scholarly journals Performance of Regression-Based Norms for Cognitive Functioning of Persons With Multiple Sclerosis in an Independent Sample

2021 ◽  
Vol 11 ◽  
Author(s):  
Ruth Ann Marrie ◽  
Christiane E. Whitehouse ◽  
Ronak Patel ◽  
Chase R. Figley ◽  
Jennifer Kornelsen ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Relative Efficiency ◽  
Employment Status ◽  
Normative Data ◽  
Healthy Adults ◽  
Cognitive Tests ◽  
Healthy Controls ◽  
Control Groups ◽  
Z Scores ◽  
Healthy Control

Background: Cognitive impairment is common in multiple sclerosis (MS). Interpretation of neuropsychological tests requires the use of normative data. Traditionally, normative data have been reported for discrete categories such as age. More recently continuous norms have been developed using multivariable regression equations that account for multiple demographic factors. Regression-based norms have been developed for use in the Canadian population for tests included in the MACFIMS and BICAMS test batteries. Establishing the generalizability of these norms is essential for application in clinical and research settings.Objectives: We aimed to (i) test the performance of previously published Canadian regression-based norms in an independently collected sample of Canadian healthy controls; (ii) compare the ability of Canadian and non-Canadian regression-based norms to discriminate between healthy controls and persons with MS; and (iii) develop regression-based norms for several cognitive tests drawn from batteries commonly used in MS that incorporated race/ethnicity in addition to age, education, and sex.Methods: We included 93 adults with MS and 96 healthy adults in this study, with a replication sample of 104 (MS) and 39 (healthy adults). Participants reported their sociodemographic characteristics, and each was administered the oral Symbol Digit Modalities Test (SDMT), the California Verbal Learning Test (CVLT-II), and the Brief Visuospatial Memory Test-Revised (BVMT-R). From the healthy control data, we developed regression-based norms incorporating race, age, education and sex. We then applied existing discrete norms and regression-based norms for the cognitive tests to the healthy controls, and generated z-scores which were compared using Spearman rank and concordance coefficients. We also used receiver operating characteristic (ROC) curves to compare the ability of each set of norms to discriminate between participants with and without MS. Within the MS samples we compared the ability of each set of norms to discriminate between differing levels of disability and employment status using relative efficiency.Results: When we applied the published regression norms to our healthy sample, impairment classification rates often differed substantially from expectations (7%), even when the norms were derived from a Canadian (Ontario) population. Most, but not all of the Spearman correlations between z-scores based on different existing published norms for the same cognitive test exceeded 0.90. However, concordance coefficients were often lower. All of the norms for the SDMT reliably discriminated between the MS and healthy control groups. In contrast, none of the norms for the CVLT-II or BVMT-R discriminated between the MS and healthy control groups. Within the MS population, the norms varied in their ability to discriminate between disability levels or employment status; locally developed norms for the SDMT and CVLT-II had the highest relative efficiency.Conclusion: Our findings emphasize the value of local norms when interpreting the results of cognitive tests and demonstrate the need to consider and assess the performance of regression-based norms developed in other populations when applying them to local populations, even when they are from the same country. Our findings also strongly suggest that the development of regression-based norms should involve larger, more diverse samples to ensure broad generalizability.

The Effect of IFN-β Treatment on Plasma Levels of BDNF and IL-6 in Relapsing-Remitting Multiple Sclerosis Patients

2021 ◽  
pp. 1-8
Author(s):  
Mansour Shajarian ◽  
Fereshteh Alsahebfosoul ◽  
Masoud Etemadifar
Keyword(s):  
Multiple Sclerosis ◽  
Plasma Levels ◽  
Case Group ◽  
Healthy Controls ◽  
Control Groups ◽  
Relapsing Remitting ◽  
Healthy Control ◽  
Multiple Sclerosis Patients ◽  
Relapsing Remitting Multiple Sclerosis

