Memory improvement in multiple sclerosis after an extensive cognitive rehabilitation program in groups with a multicenter double-blind randomized trial

2020 ◽  
Vol 34 (6) ◽  
pp. 754-763
Author(s):  
Helene Brissart ◽  
Abdou Y Omorou ◽  
Natacha Forthoffer ◽  
Eric Berger ◽  
Thibault Moreau ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Working Memory ◽  
Randomized Trial ◽  
Verbal Memory ◽  
Cognitive Rehabilitation ◽  
Verbal Learning ◽  
Rehabilitation Program ◽  
Linear Regression Models ◽  
Double Blind ◽  
Learning Abilities

Objective: The aim of this study is to determine the effectiveness of an extended cognitive rehabilitation program in group’s sessions in multiple sclerosis. Design: Double-blind multicenter randomized trial. Participants: People with multiple sclerosis of 18 to 60 years, Expanded Disability Status Scale ⩽6.0, mild to moderate cognitive impairment. Interventions: They were randomized into cognitive rehabilitation program (ProCog-SEP) or in a placebo program. ProCog-SEP comprises 13 group’s sessions over 6 months and includes psychoeducational advices and cognitive exercises. Placebo program included non-cognitive exercises. No strategy and no cognitive advice were provided. Main measures: The primary endpoint was the percentage of verbal memory learning measured by the Selective Reminding Test. A comprehensive neuropsychological assessment is carried out before and after interventions by a neuropsychologist blinded to intervention. Effectiveness of the ProCog-SEP versus Placebo has been verified using linear regression models. Results: In total, 128 participants were randomized and 110 were included in the study after planning session in groups; 101 completed this trial (77.2% females); mean age: 46.1 years (±9.6); disease duration: 11.8 years (±7.5). ProCog-SEP was more effective in increasing in learning index (9.21 (95% confidence interval (CI): 1.43, 16.99); p = 0.02) and in working memory on manipulation (0.63 (95% CI: 0.17, 1.09); p = 0.01), and updating capacities (–1.1 (95% CI: –2.13, –0.06); p = 0.04). No difference was observed for other neuropsychological outcomes. Regarding quality of life outcomes, no change was observed between the two groups. Conclusion: These findings suggest that ProCog-SEP could improve verbal learning abilities and working memory in people with multiple sclerosis. These improvements were observed with 13 group sessions over 6 months.

Abstract P55: Retinal Microvascular Parameters Predict Retinal Amyloid Burden and Co-Jointly Predict Verbal Memory

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Oana M Dumitrascu ◽  
Ryan Rosenberry ◽  
Maziyar Khansari ◽  
Yonggang Shi ◽  
Tania Torbati ◽  
...  
Keyword(s):  
Verbal Memory ◽  
Verbal Learning ◽  
Cognitive Disorders ◽  
Region Of Interest ◽  
Posterior Pole ◽  
Linear Regression Models ◽  
Adult Intelligence Scale ◽  
Vascular Abnormalities ◽  
Imaging Tool ◽  
Z Scores

Introduction: Retinal vascular features predict cognitive performance and retinal imaging is a non-invasive tool to study brain health. Patients with Alzheimer’s disease (AD)-related cognitive disorders exhibit both retinal vascular abnormalities and intraretinal accumulation of amyloid-beta (Aβ) plaque. Curcumin-enhanced retinal fluorescence imaging (CRFI) was recently translated as a safe imaging tool for retinal Aβ plaque quantification. In this study, we sought to determine whether and which retinal arterial and venous parameters are predictive of retinal Aβ burden and cognitive Z-scores. Methods: We used scanning laser ophthalmoscopy with RetiaTM (Centervue, Inc) to obtain CRFI in a cohort of patients with cognitive decline. Retinal blood vessels were segmented in a predefined circumpapillary region of interest. For each centerline, vessel tortuosity index (VTI), vessel inflection index (VII), and branching angle (VBA) were quantified, independently for arteries and veins. Additionally, we automatically quantified retinal amyloid count in the supero-temporal quadrant and its subregions: posterior pole (PP), proximal mid-periphery (PMP), and distal mid-periphery (DMP). All quantifications were done blinded to the subjects’ clinical characteristics. Linear regression models were used to assess the correlations between retinal vascular and amyloid parameters. Results: 29 subjects (55% female, mean age 64±6 years) were included in the analysis: 11 had normal cognition, 16 mild cognitive impairment and 2 probable AD. Venous VTI was the only vascular parameter significantly different across levels of Clinical Dementia Rate scores and between cognitively normal and impaired. Venous VBA was a significant predictor of DMP amyloid count (p=0.03). Arterial VII significantly predicted PP amyloid count (p=0.02). VBA predicted Wechsler Adult Intelligence Scale Z-score (p=0.08). The combined VTI-PMP amyloid index significantly predicted Wechsler Memory Scale, California Verbal Learning Test and SF-36 mental component score Z-scores (p<0.05). Conclusion: Retinal venous tortuosity discriminates across cognitive scores and in combination with PMP amyloid count may predict verbal memory and related quality-of-life scores.

