scholarly journals Relationship Between Anxiety and Cognition in Multiple Sclerosis

2019 ◽  
Vol 21 (4) ◽  
pp. 151-156 ◽  
Author(s):  
Nicholas A. Vissicchio ◽  
Caroline Altaras ◽  
Amanda Parker ◽  
Shonna Schneider ◽  
Jeffrey G. Portnoy ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Indirect Effect ◽  
Processing Speed ◽  
Neuropsychological Testing ◽  
Verbal Learning ◽  
Information Processing Speed ◽  
Eligibility Criteria ◽  
Mediation Analyses ◽  
Record Review ◽  
Relationship Of

Abstract Background: Anxiety, which is very prevalent in multiple sclerosis (MS) but understudied, has been shown to negatively affect cognition in many different populations. Slowed information processing speed underlies most cognitive impairments in MS, including verbal learning. The aim of this study was to look at how anxiety influences cognition—specifically processing speed and verbal learning—in MS. Methods: Eligibility criteria were adults (≥18 years) who had a diagnosis of clinically definite MS and had participated in neuropsychological research projects. A retrospective medical record review was conducted on the neuropsychological testing data. Two hierarchical multiple regressions were conducted to determine the unique contributions of processing speed and anxiety on verbal learning in MS, after adjusting for demographic and disability variables. Two separate mediation analyses were conducted to determine the relationship between processing speed, verbal learning, and anxiety. Results: Participants (N = 141) ranged in age from 18–91 years. Based on the multiple regression analyses, processing speed (β = 0.55, ΔR2 = 0.27, P < .001) and anxiety (β = −0.34, ΔR2 = 0.11, P < .001) were uniquely significant predictors of verbal learning. Based on the mediation analyses, there was a significant indirect effect of anxiety on verbal learning through processing speed (ab = −0.31, 95% CI = −0.60 to −0.09). There was also a significant indirect effect of processing speed on verbal learning through anxiety (ab = −0.05, 95% CI = 0.01 to 0.12). Conclusions: Results suggest a bidirectional relationship of anxiety and processing speed on verbal learning in MS. Anxiety has a significant effect on cognition and should not be overlooked. Interventions targeting anxiety may improve cognition in MS.

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
Keyword(s):  
Multiple Sclerosis ◽  
Information Processing ◽  
Cognitive Function ◽  
Processing Speed ◽  
Neuropsychological Tests ◽  
Verbal Learning ◽  
Depression Severity ◽  
Information Processing Speed ◽  
Repeatable Battery ◽  
The Relationship

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.

scholarly journals Short Report: Adherence to Neuropsychological Recommendations in Patients with Multiple Sclerosis

2019 ◽  
Vol 21 (2) ◽  
pp. 70-75
Author(s):  
Marnina Stimmel ◽  
Shaina Shagalow ◽  
Elizabeth K. Seng ◽  
Jeffrey G. Portnoy ◽  
Roseann Archetti ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Rehabilitation ◽  
Neuropsychological Testing ◽  
Treatment Recommendations ◽  
Phone Call ◽  
Short Report ◽  
Test Results ◽  
Adherence To Treatment ◽  
Other Information ◽  
Record Review

Abstract Background: Adherence to nonmedication recommendations is typically low, as seen in various health populations. Because literature on adherence to treatment recommendations made after neuropsychological testing in multiple sclerosis (MS) is lacking, this study evaluated adherence and reasons for nonadherence. Relationships between adherence to recommendations and various other factors in patients with MS were also evaluated. Methods: Of 66 adult patients seen for neuropsychological testing at an MS center, 55 were eligible for this study. Forty-five patients (mean age, 43.4 years; 75.6% women) were reached by phone, and all agreed to an interview involving questions regarding adherence to treatment recommendations. Other information was obtained through retrospective medical record review. Results: Overall self-reported adherence to recommendations made from neuropsychological testing was 38%. Adherence rates varied by recommendation type: psychopharmacological management had the highest rate (80%), and referrals for cognitive rehabilitation had the lowest (6.5%). Reasons for nonadherence included needing more information and wanting to speak with one's physician regarding the recommendations. Adherence was associated with patients' ability to spontaneously recall at least some of their recommendations and with receiving both a written report and a phone call with test results. Conclusions: Adherence to recommendations made after neuropsychological testing for patients with MS is low. Points of intervention may be to give directed feedback for each recommendation and to provide both a written report and a phone call with results and recommendations. Asking patients to repeat back the recommendations may be a simple and efficient way to increase understanding and improve adherence.

