scholarly journals Phototest for neurocognitive screening in multiple sclerosis

2016 ◽  
Vol 10 (1) ◽  
pp. 12-18
Author(s):  
Joana Pinto ◽  
Emanuela Lopes ◽  
Gerly Gonçalves ◽  
Ângela Silva ◽  
Carnero-Pardo ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Neurological Disorders ◽  
Area Under The Curve ◽  
Naming Task ◽  
Cognitive Test ◽  
Neurocognitive Impairments ◽  
Disability Status ◽  
Different Types ◽  
Fatigue Severity ◽  
Healthy Participants

Multiple Sclerosis (MS) is one of the most common neurological disorders. Cognitive dysfunction is considered a clinical marker of MS, where approximately half of patients with MS have cognitive impairment. Objective : The Phototest (PT) is a brief cognitive test with high diagnostic sensitivity, accuracy and cost-effectiveness for detecting cognitive deterioration. Our aim was to test the utility of the PT as a neurocognitive screening instrument for MS. Methods : The study enrolled 30 patients with different types of MS from an outpatient clinic as well as 19 healthy participants. In conjunction with the PT, the Montreal Cognitive Assessment (MoCA), Barthel Index (BI), Expanded Disability Status Scale (EDSS), and Fatigue Severity Scale (FSS) were administered. Results : The MS group obtained significantly lower results on all domains of the PT, except for the naming task. The PT showed good concurrent validity with the MoCA. In direct comparison to the MoCA, PT showed a greater area under the curve and higher levels of sensitivity and specificity for MS neurocognitive impairments. A cut-off score of 31 on the Phototest was associated with sensitivity of 100% and specificity of 76.7%. Conclusion : The PT is a valid, specific, sensitive and brief test that is not dependent on motor functions. The instrument could be an option for neurocognitive screening in MS, especially in identifying cases for further neuropsychological assessment and intervention.

scholarly journals Prevalence of fatigue in patients with multiple sclerosis and its effect on the quality of life

2013 ◽  
Vol 04 (03) ◽  
pp. 278-282 ◽  
Author(s):  
Karthik Nagaraj ◽  
Arun B Taly ◽  
Anupam Gupta ◽  
Chandrajit Prasad ◽  
Rita Christopher
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
World Health ◽  
Fatigue Score ◽  
Duration Of Illness ◽  
Disability Status ◽  
Fatigue Severity ◽  
The Mean ◽  
Health Organization

ABSTRACTObjective: This prospective study was carried out to observe the prevalence of fatigue in patients with multiple sclerosis (MS) and its effect on quality-of-life (QoL). Study Design and Setting: Prospective observational study in a University Tertiary Research Hospital in India. Patients and Methods: A total of 31 patients (25 females) with definite MS according to McDonald ′s criteria presented in out-patient/admitted in the Department of Neurology (between February 2010 and December 2011) were included in the study. Disease severity was evaluated using the Kurtzke′s expanded disability status scale (EDSS). Fatigue was assessed using Krupp′s fatigue severity scale (FSS). QoL was assessed by the World Health Organization QoL-BREF questionnaire. Results: The mean age of patients was 30.1 ± 9.1 years. The mean age at first symptom was 25.23 ± 6.4 years. The mean number of relapses was 4.7 ± 3.6 in the patients. The mean duration of illness was 4.9 ± 4.4 years. The mean EDSS score was 3.5 ± 2.2. Mean fatigue score was 38.7 ± 18.5 (cut-off value 36 in FSS). The prevalence of fatigue in patients with MS was 58.1% (18/31). MS patients with fatigue were significantly more impaired (P < 0.05) on all QoL domains (i.e., physical, psychosocial, social, and environment) than MS patients without fatigue. Conclusion: Prevalence of fatigue was found to be high in the MS patients in the study. All four domains of QoL were significantly more impaired in the group with fatigue than in those without fatigue.

