Treatment and management of cognitive dysfunction in patients with multiple sclerosis

DeLuca, John; Chiaravalloti, Nancy D.; Sandroff, Brian M.

doi:10.1038/s41582-020-0355-1

Cited by 141 publications

(126 citation statements)

References 203 publications

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“…The assessment of cognitive functions is becoming a cornerstone in routine clinical care and clinical trials of MS patients [1,3,5]. Especially with regard to the inclusion of cognitive tests in clinical trials, it is essential that the tests are reliable and quickly administrable.…”

Section: Discussionmentioning

confidence: 99%

“…Cognitive dysfunctions are a frequent concomitant of Multiple Sclerosis (MS) with a prevalence of 40 to 70% [1,2]. The assessment of cognitive dysfunctions in MS is therefore central to the characterization and staging of the disease [1,[3][4][5], which leads to the definition of specific MS phenotypes [6]. Several cognitive screening batteries have been developed.…”

Section: Introductionmentioning

confidence: 99%

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On the Reliability of Examining Dual-Tasking Abilities Using a Novel E-Health Device—A Proof of Concept Study in Multiple Sclerosis

Böttrich

Mückschel

Dillenseger

et al. 2020

JCM

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The assessment of neuropsychological functions and especially dual-tasking abilities is considered to be increasingly relevant in the assessment of neurological disease, and Multiple Sclerosis (MS) in particular. However, the assessment of dual-tasking abilities is hindered by specific software requirements and extensive testing times. We designed a novel e-health (progressive web application-based) device for the assessment of dual-tasking abilities usable in “bedside” and outpatient clinic settings and examined its reliability in a sample of N = 184 MS patients in an outpatient setting. Moreover, we examined the relevance of dual-tasking assessment using this device with respect to clinically relevant parameters in MS. We show that a meaningful assessment of dual-tasking is possible within 6 min and that the behavioral readouts overall show good reliability depending on dual-tasking difficulty. We show that dual-tasking readouts were correlated with clinically relevant parameters (e.g., EDSS, disease duration, processing speed) and were not affected by fatigue levels. We consider the tested dual-tasking assessment device suitable for routine clinical neuropsychological assessments of dual-tasking abilities. Future studies may further evaluate this test regarding its suitability in the long-term follow up assessments and to assess dual-tasking abilities in other neurological and psychiatric disorders.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

On the Reliability of Examining Dual-Tasking Abilities Using a Novel E-Health Device—A Proof of Concept Study in Multiple Sclerosis

Böttrich

Mückschel

Dillenseger

et al. 2020

JCM

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show abstract

“…A further problem is that many everyday situations do not only claim a circumscribed executive function but represent a mixture of different processes. For this reason, cognitive testing using common neuropsychological tests often falls short ( 1 , 6 ). Most day-to-day requirements demand several aspects of executive functions simultaneously or in rapid succession.…”

Section: Cognitive–cognitive Dual Tasking Assessment In the Context Omentioning

confidence: 99%

“…Cognitive impairment is prevalent at all phases and all subtypes of multiple sclerosis (MS). It remains one of the major causes of neurological disability in young and middle-aged adults suffering from the disease ( 1 ). The severity and the type of cognitive impairment vary considerably among individuals and can be observed both in early and in later stages.…”

Section: Introductionmentioning

confidence: 99%

“…The SDMT mainly measures perceptual and attentional speed. Although these are central dysfunctions in MS and, of course, relevant for the patients, MS patients also complain about difficulties when being confronted with “multi-tasking” situations (e.g., in job occupation) ( 1 ). Although deficits in these abilities are frequently reported by MS patients, they are not routinely examined, which is a fundamental shortcoming ( 6 ).…”

Section: Introductionmentioning

confidence: 99%

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Why Cognitive–Cognitive Dual-Task Testing Assessment Should Be Implemented in Studies on Multiple Sclerosis and in Regular Clinical Practice

Beste

Ziemssen

2020

Front. Neurol.

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Cognitive impairment is prevalent and disabling in multiple sclerosis (MS) and is severely impacting quality of life (QoL). Aside its routine assessment in clinical care, it should more often be implemented as endpoint/outcome measure in clinical trials. However, a fundamental aspect—often neglected in clinical practice and clinical trials—is the assessment of multi-tasking and dual-tasking abilities. In this perspective article, we outline why, given the nature of MS, particularly the assessment of “cognitive–cognitive dual-tasking” is relevant in MS. We delineate how knowledge from basic cognitive science can inform the assessment of this important cognitive impairment in MS. Finally, we outline how the assessment of “cognitive–cognitive dual-tasking” can be implemented in computer-based screening tools (e-health devices) that can be used not only in clinical diagnostics but also in clinical trials.

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Multiple sclerosis

Pandey¹,

Thomas²

2022

Pathy's Principles and Practice of Geriatric Medicine

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Treatment and management of cognitive dysfunction in patients with multiple sclerosis

Cited by 141 publications

References 203 publications

On the Reliability of Examining Dual-Tasking Abilities Using a Novel E-Health Device—A Proof of Concept Study in Multiple Sclerosis

On the Reliability of Examining Dual-Tasking Abilities Using a Novel E-Health Device—A Proof of Concept Study in Multiple Sclerosis

Why Cognitive–Cognitive Dual-Task Testing Assessment Should Be Implemented in Studies on Multiple Sclerosis and in Regular Clinical Practice

Multiple sclerosis

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