Neuropsychology of multiple sclerosis

Calabrese, Pasquale

doi:10.1007/s00415-006-1103-1

Cited by 121 publications

(97 citation statements)

References 53 publications

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“…Approximately two thirds of patients experience cognitive problems (Rao et al, 1993;Amato, Zipoli, & Portaccio, 2006). These include deficits in memory, attention, and executive functions (Calabrese, 2006;Chiaravalotti & DeLuca, 2008), which cause difficulties in engaging in rehabilitation, maintaining employment, and participating in social activities. A national survey of people with MS found that cognitive problems were perceived to be the most debilitating aspect of MS and a source of distress for those affected and their families and carers (Dorning, Luck, & Holloway, 2012).…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of cognitive rehabilitation for people with multiple sclerosis: a meta-synthesis of patient perspectives

Klein

Drummond

Mhizha-Murira

et al. 2017

Neuropsychological Rehabilitation

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While previous randomised controlled trials and meta-analyses offer only limited evidence for the effectiveness of cognitive rehabilitation, qualitative studies examining patient perspectives report more positive outcomes. This meta-synthesis of qualitative studies examined patient perspectives of cognitive rehabilitation for memory, attention, and executive function problems in people with multiple sclerosis. Using set eligibility criteria, we screened electronic databases, reference lists, and academic networks for

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Section: Introductionmentioning

confidence: 99%

Effectiveness of cognitive rehabilitation for people with multiple sclerosis: a meta-synthesis of patient perspectives

Klein

Drummond

Mhizha-Murira

et al. 2017

Neuropsychological Rehabilitation

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“…Cognitive dysfunction in MS involves several domains including information processing speed, attention, memory and frontal executive functions [7]. This heterogeneity is usually not observed in individuals with CIS, in whom only deficits of information processing speed and working memory have been described [5].…”

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confidence: 99%

Functional magnetic resonance imaging correlates of cognitive performance in patients with a clinically isolated syndrome suggestive of multiple sclerosis at presentation: an activation and connectivity study

et al. 2011

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Abstract:Objective. To assess whether abnormalities on functional magnetic resonance imaging (fMRI) are related to cognitive function in patients at presentation with clinically isolated syndrome (CIS) suggestive of MS. Methods. Eighteen CIS patients and 15 healthy controls (HC) performed an adapted fMRI version of the Paced Auditory Serial http://mc.manuscriptcentral.com/multiple-sclerosis Multiple Sclerosis Journal F o r P e e r R e v i e w Addition Test (PASAT). According to their PASAT performance, CIS patients were divided into two groups: 10 with a low PASAT performance (< 1SD from the mean value of HC) were considered "cognitive impairment" (CI); 8 patients were defined as "cognitively preserved" (CP). Between-group differences in the patterns of brain activations and effective connectivity were assessed. Results. During PASAT, compared to HC, CIS patients showed increased activations of the bilateral inferior parietal lobe (IPL), bilateral precuneus, bilateral middle frontal gyrus (MFG), left anterior cingulate cortex (ACC), left claustrum, right thalamus and right caudate nucleus. When CIS patients were analyzed, the CI group had a more significant activation of the bilateral IPL than HC and CP patients. Compared to CP patients, they also had more significant recruitment of the right superior parietal lobe, right cerebellum, left MFG and left ACC. The analysis of effective connectivity showed stronger connections between several regions of the right hemisphere involved in working memory function in CI patients vs. CP and HC. Conclusions. The observed differences in the patterns of cortical recruitment and connectivity in CI patients during PASAT performance are likely to be adaptive and have a role in limiting cognitive dysfunctions early in the course of MS. Methods. Eighteen CIS patients and 15 healthy controls (HC) performed an adapted fMRI version of the Paced Auditory Serial Addition Test (PASAT). According to their PASAT performance, CIS patients were divided into two groups: 10 with a low PASAT performance (< 1SD from the mean value of HC) were considered "cognitive impairment"(CI); 8 patients were defined as "cognitively preserved" (CP). Between-group differences in the patterns of brain activations and effective connectivity were assessed. Conclusions. The observed differences in the patterns of cortical recruitment and connectivity in CI patients during PASAT performance are likely to be adaptive and have a role in limiting cognitive dysfunctions early in the course of MS.

