Fluency in multiple sclerosis: which measure is best?

2002 ◽  
Vol 8 (3) ◽  
pp. 261-264 ◽  
Author(s):  
W W Beatty
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
Roc Curve ◽  
Verbal Fluency ◽  
Operating Characteristic ◽  
The Body ◽  
Healthy Controls ◽  
Semantic Fluency ◽  
Multicenter Trials ◽  
Fixed Set

Tests of verbal fluency provide brief and sensitive measures of the deficits in rapidly retrieving overlearned information common in multiple sclerosis (MS). Production of words that begin with the letters F, A, and S is the verbal fluency measure most often used with patients who are fluent in English. However, because of frequency of words beginning with certain letters varies from one language to another, it is unlikely that any fixed set of letters will be appropriate for multicenter trials that involve patients who are fluent in different languages. A possible alternative involves using semantic fluency categories that contain such a large number of exemplars that no fluent speaker of any language could exhaust the category in the allotted response time. To examine the potential usefulness of semantic fluency measures, 203 MS patients and 87 healthy controls generated words that begin with F, A, or S or were exemplars of the categories animals and parts of the body. Receiver operating characteristic (ROC) curve analyses indicated that sensitivities and specificities for the three fluency measures in discriminating patients from controls were quite similar, especially if patients with global cognitive impairment were excluded.

scholarly journals Walking to Music and Metronome at Various Tempi in Persons With Multiple Sclerosis: A Basis for Rehabilitation

2019 ◽  
Vol 33 (6) ◽  
pp. 464-475 ◽  
Author(s):  
Lousin Moumdjian ◽  
Bart Moens ◽  
Pieter-Jan Maes ◽  
Johan Van Nieuwenhoven ◽  
Bart Van Wijmeersch ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
Cognitive Impairments ◽  
Auditory Stimuli ◽  
Experimental Session ◽  
Healthy Controls ◽  
Functional Training ◽  
Training Strategy ◽  
Different Types ◽  
Auditory Cueing

Background. Mobility dysfunctions are prevalent in persons with multiple sclerosis (PwMS), thus novel rehabilitation mechanisms are needed toward functional training. The effect of auditory cueing is well-known in Parkinson’s disease, yet the application of different types of auditory stimuli at different tempi has not been investigated yet. Objectives. Investigating if PwMS, compared with healthy controls (HC), can synchronize their gait to music and metronomes at different tempi during walking and the effects of the stimuli on perceived fatigue and gait. Additionally, exploring if cognitive impairment would be a factor on the results. Methods. The experimental session consisted of 2 blocks, music and metronomes. Per block, participants walked 3 minutes per tempi, with instructions to synchronize their steps to the beat. The tempi were 0%, +2%, +4% +6%, +8%, +10% of preferred walking cadence (PWC). Results. A total of 28 PwMS and 29 HC participated. On average, participants were able to synchronize at all tempi to music and metronome. Higher synchronization was obtained for metronomes compared with music. The highest synchronization for music was found between +2% and +8% of PWC yet pwMS perceived less physical and cognitive fatigue walking to music compared with metronomes. Cognitive impaired PwMS (n = 9) were not able to synchronize at tempi higher than +6%. Conclusion. Auditory-motor coupling and synchronization was feasible in HC and PwMS with motor and cognitive impairments. PwMS walked at higher tempi than their preferred walking cadence, and lower fatigue perception with music. Coupling walking to music could be a promising functional walking training strategy.

scholarly journals PERSONALITY TRAITS AND VERBAL FLUENCY IN 10 COHORTS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S777-S778
Author(s):  
Antonio Terracciano ◽  
Angelina R Sutin
Keyword(s):  
Cognitive Impairment ◽  
Personality Traits ◽  
Verbal Fluency ◽  
Factor Model ◽  
Five Factor Model ◽  
Meta Analysis ◽  
Age Groups ◽  
Cognitive Outcomes ◽  
Semantic Fluency ◽  
Age Range

