Benchmarks of meaningful improvement on neurocognitive tests in multiple sclerosis

2021 ◽  
pp. 135245852110446
Author(s):  
Curtis Wojcik ◽  
Michael Jaworski ◽  
Michael G Dwyer ◽  
Margaret Youngs ◽  
Mahmut Unverdi ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Neuropsychological Tests ◽  
Neuropsychological Testing ◽  
Meaningful Improvement ◽  
Neurocognitive Tests ◽  
Neuropsychological Changes ◽  
Monitoring Survey ◽  
Over Time

Background: Previous studies have established benchmarks of clinically meaningful decline on neuropsychological tests. However, little is known about meaningful testing benchmarks based on gains in function. Objective: Investigate neuropsychological changes in multiple sclerosis (MS) patients with work gains and calculate benchmarks of meaningful improvement on neuropsychological tests. Methods: A total of 323 people with MS were monitored longitudinally with neuropsychological testing and the Buffalo Vocational Monitoring Survey. Results/Conclusions: Those with work gains showed significant improvement (~3 points) on the Symbol Digit Modalities Test (SDMT) over time, p = 0.01. Benchmarks for clinically meaningful improvement on the SDMT are similar to those previously established for clinically meaningful decline.

scholarly journals Longitudinal evaluation of cognitive functioning in pediatric multiple sclerosis: report from the US Pediatric Multiple Sclerosis Network

2014 ◽  
Vol 20 (11) ◽  
pp. 1502-1510 ◽  
Author(s):  
LE Charvet ◽  
EH O’Donnell ◽  
AL Belman ◽  
T Chitnis ◽  
JM Ness ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Functioning ◽  
Verbal Memory ◽  
Neuropsychological Testing ◽  
Visuomotor Integration ◽  
Pediatric Multiple Sclerosis ◽  
Age Related ◽  
The Us ◽  
Over Time

Background: Approximately one-third of those with pediatric-onset multiple sclerosis (MS) experience cognitive impairment. Less is known concerning their change in cognitive functioning over time. Objective: Changes in cognitive function over time were measured in the largest pediatric cohort to date through the US Network of Pediatric MS Centers. Methods: A total of 67 individuals with pediatric MS ( n=62) or clinically isolated syndrome (CIS, n=5), ranging from 8–17 years of age (mean age±standard deviation (SD)=14.37±2.02) completed initial and follow-up neuropsychological testing after an average of 1.64±0.63 years apart. The nine tests administered measure general intellect, attention and working memory, verbal memory, visuomotor integration, language, and executive functioning. Results: Rate of impairment (having one-third or more scores in the impaired range) was 37% at baseline and 33% at follow-up. Tests commonly impaired were measures of visuomotor integration, speeded processing, and attention. Most tested did not decline over two years. There was no clear pattern of change on any specific measure. Conclusion: Findings suggest that, over short timeframes, stable or even improved performances on measures of cognitive ability can occur. Pediatric MS may instead prevent expected age-related cognitive gains.

NEUROPSYCHOLOGICAL CHANGES IN PATIENTS WITH A CONSEQUENCE OF TRAUMATIC BRAIN INJURY

2020 ◽  
Vol 3 (1) ◽  
pp. 44-46
Author(s):  
Istatillo Shodjalilov ◽  
◽  
Saoda Igamova ◽  
Aziza Djurabekova
Keyword(s):  
Traumatic Brain Injury ◽  
Cognitive Impairment ◽  
Brain Injury ◽  
Neuropsychological Testing ◽  
Anxiety And Depression ◽  
Psychopathological Symptoms ◽  
Neuropsychological Changes ◽  
The Relationship

The incidence of cognitive impairment in TBI is high, depending on the severity. At the same time, psychopathological symptoms in the form of asthenia, increased anxiety and depression are encountered among patients with TBI. The work studied the relationship between cognitive and psychopathological symptoms in patients with TBI using neuropsychological testing on scales.

