nervous System ◽  
The Impact

Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system (CNS). These patients suffer from various comorbidities, including sexual dysfunction (SD). The lesions of MS may affect regions of the CNS along the pathway of sexual response. The Multiple Sclerosis Intimacy and Sexuality Questionnaire-19 (MSISQ-19) is a scale that assesses sexual dysfunction. Adapt and validate the MSISQ-19 to Brazilian patients with MS. 204 individuals were evaluated, 134 patients with MS and 70 healthy persons for the control group. It was determined reproducibility, validity, internal consistency and sensitivity of the MSISQ-19-BR. Among patients with MS, 54.3% of male and 71.7% of female presented some kind of SD. In the control group the results were 12.5% and 19.5%, respectively. The MSISQ-19-BR is reproducible, reliable and valid for the Brazilian population and may be used as a tool for assessing the impact of sexual dysfunction in patients with MS.

scholarly journals Validation survey of the impact of urinary incontinence (IIQ-7) and inventory of distress urogenital (UDI-6) – the short scales – in patients with multiple sclerosis

2015 ◽  
Vol 73 (1) ◽  
pp. 46-51 ◽  
Author(s):  
Lívia Palma Stievano ◽  
Guilherme Sciascia do Olival ◽  
Raquel Ataíde Peres da Silva ◽  
Vania Balardin Toller ◽  
Eduardo Gregorin Carabetta ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Urinary Incontinence ◽  
Cultural Adaptation ◽  
Cross Cultural ◽  
Control Group ◽  
Alpha Coefficient ◽  
Urogenital Distress Inventory ◽  
Mcdonald Criteria ◽  
The Impact ◽  
Review Criteria

Cross-cultural adaptation and validation of the Impact Questionnaire of Urinary Incontinence (IIQ-7) and Urogenital Distress Inventory (UDI-6) - short scale - in the Brazilian population with multiple sclerosis. The IIQ-7 and UDI-6 were translated into Portuguese, called IIQ-7-BR and UDI-6-BR. The questionnaires were administered in 211 individuals selected randomly. Of these, 140 had MS according to McDonald criteria and 71 were included in the control group. In both questionnaires, the Cronbach’s alpha coefficient was above 0.7. The IIQ-7-BR showed 94.31% concordance between the evaluated studies and UDI-6-BR, 93.33%. Thus, the instruments of this study were presented according to the standards proposed by the Instrument Review Criteria, reliability, validity and sensitivity, maintaining the original scales characteristics.

scholarly journals Effect of COVID-19 Lockdown on Patients with Multiple Sclerosis: an Italian Survey

2021 ◽  
pp. 1-7
Author(s):  
Marta Altieri ◽  
◽  
Mariangela Fratino ◽  
Flavia Pauri ◽  
Antonella Conte ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Family Caregiving ◽  
Social Life ◽  
Negative Impact ◽  
Self Report ◽  
Psychological Status ◽  
Control Group ◽  
Clinical Effects ◽  
Future Expectations ◽  
The Impact

Background: Italy was one of the first affected countries by coronavirus disease 2019 (COVID-19) pandemic. Public health measures like quarantine or national lockdown were adopted, with negative psychological and clinical effects on patients with chronic diseases. To investigate the impact of lockdown on patients with multiple sclerosis (MS), we developed a 36 items self-report questionnaire. Methods: Questionnaires were emailed to 120 patients with MS and 100 with chronic migraine (CM) as a control group, matched for age, sex, and education. The questionnaire was divided into five domains, evaluating concerns about 1) MS and therapy during COVID-19 pandemic, 2) personal and family caregiving, 3) working activities, 4) general and disease-related emotions during the lockdown, 5) future expectations concerning health status, social life, and working activity. Results: patients with MS had higher scores than those with CM in domains 4 and 5, investigating respectively general and disease-related emotions and future expectations (p= 0.05 and 0.02 respectively). About half of the patients with MS expressed some concern about the need to continue their therapy during the pandemic compared to people with CM (p= 0.0002). Conclusions: Covid-19 pandemic had a more negative impact on psychological status of patients with MS compared with those with CM

scholarly journals The Impact of Cognitive Dysfunction on Locomotor Rehabilitation Potential in Multiple Sclerosis

2019 ◽  
Vol 11 ◽  
pp. 117957351988404
Author(s):  
Stijn Denissen ◽  
Alexander De Cock ◽  
Tom Meurrens ◽  
Luc Vleugels ◽  
Ann Van Remoortel ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
Cognitive Dysfunction ◽  
Word Association ◽  
Verbal Learning ◽  
Cognitive Status ◽  
Attentional Deficits ◽  
Ambulatory Patients ◽  
The Impact ◽  
Locomotor Rehabilitation

