scholarly journals The neuropsychiatry of multiple sclerosis

2018 ◽  
Vol 24 (3) ◽  
pp. 178-187 ◽  
Author(s):  
Maria A. Ron
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
Psychiatric Comorbidity ◽  
Psychiatric Morbidity ◽  
Learning Objectives ◽  
List Type ◽  
Disease Modifying Therapies ◽  
Immune Mediated ◽  
The Uk ◽  
The Impact

SUMMARYMultiple sclerosis (MS), an immune-mediated demyelinating condition, is the most common neurological disease affecting young adults in the UK. It has a high psychiatric comorbidity and over half of patients have some degree of cognitive impairment that adds to the burden of disability. This article reviews the psychiatric and cognitive manifestations of MS and their detection and treatment. Recent advances in the treatment of the disease are briefly reviewed and the impact of disease-modifying therapies on psychiatric morbidity and cognitive impairment is discussed.LEARNING OBJECTIVES•Understand the psychiatric morbidity in MS and its biological counterparts•Understand the cognitive impairment and its biological counterparts•Become familiar with the detection and treatment of the psychiatric and cognitive manifestations of MSDECLARATION OF INTERESTNone.

Multiple Sclerosis

2019 ◽  
pp. 481-503
Author(s):  
Brian M. Sandroff ◽  
John DeLuca
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
Cognitive Rehabilitation ◽  
Daily Life ◽  
Cognitive Impairments ◽  
Brain Pathology ◽  
Future Directions ◽  
Immune Mediated ◽  
The Central Nervous System ◽  
The Impact

Multiple sclerosis (MS) is a nontraumatic, immune-mediated and neurodegenerative disease of the central nervous system. This chapter describes cognitive dysfunction in persons with MS. The chapter begins with a description of the disease and its prevalence and economic impact. This is followed by its diagnosis and current understanding of the mechanisms of the disease and its symptoms. The bulk of the chapter describes the cognitive impairments commonly observed in persons with MS. This includes the assessment of cognitive impairment, neuroimaging studies of how cognition is affected by brain pathology, the impact of cognitive impairment on daily life, and cognitive rehabilitation in MS. The chapter concludes with a brief discussion on future directions.

The State of the Art in Management Education Applicable to Aerospace Activities

1967 ◽  
Vol 71 (677) ◽  
pp. 344-348
Author(s):  
J. V. Connolly
Keyword(s):  
Management Education ◽  
State Of The Art ◽  
Aerospace Industry ◽  
List Type ◽  
Industrial Training ◽  
The Past ◽  
The Subject ◽  
Economic Necessity ◽  
The Uk ◽  
The Impact

During the past two years, there has been a sharp acceleration to the interest which industry has displayed in the subject of management education. This can be attributed to these factors: —(a) A more widespread realisation of the gap developing between the UK and a number of foreign economies, as manifested by diverging rates of the major economic indicators.(b) The attainment of top-management responsibilities by a younger generation of managers, many of whom had been given some earlier training and who were more conscious of its value than the incumbents of the job from earlier generations.(c) The publication of the Franks, Robbins and (in the aerospace industry) the Plowden reports.(d) The impact of the Industrial Training Boards making it manifest, in terms of serious levies, that training was an economic necessity and therefore must be investigated thoroughly.Notwithstanding the widespread awakening of interest, it is very belated and sets numerous problems. The problems are in two areas—scale and quality.

scholarly journals Impact of mass vaccination on SARS-CoV-2 infections among the total multiple sclerosis population receiving immunomodulatory disease-modifying therapies in England

2021 ◽  
Author(s):  
Nikos Evangelou ◽  
Afagh Garjani ◽  
Sameer Patel ◽  
Dhiren Bharkhada ◽  
Waqar Rashid ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
General Population ◽  
Mass Vaccination ◽  
Test Results ◽  
Health Security ◽  
Disease Modifying Therapies ◽  
Multiple Sclerosis Population ◽  
Impaired Immune Response ◽  
Disease Modifying ◽  
The Uk