scholarly journals Speech Discrimination Tasks: A Sensitive Sensory and Cognitive Measure in Early and Mild Multiple Sclerosis

2020 ◽  
Vol 14 ◽  
Author(s):  
Pippa Iva ◽  
Joanne Fielding ◽  
Meaghan Clough ◽  
Owen White ◽  
Branislava Godic ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Speech Intelligibility ◽  
Digit Span ◽  
Neuropsychological Testing ◽  
Verbal Learning ◽  
Ease Of Use ◽  
Clinical Use ◽  
Speech Discrimination ◽  
Cognitive Changes ◽  
Functional Scores

There is a need for reliable and objective measures of early and mild symptomology in multiple sclerosis (MS), as deficits can be subtle and difficult to quantify objectively in patients without overt physical deficits. We hypothesized that a speech-in-noise (SiN) task would be sensitive to demyelinating effects on precise neural timing and diffuse higher-level networks required for speech intelligibility, and therefore be a useful tool for monitoring sensory and cognitive changes in early MS. The objective of this study was to develop a SiN task for clinical use that sensitively monitors disease activity in early (<5 years) and late (>10 years) stages of MS subjects with mild severity [Expanded Disability Status Scale (EDSS) score < 3]. Pre-recorded Bamford-Kowal-Bench sentences and isolated keywords were presented at five signal-to-noise ratios (SNR) in one of two background noises: speech-weighted noise and eight-talker babble. All speech and noise were presented via headphones to controls (n = 38), early MS (n = 23), and late MS (n = 12) who were required to verbally repeat the target speech. MS subjects also completed extensive neuropsychological testing which included: Paced Auditory Serial Addition Test, Digit Span Test, and California Verbal Learning Test. Despite normal hearing thresholds, subjects with early and late mild MS displayed speech discrimination deficits when sentences and words were presented in babble – but not speech-weighted noise. Significant correlations between SiN performance and standardized neuropsychological assessments indicated that MS subjects with lower functional scores also had poorer speech discrimination. Furthermore, a quick 5-min task with words and keywords presented in multi-talker babble at an SNR of −1 dB was 82% accurate in discriminating mildly impaired MS individuals (median EDSS = 0) from healthy controls. Quantifying functional deficits in mild MS will help clinicians to maximize the opportunities to preserve neurological reserve in patients with appropriate therapeutic management, particularly in the earliest stages. Given that physical assessments are not informative in this fully ambulatory cohort, a quick 5-min task with words and keywords presented in multi-talker babble at a single SNR could serve as a complementary test for clinical use due to its ease of use and speed.

Difficulties in Planning Among Patients with Multiple Sclerosis: A Relative Consequence of Deficits in Information Processing Speed

2013 ◽  
Vol 19 (5) ◽  
pp. 613-620 ◽  
Author(s):  
Emily M. Owens ◽  
Douglas R. Denney ◽  
Sharon G. Lynch
Keyword(s):  
Multiple Sclerosis ◽  
Information Processing ◽  
Processing Speed ◽  
Healthy Controls ◽  
Problem Difficulty ◽  
Sufficient Time ◽  
Information Processing Speed ◽  
Tower Of London ◽  
Planning Ability

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)

Effect of dalfampridine on information processing speed impairment in multiple sclerosis

Neurology ◽  
2019 ◽  
Vol 93 (8) ◽  
pp. e733-e746 ◽  
Author(s):  
Laura De Giglio ◽  
Francesca De Luca ◽  
Flavia Gurreri ◽  
Ilaria Ferrante ◽  
Luca Prosperini ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Information Processing ◽  
Processing Speed ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Controlled Trial ◽  
Information Processing Speed ◽  
Effective Treatment Option ◽  
Double Blind ◽  
To Receive

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.