Abstract Personality traits are associated with cognitive outcomes across the lifespan, including cognitive function in young adulthood and risk of cognitive impairment and dementia in old age. This study examined the association between the Five Factor Model personality traits and verbal fluency in 10 cohorts (11 samples) that totaled more than 90,000 participants (age range 16-101). Meta-analysis indicated that participants who scored lower in Neuroticism, and higher in Extraversion, Openness, and Conscientiousness retrieved more words, independent of age, gender, and education. These associations were consistent across semantic and letter fluency tasks. Moderation analysis indicated that the associations between personality and semantic fluency were stronger in older samples (except for Openness) and among individuals with lower education. This pattern suggests that these associations are stronger in groups vulnerable to cognitive impairment and dementia. Personality traits have pervasive associations with fluency tasks that are replicable across samples and age groups.

scholarly journals Platelet and Red Blood Cell Indices in Patients with Panic Disorder: A Receiver Operating Characteristic Analysis

2020 ◽  
Vol 11 (02) ◽  
pp. 261-266 ◽  
Author(s):  
Ramdas S. Ransing ◽  
Neha Gupta ◽  
Girish Agrawal ◽  
Nilima Mahapatro
Keyword(s):  
Panic Disorder ◽  
Blood Cell ◽  
Receiver Operating Characteristic ◽  
Red Blood Cell ◽  
Roc Curve ◽  
Operating Characteristic ◽  
Healthy Controls ◽  
Distribution Width ◽  
Rbc Indices ◽  
Receiver Operating

Abstract Objective Panic disorder (PD) is associated with changes in platelet and red blood cell (RBC) indices. However, the diagnostic or predictive value of these indices is unknown. This study assessed the diagnostic and discriminating value of platelet and RBC indices in patients with PD. Materials and Methods In this cross-sectional study including patients with PD (n = 98) and healthy controls (n = 102), we compared the following blood indices: mean platelet volume (MPV), platelet distribution width (PDW), and RBC distribution width (RDW). The receiver operating characteristic (ROC) curve was used to calculate the area under the ROC curve (AUC), sensitivity, specificity, and likelihood ratio for the platelet and RBC indices. Results Statistically significant increase in PDW (17.01 ± 0.91 vs. 14.8 ± 2.06; p < 0.0001) and RDW (16.56 ± 2.32 vs. 15.12 ± 2.43; p < 0.0001) levels were observed in patients with PD. PDW and mean corpuscular hemoglobin concentration had larger AUC (0.89 and 0.74, respectively) and Youden’s index (0.65 and 0.39, respectively), indicating their higher predictive capacity as well as higher sensitivity in discriminating patients with PD from healthy controls. Conclusion PDW can be considered a “good” diagnostic or predictive marker in patients with PD.

scholarly journals Developing a Persian Verbal Fluency Test and Comparing the Results Between Healthy Persian Speakers and Persian Speakers Patients With Alzheimer Disease and Mild Cognitive Impairment

2021 ◽  
Vol 19 (4) ◽  
pp. 387-398
Author(s):  
Ahmad Reza Khatoonabadi ◽  
◽  
Mahshid Aghajanzadeh ◽  
Saman Maroufizadeh ◽  
Zahra Vahabi ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Alzheimer Disease ◽  
Verbal Fluency ◽  
Normal Group ◽  
Semantic Fluency ◽  
Verbal Fluency Test ◽  
Semantic Categories ◽  
Cognitively Intact ◽  
Fluency Test

