The cognitive reserve theory in the setting of pediatric-onset multiple sclerosis

Background: The study of cognitive reserve (CR) in relationship with cognitive impairment (CI) in pediatric-onset multiple sclerosis (POMS) may provide cues to identifying subjects at higher risk of impairment and scope for therapeutic strategies. Objectives: To assess the potential impact of CR on cognition in a cohort of POMS patients. Methods: In all, 48 POMS patients were followed up for 4.7 ± 0.4 years. CI was defined as the failure of ⩾3 tests on an extensive neuropsychological battery. Change of neuropsychological performance was assessed through the Reliable Change Index (RCI) method. At baseline, CR was estimated by measuring the intelligence quotient (IQ). The relationships were assessed through multivariable regression analyses. Results: At baseline, CI was detected in 14/48 (29.2%) patients. Two out of 57 healthy control (HC; 3.5%) met the same criteria of CI ( p < 0.001). A deteriorating cognitive performance using the RCI method was observed in 18/48 patients (37.6%). Among the 34 cases who were cognitively preserved at baseline, a higher reserve predicted stable/improving performance (odds ratio (OR) = 1.11; 95% confidence interval (CI): 1.03–1.20; p = 0.006). Conclusion: Our results suggest that higher CR in POMS patients may protect from CI, particularly in subjects with initial cognitive preservation, providing relevant implications for counseling and rehabilitation strategies.

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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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Cognitive impairment in pediatric-onset multiple sclerosis is detected by the Brief International Cognitive Assessment for Multiple Sclerosis and computerized cognitive testing

Multiple Sclerosis Journal ◽

10.1177/1352458517701588 ◽

2017 ◽

Vol 24 (4) ◽

pp. 512-519 ◽

Cited By ~ 13

Author(s):

Leigh E Charvet ◽

Michael Shaw ◽

Ariana Frontario ◽

Dawn Langdon ◽

Lauren B Krupp

Keyword(s):

Multiple Sclerosis ◽

Cognitive Impairment ◽

Cognitive Assessment ◽

Outpatient Setting ◽

Cognitive Testing ◽

Cognitive Screening ◽

Healthy Control ◽

Computer Based ◽

Brief Cognitive Assessment ◽

Pediatric Onset

Background: Cognitive impairment is a common and troubling feature of pediatric-onset multiple sclerosis (POMS). Brief cognitive assessment in the outpatient setting can identify and longitudinally monitor cognitive involvement so that early intervention is possible. Objectives: The goal of this study was to measure the sensitivity of two cognitive assessment approaches that are brief, repeatable, and suitable for clinical practice and for multicenter investigation. Methods: Participants with POMS ( n = 69) were consecutively evaluated as part of outpatient neurologic visits and compared to healthy control participants (HC, n = 66) using the Brief International Cognitive Assessment for MS (BICAMS) approach and timed information processing measures from Cogstate, a computer-based assessment. Results: There was strong agreement in the detection rate of impairment between both assessments, with 26% for the BICAMS and 27% for Cogstate. Two of the Cogstate tasks were the most sensitive individual measures. Conclusion: Both the BICAMS and Cogstate timed processing measures offer practical, sensitive, and standardized approaches for cognitive screening assessment in POMS.

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Cognitive reserve and neuropsychological performance in multiple sclerosis: A meta-analysis.

Neuropsychology ◽

10.1037/neu0000520 ◽

2019 ◽

Vol 33 (3) ◽

pp. 379-390 ◽

Cited By ~ 9

Author(s):

Gabriella Santangelo ◽

Manuela Altieri ◽

Christian Enzinger ◽

Antonio Gallo ◽

Luigi Trojano

Keyword(s):

Multiple Sclerosis ◽

Cognitive Reserve ◽

Meta Analysis ◽

Neuropsychological Performance

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Age of Onset as a Moderator of Cognitive Decline in Pediatric-Onset Multiple Sclerosis

Journal of the International Neuropsychological Society ◽

10.1017/s1355617714000642 ◽

2014 ◽

Vol 20 (8) ◽

pp. 796-804 ◽

Cited By ~ 21

Author(s):