Abstract This study aimed to understand changes in the risk of SARS-CoV-2 infection among all people with multiple sclerosis (MS) receiving immunomodulatory disease-modifying therapies (DMTs) in England, compared to the general population, following mass vaccination. Longitudinal data collected by the National Health Service (NHS) England on all MS DMT prescriptions and the UK Health Security Agency on all registered SARS-CoV-2 test results were analysed. The incidence rate ratio of SARS-CoV-2 infection among people with MS taking DMTs compared to the general population was calculated before (November 2020-January 2021) and after (July-August 2021) mass vaccination. Risk of SARS-CoV-2 infection among people on ocrelizumab or fingolimod compared to the general population increased following liberalisation of COVID-19 restrictions (during March-July 2021) despite mass vaccination. No changes were found with other DMTs. These findings converge with the impaired immune response to vaccines observed with ocrelizumab and fingolimod.

scholarly journals The Impact of Cognitive Dysfunction on Locomotor Rehabilitation Potential in Multiple Sclerosis

2019 ◽  
Vol 11 ◽  
pp. 117957351988404
Author(s):  
Stijn Denissen ◽  
Alexander De Cock ◽  
Tom Meurrens ◽  
Luc Vleugels ◽  
Ann Van Remoortel ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
Cognitive Dysfunction ◽  
Word Association ◽  
Verbal Learning ◽  
Cognitive Status ◽  
Attentional Deficits ◽  
Ambulatory Patients ◽  
The Impact ◽  
Locomotor Rehabilitation

Background: Cognitive dysfunction is a frequent manifestation of multiple sclerosis (MS) but its effect on locomotor rehabilitation is unknown. Objective: To study the impact of cognitive impairment on locomotor rehabilitation outcome in people with MS. Methods: We performed a retrospective analysis involving ambulatory patients with MS who were admitted for intensive, inpatient, multidisciplinary rehabilitation at the National Multiple Sclerosis Center of Melsbroek between the years 2012 and 2017. The Brief Repeatable Battery of Neuropsychological Tests (BRB-N) was used to determine the cognitive status of subjects as either impaired (COG–) or preserved (COG+). Locomotor outcome was compared between groups with the difference in 6-minute walk test (6MWT) measured at admission and discharge (Δ6MWT). In addition, individual test scores of the BRB-N for attention (Paced Auditory Serial Addition Test 2” and 3”), visuospatial learning/memory (7/24 Spatial Recall Test), verbal learning/memory (Selective Reminding Test) and verbal fluency (Controlled Oral Word Association Test) were correlated to the Δ6MWT. Results: A total of 318 complete and unique records were identified. Both groups showed a significant within-group Δ6MWT during hospitalization (COG+: 47.51 m; COG–: 40.97 m; P < .01). In contrast, Δ6MWT values were comparable between groups. The odds of achieving a minimal clinical important difference on the 6MWT did not differ significantly between both groups. Only attention/concentration was significantly correlated with Δ6MWT (r = 0.16, P = .013). Conclusion: Cognitive impairment based on BRB-N results appears not to impede locomotor rehabilitation in ambulatory patients with MS. Attentional deficits are correlated to the extent of locomotor rehabilitation, suggesting the presence of a subtle effect of cognition.

scholarly journals Cognitive Impairment in Multiple Sclerosis

Folia Medica ◽  
2016 ◽  
Vol 58 (3) ◽  
pp. 157-163 ◽  
Author(s):  
Anastasiya G. Trenova ◽  
Georgi S. Slavov ◽  
Maria G. Manova ◽  
Jana B. Aksentieva ◽  
Lyuba D. Miteva ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
Cognitive Disorders ◽  
Social Burden ◽  
Immune Mediated ◽  
The Social ◽  
The Central Nervous System ◽  
Axonal Transection ◽  
The Relationship

Abstract Multiple sclerosis (MS) is a socially significant immune-mediated disease, characterized by demyelination, axonal transection and oligodendropathy in the central nervous system. Inflammatory demyelination and neurodegeneration lead to brain atrophy and cognitive deficit in up to 75% of the patients. Cognitive dysfunctions impact significantly patients’ quality of life, independently from the course and phase of the disease. The relationship between pathological brain findings and cognitive impairment is a subject of intensive research. Summarizing recent data about prevalence, clinical specificity and treatment of cognitive disorders in MS, this review aims to motivate the necessity of early diagnosis and complex therapeutic approach to these disturbances in order to reduce the social burden of the disease.