Objectives: Phonemic and semantic fluency tasks are used for verbal fluency (VF) evaluation. The present study aimed to select the most appropriate semantic categories and the most frequent phonemes of Persian as items for the VF test. Then, we determine the test results in differentiation between cognitively intact people and those with Mild Cognitive Impairment (MCI) and Alzheimer Disease (AD). Methods: A cross-sectional study was conducted on 120 people (60 cognitively intact, 30 with AD, and 30 with MCI) in two phases. In phase one, linguists determine the most frequent phonemes at the beginning of Persian words and the most frequent semantic categories based on a survey. In phase two, the verbal fluency test was administered to cognitively intact people and those with cognitive impairment (patients with AD and MCI). One-way ANOVA and multiple linear regression were used for statistical analysis. Results: The normal subjects scored significantly higher in all phonemic and semantic fluency tasks than the patients with AD and people with MCI (P<0.05). Regarding the phonemic VF task, the phonemes /sh/, /s/, and then /a/ were better in differentiating the MCI and AD groups from the normal group. Regarding the semantic VF task, the animals’ category was better differentiated the MCI and AD groups from the normal group. Discussion: Comparing frequent phonemes and semantic categories of Persian across three groups of normal, AD, and MCI showed that some phonemes and semantic categories can be more differentiating in the VF task. However, it is a preliminary validation study, and this topic needs more investigation in the future.

scholarly journals T1 Relaxation Times in the Cortex and Thalamus Are Associated With Working Memory and Information Processing Speed in Patients With Multiple Sclerosis

2021 ◽  
Vol 12 ◽  
Author(s):  
Christian Thaler ◽  
Isabelle Hartramph ◽  
Jan-Patrick Stellmann ◽  
Christoph Heesen ◽  
Maxim Bester ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Working Memory ◽  
Cognitive Impairment ◽  
Information Processing ◽  
Processing Speed ◽  
T1 Mapping ◽  
Relaxation Times ◽  
Healthy Controls ◽  
Information Processing Speed ◽  
T1 Relaxation

Background: Cortical and thalamic pathologies have been associated with cognitive impairment in patients with multiple sclerosis (MS).Objective: We aimed to quantify cortical and thalamic damage in patients with MS using a high-resolution T1 mapping technique and to evaluate the association of these changes with clinical and cognitive impairment.Methods: The study group consisted of 49 patients with mainly relapsing-remitting MS and 17 age-matched healthy controls who received 3T MRIs including a T1 mapping sequence (MP2RAGE). Mean T1 relaxation times (T1-RT) in the cortex and thalami were compared between patients with MS and healthy controls. Additionally, correlation analysis was performed to assess the relationship between MRI parameters and clinical and cognitive disability.Results: Patients with MS had significantly decreased normalized brain, gray matter, and white matter volumes, as well as increased T1-RT in the normal-appearing white matter, compared to healthy controls (p &lt; 0.001). Partial correlation analysis with age, sex, and disease duration as covariates revealed correlations for T1-RT in the cortex (r = −0.33, p &lt; 0.05), and thalami (right thalamus: r = −0.37, left thalamus: r = −0.50, both p &lt; 0.05) with working memory and information processing speed, as measured by the Symbol-Digit Modalities Test.Conclusion: T1-RT in the cortex and thalamus correlate with information processing speed in patients with MS.

scholarly journals Analysis of Eyelid Blink Characteristics in Patients with Ptosis Using a Smartphone Camera

2021 ◽  
Vol 62 (7) ◽  
pp. 873-880
Author(s):  
Taesung Joo ◽  
Jin-Ho Joo ◽  
In-Ki Park ◽  
Jae-Ho Shin
Keyword(s):  
Receiver Operating Characteristic ◽  
Roc Curve ◽  
Healthy Subjects ◽  
Operating Characteristic ◽  
Control Group ◽  
Palpebral Fissure ◽  
Blink Rate ◽  
Healthy Controls ◽  
Healthy Control ◽  
Receiver Operating

