scholarly journals Dissociable cognitive patterns related to depression and anxiety in multiple sclerosis

2019 ◽  
Vol 26 (10) ◽  
pp. 1247-1255 ◽  
Author(s):  
Victoria M Leavitt ◽  
Rachel Brandstadter ◽  
Michelle Fabian ◽  
Ilana Katz Sand ◽  
Sylvia Klineova ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Sex Education ◽  
Processing Speed ◽  
Anxiety And Depression ◽  
Lesion Volume ◽  
Depression And Anxiety ◽  
Nonverbal Memory ◽  
Cognitive Correlates ◽  
Partial Correlations ◽  
Mood And Cognition

Background: Individuals with multiple sclerosis (MS) frequently present with depression and anxiety, as well as cognitive impairment, challenging clinicians to disentangle interrelationships among these symptoms. Objective: To identify cognitive functions associated with anxiety and depression in MS. Methods: Mood and cognition were measured in 185 recently diagnosed patients (Reserve Against Disability in Early Multiple Sclerosis (RADIEMS) cohort), and an independent validation sample (MEM CONNECT cohort, n = 70). Partial correlations evaluated relationships of cognition to anxiety and depression controlling for age, sex, education, and premorbid verbal intelligence. Results: In RADIEMS cohort, lower anxiety was associated with better nonverbal memory ( rp = –0.220, p = 0.003) and lower depression to better attention/processing speed ( rp = –0.241, p = 0.001). Consistently, in MEM CONNECT cohort, lower anxiety was associated with better nonverbal memory ( rp = –0.271, p = 0.028) and lower depression to better attention/processing speed ( rp = –0.367, p = 0.002). Relationships were unchanged after controlling for T2 lesion volume and fatigue. Conclusion: Consistent mood–cognition relationships were identified in two independent cohorts of MS patients, suggesting that cognitive correlates of anxiety and depression are separable. This dissociation may support more precise models to inform treatment development. Treatment of mood symptoms may mitigate effects on cognition and/or treatment of cognition may mitigate effects on mood.

FLAIR lesion volume in multiple sclerosis: Relation to processing speed and verbal memory

2005 ◽  
Vol 11 (02) ◽  
Author(s):  
JOHN J. RANDOLPH ◽  
HEATHER A. WISHART ◽  
ANDREW J. SAYKIN ◽  
BRENNA C. MCDONALD ◽  
KIMBERLY R. SCHUSCHU ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Processing Speed ◽  
Verbal Memory ◽  
Lesion Volume

Diffusion-weighted imaging predicts cognitive impairment in multiple sclerosis

2007 ◽  
Vol 13 (6) ◽  
pp. 722-730 ◽  
Author(s):  
Ralph H.B. Benedict ◽  
Jared Bruce ◽  
Michael G. Dwyer ◽  
Bianca Weinstock-Guttman ◽  
Chris Tjoa ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Processing Speed ◽  
Diffusion Weighted Imaging ◽  
Diffusion Tensor ◽  
Lesion Volume ◽  
Additive Variance ◽  
Whole Brain ◽  
Visual Spatial ◽  
Diffusion Weighted ◽  
And Performance

