scholarly journals Motor Imagery: A Resource in the Fatigue Rehabilitation for Return-to-Work in Multiple Sclerosis Patients—A Mini Systematic Review

2021 ◽  
Vol 12 ◽  
Author(s):  
Francesco Agostini ◽  
Letizia Pezzi ◽  
Marco Paoloni ◽  
Roberta Insabella ◽  
Carmine Attanasi ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Return To Work ◽  
Motor Imagery ◽  
Cognitive Processing ◽  
Cochrane Collaboration ◽  
Qualitative Synthesis ◽  
Auditory Cues ◽  
Positive Effects ◽  
Internal Stimulus ◽  
Multiple Sclerosis Patients

Fatigue is a multidimensional symptom with both physical and cognitive aspects, which can affect the quality of daily and working life activities. Motor Imagery (MI) represents an important resource for use during the rehabilitation processes, useful, among others, for job integration/reintegration, of neurological pathologies, such as Multiple Sclerosis (MS). To define the effective rehabilitation protocols that integrate MI for the reduction of fatigue in patients with MS (PwMS), a literary review was performed through August 2020. Five articles were included in the qualitative synthesis, including two feasibility pilot randomized control trials (RCTs) and 3 RCTs with good quality according to the PEDro score and a low risk of bias according to the Cochrane Collaboration tool. The literature suggested that MI, in association with rhythmic-auditory cues, may be an effective rehabilitation resource for reducing fatigue. Positive effects were observed on perceived cognitive and psychological fatigue. PwMS require greater compensatory strategies than healthy individuals, and the use of rhythmic-auditory cues may be useful for optimizing the cognitive processing of MI, which acts as an internal stimulus that is enhanced and made more vivid by outside cues. These findings provide evidence that MI is a promising rehabilitation tool for reducing fatigue in PwMS and return to work strategies.

scholarly journals Smartphone-Based Symbol-Digit Modalities Test Reliably Measures Cognitive Function in Multiple Sclerosis Patients

2020 ◽  
Author(s):  
Linh Pham ◽  
Thomas Harris ◽  
Mihael Varosanec ◽  
Peter Kosa ◽  
Bibiana Bielekova
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Processing ◽  
Processing Speed ◽  
Test Performance ◽  
Relevant Information ◽  
Imaging Features ◽  
Speed Test ◽  
Brain Parenchymal Fraction ◽  
Brain Parenchymal ◽  
Multiple Sclerosis Patients

AbstractLimited time for patient encounters prevents reliable evaluation of all neurological functions in routine clinical practice. Quantifying neurological disability in a patient-autonomous manner via smartphones may remedy this problem, if such tests provide reliable, disease-relevant information.We developed a smartphone version of the cognitive processing speed test, the Symbol-Digit Modalities Test (SDMT), and assessed its clinical utility. The traditional SDMT uses identical symbol-number codes, allowing memorization after repeated trials. In the phone app, the symbol-number codes are randomly generated.In 154 multiple sclerosis (MS) patients and 39 healthy volunteers (HV), traditional and smartphone SDMT have good agreement (Lin’s coefficient of concordance [CCC] = 0.84) and comparable test-retest variance. In subjects with available volumetric MRI and digitalized neurological examinations (112 MS, 12 HV), the SDMT scores were highly associated with T2 lesion load and brain parenchymal fraction, when controlled for relevant clinical characteristics. The smartphone SDMT association with clinical/imaging features was stronger (R2 = 0.75, p < 0.0001) than traditional SDMT (R2 = 0.65, p < 0.0001). In the longitudinal subcohort, improvements from testing repetition (learning effects), were identifiable using non-linear regression in 14/16 subjects and, on average, peaked after 8 trials. Averaging several post-learning SDMT results significantly lowers the threshold for detecting true decline in test performance.In conclusion, smartphone, self-administered SDMT is a reliable substitute of the traditional SDMT for measuring processing speed in MS patients. Granular measurements at home increase sensitivity to detect true performance decline in comparison to sporadic assessments in the clinic.

scholarly journals Deficits in Early Sensory and Cognitive Processing Are Related to Phase and Nonphase EEG Activity in Multiple Sclerosis Patients