<b><i>Background:</i></b> In recent investigations addressing neurodegenerative diseases, especially multiple sclerosis (MS), the roles of brain-derived neurotrophic factor (BDNF) and interleukin-6 (IL-6) have been examined. <b><i>Methods:</i></b> Forty-five relapsing-remitting MS (RRMS) patients, including 32 IFN-β-treated and 13 newly identified untreated cases as well as 45 sex- and age-matched healthy controls, were recruited in the study. Plasma levels of BDNF and IL-6 were assessed using the ELISA method. Data were analyzed by SPSS (ver.21). <b><i>Results:</i></b> There were significant differences between the case and healthy control groups in terms of the plasma levels of BDNF (<i>p</i> value = 0.044) and IL-6 (<i>p</i> value &#x3c;0.001). Besides, the treatment with IFN-β had no significant impact on the level of BDNF or IL-6 in RRMS patients as compared to healthy controls (<i>p</i> value = 0.716 and 0.623 for BDNF and IL-6, respectively). Furthermore, the increase in the plasma levels of BDNF and IL-6 indicated a direct correlation in the case group (<i>r</i> = 0.508, <i>p</i> value = 0.008). In detail, following the classification of the case group into 2 subgroups of IFN-β-treated and untreated patients, a direct positive correlation was observed between the plasma levels of BDNF and IL-6 in IFN-β-treated patients (<i>r</i> = 0.495, <i>p</i> value = 0.026). <b><i>Conclusion:</i></b> The IFN-β treatment seems not to be effective for upregulating BDNF and IL-6 in RRMS patients.

scholarly journals Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS): discrete and regression-based norms for the Brazilian context

2021 ◽  
Author(s):  
Carina Tellaroli Spedo ◽  
Danilo de Assis Pereira ◽  
Seth Edward Frndak ◽  
Vanessa Daccach Marques ◽  
Amilton Antunes Barreira ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Educational Level ◽  
Cognitive Assessment ◽  
Normative Data ◽  
Normative Values ◽  
Healthy Controls ◽  
Test Results ◽  
Regression Analyses ◽  
Gender And Education ◽  
Z Scores

ABSTRACT Background: The Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) has been recently developed as a brief, practical, and feasible tool for cognitive impairment in multiple sclerosis (MS). Objective: This study aimed to provide continuous and discrete normative values for the BICAMS in the Brazilian context. Methods: Normatization was achieved using six hundred and one healthy controls from the community assessed at five Brazilian geopolitical regions. Results: Mean raw scores, T scores, percentiles, and Z scores for each BICAMS measure are provided, stratified by age and educational level. Regression-based norms were provided by converting raw scores to scaled scores, which were regressed on age, gender, and education, yielding equations that can be used to calculate the predicted scores. Regression analyses revealed that age, gender, and education significantly influenced test results, as in previous studies. Conclusions: The normative data of the BICAMS to the Brazilian context presented good representativeness, improving its use in daily clinical practice.

Association between circulating leptin levels and multiple sclerosis: a systematic review and meta-analysis

2018 ◽  
Vol 94 (1111) ◽  
pp. 278-283 ◽  
Author(s):  
Xue-Feng Xie ◽  
Xiao-Hui Huang ◽  
Ai-Zong Shen ◽  
Jun Li ◽  
Ye-Huan Sun
Keyword(s):  
Multiple Sclerosis ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Control Group ◽  
Sample Type ◽  
Healthy Controls ◽  
Eligibility Criteria ◽  
Effect Model ◽  
Healthy Control

AimLeptin, synthesised by adipocytes, has been identified as a hormone that can influence inflammatory activity. Several studies have investigated leptin levels in patients with multiple sclerosis (MS), but the results are not consistent. This study aims to derive a more precise evaluation on the relationship between circulating leptin levels and MS.DesignA comprehensive literature searched up to July 2017 was conducted to evaluate the association of circulating leptin levels and MS. The random-effect model was applied to calculate pooled standardised mean difference (SMD) and its 95% CI.Main outcome measuresCirculating leptin levels of patients with MS and healthy controls.ResultsOf 2155 studies identified, 33 met eligibility criteria and 9 studies with 645 patients with MS and 586 controls were finally included in the meta-analysis. Meta-analysis revealed that, compared with the healthy control group, the MS group had significantly higher plasma/serum leptin levels, with the SMD of 0.70% and 95% CI (0.24 to 1.15). Subgroup analyses suggested that the leptin levels of patients with MS were associated with region, age, study sample size, measurement type, gender and blood sample type.ConclusionOverall, our study suggests that patients with MS have a significantly higher leptin level than in healthy controls. Further mechanism studies and longitudinal large cohort studies are still needed to further reveal the role of leptin in the pathogenesis of MS.