The impact of 2015 neuromyelitis optica spectrum disorders criteria on diagnostic rates

2016 ◽  
Vol 23 (2) ◽  
pp. 228-233 ◽  
Author(s):  
Shahd HM Hamid ◽  
Liene Elsone ◽  
Kerry Mutch ◽  
Tom Solomon ◽  
Anu Jacob
Keyword(s):  
Multiple Sclerosis ◽  
Central Nervous System ◽  
Neuromyelitis Optica ◽  
Neuromyelitis Optica Spectrum Disorders ◽  
International Panel ◽  
Central Nervous System Demyelination ◽  
Spectrum Disorders ◽  
The Uk ◽  
The Impact ◽  
New Criteria

Background: The international panel for neuromyelitis optica (NMO) diagnosis has proposed diagnostic criteria for neuromyelitis optica spectrum disorders (NMOSD). Objectives: We assessed the impact of these criteria on diagnostic rates in a large cohort of patients. Methods: We identified and applied the 2006 and 2015 criteria to all patients ( n = 176) seen in the NMO and non-multiple sclerosis central nervous system demyelination clinic (part of the UK NMO service) from January 2013 to May 2015. Results: The 2006 criteria classified 63 of 176 (36%) patients as NMO. A total of 42 patients (67%) were aquaporin 4 (AQP4) immunoglobulin G (IgG) +ve and 21 (33%) AQP4 IgG −ve. The 2015 criteria classified 111 of 176 (63%) patients as NMOSD, of which 81 (73%) were AQP4 IgG +ve and 30 (27%) were AQP4 IgG −ve. There was an increase of 48 patients (76%) diagnosed as NMOSD using the new criteria. Conclusion: Application of the 2015 criteria led to a rise in diagnosis of NMOSD by 76%. The rise in the AQP4 IgG +ve group contributed 62% and the seronegative group contributed 14%.

THE PHYSICAL, SOCIAL & ECONOMIC EXTENT OF MULTIPLE SCLEROSIS IN SUSSEX

2015 ◽  
Vol 86 (11) ◽  
pp. e4.14-e4
Author(s):  
Jacob Howells ◽  
Waqar Rashid
Keyword(s):  
Multiple Sclerosis ◽  
Informal Care ◽  
Social Care ◽  
Full Time ◽  
Walking Aids ◽  
Relapsing Remitting ◽  
The Uk ◽  
Α Level ◽  
The Impact ◽  
Walking Aid

BackgroundMultiple sclerosis (MS) is the most common disabling illness of young adults in the UK causing significant social and economical cost. The aim of this study was to ascertain further detail of the characteristics of the MS population in an area of Sussex representing about 25% of the whole region.MethodsThe following was obtained from community databases: (a) demographics; (b) employment status; (c) DMT use; (d) walking aid use and (e) utilisation of social care.ResultsN=665. The mean (SD) age was 54 (13.2) years; Relapsing-Remitting MS 51%, Secondary Progressive MS 29% and Primary Progressive MS 15%. Of participants <65 years: 56% were unemployed, 44% worked part or full-time; 57.8% of participants required walking aids to mobilise, 23.3% were on a DMT, 35.1% required informal care and 20.2% required external social care. We found associations (at α level=0.05) between unemployment and: SPMS, walking aid use, informal care and external social care.DiscussionThis study highlights the needs of people with MS in Sussex. Of note is the impact on employment and the need for walking aids and additional care associated with MS. This knowledge will allow us to better develop services for people with MS with commissioners.