scholarly journals Fatigue after a first attack of suspected multiple sclerosis

2017 ◽  
Vol 24 (7) ◽  
pp. 974-981 ◽  
Author(s):  
Roos M van der Vuurst de Vries ◽  
Jan JA van den Dorpel ◽  
Julia Y Mescheriakova ◽  
Tessel F Runia ◽  
Naghmeh Jafari ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Depression Scale ◽  
Common Symptom ◽  
Disability Status ◽  
Definite Multiple Sclerosis ◽  
Fatigue Severity ◽  
Clinically Definite Multiple Sclerosis ◽  
In Cis

Background: Fatigue is reported by more than 75% of multiple sclerosis (MS) patients. In an earlier study, we showed that fatigue is not only a common symptom in patients at time of clinically isolated syndrome (CIS; fatigued 46%) but also predicts subsequent diagnosis of clinically definite multiple sclerosis (CDMS). The course of fatigue after CIS is unknown. Objective: We aimed to explore the long-term course of fatigue after CIS. Methods: In this study, 235 CIS patients, aged 18–50 years, were prospectively followed. Patients filled in the Krupp’s Fatigue Severity Scale (FSS) and the Hospital Anxiety and Depression Scale (HADS) at baseline and annually. After reaching CDMS diagnosis, Expanded Disability Status Scale (EDSS) was obtained annually. Mixed-effects models were used to analyse longitudinal FSS measurements. Results: Fatigue at baseline was an independent predictor for CDMS diagnosis (hazard ratio (HR): 2.6, 95% confidence interval (CI): 1.6–4.4). The evolution of FSS was the same in CIS patients who remained monophasic and patients who were diagnosed with CDMS during follow-up. However, FSS increased by 0.86 units after reaching CDMS diagnosis ( p = 0.01). After this increase, the FSS course remained unaltered ( p = 0.44). Conclusion: Fatigue, which is often present at time of CIS, probably persists over time and increases after a second attack.

Fatigue in multiple sclerosis: multidimensional assessment and response to symptomatic treatment

2004 ◽  
Vol 10 (4) ◽  
pp. 462-468 ◽  
Author(s):  
Alfredo Romani ◽  
Roberto Bergamaschi ◽  
Elisa Candeloro ◽  
Enrico Alfonsi ◽  
Roberto Callieco ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Test Scores ◽  
Rating Scale ◽  
Symptomatic Treatment ◽  
Cognitive Test ◽  
Treatment Groups ◽  
Impact Scale ◽  
Relapsing Remitting ◽  
Fatigue Severity ◽  
Relapsing Remitting Multiple Sclerosis

Sixty relapsing-remitting multiple sclerosis (MS) patients were selected on the basis of their score on the Fatigue Severity Scale (FSS) and formed two groups: 40 patients (fatigued MS; MSf) scored above the 75th percentile of a previously assessed representative MS sample (100 patients), and 20 age- and sex-matched patients (nonfatigued MS patients; MSnf) scored below the 25th percentile. The patients underwent clinical evaluation (Expanded Disability Status Scale (EDSS)), further assessment of fatigue (Fatigue Impact Scale), scales evaluating depression (Hamilton Depression Rating Scale (HDRS) and Beck’s Depression Inventory (BDI)) and neuropsychological tests. All patients were evaluated for muscle fatigability and central activation by means of a biomechanical test of sustained contraction; they also underwent somatosensory evoked potentials (SSEPs) and transcranial magnetic stimulation (TMS). The patients of the MSf subgroup were then randomized to one of the following two treatments: 4-aminopyridine (4-AP) 24 mg/day and fluoxetine (FLX) 20 mg/day. After a one-week titration this treatment proceeded for 8 weeks. At the end of the treatment, EDSS, fatigue and depression scores were further evaluated. At baseline, fatigue test scores consistently correlated with depression and cognitive test scores, but not with the fatigability test. Fatigue scores decreased in both treatment groups in a similar way. Due to the design of the study, this cannot be disjoined from a placebo effect. The changes of fatigue scores could not be predicted in the FLX group, whereas in the 4-AP group higher basal fatigability test scores were associated with greater reduction in fatigue scores.

scholarly journals Fatigue in multiple sclerosis: Associations with clinical, MRI and CSF parameters