Altered effective connectivity during performance of an information processing speed task in multiple sclerosis

2011 ◽  
Vol 18 (4) ◽  
pp. 409-417 ◽  
Author(s):  
Victoria M Leavitt ◽  
Glenn Wylie ◽  
Helen M Genova ◽  
Nancy D Chiaravalloti ◽  
John DeLuca
Keyword(s):  
Multiple Sclerosis ◽  
Processing Speed ◽  
Effective Connectivity ◽  
A Priori ◽  
Brain Regions ◽  
Healthy Controls ◽  
Causality Analysis ◽  
Information Processing Speed ◽  
Neural Connections ◽  
Speed Task

Background: Functional magnetic resonance imaging (fMRI) studies of persons with multiple sclerosis (MS) reveal distinct patterns of activation during task performance. We were interested in determining whether distinct patterns of effective connectivity would be revealed with Granger causality analysis (GCA). Objective: To characterize directed neural connections in persons with MS during a processing speed task between brain regions known to be activated in healthy controls. Methods: fMRI and GCA were used to examine effective connectivity underlying performance of a processing speed task in persons with MS. In total, 16 individuals with MS and 17 healthy controls (HC) performed a modified version of the Symbol Digit Modality Task (mSDMT) in the MRI scanner. Eight seed regions were selected on the basis of a priori data showing areas involved in mSDMT performance of HC. Results: Behaviorally, the MS group attained a level of accuracy equivalent to the HC group, although they were significantly slower. While there was a great deal of overlap in the connections relied upon by both groups, the MS group showed significant differences in connectivity between critical brain regions. Specifically, the MS group had more connections from multiple regions to frontal cortices bilaterally relative to HCs. Conclusions: Greater neural recruitment by the MS group relative to HC is consistent with the neural efficiency hypothesis, and lends further support to the notion that more connections must be recruited to maintain performance in the presence of brain pathology.

Treatment of Multiple Sclerosis–Related Cognitive Problems With Adjunctive Modafinil

2008 ◽  
Vol 10 (1) ◽  
pp. 1-10 ◽  
Author(s):  
Jeffrey A. Wilken ◽  
Cynthia Sullivan ◽  
Mitchell Wallin ◽  
Catherine Rogers ◽  
Robert L. Kane ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Combination Therapy ◽  
Processing Speed ◽  
Attention Problems ◽  
Adjunctive Treatment ◽  
Information Processing Speed ◽  
Serious Adverse Events ◽  
Cognitive Domains ◽  
Relative Safety ◽  
Neurocognitive Measures

In patients with multiple sclerosis (MS), attention and information-processing-speed impairment contribute to dysfunction in other cognitive domains (learning, memory). Treatment for MS-related attention and processing-speed deficits may have dual benefits: improvement of function in these domains and in overall cognitive efficiency. The objective of this study was to determine whether adjunctive treatment of fatigue with modafinil ameliorates deficits in attention and cognitive domains reliant on attention. Relapsing-remitting MS patients receiving intramuscular interferon beta-1a (IM IFNβ-1a) were screened for attention problems with four well-validated, reliable, standardized neurocognitive measures sensitive to attention impairment. Those scoring at least 1 standard deviation below normative expectations on at least two of the measures were eligible for continued participation. Participants with normal values on all physical screening measures were randomized to one of two groups: continued IM IFNβ-1a alone or plus modafinil. Significant mean group differences were found at 4 months on multiple measures of fatigue and cognitive functioning. Patients on combination therapy reported significantly less fatigue (P <.05) and performed significantly better (P <.05) than those in the monotherapy group on measures tapping simple attention span, working memory, and phonemic verbal fluency. Combination therapy was generally well tolerated. No serious adverse events were reported by patients in either treatment arm. This study was developed as a proof of concept that attention-enhancing medications could be used to address fatigue, cognition, and mood in MS patients. The results demonstrate the need for a larger study to determine relative safety and efficacy.

Sign in / Sign up

Export Citation Format

Share Document