Sensitivity of conventional memory tests in multiple sclerosis: comparing the Rao Brief Repeatable Neuropsychological Battery and the Minimal Assessment of Cognitive Function in MS

Background Cognitive impairment is common in multiple sclerosis (MS) affecting roughly 45–60% of patients. Because memory deficits have significant impact on employment, caregiver burden, and social functioning, neuropsychological (NP) assessment is often recommended. Two widely used and validated NP batteries for MS are the Rao Brief Repeatable Neuropsychological Battery (BRNB) and the Minimal Assessment of Cognitive Function in MS (MACFIMS). Although similar, these batteries differ in the specific auditory/verbal and visual/spatial memory tests employed. The relative sensitivity of these memory tests is unknown. Methods The BRNB and MACFIMS have considerable overlap but different memory tests: the former includes the Selective Reminding Test (SRT) and the 10/36 Spatial Recall Test (10/36) and the latter the California Verbal Learning Test, Second Edition (CVLT2) and Brief Visuospatial Memory Test, Revised (BVMTR). In 65 patients with MS and 46 demographically matched controls, we compared the sensitivity of these tests, and secondarily their respective batteries. Results The BRNB and MACFIMS were comparable in their overall sensitivity to disease status. Although the BVMTR showed greater discriminative validity than the 10/36, the CVLT2 and SRT were comparable in sensitivity. The SDMT was the most sensitive NP test across both batteries. Conclusions We conclude that the BRNB and MACFIMS have comparable sensitivity among patients with MS. The sensitivity of the auditory/verbal memory tests from these batteries is similar, but the BVMTR appears to be more sensitive than the 10/36. Clinical implications are discussed.

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Early effect of thalamotomy on cognitive function in patients with Parkinson’s disease

Bio-Algorithms and Med-Systems ◽

10.1515/bams-2018-0005 ◽

2018 ◽

Vol 14 (1) ◽

Author(s):

Edward J. Gorzelańczyk ◽

Dorota Ackermann-Szulgit ◽

Marek Kunc ◽

Marek Harat ◽

Piotr Walecki

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Cognitive Function ◽

Verbal Memory ◽

Spatial Working Memory ◽

Verbal Learning ◽

Control Group ◽

Healthy Individuals ◽

Early Effect ◽

Visual Spatial

Abstract Thalamotomy is a neurosurgical procedure used in the treatment of advanced Parkinson’s disease (PD). The aim of our research is to evaluate the early impact of a lesion in the ventrointermedial nucleus (VIM) of the thalamus on cognitive and motor function in people with PD. Sixty patients who qualified for right- or left-sided VIM thalamotomy were involved in the study. The cognitive and motor functions of each patient were assessed both prior to and following the surgical procedure. Twenty-nine PD patients without ablative treatment were qualified for the comparison group, and 57 neurologically healthy individuals were assigned to the control group. The following tests were carried out: Mini Mental State Examination, Benton Visual Retention Test, Stroop Color and Word Test, Trail Making Test A&B, and Rey Auditory Verbal Learning Test. Statistically significant differences were found in reaction time, visual-spatial working memory, auditory-verbal memory, and overall level of cognitive function when comparing the results of tests carried out before and after thalamotomy and when comparing patients who had undergone surgery with untreated or healthy individuals. In patients with right-sided and left-sided thalamotomy differences were also found in the mean number of perseverative errors and recalled words.

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Restless Legs Syndrome Severity and Cognitive Function in Adults with Multiple Sclerosis: An Exploratory Pilot Study

International Journal of MS Care ◽

10.7224/1537-2073.2020-120 ◽

2021 ◽

Author(s):

Katie L.J. Cederberg ◽

Brianna Mathison ◽

Morgan L. Schuetz ◽

Robert W. Motl

Keyword(s):