scholarly journals Patient-proxy agreement on change in acute stroke patient-reported outcome measures: a prospective study

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Brittany R. Lapin ◽  
Nicolas R. Thompson ◽  
Andrew Schuster ◽  
Irene L. Katzan
Keyword(s):  
Physical Function ◽  
Inpatient Rehabilitation ◽  
Patient Reported Outcome Measures ◽  
Meaningful Change ◽  
Meaningful Improvement ◽  
T Score ◽  
Patient Reported ◽  
Exact Agreement ◽  
Over Time

Abstract Objectives Research has indicated proxies overestimate symptoms on patients’ behalves, however it is unclear whether patients and proxies agree on meaningful change across domains over time. The objective of this study is to assess patient-proxy agreement over time, as well as agreement on identification of meaningful change, across 10 health domains in patients who underwent acute rehabilitation following stroke. Methods Stroke patients were recruited from an ambulatory clinic or inpatient rehabilitation unit, and were included in the study if they were undergoing rehabilitation. At baseline and again after 30 days, patients and their proxies completed PROMIS Global Health and eight domain-specific PROMIS short forms. Reliability of patient-proxy assessments at baseline, follow-up, and the change in T-score was evaluated for each domain using intra-class correlation coefficients (ICC(2,1)). Agreement on meaningful improvement or worsening, defined as 5+ T-score points, was compared using percent exact agreement. Results Forty-one patient-proxy dyads were included in the study. Proxies generally reported worse symptoms and functioning compared to patients at both baseline and follow-up, and reported less change than patients. ICCs for baseline and change were primarily poor to moderate (range: 0.06 (for depression change) to 0.67 (for physical function baseline)), and were better at follow-up (range: 0.42 (for anxiety) to 0.84 (for physical function)). Percent exact agreement between indicating meaningful improvement versus no improvement ranged from 58.5–75.6%. Only a small proportion indicated meaningful worsening. Conclusions Patient-proxy agreement across 10 domains of health was better following completion of rehabilitation compared to baseline or change. Overall change was minimal but the majority of patient-proxy dyads agreed on meaningful change. Our study provides important insight for clinicians and researchers when interpreting change scores over time for questionnaires completed by both patients and proxies.

A-149 Demographic Correlates of a Short-Form Test of Executive Functioning

2021 ◽  
Vol 36 (6) ◽  
pp. 1203-1203
Author(s):  
Arthur M Horton ◽  
Cecil Reynolds
Keyword(s):  
Multiple Sclerosis ◽  
Traumatic Brain Injury ◽  
Executive Functioning ◽  
Private Practice ◽  
Short Form ◽  
Statistical Significance ◽  
Neuropsychological Testing ◽  
Card Sorting ◽  
Demographic Correlates ◽  
Education Levels

Abstract Objective This poster explores demographic correlates of a recently developed Short-Form Test of Executive Functioning. Method Subjects were 23 adults referred by neurologists and psychiatrist for neuropsychological testing to a private practice. All subjects signed informed consent documents. Subjects included 12 males and 11 females, 20 subjects were Caucasians and 3 were African-Americans, 22 were right handed. The subjects’ ages ranged from 20 to 74 (M-52.04, SD-14.87) and the subjects education levels ranged from 10–20 (M-15.87, SD-3.45). Diagnoses included Stroke-12, Traumatic Brain Injury-6, Alzheimer’s disease-2, Multiple Sclerosis-1, Parkinson’s disease-1 and Epilepsy-1. All subjects were administered neuropsychological testing including the Short-Form Test of Executive Functioning (SF-TEF) The Sf-TEF is composed of 3 card sorting subtests of the Test of Verbal and Conceptual Fluency (TVCF) but rather than administering 116 cards only 58 are administered and full scales scores prorated to save time. The scales are Number Correct, Perseveration Errors and Number of Categories. The 3 short form subjects were each correlated with the subjects age and education variables. Results The correlations between the Number Correct, Perseveration Errors and Number of Categories scores and age scores were 0.247, 0.01, and 0.08 and correlations between the Number Correct, Perseveration Errors and Number of Categories scores and education levels were 0.21, 0.273 and 0.12 which were all non-significant at the P < 0.05 level of statistical significance. Conclusions These results suggest that the scores of the Number Correct, Perseveration Errors and Number of Categories subtests were not unduly influenced by the subjects’ age and education.