scholarly journals Validation of Discrete and Regression-Based Performance and Cognitive Fatigability Normative Data for the Paced Auditory Serial Addition Test in Multiple Sclerosis

2021 ◽  
Vol 15 ◽  
Author(s):  
Caitlin S. Walker ◽  
Jason A. Berard ◽  
Lisa A. S. Walker
Keyword(s):  
Multiple Sclerosis ◽  
Normative Data ◽  
Cognitive Effort ◽  
Similar Proportion ◽  
Healthy Controls ◽  
Performance Decrement ◽  
Impaired Performance ◽  
Objective Performance ◽  
Serial Addition ◽  
Over Time

Cognitive fatigability is an objective performance decrement that occurs over time during a task requiring sustained cognitive effort. Although cognitive fatigability is a common and debilitating symptom in multiple sclerosis (MS), there is currently no standard for its quantification. The objective of this study was to validate the Paced Auditory Serial Addition Test (PASAT) discrete and regression-based normative data for quantifying performance and cognitive fatigability in an Ontario-based sample of individuals with MS. Healthy controls and individuals with MS completed the 3″ and 2″ versions of the PASAT. PASAT performance was measured with total correct, dyad, and percent dyad scores. Cognitive fatigability scores were calculated by comparing performance on the first half (or third) of the task to the last half (or third). The results revealed that the 3″ PASAT was sufficient to detect impaired performance and cognitive fatigability in individuals with MS given the increased difficulty of the 2″ version. In addition, using halves or thirds for calculating cognitive fatigability scores were equally effective methods for detecting impairment. Finally, both the discrete and regression-based norms classified a similar proportion of individuals with MS as having impaired performance and cognitive fatigability. These newly validated discrete and regression-based PASAT norms provide a new tool for clinicians to document statistically significant cognitive fatigability in their patients.

Relationship of cognitive impairment to psychiatric symptoms in multiple sclerosis

2008 ◽  
Vol 14 (8) ◽  
pp. 1084-1090 ◽  
Author(s):  
N Figved ◽  
R Benedict ◽  
G Klevan ◽  
KM Myhr ◽  
HI Nyland ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Verbal Memory ◽  
Psychiatric Symptoms ◽  
Cognitive Tests ◽  
Cognitive Changes ◽  
Impaired Performance ◽  
Impaired Memory ◽  
Healthy Control ◽  
Relationship Of ◽  
The Relationship

Psychiatric and cognitive changes are common in patients with multiple sclerosis (MS), but their relationship has not received much attention. We studied the relationship between psychiatric symptoms and verbal memory, working memory, and mental speed in 78 patients with MS and 40 healthy control subjects using linear regression analyses. The MS group exhibited impaired performance on all cognitive tests. Apathy was associated with intrusions and depression with impaired memory and mental speed. The association between apathy and intrusions supports the hypothesis that lesions in frontal areas or frontal connections contribute to a specific neuropsychiatric syndrome in patients with MS.

scholarly journals Plasma Metabolomic and Intestinal Microbial Analyses of Patients With Severe Aplastic Anemia

2021 ◽  
Vol 9 ◽  
Author(s):  
Yuanyuan Shao ◽  
Weiwei Qi ◽  
Xiaomei Zhang ◽  
Ningyuan Ran ◽  
Chunyan Liu ◽  
...  
Keyword(s):  
Aplastic Anemia ◽  
Molecular Mechanisms ◽  
Bone Marrow Failure ◽  
Plasma Concentrations ◽  
Severe Aplastic Anemia ◽  
Healthy Controls ◽  
Control Groups ◽  
Metabolic Markers ◽  
Healthy Control ◽  
Metabolomic Study