Following a previous study with diffusion tensor imaging, we investigated the correlation between diffusion-weighted imaging (DWI) and cognitive dysfunction in multiple sclerosis (MS). We studied 60 MS patients (mean age 45.8±9.0 years) using 1.5-T MRI. Disease course was RR=40 and SP = 20. Mean disease duration was 12.8±8.7 years. Mean EDSS was 3.4±1.7. Whole brain, gray and white matter normalized volumes were calculated on 3D SPGR T1-WI using a fully automated Hybrid SIENAX method. Parenchymal mean diffusivity (PMD) maps were created after automated segmentation of the brain parenchyma and cerebrospinal fluid using T2-WI and DW images. Histogram analysis was performed and DWI indices of peak position (PP), peak height (PH), mean parenchymal diffusivity (MPD) and entropy were obtained. Neuropsychological (NP) evaluation emphasized auditory/verbal and visual/spatial memory, as well as processing speed and executive function. We found significant correlations between DWI and performance in all cognitive domains. Overall, stronger correlations emerged for MPD and entropy than other DWI measures, although all correlations were in the expected direction. The strongest association was between DWI entropy and performance on the Symbol Digit Modalities Test, which assesses processing speed and working memory (r = -0.54). Fisher r to z transformations revealed that DWI, gray matter (GMF) and whole brain (BPF) atrophy, T1-lesion volume (LV) and T2-LV all accounted for similar amounts of variance in NP testing. Stepwise regression models determined whether multiple MRI measures predicted unique additive variance in test performance. GMF (R2 = 0.35, F =30.82, P <0.01) and entropy (ΔR2 =0.06, ΔF=5.47, P <0.05) both accounted for unique variance in processing speed. Our data make a stronger case for the clinical validity of DWI in MS than heretofore reported. DWI has very short acquisition times, and the segmentation method applied in the present study is reliable and fully automated. Given its overall simplicity and moderate correlation with cognition, DWI may offer several logistic advantages over more traditional MRI measures when predicting the presence of NP impairment. Multiple Sclerosis 2007; 13: 722-730. http://msj.sagepub.com

The Risk of Depression and Anxiety in the Post-diagnostic Period of Multiple Sclerosis Measured by Screening Instruments and Structured Interviews

2017 ◽  
Vol 41 (S1) ◽  
pp. S236-S236 ◽  
Author(s):  
H. Hoang ◽  
E. Stenager ◽  
E. Stenager
Keyword(s):  
Multiple Sclerosis ◽  
Depression Scale ◽  
Structured Interview ◽  
Anxiety And Depression ◽  
Depression And Anxiety ◽  
Screening Instruments ◽  
Hospital Anxiety ◽  
Structured Interviews ◽  
Clinical Screening ◽  
Competing Interest

ObjectiveTo examine the risk of depression and anxiety in MS patients in the post-diagnostic period by using clinical screening instruments and a diagnostic structured clinical interview.MethodA population of 134 MS patients was examined for the risk of depression and anxiety in the post-diagnostic period of MS using the clinical screening instruments Beck Depression Inventory (BDI) and Hospital Anxiety and Depression Scale (HADS). Within six weeks of diagnosis, patients with cut-off > 12 for BDI and > 7 for HADS were offered a clinical structured interview using the Schedules for Clinical Assessment in Neuropsychiatry/SCAN Version 2.1.ResultsThe prevalence of depressive symptoms and depression in the post-diagnostic period of MS was 49.2% when using the screening instruments, but only 15.2% when using the SCAN interview. For anxiety, the prevalence was 3.4% for both the screening instruments and the SCAN interview in the post-diagnostic period of MS.ConclusionMS patients have a risk of depression and anxiety in the post-diagnostic period of MS, but it is crucial to consider which tools to use in a clinical setting to investigate depression and anxiety in MS patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Affective Disorder and Functional Status as well as Selected Sociodemographic Characteristics in Patients with Multiple Sclerosis, Parkinson’s Disease and History of Stroke

Medicina ◽  
2020 ◽  
Vol 56 (3) ◽  
pp. 117 ◽  
Author(s):  
Andrzej Knapik ◽  
Ewa Krzystanek ◽  
Justyna Szefler–Derela ◽  
Joanna Siuda ◽  
Jerzy Rottermund ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Functional Status ◽  
Affective Disorders ◽  
Depression Scale ◽  
Anxiety And Depression ◽  
Sociodemographic Characteristics ◽  
Stroke Survivors ◽  
Depression And Anxiety ◽  
Diagnostic Threshold ◽  
History Of

