scholarly journals Brief Cognitive Monitoring in Multiple Sclerosis Patients in Latvia / Kognitīvo Funkciju Monitorings Multiplās Sklerozes Pacientiem Latvijā

2015 ◽  
Vol 69 (5) ◽  
pp. 228-231
Author(s):  
Līga Mekša ◽  
Guntis Karelis ◽  
Lana Vainšteine ◽  
Sandra Svilpe ◽  
Gundega Gulbe ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Visual Memory ◽  
Neuropsychological Testing ◽  
Expert Committee ◽  
Cognitive Changes ◽  
Disability Status ◽  
Expert Analysis ◽  
Trained Staff ◽  
Multiple Sclerosis Patients ◽  
Cognitive Monitoring

Abstract Cognitive changes are common in people with multiple sclerosis (MS). The neuropsychological testing requires specialised trained staff, time-consuming expert analysis and complicated test result interpretation. An expert committee recommended the Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS), which is optimised for small centres. We conducted the Symbol Digit Modalities Test (SDMT) and Brief Visuospatial Memory Test (BVMT), for which the results were comparable with similar results in literature. Most MS patients showed decreased attention and processing speed, while visual memory was generally normal. Cognitive impairment occurrence is not strongly related to Expanded Disability Status Scale (EDSS) score.

scholarly journals The Effect of Various Cognitive-Motor and Motor-Motor Tasks on the Motor and Cognitive Function of Patients Multiple Sclerosis: A Randomized Controlled Trial

2020 ◽  
Author(s):  
Arash Abasnia ◽  
Mehdi Shahbazi ◽  
Elahe Arab Ameri
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Function ◽  
Motor Function ◽  
Controlled Trial ◽  
Motor Tasks ◽  
Cognitive Changes ◽  
Significance Level ◽  
Disability Status ◽  
Task Training ◽  
Multiple Sclerosis Patients

Abstract Background: 85% of multiple sclerosis patients suffer from impaired motor function and 65% from cognitive impairment. Therefore The main purpose of this study is to improve the cognitive and motor function of patients using dual tasks.Methods: The study samples were 60 women with MS (20-50 years) with an Expanded Disability Status Scale 2-4 and the duration of the period (10-14 years) who were divided into 4 groups and for eight weeks each week including two sessions 45 They practiced dual cognitive, motor, and individual training for 45 to 60 minutes. Data were analyzed by composite variance analysis at significance level of P <0.05.Results: The results of compound analysis analysis showed that the training of cognitive-motor tasks improved the significance of motor function (p = 0.0005) and cognitive performance (p = 0.0001) compared to the other three groups.Conclusion: The results of this study suggest that the physical benefits of training are always superior to cognitive changes. Dual-task training can be considered a good way to improve cognitive and cognitive function.Trial registration: This study was registered in the Iranian Clinical Trial Center with the number IRCT20200812048384N1, http://www.irct.ir/trial/50300, registered 26 August 2020.

Disability status and dental pathology in multiple sclerosis patients

2015 ◽  
Vol 4 (6) ◽  
pp. 567-571 ◽  
Author(s):  
Adriana Octaviana Dulamea ◽  
Voicu Boscaiu ◽  
Maria Mirela Sava
Keyword(s):  
Multiple Sclerosis ◽  
Dental Pathology ◽  
Disability Status ◽  
Multiple Sclerosis Patients

scholarly journals Monitoring cognitive change in multiple sclerosis using a computerized cognitive battery

2018 ◽  
Vol 4 (4) ◽  
pp. 205521731881551 ◽  
Author(s):  
L De Meijer ◽  
D Merlo ◽  
O Skibina ◽  
EJ Grobbee ◽  
J Gale ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Change ◽  
Progressive Multiple Sclerosis ◽  
Healthy Controls ◽  
Relapsing Remitting ◽  
Remitting Multiple Sclerosis ◽  
Serial Addition ◽  
Multiple Sclerosis Patients ◽  
Relapsing Remitting Multiple Sclerosis ◽  
Cognitive Monitoring

Background Cognitive monitoring that can detect short-term change in multiple sclerosis is challenging. Computerized cognitive batteries such as the CogState Brief Battery can rapidly assess commonly affected cognitive domains. Objectives The purpose of this study was to establish the acceptability and sensitivity of the CogState Brief Battery in multiple sclerosis patients compared to controls. We compared the sensitivity of the CogState Brief Battery to that of the Paced Auditory Serial Addition Test over 12 months. Methods Demographics, Expanded Disability Status Scale scores, depression and anxiety scores were compared with CogState Brief Battery and Paced Auditory Serial Addition Test performances of 51 patients with relapsing–remitting multiple sclerosis, 19 with secondary progressive multiple sclerosis and 40 healthy controls. Longitudinal data in 37 relapsing–remitting multiple sclerosis patients were evaluated using linear mixed models. Results Both the CogState Brief Battery and the Paced Auditory Serial Addition Test discriminated between multiple sclerosis and healthy controls at baseline ( p<0.001). CogState Brief Battery tasks were more acceptable and caused less anxiety than the Paced Auditory Serial Addition Test ( p<0.001). In relapsing–remitting multiple sclerosis patients, reaction time slowed over 12 months ( p<0.001) for the CogState Brief Battery Detection (mean change –34.23 ms) and Identification (–25.31 ms) tasks. Paced Auditory Serial Addition Test scores did not change over this time. Conclusions The CogState Brief Battery is highly acceptable and better able to detect cognitive change than the Paced Auditory Serial Addition Test. The CogState Brief Battery could potentially be used as a practical cognitive monitoring tool in the multiple sclerosis clinic setting.