2017 ◽  
Vol 24 (8) ◽  
pp. 1115-1125 ◽  
Author(s):  
Viola Biberacher ◽  
Paul Schmidt ◽  
Rebecca C Selter ◽  
Verena Pernpeinter ◽  
Markus C Kowarik ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Validation Cohort ◽  
Brain Structures ◽  
Grey Matter Volume ◽  
Disability Status ◽  
Structural Brain Damage ◽  
Cortical Grey Matter ◽  
Fatigue Severity ◽  
Magnetic Resonance Imaging Mri ◽  
Inflammatory Milieu

Background: Damage of different brain structures has been related to fatigue. Alternatively, functional alterations of central nervous system (CNS) cells by the inflammatory milieu within the CNS may be responsible for the development of fatigue. Aim: To investigate the effect of structural brain damage and inflammatory cerebrospinal fluid (CSF) changes on fatigue in multiple sclerosis (MS). Methods: We determined the association of different clinical, CSF and magnetic resonance imaging (MRI) parameters with prevalence and severity of fatigue, as measured by the Fatigue Scale for Motor and Cognitive Functions in 68 early MS patients (discovery cohort). We validated our findings in two MS cohorts: the MRI validation cohort ( N = 233) for the clinical and MRI parameters, and the CSF validation cohort ( N = 81) for the clinical and CSF parameters. Results: Fatigue was associated with clinical disability. Fatigue did not correlate with any CSF parameter but correlated negatively with total and cortical grey matter volume. However, when controlling for Expanded Disability Status Scale (EDSS) in a multivariate model, these associations lost significance. Conclusion: Disability and disease duration best explain fatigue severity but none of the tested MRI or CSF parameter was reliably associated with fatigue.

scholarly journals Restless Leg Syndrome in Patients with Multiple Sclerosis and its Effect on Frequency of Daytime Sleepiness and Fatigue of the Patients

2016 ◽  
Vol 5 (1) ◽  
pp. 7-12
Author(s):  
Nahid Ashjazadeh ◽  
Zahra Shamszadeh
Keyword(s):  
Multiple Sclerosis ◽  
Daytime Sleepiness ◽  
Study Group ◽  
Expanded Disability Status Scale ◽  
Restless Leg Syndrome ◽  
Severity Scale ◽  
Medical Sciences ◽  
Disability Status ◽  
Fatigue Severity ◽  
Study Participants

Background: Restless leg syndrome (RLS), fatigue and daytime sleepiness are three known co-morbidities in patients with multiple sclerosis (MS). The aim of this study was to evaluate the frequency of RLS in patients with MS and its effect on the frequency of fatigue and daytime sleepiness in these patients. Material and Methods: One hundred twenty patients who referred to the Inpatients Neurology Ward of Chamran hospital, affiliated with the Shiraz University of Medical Sciences, from June 2014 to March 2015, were selected as the study participants. The patients with clinically definite MS, according to the 2010 Revised Mc-Donald criteria, and expanded disability status scale (EDSS) ≤5.5 were included. RLS, fatigue and daytime sleepiness were assessed by the criteria of the International RLS study group (IRLSSG), fatigue severity scale (FSS) and Epworth sleepiness scale (ESS) respectively and the related statistical analyzes were conducted. Results: Seventy eight patients (65%) met all the four IRLSSG criteria, 77 patients (64.1%) suffered from fatigue and only 36 patients (30%) had excessive daytime sleepiness. RLS was not significantly linked to mean age, sex, MS duration, and daytime sleepiness of the studied MS patients, but fatigue was more frequent in MS patients with RLS, which was statistically significant (P=0.018). Conclusion: The main result of this study is that RLS is a common comorbidity in MS and the patients with MS, who also suffer from RLS. They have frequently experienced higher fatigue symptoms than those without RLS. Therefore, the appropriate diagnosis and management of RLS may improve both RLS and fatigue in these patients. [GMJ. 2016;5(1):7-12]

scholarly journals Screening of Cognitive Impairment in Patients with Multiple Sclerosis: A Cross-Sectional Study in Georgia

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Nazibrola Botchorishvili ◽  
Nino Shiukashvili ◽  
Nina Mikeladze ◽  
Ann Dzagnidze ◽  
Nino Mikava ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
Cognitive Assessment ◽  
Negative Impact ◽  
Cognitive Status ◽  
Screening Tools ◽  
Cognitive Test ◽  
Favorable Effect ◽  
Common Symptom ◽  
Disability Status