Background: Cognitive dysfunction is a frequent manifestation of multiple sclerosis (MS) but its effect on locomotor rehabilitation is unknown. Objective: To study the impact of cognitive impairment on locomotor rehabilitation outcome in people with MS. Methods: We performed a retrospective analysis involving ambulatory patients with MS who were admitted for intensive, inpatient, multidisciplinary rehabilitation at the National Multiple Sclerosis Center of Melsbroek between the years 2012 and 2017. The Brief Repeatable Battery of Neuropsychological Tests (BRB-N) was used to determine the cognitive status of subjects as either impaired (COG–) or preserved (COG+). Locomotor outcome was compared between groups with the difference in 6-minute walk test (6MWT) measured at admission and discharge (Δ6MWT). In addition, individual test scores of the BRB-N for attention (Paced Auditory Serial Addition Test 2” and 3”), visuospatial learning/memory (7/24 Spatial Recall Test), verbal learning/memory (Selective Reminding Test) and verbal fluency (Controlled Oral Word Association Test) were correlated to the Δ6MWT. Results: A total of 318 complete and unique records were identified. Both groups showed a significant within-group Δ6MWT during hospitalization (COG+: 47.51 m; COG–: 40.97 m; P < .01). In contrast, Δ6MWT values were comparable between groups. The odds of achieving a minimal clinical important difference on the 6MWT did not differ significantly between both groups. Only attention/concentration was significantly correlated with Δ6MWT (r = 0.16, P = .013). Conclusion: Cognitive impairment based on BRB-N results appears not to impede locomotor rehabilitation in ambulatory patients with MS. Attentional deficits are correlated to the extent of locomotor rehabilitation, suggesting the presence of a subtle effect of cognition.

T1 cortical hypointensities and their association with cognitive disability in multiple sclerosis

2010 ◽  
Vol 16 (10) ◽  
pp. 1203-1212 ◽  
Author(s):  
Francesca Bagnato ◽  
Zeena Salman ◽  
Robert Kane ◽  
Sungyoung Auh ◽  
Fredric K Cantor ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
White Matter ◽  
Statistical Significance ◽  
Verbal Learning ◽  
Lesion Volume ◽  
Cognitive Disability ◽  
3.0 Tesla ◽  
Multiple Sclerosis Patients ◽  
The Impact

Background: Neocortical lesions (NLs) largely contribute to the pathology of multiple sclerosis (MS), although their relevance in patients’ disability remains unknown. Objective: To assess the incidence of T1 hypointense NLs by 3.0-Tesla magnetic resonance imaging (MRI) in patients with MS and examine neocortical lesion association with cognitive impairment. Methods: In this case-control study, 21 MS patients and 21 age-, sex- and years of education-matched healthy volunteers underwent: (i) a neuropsychological examination rating cognitive impairment (Minimal Assessment of Cognitive Function in MS); (ii) a 3.0-Tesla MRI inclusive of an isotropic 1.0 mm3 three-dimensional inversion prepared spoiled gradient-recalled-echo (3D-IRSPGR) image and T1- and T2-weighted images. Hypointensities on 3D-IRSPGR lying in the cortex, either entirely or partially were counted and association between NLs and cognitive impairment investigated. Results: A total of 95 NLs were observed in 14 (66.7%) patients. NL+ patients performed poorer (p = 0.020) than NLpatients only on the delayed recall component of the California Verbal Learning Test. This difference lost statistical significance when a correction for white matter lesion volume was employed. Conclusions: Although T 1 hypointense NLs may be present in a relatively high proportion of multiple sclerosis patients, the impact that they have in cognitive impairment is not independent from white matter disease.

scholarly journals Dementing brain processes in patients with Wilson’s disease and multiple sclerosis (pathogenesis and treatment approaches)

2019 ◽  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
Wilson’S Disease ◽  
Early Stage ◽  
Critical Mass ◽  
Wilson's Disease ◽  
Biological Aging ◽  
Cognitive Mechanisms ◽  
The Impact ◽  
The Brain