2021 ◽  
Vol 11 (5) ◽  
pp. 629
Author(s):  
Esteban Sarrias-Arrabal ◽  
Sara Eichau ◽  
Alejandro Galvao-Carmona ◽  
Elvira Dominguez ◽  
Guillermo Izquierdo ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
Cognitive Processing ◽  
Attentional Focus ◽  
Alpha Activity ◽  
Gamma Band ◽  
Strong Activity ◽  
Lower Amplitude ◽  
Multiple Sclerosis Patients ◽  
Visual Oddball

Currently, there is scarce knowledge about the relation between spectral bands modulations and the basis of cognitive impairment in multiple sclerosis (MS). In this sense, analyzing the evoked or phase activity can confirm results from traditional event-related potential (ERP) studies. However, studying the induced or nonphase activity may be necessary to elucidate hidden compensatory or affected cognitive mechanisms. In this study, 30 remitting-relapsing multiple sclerosis patients and 30 healthy controls (HCs) matched in sociodemographic variables performed a visual oddball task. The main goal was to analyze phase and nonphase alpha and gamma bands by applying temporal spectral evolution (TSE) and its potential relation with cognitive impairment in these patients. The behavioural results showed slower reaction time and poorer accuracy in MS patients compared to controls. In contrast, the time-frequency analysis of electroencephalography (EEG) revealed a delay in latency and lower amplitude in MS patients in evoked and induced alpha compared to controls. With respect to the gamma band, there were no differences between the groups. In summary, MS patients showed deficits in early sensorial (evoked alpha activity) and cognitive processing (induced alpha activity in longer latencies), whereas the induced gamma band supported the hypothesis of its role in translation of attentional focus (induced activity) and did not show strong activity in this paradigm (visual oddball).

scholarly journals Assessment of reliability and validity of the mental chronometry task based on the box and block test in multiple sclerosis patients

2021 ◽  
Keyword(s):  
Multiple Sclerosis ◽  
Visual Analogue Scale ◽  
Motor Imagery ◽  
Analogue Scale ◽  
Reliability And Validity ◽  
Retest Reliability ◽  
Mental Chronometry ◽  
Multiple Sclerosis Patients ◽  
Block Test ◽  
Test Retest Reliability

Objectives: Motor imagery (MI) is the visualization of action without its overt performance. One of the measures of explicit MI is mental chronometry which has been applied to multiple sclerosis (MS) patients; nonetheless, the reliability and validity of this tool has been never confirmed. Therefore, the present study aimed to assess the reliability and validity of mental chronometry in MS patients. Methods: A number of 60 MS patients who met the inclusion criteria were included in the present study via the census method. Thereafter, 20 MS patients were tested via mental chronometry based on the box and block test, as well as kinesthetic and visual imagery questionnaire-20 (KVIQ-20) in two sessions with a 10-day interval. Intra-class correlation coefficients (ICCs) were calculated to determine the test-retest reliability of mental chronometry. Pearson’s correlation analysis was used to evaluate criterion validity with the KVIQ-20. Results: The test-retest reliability for the mental chronometry was good (ICCs: visual analogue scale=0.88, mean execution and motor imagery absolute difference= 0.75, imagery duration=0.91, and execution duration=0.97). Moreover, the concurrent validity between the visual analogue scale of mental chronometry and KVIQ-20 was good. Conclusion: As evidenced by the results of the present study, the mental chronometry based on box and block is a reliable and valid tool for the assessment of motor imagery in MS patients.

scholarly journals Altered phase and nonphase EEG activity expose impaired maintenance of a spatial-object attentional focus in multiple sclerosis patients

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
M. Vazquez-Marrufo ◽  
E. Sarrias-Arrabal ◽  
R. Martin-Clemente ◽  
A. Galvao-Carmona ◽  
G. Navarro ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
Cognitive Processing ◽  
Attentional Focus ◽  
Cognitive Mechanisms ◽  
Neural Basis ◽  
Attentional Deficits ◽  
Time Frequency ◽  
General Slowing ◽  
Multiple Sclerosis Patients