Multiple Sclerosis ◽

Cognitive Function ◽

Restless Legs Syndrome ◽

Processing Speed ◽

Verbal Memory ◽

Visual Memory ◽

Rating Scale ◽

Verbal Learning ◽

Restless Legs ◽

Falling Asleep

Abstract Background: Restless legs syndrome (RLS) is a sleep disorder present in as many as 26% of persons with multiple sclerosis (MS) and can be associated with cognitive function. The present study examined the relationships between RLS symptoms (severity, frequency, occurrence) and cognitive function in adults with MS who have RLS. Methods: Twenty-two participants attended one laboratory session and completed the International Restless Legs Syndrome Study Group Rating Scale (IRLS), the Restless Legs Syndrome-6 Scale (RLS-6), and then the Brief International Cognitive Assessment for Multiple Sclerosis battery consisting of the Symbol Digit Modalities Test; California Verbal Learning Test, Second Edition; and Brief Visuospatial Memory Test–Revised. Results: Nonparametric bivariate correlations indicated that worse IRLS total severity was associated with slower processing speed (ρ = −0.42), worse verbal memory (ρ = −0.63), and worse visual memory (ρ = −0.61); worse RLS severity at falling asleep was associated with worse verbal memory (ρ = −0.45) and worse visual memory (ρ = −0.55); and worse RLS severity during the day while active was associated with slower processing speed (ρ = −0.58), worse verbal memory (ρ = −0.52), and worse visual memory (ρ = −0.60). Conclusions: These results suggest that those with more severe RLS, including worse symptoms at falling asleep and during the day while active, might experience worse cognitive function, particularly processing speed and memory. Future research should evaluate whether treatment of RLS symptoms can offer new opportunities for managing cognitive dysfunction in adults with MS.

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Internet-based cognitive testing in multiple sclerosis

Multiple Sclerosis Journal ◽

10.1177/1352458507077626 ◽

2007 ◽

Vol 13 (8) ◽

pp. 1011-1019 ◽

Cited By ~ 19

Author(s):

M. Younes ◽

J. Hill ◽

J. Quinless ◽

M. Kilduff ◽

B. Peng ◽

...

Keyword(s):

Multiple Sclerosis ◽

Cognitive Function ◽

Verbal Memory ◽

Stability Index ◽

Cross Sectional Study ◽

Cognitive Testing ◽

The Internet ◽

Cross Sectional ◽

Multiple Sclerosis Patients

Cognitive impairment in multiple sclerosis is difficult to study because of the heterogeneity and variability of this disease. The gold standard for measurement of cognitive function in multiple sclerosis is a full battery of neurocognitive tests, which is time consuming and expensive. Some cognitive tests like the PASAT, a measure of working verbal memory and processing speed, have been proposed for screening and follow-up of cognitive function in clinical trials. We studied whether we could measure cognitive function in multiple sclerosis over the Internet. For this we used the Cognitive Stability Index (CSI)™, developed for persons with known or suspected primary central nervous system illness. The CSI was compared with formal neurocognitive testing (NPsych) and the PASAT in a cross-sectional study of 40 consecutive multiple sclerosis patients with subjective cognitive complaints. NPsych revealed that only 18 of the 40 patients (46%) were cognitively impaired. Although both the CSI and the PASAT were equalivalent in their specificity (86%), the CSI was significantly more sensitive than the PASAT (83% versus 28%). We conclude that the CSI, because of its availability over the Internet, has great potential as a tool for screening and follow up of cognitive function in multiple sclerosis. Multiple Sclerosis 2007; 13: 1011—1019. http://msj.sagepub.com

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Validity and Reliability of Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) in Indonesia and the Correlation with Quality of Life

Neurology Research International ◽

10.1155/2019/4290352 ◽

2019 ◽

Vol 2019 ◽

pp. 1-7

Author(s):

Riwanti Estiasari ◽

Yuhyi Fajrina ◽

Diatri Nari Lastri ◽

Syarli Melani ◽

Kartika Maharani ◽

...