scholarly journals Speech Discrimination Tasks: A Sensitive Sensory and Cognitive Measure in Early and Mild Multiple Sclerosis

2020 ◽  
Vol 14 ◽  
Author(s):  
Pippa Iva ◽  
Joanne Fielding ◽  
Meaghan Clough ◽  
Owen White ◽  
Branislava Godic ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Speech Intelligibility ◽  
Digit Span ◽  
Neuropsychological Testing ◽  
Verbal Learning ◽  
Ease Of Use ◽  
Clinical Use ◽  
Speech Discrimination ◽  
Cognitive Changes ◽  
Functional Scores

There is a need for reliable and objective measures of early and mild symptomology in multiple sclerosis (MS), as deficits can be subtle and difficult to quantify objectively in patients without overt physical deficits. We hypothesized that a speech-in-noise (SiN) task would be sensitive to demyelinating effects on precise neural timing and diffuse higher-level networks required for speech intelligibility, and therefore be a useful tool for monitoring sensory and cognitive changes in early MS. The objective of this study was to develop a SiN task for clinical use that sensitively monitors disease activity in early (&lt;5 years) and late (&gt;10 years) stages of MS subjects with mild severity [Expanded Disability Status Scale (EDSS) score &lt; 3]. Pre-recorded Bamford-Kowal-Bench sentences and isolated keywords were presented at five signal-to-noise ratios (SNR) in one of two background noises: speech-weighted noise and eight-talker babble. All speech and noise were presented via headphones to controls (n = 38), early MS (n = 23), and late MS (n = 12) who were required to verbally repeat the target speech. MS subjects also completed extensive neuropsychological testing which included: Paced Auditory Serial Addition Test, Digit Span Test, and California Verbal Learning Test. Despite normal hearing thresholds, subjects with early and late mild MS displayed speech discrimination deficits when sentences and words were presented in babble – but not speech-weighted noise. Significant correlations between SiN performance and standardized neuropsychological assessments indicated that MS subjects with lower functional scores also had poorer speech discrimination. Furthermore, a quick 5-min task with words and keywords presented in multi-talker babble at an SNR of −1 dB was 82% accurate in discriminating mildly impaired MS individuals (median EDSS = 0) from healthy controls. Quantifying functional deficits in mild MS will help clinicians to maximize the opportunities to preserve neurological reserve in patients with appropriate therapeutic management, particularly in the earliest stages. Given that physical assessments are not informative in this fully ambulatory cohort, a quick 5-min task with words and keywords presented in multi-talker babble at a single SNR could serve as a complementary test for clinical use due to its ease of use and speed.

scholarly journals Reducing return of disease activity in patients with relapsing multiple sclerosis transitioned from natalizumab to teriflunomide: 12-month interim results of teriflunomide therapy

2019 ◽  
Vol 5 (1) ◽  
pp. 205521731882461
Author(s):  
Stanley L Cohan ◽  
Keith Edwards ◽  
Lindsay Lucas ◽  
Tiffany Gervasi-Follmar ◽  
Judy O’Connor ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Disease Activity ◽  
Brain Magnetic Resonance Imaging ◽  
T2 Lesions ◽  
Disability Status ◽  
The Mean ◽  
Multiple Sclerosis Patients ◽  
Mean Time ◽  
Relapsing Multiple Sclerosis

Background Natalizumab is an effective treatment for relapsing multiple sclerosis. Return of disease activity upon natalizumab discontinuance creates the need for follow-up therapeutic strategies. Objective To assess the efficacy of teriflunomide following natalizumab discontinuance in relapsing multiple sclerosis patients. Methods Clinically stable relapsing multiple sclerosis patients completing 12 or more consecutive months of natalizumab, testing positive for anti-John Cunningham virus antibody, started teriflunomide 14 mg/day, 28 ± 7 days after their final natalizumab infusion. Physical examination, Expanded Disability Status Scale, laboratory assessments, and brain magnetic resonance imaging were performed at screening and multiple follow-up visits. Results Fifty-five patients were enrolled in the study. The proportion of patients relapse-free was 0.94, restricted mean time to first gadolinium-enhancing lesion was 10.9 months and time to 3-month sustained disability worsening was 11.8 months. The mean number of new or enlarging T2 lesions per patient at 12 months was 0.42. Exploratory analyses revealed an annualized relapse rate of 0.08, and a proportion of patients with no evidence of disease activity of 0.68. Forty-seven patients (85.5%) reported adverse events, 95% of which were mild to moderate. Conclusions Teriflunomide therapy initiated without natalizumab washout resulted in a low rate of return of disease activity. Clinicians may consider this a worthwhile strategy when transitioning clinically stable patients off natalizumab to another therapy. ClinicalTrials.gov Identifier: NCT01970410