The main arguments in support of researching anxiety and depression in patients with chronic somatic diseases are the prevalence of affective disorders in the population, somatic conditions as risk factors of affective disorders and the search for effective preventative and therapeutic strategies. The aim of the study was to determine the association between the functional status, selected sociodemographic characteristics and prevalence as well as severity of anxiety and depression in patients with multiple sclerosis (MS), Parkinson’s disease (PD) and history of stroke (S). Material and methods: Eighty participants (44 women and 36 men) with MS (n = 22), PD (n = 31) and history of stroke (n = 27) were enrolled. All participants completed a questionnaire consisting of metrics, the Katz Index of Independence in Activities of Daily Living and the Hospital Anxiety and Depression Scale (HADS). Results: Fifty-five per cent of all participants did not present with anxiety or depression, 20% scored above the diagnostic threshold on the anxiety scale and 26% scored above the diagnostic threshold on the depression scale. Subgroup analysis revealed that anxiety and depression sufferers were 13.64% and 13.64% of MS patients, respectively; 22.58% and 35.48% of PD patients, respectively; and 22.22% and 25.93% of stroke survivors, respectively. There was a significant correlation between depression and independence level in the entire group and between depression and marital status in stroke survivors. Conclusions: Although depression and anxiety are highly prevalent in patients with neurological conditions, the disorder has a very individual nature and is not associated with the patient’s age, duration of a condition or concomitant diseases. Screening for depression and anxiety as a part of comprehensive approach may increase treatment efficacy in neurological patients

Depression, anxiety and multiple sclerosis: Links with alexithymia

2011 ◽  
Vol 26 (S2) ◽  
pp. 1698-1698 ◽  
Author(s):  
J. Aloulou ◽  
C. Hachicha ◽  
R. Masmoudi ◽  
A. Boukhris ◽  
C. Mhiri ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Mood State ◽  
Disease Onset ◽  
Depression Scale ◽  
Anxiety And Depression ◽  
Depression And Anxiety ◽  
Hospital Anxiety ◽  
Long Period ◽  
Prevalence Of Depression ◽  
Degree Of Disability

The aim of our study was to assess the prevalence of depression and anxiety in a population of patients treated for multiple sclerosis (MS) and their link with alexithymia.Method31 patients with MS according to McDonald's criteria, and followed in neurology department took part in the study. All patients were evaluated using a protocol to collect the epidemiological, clinical and evolution of the disease. We used versions of Arabized-Hospital Anxiety and Depression Scale (HADS) to assess the mood state and the Toronto Alexithymia Scale (TAS-20) for alexithymia.Results and commentsParticipants were divided on 18 women and 13 men with a mean age of 39 years. The prevalence of depression and anxiety were 42% and 52% respectively. The prevalence of alexithymia was 43%. The anxiety was correlated with the degree of disability and age of disease onset. Similarly, depression was more frequently observed in patients with higher EDSS, a long period of evolution. A positive correlation was found between alexithymia, depression and anxiety.Our study showed that half of all MS patients have mood disorders. However, depression is the most common and most disabling psychiatric disorder in MS. The place of anxiety should not be neglected because in case of comorbidity with depression, can be an aggravating factor. The frequency of alexitymia is high and appears to be positively correlated with depression and anxiety.

Depression and cognitive function in early multiple sclerosis: Multitasking is more sensitive than traditional assessments

2020 ◽  
pp. 135245852095835
Author(s):  
Lisa Glukhovsky ◽  
Daniel Kurz ◽  
Rachel Brandstadter ◽  
Victoria M Leavitt ◽  
Stephen Krieger ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Gray Matter Volume ◽  
Depression Symptoms ◽  
Lesion Volume ◽  
Cognitive Tests ◽  
Healthy Controls ◽  
Mild Depression ◽  
Cognitive Assessments ◽  
Partial Correlations ◽  
Magnetic Resonance Imaging Mri

Background: Persons with multiple sclerosis (MS) and depression symptoms report real-world cognitive difficulties that may be missed by laboratory cognitive tests. Objective: To examine the relationship of depressive symptoms to cognitive monotasking versus multitasking in early MS. Method: Persons with early MS ( n = 185; ⩽5 years diagnosed) reported mood, completed monotasking and multitasking cognitive tests, and received high-resolution 3.0 T magnetic resonance imaging (MRI). Partial correlations analyzed associations between mood and cognition, controlling for age, sex, estimated premorbid IQ, T2 lesion volume, and normalized gray matter volume. Results: Depression symptoms were more related to worse cognitive multitasking (−0.353, p < 0.001) than monotasking ( r = −0.189, p = 0.011). There was a significant albeit weaker link to cognitive efficiency composite score ( r = −0.281, p < 0.001), but not composite memory ( r = −0.036, p > 0.50). Findings were replicated with a second depression measure. Multitasking was worse in patients with at least mild depression than both patients with no/minimal depression and healthy controls. Multitasking was not related to mood in healthy controls. Conclusions: Depression symptoms are linked to cognitive multitasking in early MS; standard monotasking cognitive assessments appear less sensitive to depression-related cognition. Further investigation should determine directionality and mechanisms of this relationship, with the goal of enhancing treatment for cognitive dysfunction and depression in MS.