AbstractSome of the anatomical and functional basis of cognitive impairment in multiple sclerosis (MS) currently remains unknown. In particular, there is scarce knowledge about modulations in induced EEG (nonphase activity) for diverse frequency bands related to attentional deficits in this pathology. The present study analyzes phase and nonphase alpha and gamma modulations in 26 remitting-relapsing multiple sclerosis patients during their participation in the attention network test compared with twenty-six healthy controls (HCs) matched in sociodemographic variables. Behavioral results showed that the MS group exhibited general slowing, suggesting impairment in alerting and orienting networks, as has been previously described in other studies. Time–frequency analysis of EEG revealed that the gamma band was related to the spatial translation of the attentional focus, and the alpha band seemed to be related to the expectancy mechanisms and cognitive processing of the target. Moreover, phase and nonphase modulations differed in their psychophysiological roles and were affected differently in the MS and HC groups. In summary, nonphase modulations can unveil hidden cognitive mechanisms for phase analysis and complete our knowledge of the neural basis of cognitive impairment in multiple sclerosis pathology.

scholarly journals A Narrative Review on Biopsychosocial Predictors of Cognitive Impairment among Multiple Sclerosis Patients: Directions for Malaysia Studies

2021 ◽  
Vol 19 (01) ◽  
pp. 21-29
Author(s):  
JIA WEARN CHONG ◽  
NORMAH CHE DIN ◽  
PAULINE JOSEPH JOYCE
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
Cognitive Functioning ◽  
Selection Criteria ◽  
Research Evidence ◽  
Narrative Review ◽  
Qualitative Synthesis ◽  
Future Directions ◽  
Course Of Disease ◽  
Multiple Sclerosis Patients

Cognitive impairment is the most disabling symptoms of Multiple Sclerosis (MS). Researchers have been studying factors that could predict cognitive impairment among MS patients hoping to alleviate its consequences and gather indicators of the disease progression. However, there were limited up-to-date articles that review the predictors of cognitive impairment among MS patients. In Malaysia, the topic about cognitive functioning in MS was absent. This review aims to identify and synthesize the research evidence concerning biopsychosocial variables on cognitive impairment among this population for future directions in Malaysia researches. A narrative review was performed by identifying research articles from year 2004 to 2019 through PubMed, EBSCOhost, Scopus and Google Scholar. Full-text articles meeting the selection criteria were included for qualitative synthesis. A total of 12 studies were included. Studies included in this paper found that age, course of disease and anxiety predicts cognitive functioning. Mixed results were found among variables such as gender, disability, fatigue, burden of lesion, depression and educational level. Stress was correlated with cognitive functioning but it was not a significant predictor. Although many factors were found to affect cognitive functioning among MS patients, evidence provided from this review indicates that their relationships might not be linear and direct.

Clinical significance of atrophy and white matter mean diffusivity within the thalamus of multiple sclerosis patients

2013 ◽  
Vol 19 (11) ◽  
pp. 1478-1484 ◽  
Author(s):  
Ralph HB Benedict ◽  
Hanneke E Hulst ◽  
Niels Bergsland ◽  
Menno M Schoonheim ◽  
Michael G Dwyer ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
White Matter ◽  
Cognitive Processing ◽  
Diffusion Tensor ◽  
Mean Diffusivity ◽  
Brain Magnetic Resonance Imaging ◽  
Cognitive Tests ◽  
Explained Variance ◽  
Multiple Sclerosis Patients

Background: Gray-matter (GM) atrophy is strongly predictive of cognitive impairment in multiple sclerosis (MS) patients. The thalamus is the region where the atrophy/cognition correlation is most robust. However, few studies have assessed diffusion tensor imaging (DTI) metrics within the thalamus. Objective: This study was designed to determine if thalamus white matter DTI predicts cognitive impairment after accounting for the effects of volume loss. Methods: We enrolled 75 MS patients and 18 healthy controls undergoing 3T brain magnetic resonance imaging (MRI). Thalamus volumes were calculated on 3D T1 images. Voxelwise analyses of DTI metrics were performed within the thalamic white matter tracts. Neuropsychological (NP) testing, acquired using consensus standard methods, contributed measures of memory, cognitive processing speed and executive function. Results: All cognitive tests were significantly predicted ( R2 =0.31, p<0.001) by thalamus volume after accounting for influence of demographics. Mean diffusivity was retained in regression models predicting all cognitive tests, adding from 7–13% of additional explained variance ( p<0.02) after accounting for thalamus volume. Conclusions: We confirm the significant role of thalamus atrophy in MS-associated cognitive disorder, and further report that subtle thalamus pathology as detected by DTI adds incremental explained variance in predicting cognitive impairment.

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