scholarly journals S84. EFFECTS OF COGNITIVE REHABILITATION AND ILLNESS DURATION ON VERBAL MEMORY AND LEARNING IN SCHIZOPHRENIA

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S66-S66
Author(s):  
Dimitrios Kontis ◽  
Angeliki Andreopoulou ◽  
Spyridoula Vassilouli ◽  
Dimitra Giannakopoulou ◽  
Eleni Siettou ◽  
...  
Keyword(s):  
Occupational Therapy ◽  
Learning And Memory ◽  
Verbal Memory ◽  
Cognitive Rehabilitation ◽  
Verbal Learning ◽  
Post Treatment ◽  
Naturalistic Study ◽  
Memory And Learning ◽  
Preliminary Results ◽  
Immediate Recall

Abstract Background Cognitive remediation has been associated with enhanced cognition and psychosocial functioning in schizophrenia (SCZ). We present the preliminary results of a naturalistic study using a Cognitive Rehabilitation Programme (CRP) in Athens, Greece. The programme includes 40 individual hourly sessions, having a frequency of at least 2 sessions per week. It has a cognitive exercises and a social cognition module and aims at improving social functioning through cognitive enhancement. The CRP is implemented at a specialized Unit of the Greek National Health Service which is located in the centre of Athens for patients with SCZ living in the community. Methods We analyzed the CRP effects on verbal learning and memory, for the first 47 patients with SCZ referred to the Unit who took part in a naturalistic study. We compared these effects with those from a control group of 8 patients with SCZ undergoing occupational therapy. We conducted seven linear regression analyses investigating the effects of the CRP on verbal learning parameters using the Hopkins Verbal Learning Test (HVLT) (immediate total recall-ITR, immediate recall at the three learning trials (IRLT1, IRLT2, IRLT3), delayed recall (DR), retention (RT), recognition (RC) controlling for the duration of illness (DOI). In these analyses the relevant HVLT post-treatment scores were the dependent variables and CRP (receipt or not) and DOI were the independent variables controlling for the effects of baseline HVLT scores. Results 47 patients with SCZ completed the CRP (15 women and 32 men, mean age=42.34 years-standard deviation/SD=11.69, mean DOI=18.27-SD=10.88). 8 patients (5 women and 3 men, mean age=54.5 years, SD=8.14, mean DOI=26.25, SD=10.63) participated in occupational therapy sessions of the same duration. Baseline HVLT scores strongly correlated with post-treatment scores in all analyses. CRP was associated with increased post-treatment HVLT total immediate recall scores (B=3.35, 95% Confidence Interval-CI=0.66, 6, t=2.5, df=49, p=0.016). DOI was associated with decreased post-treatment HVLT total immediate recall scores (B=-0.11, 95%CI=-0.2, -0.02, t=-0.25, df=49, p=0.015). Further analysis of the subjects’ performance in the three IRLTs revealed that the effect of CRP approached statistical significance in the IRLT1 (B=1.21, 95% CI=-0.04, 2.46, t=1.95, df=47, p=0.058). DOI was negatively associated with IRLT1 scores (B=-0.05, 95%CI= -0.09, -0.004, t=-2.23, df=49, p=0.023) and IRLT3 scores (B=-0.05, 95%CI=-0.1, -0.007, t=-2.3, df=48, p=0.026). The association of CRP and DOI with IRLT2 scores was not significant. DOI was negatively correlated with DR scores (B=-0.11, 95%CI=-0.16, -0.06, t=-4.38, df=49, p&lt;0.001). Similarly, DOI was negatively associated with RT scores (B=-1, 95%CI=-1.67, -0.35, df=49, p=0.004). We failed to find any effect of CRP on DR and RT scores. The ANOVA Model for RC scores was not significant. Discussion We presented preliminary results of an ongoing naturalistic study. CRP was associated with improved immediate recall, after controlling for the effects of the DOI. However, we failed to find any association of CRP with other verbal learning and memory measures. DOI negatively affected immediate and delayed verbal memory and learning. Although the naturalistic design of our study supports its external validity, it also limits the interpretation of our findings. Due to its preliminary character, our study was underpowered. A future blind randomized trial recruiting more subjects could shed more light onto the effect of CRP on cognition and functioning in schizophrenia.

