scholarly journals KOGNITYVINIO FUNKCIONAVIMO IR DEPRESIŠKUMO RYŠYS SERGANT IŠSĖTINE SKLEROZE: TRUMPO DAUGIAKARČIO NEUROPSICHOLOGINIŲ TESTŲ RINKINIO TAIKYMAS LIETUVOJE

Psichologija ◽  
2005 ◽  
Vol 32 ◽  
pp. 74-86 ◽  
Author(s):  
Ramunė Grambaitė ◽  
Rūta Sargautytė

Nors susirgus išsėtine skleroze (IS) 40–70% žmonių sutrinka kognityvinis funkcionavimas, o depresija taip pat dažnai lydi IS (nustatoma 27–54% sergančiųjų), duomenys apie jų sąryšį gana prieštaringi. Straipsnyje analizuojamas kognityvinio funkcionavimo ir depresiškumo ryšys sergant išsėtine skleroze ir Trumpo daugiakarčio neuropsichologinių testų rinkinio (BRBNT) taikymo galimybės. Tyrime dalyvavo 41 žmogus, sergantis IS, ir 52 sveiki asmenys. Kognityvinėms funkcijoms vertinti buvo išversta ir naudojama BRBNT B versija (Rao and Peyser, 1986). Depresiškumui vertinti buvo taikomas Becko depresijos inventarijus (BDI-II). Gauti rezultatai rodo, jog sergančiųjų IS verbalinis išmokimas yra neigiamai susijęs su depresiškumu: depresiškumas statistiškai reikšmingai koreliuoja su pastovaus ilgalaikio atgaminimo rodikliais ir su ilgalaikiu atgaminimu po tam tikro uždelsimo laikotarpio, tačiau hipotezė, jog egzistuoja ryšys tarp informacijos apdorojimo greičio ir depresiškumo, nepasitvirtino. Klasifikuojant tiriamuosius į sveikus ir sergančius IS, gautas 100% BRBNT jautrumas, taip pat 100% specifiškumas.Pagrindiniai žodžiai: išsėtinė sklerozė, kognityvinis funkcionavimas, depresiškumas. THE RELATIONSHIP BETWEEN COGNITIVE FUNCTION AND DEPRESSION SEVERITY IN MULTIPLE SCLEROSIS PATIENTS: APPLICATION OF THE BRIEF REPEATABLE BATTERY OF NEUROPSYCHOLOGICAL TESTS (BRBNT) IN LITHUANIARamunė Grambaitė, Rūta Sargautytė SummaryMultiple sclerosis (MS) is an inflammatory and neurodegenerative disorder that affects primarily the cerebral white matter, thereby causing both physical and psychological disability. The purpose of this study was to investigate the possible relationship between cognitive function and depression severity in MS patients, as well as sensitivity and specificity characteristics of the BRBNT (The Brief Repeatable Battery of Neuropsychological Tests). We investigated 41 MS patients and 52 healthy people.Forty-one controls were selected from fifty-two healthy subjects and were individually matched with MS subjects for age, gender and education. BRBNT (Rao and Peyser, 1986) was designed for measuring verbal learning, visuospatial learning, sustained attention and concentration, information processing speed and verbal fluency cognitive functions. The B version of the BRBNT was translated and used in our study. Beck Depression Inventory-Second Edition (BDI-II) (Beck, 1996) was used for the evaluation of depression severity.Results of our study confirmed that depression severity was associated with verbal learning: Consistent Long Term Retrieval and the Delayed Recall significantly negatively related to depression severity. The relationship between information processing speed and depression severity was also negative, but not statistically significant. The five individual BRBNT tests separately did not significantly discriminate healthy controls from MS patients; however, when all the five BRBNT tests put together we found 100% sensitivity of and 100% specificity.Our findings lead to the conclusion that neuropsychological testing is important in organizing help strategies for MS patients. BRBNT is a sensitive measure of cognitive function in MS, and may assist with differential diagnosis. Similarly, BRBNT could well be applied to other groups of patients, whose illness results in physical and/or cognitive functional limitations.Keywords: multiple sclerosis, cognitive function, depression severity.

2015 ◽  
Vol 73 (2) ◽  
pp. 90-95 ◽  
Author(s):  
Emine Bilgi ◽  
Hasan Hüseyin Özdemir ◽  
Ayhan Bingol ◽  
Serpil Bulut

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.


2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e14018-e14018
Author(s):  
Alberto Zaniboni ◽  
Federica Andreis ◽  
Marco Ferri ◽  
Maria Mazzocchi ◽  
Fausto Meriggi ◽  
...  

e14018 Background: Chemotherapy improves the survival rate of stage III colon cancer patients. The combination of oxaliplatin, 5-fluorouracil and leucovorin (the FOLFOX4 regimen) has emerged as the standard of care. Cognitive changes and disfunction after cancer chemotherapy are increasingly reported as a disturbing side-effect in cancer survivors. This prospective study evaluates potential alterations in cognitive function in Folfox4-treated patients. Methods: We evaluated 57 consecutive colorectal cancer patients who received adjuvant chemotherapy with FOLFOX4. Patients underwent a complete battery of neuropsychological tests at three different times: before (T0), at the end (T1) and six months after treatment (T2). Changes in neuropsychological test scores at T0, T1 and T2 were compared with a two tail t-test (T1-T0, T2-T1, T2-T0), using the repeated measure ANOVA model. Results: We have analyzed cognitive impairment (Mini Mental State Examination, MMSE), visuo-spatial memory, information processing speed (Trial Making Test-A and Trial Making Test-B), verbal memory (Rey Auditory Verbal Learning Test), emotional distress (Psychological Distress Inventory), anxiety (State and Trait Anxiety Inventory) and depression (Beck Depression Inventory). We found no cognitive impairment in time considered, as we found a median MMSE score of 27,51 ± 1,21 at T0, 27,63 ± 0,65 at T1 and 27,26 ± 1,17 at T2. We noticed some transient variations in tests evaluating verbal memory and in information processing speed performances. The only significative scores modifications were those related to anxiety and depression. Conclusions: We found no significant effect on cognitive function related to chemotherapy, the only little modification is about some emotional performance during chemotherapy. These findings may be explained by the central role of the psychological adaptation process, which occurs during the period from diagnosis to completion of treatment and is characterized by anxiety and adjustment depression. Our results seem to rule out any significant cognitive impairment due to adjuvant Folfox4 chemotherapy in colon cancer patients.