Keyword(s):

Quality Of Life ◽

Multiple Sclerosis ◽

Cognitive Impairment ◽

Cognitive Function ◽

Cognitive Assessment ◽

Verbal Learning ◽

Retest Reliability ◽

Cognitive Evaluation ◽

Test Retest Reliability

Introduction. Multiple Sclerosis (MS) can affect cognitive function that might interfere with quality of life. Processing speed and memory are the most common area of cognitive impairment. Cognitive evaluation in daily practice is often difficult to be performed since it needs neuropsychological expert and is time-consuming. Brief International Cognitive Assessment for MS (BICAMS) is valid and practical for cognitive evaluation. This study aims to validate BICAMS in Indonesian MS patients and healthy controls (HC) and to analyse the effect of cognitive impairment on quality of life. Methods. BICAMS, which composes Symbol Digits Modalities Test (SDMT), California Verbal Learning Test-Second Edition (CVLT-II), and Brief Visuospatial Memory Test-Revised (BVMT-R), was translated and cross-culturally adapted to Indonesian from the original BICAMS and then administered to 40 Indonesian MS patients and 66 HC matched by sex, age, and education. Test-retest reliability was performed on 16-MS patients and 42 HC. Quality of life was measured using Multiple Sclerosis Quality of Life (MSQOL-54) instrument. Results. The SDMT, CVLT-II, and BVMT-R score in MS patients were significantly lower than those in HC (effect size, r: 0.61, 0.36, and 0.47, respectively). Test-retest reliability for all tests was satisfactory with correlation coefficient for SDMT, CVLT-II, and BVMT-R in MS subjects 0.86, 0.81, and 0.83, respectively. Using 5th percentile of HC score as cut-off, 15% MS subjects had impairment in one test, 27.5% in two tests, and 40% in three tests. BICAMS was moderately correlated with EDSS but was not correlated with disease duration and relapse rate. SDMT score correlated with physical function and physical and mental role limitation. Conclusion. BICAMS is valid and reliable for assessing cognitive function of Indonesia MS patients.

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Interferon Beta 1-B in Verbal Memory Functioning of Patients with Relapsing-Remitting Multiple Sclerosis

Perceptual and Motor Skills ◽

10.2466/pms.1998.86.3.1099 ◽

1998 ◽

Vol 86 (3) ◽

pp. 1099-1106 ◽

Cited By ~ 20

Author(s):

Michael J. Selby ◽

Naomi Ling ◽

J. Michael Williams ◽

Amanda Dawson

Keyword(s):

Multiple Sclerosis ◽

Verbal Memory ◽

Interferon Beta ◽

Adult Intelligence Scale ◽

Memory Tests ◽

Control Subjects ◽

Memory Functioning ◽

Relapsing Remitting ◽

Remitting Multiple Sclerosis ◽

Relapsing Remitting Multiple Sclerosis

The effects of interferon Beta 1-b (Betaseron) on verbal memory functioning was examined in 167 patients with relapsing-remitting multiple sclerosis and 112 matched normal controls. Subjects were administered 10 verbal memory tests from the Memory Assessment Scales and the Verbal subtests from the Wechsler Adult Intelligence Scale. Analysis showed subjects treated with Betaseron ( n = 73) did not perform significantly better on measures of verbal memory or verbal ability than subjects not receiving the drug ( n = 94), although the mean performance of treated subjects was higher across all verbal memory tests. Both groups of patients performed significantly worse on verbal memory subtests measuring list acquisition, delayed list recall, delayed cued recall, and the immediate and delayed recall of names and faces than control subjects. Although patients had lower performance scores across all memory tests than the control subjects, their scores were not within the impaired range. These results do not permit a clear conclusion about the effects of Betaseron on verbal memory for any effect is probably obscured by the relatively preserved cognitive functioning of this outpatient sample.