Purpose: To compare eyelid blink characteristics between patients with ptosis and healthy controls using a smartphone camera. Methods: The ptosis group consisted of 20 senile aponeurotic ptosis patients with margin reflex distance1 ≤2.5 mm and the control group consisted of 10 healthy subjects without ptosis. The ptosis group was further divided into two groups based on an age cutoff of 70 years. Palpebral fissure height, levator function, margin reflex distance1, inter-blink interval, blink duration, blink rate, and blink velocity were measured and compared between the three groups based on photographs of the eyelids and videos of blinking taken with a smartphone camera. Results: The palpebral fissure height, levator function, margin reflex distance1, and blink velocity were lower in the ptosis groups than in the control group but these values did not differ between the two ptosis groups. The palpebral fissure height, levator function, and margin reflex distance1 were correlated with blink velocity. In the receiver operating characteristic (ROC) curve of blink velocity, the area under the receiver operating characteristic (AUROC) curve value was as high as 0.969 and the cut-off value was 32.36 mm/s. Conclusions: It is possible to analyze eyelid blink characteristics using a smartphone camera and the results confirmed that palpebral fissure height, levator function, margin reflex distance1, and blink velocity were lower in the senile aponeurotic ptosis group than in the healthy control group and were unaffected by age. Additionally, blink velocity is valuable for diagnosis of ptosis due to the correlation between the degree of ptosis, blink velocity, and the ROC curve of blink velocity.

scholarly journals Circulating Inflammatory miRNAs Associated with Parkinson’s Disease Pathophysiology

Biomolecules ◽  
2020 ◽  
Vol 10 (6) ◽  
pp. 945 ◽  
Author(s):  
Sara R. Oliveira ◽  
Pedro A. Dionísio ◽  
Leonor Correia Guedes ◽  
Nilza Gonçalves ◽  
Miguel Coelho ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Roc Curve ◽  
Operating Characteristic ◽  
Disease Diagnosis ◽  
Healthy Controls ◽  
Roc Curve Analysis ◽  
Additional Group ◽  
Lrrk2 Gene ◽  
Non Coding Rnas

Parkinson’s disease (PD) is the second most common neurodegenerative disease worldwide, being largely characterized by motor features. MicroRNAs (miRNAs) are small non-coding RNAs, whose deregulation has been associated with neurodegeneration in PD. In this study, miRNAs targeting cell death and/or inflammation pathways were selected and their expression compared in the serum of PD patients and healthy controls. We used two independent cohorts (discovery and validation) of 20 idiopathic PD patients (iPD) and 20 healthy controls each. We also analyzed an additional group of 45 patients with a mutation in the leucine-rich repeat kinase 2 (LRRK2) gene (LRRK2-PD). miRNA expression was determined using Taqman qRT-PCR and their performance to discriminate between groups was assessed by receiver operating characteristic (ROC) curve analysis. We found miR-146a, miR-335-3p, and miR-335-5p downregulated in iPD and LRRK2-PD patients versus controls in both cohorts. In addition, miR-155 was upregulated in LRRK2-PD compared to iPD patients showing an appropriate value of area under the ROC curve (AUC 0.80) to discriminate between the two groups. In conclusion, our study identified a panel of inflammatory related miRNAs differentially expressed between PD patients and healthy controls that highlight key pathophysiological processes and may contribute to improve disease diagnosis.

The PASAT performance among patients with multiple sclerosis: analyses of responding patterns using different scoring methods

2006 ◽  
Vol 12 (5) ◽  
pp. 586-593 ◽  
Author(s):  
E Rosti ◽  
P Hämäläinen ◽  
K Koivisto ◽  
L Hokkanen
Keyword(s):  
Multiple Sclerosis ◽  
Clinical Trials ◽  
Cognitive Impairment ◽  
Assessment Tool ◽  
Cognitively Impaired ◽  
Healthy Controls ◽  
Scoring Methods ◽  
Multiple Sclerosis Functional Composite ◽  
Relapsing Remitting ◽  
Serial Addition