scholarly journals Web-based physiotherapy for people affected by multiple sclerosis: a single blind, randomized controlled feasibility study

2018 ◽  
Vol 33 (3) ◽  
pp. 473-484 ◽  
Author(s):  
Lorna Paul ◽  
Linda Renfrew ◽  
Jennifer Freeman ◽  
Heather Murray ◽  
Belinda Weller ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Outcome Measures ◽  
Exercise Programme ◽  
Home Exercise ◽  
Walk Test ◽  
Web Based ◽  
Randomized Controlled ◽  
Home Exercise Programme ◽  
Minute Walk ◽  
Over Time

Objective: To examine the feasibility of a trial to evaluate web-based physiotherapy compared to a standard home exercise programme in people with multiple sclerosis. Design: Multi-centre, randomized controlled, feasibility study. Setting: Three multiple sclerosis out-patient centres. Participants: A total of 90 people with multiple sclerosis (Expanded Disability Status Scale 4–6.5). Interventions: Participants were randomized to a six-month individualized, home exercise programme delivered via web-based physiotherapy ( n = 45; intervention) or a sheet of exercises ( n = 45; active comparator). Outcome measures: Outcome measures (0, three, six and nine months) included adherence, two-minute walk test, 25 foot walk, Berg Balance Scale, physical activity and healthcare resource use. Interviews were undertaken with 24 participants and 3 physiotherapists. Results: Almost 25% of people approached agreed to take part. No intervention-related adverse events were recorded. Adherence was 40%–63% and 53%–71% in the intervention and comparator groups. There was no difference in the two-minute walk test between groups at baseline (Intervention-80.4(33.91)m, Comparator-70.6(31.20)m) and no change over time (at six-month Intervention-81.6(32.75)m, Comparator-74.8(36.16)m. There were no significant changes over time in other outcome measures except the EuroQol-5 Dimension at six months which decreased in the active comparator group. For a difference of 8(17.4)m in two-minute walk test between groups, 76 participants/group would be required (80% power, P > 0.05) for a future randomized controlled trial. Conclusion: No changes were found in the majority of outcome measures over time. This study was acceptable and feasible by participants and physiotherapists. An adequately powered study needs 160 participants.

scholarly journals Evaluation of the effects of group psychotherapy on cognitive function in patients with multiple sclerosis with cognitive dysfunction and depression

2015 ◽  
Vol 73 (2) ◽  
pp. 90-95 ◽  
Author(s):  
Emine Bilgi ◽  
Hasan Hüseyin Özdemir ◽  
Ayhan Bingol ◽  
Serpil Bulut
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
Cognitive Function ◽  
Group Psychotherapy ◽  
Cognitive Dysfunction ◽  
Beck Depression Inventory ◽  
Neuropsychological Tests ◽  
Depression Severity ◽  
Group Members ◽  
Repeatable Battery

Objective This study will evaluate how decreasing depression severity via group psychotherapy affects the cognitive function of patients with multiple sclerosis (MS) who are also diagnosed with depression and cognitive dysfunction. Method MS patients completed the Brief Repeatable Battery of Neuropsychological Tests and Beck Depression Inventory (BDI). The group members diagnosed with depression and cognitive dysfunction underwent group psychotherapy for 3 months. Upon completion of psychotherapy, both tests were readministered. Results Depression and cognitive dysfunction were comorbid in 15 (13.9%) of patients. Although improvement was detected at the end of the 3-month group psychotherapy intervention, it was limited to the BDI and the Paced Auditory Test. Conclusion Group psychotherapy might decrease cognitive impairment in MS patients.

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