Cognitive impairment (CI) is a common symptom of multiple sclerosis (MS), with a significant negative impact on the occupational and social functioning of patients. This study aimed to estimate the prevalence and characteristics of CI among MS patients in Georgia. Sixty-eight patients with MS attending a neurology outpatient clinic in Tbilisi, Georgia, were enrolled in the study. Cognitive status was evaluated using two screening tools: the Brief International Cognitive Assessment for MS and the Montreal Cognitive Assessment. The overall prevalence of CI in our MS patients was 47%. We found negative associations between cognitive test results and patients’ age, disability status, and depression. Lower education, higher scores on the Expanded Disability Status Scale, and the progressive course of MS were the main predictors of CI in the logistic regression analysis. This is the first study in Georgia to evaluate CI in patients with MS. The prevalence of CI in our study was comparable with those reported in other countries; however, we found greater impairment of the executive system compared to other cognitive domains. In our study, patients who were on continuous DMT showed significantly better performance on the cognitive tests used, indicating possible favorable effect of immunomodulatory drugs on cognition.

Personality Functioning in Patients with a Progressive Course of Multiple Sclerosis

2010 ◽  
Vol 107 (2) ◽  
pp. 629-646 ◽  
Author(s):  
Rita Lorio ◽  
Giuseppe Moressa ◽  
Francesca Meneghello ◽  
Silvia Salcuni ◽  
Alessandro Zennaro ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Self Esteem ◽  
Control Group ◽  
Rorschach Test ◽  
State Trait Anxiety Inventory ◽  
Personality Functioning ◽  
Self Image ◽  
Disability Status ◽  
Healthy Participants ◽  
Progressive Course

This study intended to describe general personality functioning in patients with a progressive course of multiple sclerosis. 55 consecutive rehabilitation inpatients with progressive course of multiple sclerosis were assessed with a multimethod test battery: the Expanded Disability Status Scale, the Beck Depression Inventory, the State-Trait Anxiety Inventory, the Rosenberg Self-esteem Scale, and the Rorschach Test administered and scored with Comprehensive System. The control group comprised 55 healthy participants with similar sociodemographic characteristics. Specific differences were found for both cognitive and affective aspects, as the patients with progressive course of multiple sclerosis had less positive self-image, less effective mediation processing, and an affective approach to reality. Present data illustrated the usefulness of examining patients with a progressive course of multiple sclerosis to identify abilities and difficulties in cognitive and affective patterns, and support better adaptation to relationships and the environment.

Fatigue in multiple sclerosis and its relationship to depression and neurologic disability

2000 ◽  
Vol 6 (3) ◽  
pp. 181-185 ◽  
Author(s):  
R Bakshi ◽  
Z A Shaikh ◽  
R S Miletich ◽  
D Czarnecki ◽  
J Dmochowski ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Physical Disability ◽  
Depression Severity ◽  
Severity Scale ◽  
Severity Scores ◽  
Disability Status ◽  
Relapsing Remitting ◽  
Neurologic Disability ◽  
Fatigue Severity ◽  
Improve Fatigue

We studied multiple sclerosis fatigue (MSF) and its relationship to depression and disability. Seventy-one patients [50 relapsing-remitting, 21 secondary progressive] were grouped by Fatigue Severity Scale (FSS) into MS-fatigue (MSF) (FSS55; n=46) or MS-nonfatigue (MSNF) (FSS44; n=20). Forty-one patients were grouped into MS-depression (MSD) (n=15) or MS-nondepression (MSND) (n=26) by interview. Higher expanded disability status scale (EDSS) scores were noted in MSF than MSNF patients (P=0.0003); EDSS scores correlated with FSS scores (rho=0.43, P=0.003). However, fatigue was present in 58% (n=29) of relapsing-remitting patients and in 52% (n=26) of patients with mild physical disability (EDSS53.5). Hamilton/Beck depression severity scores were higher in MSF than MSNF patients and correlated with FSS scores (P50.05). MSD had higher FSS scores than MSND patients (P=0.008). After controlling for EDSS, depression severity continued to correlate with FSS scores (rho=0.37, P=0.02). After controlling for depression, FSS scores no longer correlated with EDSS scores (rho=0.27, P=0.09). Thus, MSF is independent of physical disability, but is associated with depression, suggesting that common mechanisms play a role in MSF and MSD including psychological factors or brain lesions in specific neuroanatomic pathways. Further study is warranted to determine if antidepressant medications improve fatigue in MS.