Banafsheh Hosseini ◽

David B. Flora ◽

Brenda L. Banwell ◽

Christine Till

Keyword(s):

Multiple Sclerosis ◽

Cognitive Decline ◽

Social Status ◽

Cognitive Reserve ◽

Disease Onset ◽

Rate Of Change ◽

Childhood And Adolescence ◽

Younger Age ◽

Pediatric Onset ◽

Cognitive Maturation

AbstractCognitive impairment is often reported in pediatric-onset multiple sclerosis (MS). Using serial cognitive data from 35 individuals with pediatric-onset MS, this study examined how age at disease-onset and proxies of cognitive reserve may impact cognitive maturation over the course of childhood and adolescence. Neuropsychological evaluations were conducted at baseline and up to four more assessments. Of the 35 participants, 7 completed only one assessment, 5 completed two assessments, 13 completed three assessments, 10 completed four or more assessments. Growth curve modeling was used to assess longitudinal trajectories on the Trail Making Test-Part B (TMT-B) and the Symbol Digit Modalities (SDMT; oral version) and to examine how age at disease onset, baseline Full Scale IQ, and social status may moderate rate of change on these measures. Mean number of evaluations completed per patient was 2.8. Younger age at disease onset was associated with a greater likelihood of cognitive decline on both the TMT-B (p=.001) and SDMT (p=.005). Baseline IQ and parental social status did not moderate any of the cognitive trajectories. Findings suggest that younger age at disease-onset increases the vulnerability for disrupted performance on measures of information processing, visual scanning, perceptual/motor speed, and working memory. Proxies of cognitive reserve did not protect against the progression of decline on these measures. Young patients with MS should be advised to seek follow-up cognitive evaluation to assess cognitive maturation and to screen for the potential late emergence of cognitive deficits. (JINS, 2014, 20, 1–9)

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Supplemental Material for Cognitive Reserve and Neuropsychological Performance in Multiple Sclerosis: A Meta-Analysis

Neuropsychology ◽

10.1037/neu0000520.supp ◽

2019 ◽

Keyword(s):

Multiple Sclerosis ◽

Cognitive Reserve ◽

Meta Analysis ◽

Neuropsychological Performance

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Neuropsychological Performance in DSM-IV ADHD Subtypes: An Exploratory Study with Untreated Adolescents

The Canadian Journal of Psychiatry ◽

10.1177/070674370204700908 ◽

2002 ◽

Vol 47 (9) ◽

pp. 863-869 ◽

Cited By ~ 70

Author(s):

Marcelo Schmitz ◽

Luciana Cadore ◽

Marcelo Paczko ◽

Letícia Kipper ◽

Márcia Chaves ◽

...

Keyword(s):

Digit Span ◽

Wisconsin Card Sorting Test ◽

Neuropsychological Performance ◽

Card Sorting ◽

Neuropsychological Battery ◽

Adhd Subtypes ◽

Cognitive Differences ◽

Control Subjects ◽

Healthy Control ◽

Dsm Iv

Objective: To explore neuropsychological performance in untreated Brazilian adolescents suffering from attention-deficit hyperactivity disorder (ADHD). Method: We assessed 30 untreated adolescents with ADHD and 60 healthy control subjects, aged 12 to 16 years, using a neuropsychological battery including the Wisconsin Card-Sorting Test (WCST), the Stroop Test (ST), the Digit Span, and the Word Span. Results: We found neuropsychological differences among the DSM-IV ADHD subtypes. Adolescents with the predominantly inattentive subtype (ADHD-I) performed more poorly than did control subjects on both the Digit Span and the ST. On both the Digit Span and the WCST, adolescents with the combined subtype (ADHD-C) presented significantly more impairments than did control subjects. Adolescents with the predominantly hyperactive-impulsive type (ADHD-HI) did not differ significantly from the control subjects in any measure assessed, but had a better performance than did those with ADHD-C on both the Digit Span and the WCST. In addition, adolescents with ADHD-HI performed better on the ST than did adolescents with ADHD-I. Conclusions: These findings suggest cognitive differences among ADHD subtypes, supporting the diagnostic distinction among them. Adolescents with ADHD-HI do not seem to have significant cognitive deficits.