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Mild cognitive impairment: applicability of research criteria in a memory clinic and characterization of cognitive profile

Psychological Medicine ◽

10.1017/s0033291705006744 ◽

2006 ◽

Vol 36 (4) ◽

pp. 507-515 ◽

Cited By ~ 83

Author(s):

SUVARNA ALLADI ◽

ROBERT ARNOLD ◽

JOANNA MITCHELL ◽

PETER J. NESTOR ◽

JOHN R. HODGES

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Verbal Memory ◽

Verbal Learning ◽

Case Definition ◽

Memory Clinic ◽

Memory Tests ◽

Amnestic Mci ◽

Learning Test ◽

Research Criteria

Background. We explored the applicability of recently proposed research criteria for mild cognitive impairment (MCI) in a memory clinic and changes in case definition related to which memory tests are used and the status of general cognitive function in MCI.Method. A total of 166 consecutive GP referrals to the Cambridge Memory Clinic underwent comprehensive neuropsychological and psychiatric evaluation.Results. Of 166 cases, 42 were excluded (significant depression 8, established dementia 29 and other disorders 5). Of 124 non-demented, non-depressed patients, 72 fulfilled Petersen's criteria for amnestic MCI based upon verbal memory performance [the Rey Auditory Verbal Learning Test (RAVLT)] and 90 met criteria if performance on verbal and/or non-verbal memory tests [the Rey figure recall or the Paired Associates Learning test (PAL)] was considered. Of the 90 broadly defined MCI cases, only 25 had pure amnesia: other subtle semantic and/or attention deficits were typically present. A further 12 were classed as non-amnestic MCI and 22 as ‘worried well’.Conclusions. Definition of MCI varies considerably dependent upon the tests used for case definition. The majority have other cognitive deficits despite normal performance on the Mini-mental State Examination (MMSE) and intact activities of daily living (ADL) and fit within multi-domain MCI. Pure amnesic MCI is rare.

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Abstract P400: Dietary Pattern is Associated with Better Cognitive Function: The CARDIA Study

Circulation ◽

10.1161/circ.127.suppl_12.ap400 ◽

2013 ◽

Vol 127 (suppl_12) ◽

Author(s):

Na Zhu ◽

David R Jacobs ◽

Katie A Meyer ◽

Ka He ◽

Lenore J Launer ◽

...

Keyword(s):

Cognitive Function ◽

Verbal Memory ◽

Dietary Pattern ◽

A Priori ◽

Verbal Learning ◽

Stroop Test ◽

Digit Symbol Substitution Test ◽

Middle Aged ◽

Diet Pattern ◽

Diet Score

Primary prevention of cognitive function decline is important for a middle-aged population, but further evidence about the influence of dietary pattern is needed. An A Priori Diet Quality Score (diet score) and cognitive function were studied in the community-based Coronary Artery Risk Development in Young Adults (CARDIA) study of black and white men and women aged 18-30 in 1985-86 (year 0, Y0). We hypothesized that a higher diet score, measured at Y0 and Y20, predicts better cognitive function measured at Y25. The diet scores incorporated 46 foods groups (each in servings/day categorized into quintiles), with higher scores indicating higher quality diets. The score was the sum of quintile ranks of foods rated healthy, 0 for foods rated neutral, and reversed quintile ranks of foods rated less healthy. Cognitive tests at Y25 measured verbal memory (Rey Auditory-Verbal Learning Test (RAVLT)), psychomotor speed (Digit Symbol Substitution Test (DSST)) and executive function (Stroop Test). Higher cognitive function is reflected by higher RAVLT and DSST scores and lower Stroop Test scores. For each additional 10 units of diet score at Y20, the RAVLT was 0.23 words recalled higher, the DSST was 0.87 digits higher, and the Stroop Test score was 0.69 lower. Diet score measured at Y0 was less strongly but still significantly associated with cognitive scores. In exploratory analysis, we found that education modified the relation between diet pattern and cognitive function measures, e.g. diet and DSST at Y20 were associated in less educated subjects, but not in higher educated subjects (P for interaction =0.02). In conclusion, higher diet score was associated with better cognitive function 5 years later in apparently healthy middle-aged adults. However, diet pattern was not related to some measures of cognitive function in better educated subjects, conceivably because of compensatory behaviors in better educated people that would maintain higher cognitive function scores, despite lower quality diet.