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“…Information processing speed, verbal memory, cognitive flexibility and executive function are all impaired. 39 The presentation of cognitive deficit in MS is variable. Cognitive function tends not to correlate with other markers of relapse and remission and the syndrome of a rapidly progressive dementia is rare but there is usually a progressive course with more cognitive domains affected, as well as correlation with markers of physical disability and social dysfunction.…”

Section: Cognitive Disordersmentioning

confidence: 99%

Management of neuropsychiatric symptoms in multiple sclerosis

Sommerlad¹,

Price²,

Trip³

2014

Prog Neurol Psychiatry

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M ultiple sclerosis (MS) is the commonest cause of neurological disability in young and middleaged adults. 1 The characteristic pathological features are demyelinating plaques, astrocytic gliosis and immune-mediated inflammation anywhere within the CNS, with the periventricular region, brainstem, juxta cortical region, optic nerves and spinal cord being particularly common targets. The neurological manifestations are diverse, although they usually reflect the function of the affected anatomical site, and the course of the illness is variable and initially difficult to predict with accuracy.In 80-90 per cent of cases, MS is relapsing-remitting in nature with two-thirds of these cases developing a secondary progressive form of the condition a variable number of years after onset and a third having a relapsing-remitting course that does not result in long-term serious disability. The remaining 10-20 per cent of patients have a primary progressive course with gradually worsening symptoms. 2 The prognosis can be poor in the long term but progression is frequently slow; recent evidence suggests a median of 28 years before a stick is required for walking. 3 The UK annual incidence of MS is 10 in 100 000 with a prevalence of 200 in 100 000. 4 There is estimated to be over 100 000 people suffering from the condition in the UK. The median age of onset is 31 years and it is approximately twice as common in women. 5 It has a multifactorial aetiology with genetic and environmental factors shown to be important. There is 31 per cent monozygotic concordance compared to 5 per cent in dizygotic twins 6 while the environmental influence is demonstrated by marked variations in prevalence in genetically homogenous populations. 7 Prevalence increases with increasing distance from the equator and those who emigrate in childhood have prevalence rates consistent with their adopted country. 8 MS commonly presents with weakness, tingling or numbness in the limbs; diplopia, visual loss or impaired visual acuity; vertigo; dysarthria and ataxia; fatigue; and bladder and bowel disturbance. 5 The array of presenting symptoms in MS can lead to diagnostic uncertainty and neuropsychiatric conditions such as somatisation disorder are sometimes suspected. A study demonstrated that 16 per cent of patients with MS had been referred to a psychiatrist between the onset of neurological symptoms and diagnosis of MS. In spite of neurological symptoms being present in the majority of cases, these remained largely overlooked and diagnoses of conversion disorder and hysterical personality disorder were applied, 9 although the increased use of MRI scans since this finding was reported has improved diagnostic accuracy. While neurological features are the most recognised manifestations of MS, psychopathology, including affective, psychotic and cognitive disorders, is also common. The identification of these symptoms is often more difficult and diagnosis can be delayed. Psychiatric symptoms can occur at onset or later in the MS disease process and initial psych...

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Neuropsychology of multiple sclerosis

Cited by 121 publications

References 53 publications

Effectiveness of cognitive rehabilitation for people with multiple sclerosis: a meta-synthesis of patient perspectives

Effectiveness of cognitive rehabilitation for people with multiple sclerosis: a meta-synthesis of patient perspectives

Functional magnetic resonance imaging correlates of cognitive performance in patients with a clinically isolated syndrome suggestive of multiple sclerosis at presentation: an activation and connectivity study

Management of neuropsychiatric symptoms in multiple sclerosis

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