Ginkgo biloba for the improvement of cognitive performance in multiple sclerosis

2007 ◽  
Vol 13 (3) ◽  
pp. 376-385 ◽  
Author(s):  
J. Lovera ◽  
B. Bagert ◽  
K. Smoot ◽  
C.D. Morris ◽  
R. Frank ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Performance ◽  
Ginkgo Biloba ◽  
Color Word ◽  
Word Association ◽  
Controlled Trial ◽  
Verbal Learning ◽  
Stroop Test ◽  
Interference Condition ◽  
Double Blind

Objectives To determine if Ginkgo biloba (GB) improves the cognitive performance of subjects with multiple sclerosis (MS). Methods Randomized, double-blind, placebo-controlled trial of GB, 120 mg twice a day or placebo for 12 weeks. The primary outcomes were: the long delay free recall from the California Verbal Learning Test-II; the Paced Auditory Serial Addition Test; the Controlled Oral Word Association Test; the Symbol Digit Modalities Test; Useful Field of View Test; and the color-word interference condition from the Stroop Color and Word Test. Results On completion, the GB group (n=20) was 4.5 seconds (95% confidence interval (CI) (7.6, 0.9), P=0.015) faster than the placebo group (n=18) on the color-word interference condition of the Stroop test. Subjects who were more impaired at baseline experienced more improvement with GB (treatment*baseline interaction, F=8.10, P=0.008). We found no differences on the other neuropsychological tests. Subjects on GB reported fewer cognitive difficulties in the Retrospective Memory Scale of the Perceived Deficits Questionnaire than subjects on placebo (1.5 points, 95% CI (2.6, 0.3), P=0.016). No serious drug related side-effects occurred and GB did not alter platelet function assays. Conclusion Overall, GB did not show a statistically significant improvement in cognitive function. A treatment effect trend, limited to the Stroop test, suggests that GB may have an effect on cognitive domains assessed by this test, such as susceptibility to interference and mental flexibility. Multiple Sclerosis 2007; 13: 376-385. http://msj.sagepub.com

Symptomatic remission and neurocognitive functioning in patients with schizophrenia

2011 ◽  
Vol 41 (10) ◽  
pp. 2131-2139 ◽  
Author(s):  
A. Hofer ◽  
T. Bodner ◽  
A. Kaufmann ◽  
G. Kemmler ◽  
U. Mattarei ◽  
...  
Keyword(s):  
Working Memory ◽  
Functional Outcome ◽  
Verbal Memory ◽  
Verbal Fluency ◽  
Employment Status ◽  
Visual Memory ◽  
Verbal Learning ◽  
Neurocognitive Functioning ◽  
Remission Status ◽  
Symptomatic Remission

BackgroundA cross-sectional study was conducted in participants with schizophrenia to explore a potential association between the patients' remission status and neurocognitive functioning and to examine whether these factors have an impact on functional outcome.MethodPsychopathological symptoms were rated by means of the Positive and Negative Syndrome Scale with symptom remission being assessed by applying the severity component of the recently proposed remission criteria. Tests for the cognitive battery were selected to cover domains known to be impaired in patients with schizophrenia. Next to pre-morbid intelligence, attention performance, executive functioning, verbal fluency, verbal learning and memory, working memory and visual memory were assessed. The joint effect of remission status and neurocognitive functioning on treatment outcome was investigated by logistic regression analysis.ResultsOut of 140 patients included in the study, 62 were symptomatically remitted. Mean age, education and sex distribution were comparable in remitted and non-remitted patients. Remitted patients showed significantly higher values on tests of verbal fluency, alertness and optical vigilance. Both symptomatic remission as well as performance on tests of working memory and verbal memory had a significant effect on the patients' employment status.ConclusionsIn the present study neuropsychological measures of frontal lobe functioning were associated with symptomatic remission from schizophrenia. In addition, both symptomatic remission and performance on tests of working memory and verbal memory had a significant effect on the patients' employment status. Longitudinal follow-up data are needed to determine how the associations of these determinants of functional outcome interact and change over time.

scholarly journals Glyceryl trinitrate in first-episode psychosis unmedicated with antipsychotics: A randomised controlled pilot study