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The utility of regression-based norms in interpreting the minimal assessment of cognitive function in multiple sclerosis (MACFIMS)

Journal of the International Neuropsychological Society ◽

10.1017/s1355617709990750 ◽

2009 ◽

Vol 16 (1) ◽

pp. 6-16 ◽

Cited By ~ 102

Author(s):

BRETT A. PARMENTER ◽

S. MARC TESTA ◽

DAVID J. SCHRETLEN ◽

BIANCA WEINSTOCK-GUTTMAN ◽

RALPH H. B. BENEDICT

Keyword(s):

Multiple Sclerosis ◽

Cognitive Function ◽

Sex Education ◽

Reliability And Validity ◽

Demographic Variables ◽

Clinical Settings ◽

Regression Analyses ◽

Neuropsychological Battery ◽

Data Set ◽

Unique Data

AbstractThe Minimal Assessment of Cognitive Function in Multiple Sclerosis (MACFIMS) is a consensus neuropsychological battery with established reliability and validity. One of the difficulties in implementing the MACFIMS in clinical settings is the reliance on manualized norms from disparate sources. In this study, we derived regression-based norms for the MACFIMS, using a unique data set to control for standard demographic variables (i.e., age, age2, sex, education). Multiple sclerosis (MS) patients (n = 395) and healthy volunteers (n = 100) did not differ in age, level of education, sex, or race. Multiple regression analyses were conducted on the performance of the healthy adults, and the resulting models were used to predict MS performance on the MACFIMS battery. This regression-based approach identified higher rates of impairment than manualized norms for many of the MACFIMS measures. These findings suggest that there are advantages to developing new norms from a single sample using the regression-based approach. We conclude that the regression-based norms presented here provide a valid alternative to identifying cognitive impairment as measured by the MACFIMS. (JINS, 2010, 16, 6–16.)

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Renal Function and Long-Term Decline in Cognitive Function: The Baltimore Longitudinal Study of Aging

American Journal of Nephrology ◽

10.1159/000430922 ◽

2015 ◽

Vol 41 (4-5) ◽

pp. 305-312 ◽

Cited By ~ 16

Author(s):

Stephen L. Seliger ◽

Carrington R. Wendell ◽

Shari R. Waldstein ◽

Luigi Ferrucci ◽

Alan B. Zonderman

Keyword(s):

Renal Function ◽

Longitudinal Study ◽

Cognitive Function ◽

Cognitive Functions ◽

Verbal Memory ◽

Visual Memory ◽

Verbal Learning ◽

Community Based ◽

Baltimore Longitudinal Study

Background: Renal disease has been associated with greater risk of dementia and greater cognitive impairment. However, the relationship of lower renal function with long-term decline in specific domains of cognitive function remains unclear among community-dwelling, non-demented individuals. Methods: Stroke- and dementia-free participants (n = 2,116) were enrolled in the Baltimore Longitudinal Study of Aging, a community-based, prospective, longitudinal study. Renal function was estimated by the inverse of serum creatinine adjusted for age, sex and race and (in sensitivity analyses) estimated glomerular filtration rate (eGFR) using the MDRD formula. Outcome measures were changes in scores on 6 cognitive tests encompassing a range of cognitive functions, measured at 2-year intervals. Mixed-effects regression models examined the longitudinal relations of renal function with cognitive functions after adjusting for demographics, comorbidity and other potential confounders. Results: Mean age at initial testing was 53.9 years (SD 17.1), and 94 participants (4.4%) had an eGFR <60 ml/min/1.73 m2 and 18.5% had at least one comorbidity. With increasing age, longitudinal increases in creatinine concentrations were associated with more rapid decline in performance on several cognitive measures, including the learning slope of the California Verbal Learning Test, a test of verbal learning (p < 0.01), and the Benton Visual Retention Test, a test of visual memory (p < 0.01). Associations were similar for changes in eGFRMDRD, which was also associated with the rate of decline in verbal memory. Conclusion: In a community-based adult population, declines in renal function independently associated with greater long-term declines in visual memory and verbal memory and learning.

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

Clinical Rehabilitation ◽

10.1177/0269215520920333 ◽

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.

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