Aplastic anemia results from bone marrow failure caused by an autoimmune abnormality, but the pathogenesis of severe aplastic anemia (SAA) is not well characterized. To identify potential metabolic markers of SAA and to further elucidate the pathogenetic mechanisms of SAA, we performed a metabolomic study of plasma samples and characterized the intestinal microbiota of patients with SAA and healthy controls. Patients with SAA had more Enterobacteriales and Lactobacillales, but fewer Bacteroidales, Clostridiales, and Erysipelotrichales than healthy controls. At the species level, the abundances of Escherichia coli and others including Clostridium citroniae were higher, whereas those of Prevotella copri, Roseburia faecis, and Ruminococcus bromii were lower. Eight metabolites showed significantly different plasma concentrations in the SAA and healthy control groups. Coumaric acid, L-phenylalanine, and sulfate were present at higher concentrations in the SAA group; whereas L-glutamic γ-semialdehyde, theobromine, 3a, 7a-dihydroxy-5b-cholestane, γ-δ-dioxovaleric acid, and (12Z)-9, 10-dihydroxyoctadec-12-enoic acid were present at lower concentrations. In conclusion, patients with SAA show abnormalities in both their plasma metabolomes and intestinal microbial compositions. These differences might reflect the molecular mechanisms involved in the defective immunity that characterizes SAA.

scholarly journals Implicit and Explicit Mentalizing Deficits in Adolescent Inpatients: Specificity and Incremental Value of Borderline Pathology

2020 ◽  
Vol 34 (Supplement B) ◽  
pp. 64-83
Author(s):  
Francesca Penner ◽  
Veronica McLaren ◽  
Jacob Leavitt ◽  
Omer Faruk Akca ◽  
Carla Sharp
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Borderline Personality ◽  
Healthy Controls ◽  
Control Groups ◽  
Incremental Value ◽  
Healthy Control ◽  
Implicit And Explicit ◽  
Adolescent Inpatients ◽  
Internalizing And Externalizing

Research has demonstrated mentalizing impairment associated with borderline personality disorder (BPD) in adolescents. However, mentalizing performance in adolescents with BPD has never been compared to that of psychiatric control and healthy control adolescents simultaneously. The present study aimed to (a) compare implicit and explicit mentalizing, and hypermentalizing errors in implicit mentalizing, across youth with BPD and psychiatric and healthy controls, and (b) evaluate the association of borderline features with mentalizing deficits over and above internalizing and externalizing. Psychiatric inpatients with BPD (n = 139), inpatient psychiatric controls (n = 310), and healthy adolescents (n = 134) completed two mentalizing tasks, an interview assessing BPD, and measures of psychopathology. Results showed that BPD specificity could be demonstrated only for implicit mentalizing and hypermentalizing. Explicit mentalizing deficits did not differ between BPD and psychiatric control groups. Borderline features had unique associations to implicit mentalizing and hypermentalizing, over and above internalizing and externalizing.

scholarly journals The Prevalence of Demodex folliculorum and Demodex brevis in Cylindrical Dandruff Patients

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Jing Zhong ◽  
Yiwei Tan ◽  
Saiqun Li ◽  
Lulu Peng ◽  
Bowen Wang ◽  
...  
Keyword(s):  
Sample Population ◽  
Healthy Controls ◽  
Control Groups ◽  
Old Patients ◽  
Factors Associated ◽  
Demodex Folliculorum ◽  
Demodex Brevis ◽  
Positive Rate ◽  
Healthy Control ◽  
Eye Examination