scholarly journals Validation of Mood Measures for People with Multiple Sclerosis

2014 ◽  
Vol 16 (2) ◽  
pp. 105-109 ◽  
Author(s):  
Tessa M. Watson ◽  
Emma Ford ◽  
Esme Worthington ◽  
Nadina B. Lincoln
Keyword(s):  
Multiple Sclerosis ◽  
Depression Scale ◽  
High Sensitivity ◽  
High Specificity ◽  
Anxiety And Depression ◽  
Cutoff Score ◽  
Depression And Anxiety ◽  
Hospital Anxiety ◽  
Depression Subscale ◽  
Anxiety Subscale

Background: Valid assessments are needed in order to identify anxiety and depression in people with multiple sclerosis (MS). The objective of this study was to assess the validity of questionnaire measures of mood in people with MS. Methods: People with MS were recruited from a clinic database and asked to complete and return a questionnaire containing the Beck Anxiety Inventory (BAI), Beck Depression Inventory–II (BDI-II), and Hospital Anxiety and Depression Scale (HADS). Those who returned the questionnaire were invited to complete a structured clinical interview, which was blind to the results of the questionnaire. Results: The BDI-II and HADS were both found to be valid measures to detect depression and anxiety in people with MS. An optimum cutoff score of 23 for the BDI-II yielded high sensitivity (85%) and high specificity (76%). An optimum cutoff score of 11 for the HADS demonstrated high sensitivity and specificity for both the Anxiety subscale (sensitivity 90%, specificity 92%) and the Depression subscale (sensitivity 77%, specificity 81%). The BAI had high sensitivity (80%) but poor specificity (46%) for detecting anxiety. Conclusion: The BDI-II and HADS can be used to identify mood disorders in people with MS.

scholarly journals Distractibility in multiple sclerosis: The role of depression

2016 ◽  
Vol 2 ◽  
pp. 205521731665315 ◽  
Author(s):  
Viral P Patel ◽  
Aaron Zambrana ◽  
Lisa AS Walker ◽  
Nathan Herrmann ◽  
Richard H Swartz ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Regression Analysis ◽  
Cognitive Assessment ◽  
Ecological Validity ◽  
Depression Scale ◽  
Anxiety And Depression ◽  
Depression And Anxiety ◽  
Hospital Anxiety ◽  
Impaired Performance

The present study assesses the influence of depression and anxiety on the effects of cognitive distracters in people with multiple sclerosis (MS). Participants completed computerized versions of the Symbol Digit Modalities Test (c-SDMT) with ( n = 51) and without ( n = 51) auditory distracters. Based on the Hospital Anxiety and Depression Scale (HADS), 29 (28.4%) and 51 (50%) participants were classified as depressed or anxious, respectively. A regression analysis revealed that depression ( p = 0.034), not anxiety ( p = 0.264), further impaired performance on the c-SDMT, particularly in the presence of distracters. These results suggest that distracter effects are influenced by depression more than anxiety. Given that distracters are ubiquitous in real-world environments, their use in a cognitive assessment adds to the ecological validity of the results.

scholarly journals Coming off cannabis: a cognitive and magnetic resonance imaging study in patients with multiple sclerosis

Brain ◽  
2019 ◽  
Vol 142 (9) ◽  
pp. 2800-2812 ◽  
Author(s):  
Anthony Feinstein ◽  
Cecilia Meza ◽  
Cristiana Stefan ◽  
Richard W. Staines
Keyword(s):  
Multiple Sclerosis ◽  
Executive Function ◽  
Functional Mri ◽  
Processing Speed ◽  
Visual Memory ◽  
Cognitive Change ◽  
Group Differences ◽  
Lesion Volume ◽  
Memory Processing ◽  
Cognitive Improvement