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Influence of cognitive reserve on neuropsychological functioning in Parkinson's disease

Acta Neuropsychiatrica ◽

10.1034/j.1601-5215.2002.140502.x ◽

2002 ◽

Vol 14 (5) ◽

pp. 207-215 ◽

Cited By ~ 4

Author(s):

Juan L Sánchez ◽

Marina Rodríguez ◽

Juan Carro

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Cognitive Reserve ◽

Neuropsychological Functioning ◽

Clinical Group ◽

Neuropsychological Performance ◽

Clinical Effects ◽

Neuropsychological Battery ◽

Level Of Education ◽

Premorbid Intelligence

Background:In recent years, attention has been drawn to the association between a low level of education and dementia, an almost generalized finding in the majority of studies on the prevalence of dementia where the level of education of the population was highly diversified. The protective effect of education is not limited to Alzheimer's disease but is also seen in other types of dementia, Parkinson's disease (PD), and even in the cognitive deterioration linked to agingObjective:To evaluate neuropsychological performance in (PD) subjects and to evaluate the influence of cognitive reserve (RC) on their neuropsychological performance.Subjects:An extensive neuropsychological battery of tests was applied to a total of 79 subjects, 33 of whom were diagnosed with PD.Measures:RC scores were based on a combination of years of education, a measure of occupational attainment, and an estimate of premorbid intelligence.Results:As regards the specific disturbances found in the clinical group subjects, a lower performance in memory, attention, visuospatial, visuoconstructive, and perceptive skills was seen. With respect to our second objective, our results showed that patients diagnosed with PD who had a high RC reached a higher neuropsychological level of performance than those subjects with a low reserve.Conclusions:Early neuropsychological impairments in PD are most evident in individuals with lower RC. As has been found in other neurological disorders, individuals with greater RC may be less sensitive to the initial clinical effects of the underlying neuropathological process.

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Exploring the Potential Impact of Sentence-Level Comprehension and Sentence-Level Fluency on Deaf Students' Passage Comprehension

Journal of Speech Language and Hearing Research ◽

10.1044/2020_jslhr-19-00205 ◽

2020 ◽

Vol 63 (7) ◽

pp. 2281-2292

Author(s):

Ying Zhao ◽

Xinchun Wu ◽

Hongjun Chen ◽

Peng Sun ◽

Ruibo Xie ◽

...

Keyword(s):

Independent Predictor ◽

Vocabulary Knowledge ◽

Group Differences ◽

Regression Analyses ◽

Deaf Students ◽

Mediating Role ◽

Sentence Level ◽

Mediating Mechanisms ◽

Potential Impact ◽

The Relationship

Purpose This exploratory study aimed to investigate the potential impact of sentence-level comprehension and sentence-level fluency on passage comprehension of deaf students in elementary school. Method A total of 159 deaf students, 65 students ( M age = 13.46 years) in Grades 3 and 4 and 94 students ( M age = 14.95 years) in Grades 5 and 6, were assessed for nonverbal intelligence, vocabulary knowledge, sentence-level comprehension, sentence-level fluency, and passage comprehension. Group differences were examined using t tests, whereas the predictive and mediating mechanisms were examined using regression modeling. Results The regression analyses showed that the effect of sentence-level comprehension on passage comprehension was not significant, whereas sentence-level fluency was an independent predictor in Grades 3–4. Sentence-level comprehension and fluency contributed significant variance to passage comprehension in Grades 5–6. Sentence-level fluency fully mediated the influence of sentence-level comprehension on passage comprehension in Grades 3–4, playing a partial mediating role in Grades 5–6. Conclusions The relative contributions of sentence-level comprehension and fluency to deaf students' passage comprehension varied, and sentence-level fluency mediated the relationship between sentence-level comprehension and passage comprehension.

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