The Paced Auditory Serial Addition Test (PASAT) is widely used in the evaluation of multiple sclerosis (MS) patients’ cognitive performance, and also used as the sole measure of cognition in a recently developed assessment tool for MS clinical trials, the Multiple Sclerosis Functional Composite (MSFC). We analysed if MS patients and healthy controls have different patterns of responding in the PASAT, and whether different scoring methods influence the PASAT’s sensitivity and specificity in detecting disease-associated cognitive impairment. Forty-five relapsing-remitting MS patients and 48 healthy controls were evaluated using the PASAT and a comprehensive neuropsychological examination. Cognitively deteriorated MS patients compensated for their difficulties in PASAT by omitting rather than guessing answers. They skipped items intermittently, which reduces the difficulty of the task. Furthermore, towards the end of the PASAT’s 60-item series MS patients’ performance had a trend to fade whereas controls’ performance was more even throughout the task. The dyad score or the percent dyad score did not essentially improve the sensitivity or the specificity, but the accuracy improved when the answers at the end of the PASAT series were specifically emphasized. Using the combined score, 73% of the patients were correctly classified as cognitively impaired or unimpaired.

scholarly journals Phonological Fluency Strategy of Switching Differentiates Relapsing-Remitting and Secondary Progressive Multiple Sclerosis Patients

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
L. Messinis ◽  
M. H. Kosmidis ◽  
C. Vlahou ◽  
A. C. Malegiannaki ◽  
G. Gatzounis ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Verbal Fluency ◽  
Progressive Multiple Sclerosis ◽  
Word Production ◽  
Secondary Progressive Multiple Sclerosis ◽  
Healthy Controls ◽  
Secondary Progressive ◽  
Relapsing Remitting ◽  
Multiple Sclerosis Patients ◽  
Fluency Task

The strategies used to perform a verbal fluency task appear to be reflective of cognitive abilities necessary for successful daily functioning. In the present study, we explored potential differences in verbal fluency strategies (switching and clustering) used to maximize word production by patients with relapsing-remitting multiple sclerosis (RRMS) versus patients with secondary progressive multiple sclerosis (SPMS). We further assessed impairment rates and potential differences in the sensitivity and specificity of phonological versus semantic verbal fluency tasks in discriminating between those with a diagnosis of MS and healthy adults. We found that the overall rate of impaired verbal fluency in our MS sample was consistent with that in other studies. However, we found no differences between types of MS (SPMS, RRMS), on semantic or phonological fluency word production, or the strategies used to maximize semantic fluency. In contrast, we found that the number of switches differed significantly in the phonological fluency task between the SPMS and RRMS subtypes. The clinical utility of semantic versus phonological fluency in discriminating MS patients from healthy controls did not indicate any significant differences. Further, the strategies used to maximize performance did not differentiate MS subgroups or MS patients from healthy controls.

scholarly journals Sensitivity and Specificity of the ECAS in Parkinson’s Disease and Progressive Supranuclear Palsy

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Jennifer A. Foley ◽  
Elaine H. Niven ◽  
Andrew Paget ◽  
Kailash P. Bhatia ◽  
Simon F. Farmer ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Impairment ◽  
Progressive Supranuclear Palsy ◽  
Verbal Fluency ◽  
High Sensitivity ◽  
Healthy Controls ◽  
Diagnostic Challenge ◽  
Motor Disability ◽  
Severe Motor

Disentangling Parkinson’s disease (PD) and progressive supranuclear palsy (PSP) may be a diagnostic challenge. Cognitive signs may be useful, but existing screens are often insufficiently sensitive or unsuitable for assessing people with motor disorders. We investigated whether the newly developed ECAS, designed to be used with people with even severe motor disability, was sensitive to the cognitive impairment seen in PD and PSP and able to distinguish between these two disorders. Thirty patients with PD, 11 patients with PSP, and 40 healthy controls were assessed using the ECAS, as well as an extensive neuropsychological assessment. The ECAS detected cognitive impairment in 30% of the PD patients, all of whom fulfilled the diagnostic criteria for mild cognitive impairment. The ECAS was also able to detect cognitive impairment in PSP patients, with 81.8% of patients performing in the impaired range. The ECAS total score distinguished between the patients with PSP and healthy controls with high sensitivity (91.0) and specificity (86.8). Importantly, the ECAS was also able to distinguish between the two syndromes, with the measures of verbal fluency offering high sensitivity (82.0) and specificity (80.0). In sum, the ECAS is a quick, simple, and inexpensive test that can be used to support the differential diagnosis of PSP.

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