The relationship between attention impairment and information processing speed in patients with multiple sclerosis

Author(s):  
Karin Zebenholzer
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.


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.


2014 ◽  
Vol 20 (11) ◽  
pp. 1453-1463 ◽  
Author(s):  
Magdalena Wojtowicz ◽  
Erin L Mazerolle ◽  
Virender Bhan ◽  
John D Fisk

Background: Patients with multiple sclerosis (MS) demonstrate slower and more variable performance on attention and information processing speed tasks. Greater variability in cognitive task performance has been shown to be an important predictor of neurologic status and provides a unique measure of cognitive performance in MS patients. Objectives: This study investigated alterations in resting-state functional connectivity associated with within-person performance variability in MS patients. Methods: Relapsing–remitting MS patients and matched healthy controls completed structural MRI and resting-state fMRI (rsfMRI) scans, as well as tests of information processing speed. Performance variability was calculated from reaction time tests of processing speed. rsfMRI connectivity was investigated within regions associated with the default mode network (DMN). Relations between performance variability and functional connectivity in the DMN within MS patients were evaluated. Results: MS patients demonstrated greater reaction time performance variability compared to healthy controls ( p<0.05). For MS patients, more stable performance on a complex processing speed task was associated with greater resting-state connectivity between the ventral medial prefrontal cortex and the frontal pole. Conclusions: Among MS patients, greater functional connectivity between medial prefrontal and frontal pole regions appears to facilitate performance stability on complex speed-dependent information processing tasks.


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