AbstractCognitive dysfunction affects 40–80% of patients with multiple sclerosis. Smoking cannabis may add to these deficits. It is unclear whether coming off cannabis results in cognitive improvement. To address this question, 40 patients with multiple sclerosis who started using cannabis after the onset of multiple sclerosis and who used it for at least 4 days a week over many years were divided by odd-even number selection into two groups: cannabis continuation and cannabis withdrawal. Assessments took place at baseline and after 28 days and included serial versions of the Brief Repeatable Neuropsychological Battery for multiple sclerosis containing tests of verbal and visual memory, processing speed and executive function; structural and functional MRI, the latter entailing a compatible version of the Symbol Digit Modalities Test; urine for cannabinoid metabolites to detect compliance with abstinence. Only those participants deemed globally impaired at baseline (failure on at least two cognitive domains) were enrolled. The results revealed that the two groups were well matched demographically and neurologically. One subject was removed from the withdrawal group because of failed abstinence. Urine analysis revealed the cannabinoid consumed was predominantly tetrahydrocannabinol (THC). There were no baseline between group cognitive differences, but by Day 28 the withdrawal group performed significantly better on every cognitive index (P < 0.0001 for all). Significant within group differences were present for every test over time, but only in the abstinent group (P < 0.0001 for all tests). There were no between group baseline or Day 28 differences in structural MRI indices (global atrophy, total T1 and T2 lesion volume). At index assessment the two groups had a similar performance on the functional MRI-compatible Symbol Digit Modalities Test and there were no group differences in brain activation. However, by Day 28, the withdrawal group completed more trials correctly (P < 0.012) and had a faster reaction time (P < 0.002), associated with significantly increased activation in brain regions known to be associated with performance of the test (bilateral inferior frontal gyri, caudate and declive/cerebellum, P < 0.001 for all regions). These results reveal that patients with multiple sclerosis who are frequent, long-term cannabis users can show significant improvements in memory, processing speed and executive function after 28 days of drug abstinence. The absence of similar improvements in a matched multiple sclerosis group that remained on cannabis shows that beneficial cognitive change after stopping cannabis is not solely attributable to the effects of practice.

In multiple sclerosis anxiety, not depression, is related to gender

2015 ◽  
Vol 22 (2) ◽  
pp. 239-244 ◽  
Author(s):  
Marie Théaudin ◽  
Kristoffer Romero ◽  
Anthony Feinstein
Keyword(s):  
Multiple Sclerosis ◽  
General Population ◽  
Linear Regression Analysis ◽  
Depression Scale ◽  
Anxiety And Depression ◽  
Depression And Anxiety ◽  
Symptoms Of Depression ◽  
High Prevalence ◽  
Psychiatric Sequelae ◽  
The Impact

Background: There is a high prevalence of depressive and anxiety disorders in multiple sclerosis (MS), a disease 2.5 times more frequent in females. Contrary to the general population, in whom studies have demonstrated higher rates of depression and anxiety in females, little is known about the impact of gender on psychiatric sequelae in MS patients. Objectives: We conducted a retrospective study to try to clarify this uncertainty. Methods: Demographic, illness-related and behavioral variables were obtained from a neuropsychiatric database of 896 patients with a confirmed diagnosis of MS. Symptoms of depression and anxiety were obtained with the Hospital Anxiety and Depression Scale (HADS). Gender comparisons were undertaken and predictors of depression and anxiety sought with a linear regression analysis. Results: HADS data were available for 711 of 896 (79.35%) patients. Notable gender differences included a higher frequency of primary progressive MS in males ( p = 0.002), higher HADS anxiety scores in females ( p < 0.001), but no differences in HADS depression scores. Conclusion: In MS, gender influences the frequency of anxiety only. This suggests that the etiological factors underpinning anxiety and depression in MS are not only different from one another, but also in the case of depression, different from those observed in general population samples.

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