Purpose. To compare the prevalence of and factors associated with Demodex brevis and Demodex folliculorum in patients with cylindrical dandruff (CD group) and healthy controls. Methods. Eyelashes were taken from 1680 patients with CD and 1700 healthy controls in China from March 2015 to May 2017. All patients underwent a complete eye examination, and Demodex spp. were counted. The prevalence was analyzed according to age, gender, and clinical features. Results. Mean patient age was 42.93 ± 16.52 (3–88) and 39.4 ± 13.6 (7–81) years old in the CD and healthy control groups, respectively. In the CD and healthy groups, the positive rate for Demodex folliculorum was 27.92% and 8.47%, respectively, while that for Demodex brevis was 31.67% and 6.65%, respectively. In the CD group, the prevalence of Demodex brevis was higher than that of Demodex folliculorum, no matter in the females (33.65% versus 29.01%) or the males (28.54% versus 23.88%) in the CD group. Moreover, the numbers of Demodex folliculorum and Demodex brevis were significantly and positively correlated with age, in both children and old patients (both P<0.001), as well as with the severity of eyelid congestion (all P<0.05). Conclusions. In a large sample population, the prevalence of Demodex brevis and Demodex folliculorum was higher in the CD group than in healthy volunteers. In addition, the severity of eyelid congestion might be exacerbated by the number of Demodex spp., which may therefore provide a good clinical reference and objective guide.

Gait Mechanics Are Different Between Healthy Controls and Patients With Multiple Sclerosis

2013 ◽  
Vol 29 (3) ◽  
pp. 303-311 ◽  
Author(s):  
Jessie M. Huisinga ◽  
Kendra K. Schmid ◽  
Mary L. Filipi ◽  
Nicholas Stergiou
Keyword(s):  
Multiple Sclerosis ◽  
Joint Torque ◽  
Group Differences ◽  
Healthy Controls ◽  
Joint Power ◽  
Joint Torques ◽  
Gait Parameters ◽  
Healthy Control ◽  
Gait Mechanics ◽  
Walking Velocity

Multiple sclerosis (MS) causes severe gait problems in relatively young individuals, yet there have been limited studies to quantitatively identify the specific gait parameters that are affected. The purpose of this study was to define any differences in biomechanical gait parameters between patients with MS and healthy controls. A total of 31 MS patients and 31 healthy controls were evaluated: joint torques and joint powers were calculated at the ankle, knee, and hip during the stance phase of gait. The self-selected walking velocity was used as a covariate in the analysis to ensure that group differences were not due to differences in walking velocity between the MS and healthy control groups. Reduced angular range, less joint torque, and reduced joint power were seen in patients with MS. We also found significant correlations between biomechanical gait parameters and EDSS score, which provides a clinical rating of disease severity. Our findings provide a quantitative assessment of the gait mechanics employed in patients with MS. The altered lower extremity mechanics observed in patients with MS reflect both a neurological and strength deficit compared with healthy controls during walking.

scholarly journals A-021 Normative Data on Montreal Cognitive Assessment Total Scores in Healthy Controls

2020 ◽  
Vol 35 (6) ◽  
pp. 811-811
Author(s):  
Ratcliffe L ◽  
Marker C
Keyword(s):  
Cognitive Assessment ◽  
Normative Data ◽  
Screening Tool ◽  
Geographical Location ◽  
Healthy Adults ◽  
Montreal Cognitive Assessment ◽  
Healthy Controls ◽  
Strongly Correlated ◽  
Cognitive Screening ◽  
Cutoff Scores

Abstract The Montreal Cognitive Assessment (MoCA) is considered to be a suitable, sensitive, and specific cognitive screening tool for detecting mild cognitive impairment. Research has reported variable cutoff scores for the MoCA based upon geographical location. The aim of the present study is to provide normative data in a sample of cognitively healthy adults. Data was collected through the National Alzheimer’s Coordinating Center (NACC). A population of healthy adults (N = 3610) was examined (66% female, 78% Caucasian, 16% African American, 6% Other). MoCA normative data were derived from age and education, which were found to be weakly but significantly associated with age (r = −.203, p = .000) and more strongly correlated with education (r = .402, p = .000). Total scores (M = 26.25, SD = 2.75) were at the suggested cutoff for impairment (&lt; 26). Based on an ANOVA, age had a significant effect on MoCA scores (F (6, 3603) = 25.30, p &lt; .001). A second ANOVA revealed that education also had a significant effect on MoCA scores (F (2, 3582) = 290.56, p &lt; .001). Individuals with higher levels of education obtained higher MoCA scores. Performance was also found to decrease slightly with age. Therefore, clinicians should use caution when applying the recommended cutoff scores.

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