Obstructive sleep apnea is associated with fatigue in multiple sclerosis

2011 ◽  
Vol 18 (8) ◽  
pp. 1159-1169 ◽  
Author(s):  
M Kaminska ◽  
RJ Kimoff ◽  
A Benedetti ◽  
A Robinson ◽  
A Bar-Or ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Apnea Hypopnea Index ◽  
Severe Fatigue ◽  
Obstructive Sleep ◽  
Disability Status ◽  
Fatigue Severity ◽  
Relationship Of ◽  
Multiple Sleep Latency

Background: Multiple sclerosis (MS) patients often suffer from fatigue. Objective: We evaluated the relationship of obstructive sleep apnea (OSA) to fatigue and sleepiness in MS patients. Methods: Ambulatory MS patients without known sleep disorders and healthy controls underwent diagnostic polysomnography and a multiple sleep latency test (objective sleepiness measure). Fatigue was measured with the Fatigue Severity Scale (FSS) and the Multidimensional Fatigue Inventory (MFI), and subjective sleepiness by Epworth Sleepiness Scale. Covariates included age, sex, body mass index, Expanded Disability Status Scale (EDSS), depression, pain, nocturia, restless legs syndrome, and medication. Results: OSA (apnea–hypopnea index ≥15) was found in 36 of 62 MS subjects and 15 of 32 controls. After adjusting for confounders, severe fatigue (FSS ≥5) and MFI-mental fatigue (>group median) were associated with OSA and respiratory-related arousals in MS, but not control subjects. Subjective and objective sleepiness were not related to OSA in either group. In a multivariate model, variables independently associated with severe fatigue in MS were severe OSA [OR 17.33, 95% CI 2.53–199.84], EDSS [OR 1.88, 95% CI 1.21–3.25], and immunomodulating treatment [OR 0.14, 95% CI 0.023–0.65]. Conclusions: OSA was frequent in MS and was associated with fatigue but not sleepiness, independent of MS-related disability and other covariates.

scholarly journals Measuring Gait Stability in People with Multiple Sclerosis Using Different Sensor Locations and Time Scales

Sensors ◽  
2021 ◽  
Vol 21 (12) ◽  
pp. 4001
Author(s):  
Roy Müller ◽  
Lucas Schreff ◽  
Lisa-Eyleen Koch ◽  
Patrick Oschmann ◽  
Daniel Hamacher
Keyword(s):  
Multiple Sclerosis ◽  
Time Scale ◽  
Inertial Sensors ◽  
Foot Kinematics ◽  
Gait Stability ◽  
Trunk Movements ◽  
Disability Status ◽  
Healthy Participants ◽  
Minute Walk ◽  
Sensor Locations

The evaluation of local divergence exponent (LDE) has been proposed as a common gait stability measure in people with multiple sclerosis (PwMS). However, differences in methods of determining LDE may lead to different results. Therefore, the purpose of the current study was to determine the effect of different sensor locations and LDE measures on the sensitivity to discriminate PwMS. To accomplish this, 86 PwMS and 30 healthy participants were instructed to complete a six-minute walk wearing inertial sensors attached to the foot, trunk and lumbar spine. Due to possible fatigue effects, the LDE short (~50% of stride) and very short (~5% of stride) were calculated for the remaining first, middle and last 30 strides. The effect of group (PwMS vs. healthy participants) and time (begin, mid, end) and the effect of Expanded Disability Status Scale (EDSS) and time were assessed with linear random intercepts models. We found that perturbations seem to be better compensated in healthy participants on a longer time scale based on trunk movements and on a shorter time scale (almost instantaneously) according to the foot kinematics. Therefore, we suggest to consider both sensor location and time scale of LDE when calculating local gait stability in PwMS.

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