Performance Validity Testing in Multiple Sclerosis

2020 ◽  
Vol 26 (10) ◽  
pp. 1028-1035 ◽  
Author(s):  
Rachel Galioto ◽  
Kaltra Dhima ◽  
Ophira Berenholz ◽  
Robyn Busch
Keyword(s):  
Multiple Sclerosis ◽  
Psychological Symptoms ◽  
Neuropsychological Testing ◽  
Intractable Epilepsy ◽  
Neuropsychological Evaluation ◽  
Performance Validity ◽  
Retrospective Data Analysis ◽  
Disability Status ◽  
Validity Tests ◽  
Item Scores

AbstractObjective:Performance validity tests (PVTs) are designed to detect nonvalid responding on neuropsychological testing, but their associations with disease-specific and other factors are not well understood in multiple sclerosis (MS). We examined PVT performance among MS patients and associations with clinical characteristics, cognition, mood, and disability status.Method:Retrospective data analysis was conducted on a sample of patients with definite MS (n = 102) who were seen for a clinical neuropsychological evaluation. Comparison samples included patients with intractable epilepsy seen for presurgical workup (n = 102) and patients with nonacute mild traumatic brain injury (mTBI; n = 50). Patients completed the Victoria Symptom Validity Test (VSVT) and validity cutoffs were defined as <16/24 and <18/24 on the hard items.Results:In this MS cohort, 14.4% of patients scored <16 on the VSVT hard items and 21.2% scored <18. VSVT hard item scores were associated with disability status and depression, but not with neuropsychological scores, T2 lesion burden, atrophy, disease duration, or MS subtype. Patients applying for disability benefits were 6.75 times more likely to score <18 relative to those who were not seeking disability. Rates of nonvalid scores were similar to the mTBI group and greater than the epilepsy group.Conclusions:This study demonstrates that nonvalid VSVT scores are relatively common among MS patients seen for clinical neuropsychological evaluation. VSVT performance in this group relates primarily to disability status and psychological symptoms and does not reflect factors specific to MS (i.e., cognitive impairment, disease severity). Recommendations for future clinical and research practices are provided.

The risk of fracture in incident multiple sclerosis patients: The Danish National Health Registers

2012 ◽  
Vol 18 (11) ◽  
pp. 1609-1616 ◽  
Author(s):  
Marloes T Bazelier ◽  
Joan Bentzen ◽  
Peter Vestergaard ◽  
Egon Stenager ◽  
Hubert GM Leufkens ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Hip Fracture ◽  
National Health ◽  
Osteoporotic Fracture ◽  
Population Based ◽  
Risk Of Fracture ◽  
Increased Risk ◽  
Disability Status ◽  
Multiple Sclerosis Patients ◽  
Health Registers

Background: Patients with multiple sclerosis (MS) may be at increased risk of fractures owing to osteoporosis and falling. Objective: To evaluate the risk of fracture in incident MS patients drawn from a dedicated MS registry compared with population-based controls. Methods: We conducted a population-based cohort study (1996–2007) utilising the Danish National Health Registers that were linked to the Danish MS Registry and the Danish MS Treatment Registry. Incident MS patients (2963 cases) were 1:6 matched by year of birth, gender, calendar time and region to persons without MS (controls). Cox proportional hazards models and logistic regression were used to estimate the risk of fracture in MS. Time-dependent adjustments were made for age, history of diseases and drug use. Results: Compared with controls, patients with MS had no overall increased risk of fracture (adjusted hazard ratio (adj. HR): 1.0, 95% CI: 0.9–1.2). However, the risk of femur/hip fracture (adj. HR: 1.9, 95% CI: 1.1–3.4) was significantly increased compared to controls. As compared with unexposed patients, MS patients who had been exposed to a short course of methylprednisolone in the prior year had no significantly increased risk of osteoporotic fracture (adj. HR: 1.2, 95% CI: 0.5–2.9). Disabled MS patients with Expanded Disability Status Scale [EDSS] scores between 6 and 10, had a 2.6-fold increased risk of osteoporotic fracture (adjusted odds ratio (adj. OR): 2.6, 95% CI: 1.0–6.6) compared to patients with an EDSS score between 0 and 3. Conclusion: Patients with MS had a higher risk of femur/hip fracture than controls. Disability status is probably more important than glucocorticoid use in the aetiology of MS and osteoporotic fracture.

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