2020 ◽  
Vol 34 (8) ◽  
pp. 839-847 ◽  
Author(s):  
Kate Merritt ◽  
Ana Catalan ◽  
Samuel Cowley ◽  
Arsime Demjaha ◽  
Matthew Taylor ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Glyceryl Trinitrate ◽  
Verbal Memory ◽  
Alternative Hypothesis ◽  
Controlled Trial ◽  
Verbal Learning ◽  
Nitric Oxide Donor ◽  
Psychotic Symptoms ◽  
First Episode ◽  
Double Blind

Background: There is a pressing need for new classes of treatment for psychosis. A key therapeutic target for novel compounds is the NMDA receptor, which may be modulated by nitric oxide donors such as sodium nitroprusside (SNP). Recent studies of SNP in patients with psychosis have mixed results, and the drug has to be administered intravenously. Glyceryl trinitrate (GTN) is a well-established cardiovascular medicine that is also a nitric oxide donor, and can be given orally. Aims: We explored the safety and potential effects of GTN in unmedicated patients with a first episode of psychosis. Methods: This was a single-centre, randomised, double-blind, placebo-controlled trial from December 2016 to April 2019 (ClinicalTrials.gov identifier: NCT02906553). Patients received 3 × sprays of GTN or placebo for three consecutive days, and were re-assessed on Days 1, 2, 3 and 7. The primary outcome was cognition (Jumping to Conclusions task), secondary outcomes were symptoms (Positive and Negative Syndrome Scale (PANSS)), verbal memory (Hopkins Verbal Learning task), and mood (Bond–Lader Visual Analogue Scales). Results: Nineteen patients were randomised, and 13 participants were included in the analyses. Compared with placebo, GTN was well tolerated, but was not associated with significant effects on cognition, symptoms, or mood. Bayesian statistics indicate that our results were 2× more likely under the null hypothesis than the alternative hypothesis, providing anecdotal evidence that GTN does not improve psychotic symptoms. Conclusions: We found no indication of an effect of GTN on symptoms of psychosis or cognition.

scholarly journals Double-Blind Controlled Randomized Trial of Cyclophosphamide versus Methylprednisolone in Secondary Progressive Multiple Sclerosis

PLoS ONE ◽  
2017 ◽  
Vol 12 (1) ◽  
pp. e0168834 ◽  
Author(s):  
Bruno Brochet ◽  
Mathilde S. A. Deloire ◽  
Paul Perez ◽  
Timothé Loock ◽  
Louise Baschet ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Randomized Trial ◽  
Progressive Multiple Sclerosis ◽  
Secondary Progressive Multiple Sclerosis ◽  
Double Blind ◽  
Secondary Progressive

Verbal Memory Function in Intellectually Well-Functioning Adults With ADHD: Relations to Working Memory and Response Inhibition

2015 ◽  
Vol 23 (10) ◽  
pp. 1188-1198 ◽  
Author(s):  
Astri J. Lundervold ◽  
Helene Barone Halleland ◽  
Erlend Joramo Brevik ◽  
Jan Haavik ◽  
Lin Sørensen
Keyword(s):  
Working Memory ◽  
Executive Function ◽  
Response Inhibition ◽  
Verbal Memory ◽  
Memory Performance ◽  
Memory Function ◽  
Verbal Learning ◽  
Substantial Part ◽  
Adhd Group ◽  
Immediate Memory

Objective: To investigate verbal memory function with relation to working memory (WM) and response inhibition (RI) in adults with ADHD. Method: Verbal memory function was assessed by the California Verbal Learning Test–Second Edition (CVLT-II), WM by the Paced Serial Addition Test, and RI by the Color-Word Interference Test from Delis–Kaplan Executive Function System in a sample of adults with normal to high intellectual function (IQ). Results: The ADHD group ( n = 74) obtained lower scores than controls on measures of learning, recall, and immediate memory (CVLT-II). WM and RI explained a substantial part of verbal memory performance in both groups. A group to executive function (EF) interaction effect was identified for the total number of intrusions and false positive responses on the CVLT-II recognition trial. Conclusion: Verbal memory performance only partially overlaps with EF in intellectually well-functioning adults with ADHD. Both EF and verbal memory function should be assessed as part of a neuropsychological evaluation of adults with ADHD. (J. of Att. Dis. XXXX; XX(X) XX-XX)

scholarly journals Employing connectome-based models to predict working memory in multiple sclerosis