T1 cortical hypointensities and their association with cognitive disability in multiple sclerosis

2010 ◽  
Vol 16 (10) ◽  
pp. 1203-1212 ◽  
Author(s):  
Francesca Bagnato ◽  
Zeena Salman ◽  
Robert Kane ◽  
Sungyoung Auh ◽  
Fredric K Cantor ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
White Matter ◽  
Statistical Significance ◽  
Verbal Learning ◽  
Lesion Volume ◽  
Cognitive Disability ◽  
3.0 Tesla ◽  
Multiple Sclerosis Patients ◽  
The Impact

Background: Neocortical lesions (NLs) largely contribute to the pathology of multiple sclerosis (MS), although their relevance in patients’ disability remains unknown. Objective: To assess the incidence of T1 hypointense NLs by 3.0-Tesla magnetic resonance imaging (MRI) in patients with MS and examine neocortical lesion association with cognitive impairment. Methods: In this case-control study, 21 MS patients and 21 age-, sex- and years of education-matched healthy volunteers underwent: (i) a neuropsychological examination rating cognitive impairment (Minimal Assessment of Cognitive Function in MS); (ii) a 3.0-Tesla MRI inclusive of an isotropic 1.0 mm3 three-dimensional inversion prepared spoiled gradient-recalled-echo (3D-IRSPGR) image and T1- and T2-weighted images. Hypointensities on 3D-IRSPGR lying in the cortex, either entirely or partially were counted and association between NLs and cognitive impairment investigated. Results: A total of 95 NLs were observed in 14 (66.7%) patients. NL+ patients performed poorer (p = 0.020) than NLpatients only on the delayed recall component of the California Verbal Learning Test. This difference lost statistical significance when a correction for white matter lesion volume was employed. Conclusions: Although T 1 hypointense NLs may be present in a relatively high proportion of multiple sclerosis patients, the impact that they have in cognitive impairment is not independent from white matter disease.

scholarly journals Dementing brain processes in patients with Wilson’s disease and multiple sclerosis (pathogenesis and treatment approaches)

2019 ◽  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
Wilson’S Disease ◽  
Early Stage ◽  
Critical Mass ◽  
Wilson's Disease ◽  
Biological Aging ◽  
Cognitive Mechanisms ◽  
The Impact ◽  
The Brain

This article discusses various aspects of dementing processes in patients with Wilson’s disease (WD) and multiple sclerosis (MS), followed by a discussion of current pathogenetic treatment methods for these patients. A comprehensive clinical and laboratory study showed that the pathogenesis and staged development of the dementing process in patients with WD and MS largely coincides with those in patients with Alzheimer's disease and depends on three groups of factors: genetic predisposition, natural (biological) aging, and endo and exogenous pathogenic factors effects on the brain. Therefore, on the basis of the data presented by us, as well as literature data, it allows us to state that dementia is an organic pathophysiological syndrome of destruction of the critical mass of structural-functional blocks and systems of cognitive mechanisms of the brain. Each individual has his own, genetically determined, critical mass of cognitive mechanisms. Like any false system, this one is ultimately subject to both natural (slow) decay and pathological (accelerated) decay due to the death of neurons both in the type of apoptosis and in the type of necrosis. Thus, in patients with WD and MS, the pathogenetic process always involves structures sooner or later that ensure the functioning of the cognitive functions of the brain and lead to the development of their defects, therefore, therapy should be prescribed for the treatment of these patients. Dementia should be treated at its early stage, at the stage of cognitive impairment (CI). The general principles of managing patients with CI are the determination of the etiopathogenetic cause underlying the development of cognitive impairment, the reduction in the degree and prevention of the progression of cognitive deficit and the impact, if possible, on risk factors. Also, at all stages of cognitive deficiency, treatment of concomitant somatic diseases and correction of the emotional state are relevant. Therefore, timely prescribed comprehensive, pathogenetically substantiated personified therapy helps prevent irreversible consequences and improves the quality of life of patients.

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