This article discusses various aspects of dementing processes in patients with Wilson’s disease (WD) and multiple sclerosis (MS), followed by a discussion of current pathogenetic treatment methods for these patients. A comprehensive clinical and laboratory study showed that the pathogenesis and staged development of the dementing process in patients with WD and MS largely coincides with those in patients with Alzheimer's disease and depends on three groups of factors: genetic predisposition, natural (biological) aging, and endo and exogenous pathogenic factors effects on the brain. Therefore, on the basis of the data presented by us, as well as literature data, it allows us to state that dementia is an organic pathophysiological syndrome of destruction of the critical mass of structural-functional blocks and systems of cognitive mechanisms of the brain. Each individual has his own, genetically determined, critical mass of cognitive mechanisms. Like any false system, this one is ultimately subject to both natural (slow) decay and pathological (accelerated) decay due to the death of neurons both in the type of apoptosis and in the type of necrosis. Thus, in patients with WD and MS, the pathogenetic process always involves structures sooner or later that ensure the functioning of the cognitive functions of the brain and lead to the development of their defects, therefore, therapy should be prescribed for the treatment of these patients. Dementia should be treated at its early stage, at the stage of cognitive impairment (CI). The general principles of managing patients with CI are the determination of the etiopathogenetic cause underlying the development of cognitive impairment, the reduction in the degree and prevention of the progression of cognitive deficit and the impact, if possible, on risk factors. Also, at all stages of cognitive deficiency, treatment of concomitant somatic diseases and correction of the emotional state are relevant. Therefore, timely prescribed comprehensive, pathogenetically substantiated personified therapy helps prevent irreversible consequences and improves the quality of life of patients.

The contribution of depressive symptoms to slowness of information processing in relapsing remitting multiple sclerosis

2016 ◽  
Vol 22 (12) ◽  
pp. 1607-1615 ◽  
Author(s):  
Genny Lubrini ◽  
Marcos Ríos Lago ◽  
Jose A Periañez ◽  
Antonio Tallón Barranco ◽  
Consuelo De Dios ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
Information Processing ◽  
Depressive Symptoms ◽  
General Population ◽  
Cognitive Demands ◽  
Fundamental Factor ◽  
Relapsing Remitting ◽  
Relapsing Remitting Multiple Sclerosis ◽  
The Impact

Background: Slowness of information processing has been suggested as a fundamental factor modulating cognitive impairment in multiple sclerosis (MS). However, the contribution of depressive symptoms (DS) to slowness remains unclear. One of the most accepted hypotheses on the impact of depression on the general population suggests that depression interferes only with tasks requiring high cognitive demands. However, no studies have investigated if the same pattern occurs in MS. Objective: The aim of this study was to determine the profile of the contribution of DS to slowness. Methods: Four Reaction Time (RT) tasks requiring an increasing level of cognitive demands were administered to 35 relapsing remitting MS patients with DS, 33 MS patients without DS, 17 depressed non-MS patients and 27 controls. Results: MS patients without DS obtained longer RTs than controls in all the tasks. On the contrary, depressed non-MS patients were slower than controls only in the most demanding task. Finally, MS patients with DS were slower than MS patients without DS not only in the most demanding task but also in the task requiring a lower level of cognitive demands. Conclusion: The contribution of DS to slowness depends on the level of cognitive demands. However, its impact on MS is more deleterious than on the general population.

How Old Do You Think I Am? Speech-Language Predictors of Perceived Age and Communicative Competence

2019 ◽  
Vol 62 (7) ◽  
pp. 2455-2472
Author(s):  
Jean K. Gordon ◽  
Kim Andersen ◽  
Gabriella Perez ◽  
Eileen Finnegan
Keyword(s):  
Communicative Competence ◽  
Speech Rate ◽  
Spoken Language ◽  
Speech And Language ◽  
Factors Affecting ◽  
Age Related ◽  
Primary Means ◽  
Perceived Age ◽  
The Impact

Purpose Spoken language serves as a primary means of social interaction, but speech and language skills change with age, a potential source of age-related stereotyping. The goals of this study were to examine how accurately age could be estimated from language samples, to determine which speech and language cues were most informative, and to assess the impact of perceived age on judgments of the speakers' communication skills. Method We analyzed narratives from 84 speakers aged 30–89 years to identify age-related differences and compared these differences to factors affecting perceptions of age and communicative competence. Three groups of raters estimated the speakers' ages and judged the quality of their communication: 44 listeners listened to audio-recorded narratives, 51 readers read transcripts of the narratives, and 24 voice raters listened to 10-s samples of speech extracted from one of the narratives. Results Older speakers spoke more slowly but showed minimal linguistic differences compared to younger speakers. Speakers' ages were estimated quite accurately, even from 10-s samples. Estimates were largely based on cues available in the acoustic signal—speech rate and vocal characteristics—so listeners were more accurate than readers. However, an overreliance on these cues also contributed to overestimates of speakers' ages. Communication ratings were not strongly related to perceived age but were influenced by various aspects of speech and language. In particular, speakers who produced longer narratives and spoke more quickly were judged to be better communicators. Conclusion Speakers tend to be judged on relatively superficial aspects of spoken language, in part because age-related change is most evident at these levels. Implications of these findings for age-related theories of stereotyping and speech-language intervention are discussed.

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