2012 ◽  
Vol 19 (2) ◽  
pp. 173-180 ◽  
Author(s):  
Jonathan D. Rodgers ◽  
Kris Tjaden ◽  
Lynda Feenaughty ◽  
Bianca Weinstock-Guttman ◽  
Ralph H. B. Benedict

AbstractWe examined cognitive predictors of speech and articulation rate in 50 individuals with multiple sclerosis (MS) and 23 healthy controls. We measured speech and articulation rate from audio-recordings of participants reading aloud and talking extemporaneously on a topic of their choice (i.e., self-generated speech). Articulation rate was calculated for each speech sample by removing lexically irrelevant vocalizations and pauses of >200 ms. Speech rate was similarly calculated including pauses. Concurrently, the Minimal Assessment of Cognitive Function in Multiple Sclerosis (MACFIMS) battery, as well as standardized tests of sentence intelligibility and syllable repetition were administered. Analysis of variance showed that MS patients were slower on three of the four rate measures. Greater variance in rate measures was accounted for by cognitive variables for the MS group than controls. An information processing speed composite, as measured by the Symbol Digit Modalities Test (SDMT) and the Paced Auditory Serial Addition Test (PASAT), was the strongest predictor among cognitive tests. A composite of memory tests related to self-generated speech, above and beyond information processing speed, but not to oral reading. Self-generated speech, in this study, was not found to relate more strongly to cognitive tests than simple reading. Implications for further research are discussed. (JINS, 2012, 18, 1–8)


2013 ◽  
Vol 19 (5) ◽  
pp. 613-620 ◽  
Author(s):  
Emily M. Owens ◽  
Douglas R. Denney ◽  
Sharon G. Lynch

AbstractPrevious studies show that MS patients take longer than healthy controls to plan their solutions to Tower of London (TOL) problems but yield conflicting results regarding the quality of their solutions. The present study evaluated performance under untimed or timed conditions to assess the possibility that differences in planning ability only occur when restrictions in solution times are imposed. MS patients (n = 39) and healthy controls (n = 43) completed a computerized version of the TOL under one of two conditions. In the untimed condition, participants were allowed as much time as needed on each problem. In the timed condition, limits were imposed on solution times and time remaining was displayed with each problem. Patients exhibited longer planning times than controls, and the disparity between groups increased with problem difficulty. Planning performance depended upon condition. In the untimed condition, patients and controls performed equally well. When solution times were restricted, however, patients solved fewer problems than controls. MS patients’ planning ability is intact when permitted sufficient time to formulate the required plan. Deficiencies in planning are only evident when time is restricted, and, therefore, are more accurately considered a relative consequence of disease-related problems in information processing speed. (JINS, 2013, 19, 1–8)


Neurology ◽  
2019 ◽  
Vol 93 (8) ◽  
pp. e733-e746 ◽  
Author(s):  
Laura De Giglio ◽  
Francesca De Luca ◽  
Flavia Gurreri ◽  
Ilaria Ferrante ◽  
Luca Prosperini ◽  
...  

ObjectiveTo test a possible benefit of dalfampridine on information processing speed (IPS), a key function for cognitive impairment (CogIm) in multiple sclerosis (MS).MethodsIn this randomized, double-blind, placebo-controlled trial, we included patients with a score on the Symbol Digit Modalities Test (SDMT) under the 10th percentile of the reference value. Patients were randomized in a 2:1 ratio to receive dalfampridine 10 mg or placebo twice daily for 12 weeks. They underwent a comprehensive neuropsychological evaluation at screening (T0), at the end of treatment (T1), and after a 4-week follow-up (T2). The primary endpoint was improvement in SDMT.ResultsOut of 208 patients screened, 120 were randomized to receive either dalfampridine (n = 80) or placebo (n = 40). At T1, the dalfampridine group presented an increase of SDMT scores vs placebo group (mean change 9.9 [95% confidence interval (CI) 8.5–11.4] vs 5.2 [95% CI 2.8–7.6], p = 0.0018; d = 0.60 for raw score; and 0.8 [95% CI 0.6–1] vs 0.3 [95% CI 0.0–0.5], p = 0.0013; d = 0.61 for z scores; by linear mixed model with robust standard error). The improvement was not sustained at T2. A beneficial effect of dalfampridine was observed in the Paced Auditory Serial Addition Test and in cognitive fatigue.ConclusionDalfampridine could be considered as an effective treatment option for IPS impairment in MS.Trial registration2013-002558-64 EU Clinical Trials Register.Classification of evidenceThis study provides Class I evidence that for patients with MS with low scores on the SDMT, dalfampridine improves IPS.


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