2021 ◽  
Author(s):  
Heena R. Manglani ◽  
Stephanie Fountain-Zaragoza ◽  
Anita Shankar ◽  
Jacqueline A. Nicholas ◽  
Ruchika Shaurya Prakash
Keyword(s):  
Multiple Sclerosis ◽  
Working Memory ◽  
Functional Connectivity ◽  
Predictive Modeling ◽  
Cognitive Rehabilitation ◽  
Clinical Samples ◽  
Validation Sample ◽  
Whole Brain ◽  
Internal Validation ◽  
Individual Level

AbstractBackgroundIndividuals with multiple sclerosis (MS) are vulnerable to deficits in working memory, and the search for neural correlates of working memory in circumscribed areas has yielded inconclusive findings. Given the widespread neural alterations observed in MS, predictive modeling approaches that capitalize on whole-brain connectivity may better capture individual-level working memory in this population.MethodsHere, we applied connectome-based predictive modeling to functional MRI data from working memory tasks in two independent samples with relapsing-remitting MS. In the internal validation sample (ninternal = 36), functional connectivity data were used to train a model through cross-validation to predict accuracy on the Paced Visual Serial Addition Test, a gold-standard measure of working memory in MS. We then tested its ability to predict performance on the N-back working memory task in the external validation sample (nexternal = 36).ResultsThe resulting model successfully predicted working memory in the internal validation sample but did not extend to the external sample. We also tested the generalizability of an existing model of working memory derived in healthy young adults to people with MS. It showed successful prediction in both MS samples, demonstrating its translational potential. We qualitatively explored differences between the healthy and MS models in intra- and inter-network connectivity amongst canonical networks.DiscussionThese findings suggest that connectome-based predictive models derived in people with MS may have limited generalizability. Instead, models identified in healthy individuals may offer superior generalizability to clinical samples, such as MS, and may serve as more useful targets for intervention.Impact StatementWorking memory deficits in people with multiple sclerosis have important consequence for employment, leisure, and daily living activities. Identifying a functional connectivity-based marker that accurately captures individual differences in working memory may offer a useful target for cognitive rehabilitation. Manglani et al. demonstrate machine learning can be applied to whole-brain functional connectivity data to identify networks that predict individual-level working memory in people with multiple sclerosis. However, existing network-based models of working memory derived in healthy adults outperform those identified in multiple sclerosis, suggesting translational potential of brain networks derived in large, healthy samples for predicting cognition in multiple sclerosis.

Neurocognitive Predictors of Functioning in Schizophrenia: Five Years Follow Up Study

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
M.L. Vargas ◽  
J.C. Sanz ◽  
N. Jimeno-Bulnes ◽  
S. Lopez
Keyword(s):  
Processing Speed ◽  
Verbal Memory ◽  
Verbal Learning ◽  
Outcome Variable ◽  
California Verbal Learning Test ◽  
Linear Regression Models ◽  
Psychiatric Admission ◽  
Processing Speed Index ◽  
Learning Test

Aims:Verbal memory and processing speed are two of the proposed neurocognitive predictors in schizophrenia. the objective is to determinate neurocognitive predictors of functioning in one five years follow-up period on ambulatory schizophrenia patients.Method:We conduct one cohort study on 30 schizophrenia out-patients (19 male; age mean: 32.8 years; SD:7.2). at the moment of inclusion it was applied one neuropsychological battery sensitive to neuropsychological deficit in schizophrenia: WAIS-III, BADS, WCST, Colour Trails, Trail Making A and B, BVRT, California Verbal Learning Test (Spanish version: TAVEC). Variables was summarized determining Z values and principal components. the cohort was prospectively studied for up to five years. as result variables it were considered: time to the first antipsychotic-drug change, time to the first psychiatric admission, and average five-years annual score in the Strauss-Carpenter Outcome Scale. It was constructed Cox and Linear Regression Models to determinate the better predicting neurocognitive components.Results:The better global outcome was directly related with WAIS-III processing speed index (corrected R square: 0.19; p = 0.02; beta constant= 0.469; beta WAIS-III processing speed= 0.125). None predictor was selected for the outcome variable change of antipsychotic. Psychiatric admission was predicted (p=0.006) by implicit learning (beta= -2.19), executive functioning (beta= 1.02), WAIS-III Total IQ (beta= 0.45) and WAIS-III Perceptual Organization Index (beta= -0.20).Conclusion:Higher processing speed index predicts one better functioning outcome during five-years follow-up. the risk for psychiatric admission was heterogeneously related with neurocognitive predictors. Verbal memory did not predict functional outcome.

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