Multiple Sclerosis (MS) is associated with MRI signal alteration and neuropsychological (NP) dysfunction. Screening tools have been developed to identify patients at high risk for these neurological complications of MS. One such measure, the Multiple Sclerosis Neuropsychological Screening Questionnaire (MSNQ), has well-established reliability and predictive validity. In this article, we report on the accumulated findings derived from 162 consecutive research participants and MS clinic attendees. Our data show significant correlation between both patient- and informant-report MSNQ and NP impairment. As shown previously, larger, and more significant correlations are found between informant-report MSNQs than with patient-report MSNQs. In addition, we find that the MSNQ predicts follow-up NP testing 51 weeks after baseline with a similar degree of association. Finally, the MSNQ is correlated with MRI measures of whole-brain lesion burden and atrophy, secondary progressive course, and vocational disability. We conclude that the MSNQ is reliable and valid for detecting neuropsychological and neuropsychiatric complications of MS.
"The prevalence of depression in MS is reported to range from 16% to 46% and depression is considered to be more frequent in MS than in other chronic neurological diseases, with a higher risk of suicide [6–8]. Cognitive impairment is present in 40% to 65% of MS patients at any stage of the disease [9, 10] and mainly affects long-term episodic and working memory, executive functions, information processing speed, and attention. Verbal episodic memory impairment and memory complaint are common in the early stage of the disease. "
[Show abstract][Hide abstract] ABSTRACT: and Purpose
. Fatigue and memory impairment are common symptoms in multiple sclerosis (MS) and both may interact with cognition. This can contribute to making a complaint misrepresentative of the objective disorder. We sought to determine whether fatigue complaint in MS reflects memory impairment and investigated whether patients’ subjective fatigue is associated with memory complaint.
. Fifty MS patients complaining of fatigue underwent subjective assessment of fatigue and memory complaint measured using self-assessment scales. Cognitive functions were assessed using a battery of neuropsychological tests, including a test of verbal episodic memory, the selective reminding test (SRT). Correlations were studied between subjective fatigue, memory complaint, and performance in verbal episodic memory.
. Depression score, psychotropic and/or antiepileptic drug use, Expanded Disability Status Scale (EDSS) score, and MS form were confounding factors. After adjusting for these confounding factors, neither fatigue complaint nor memory complaint was correlated with SRT performance. Subjective fatigue was significantly associated with memory complaint.
. Although complaint of fatigue in MS was correlated with memory complaint, subjective fatigue was not the expression of memory impairment.
[Show abstract][Hide abstract] ABSTRACT: Neuropsychological impairment is common in MS but routine evaluation is cumbersome. Many proposed avenues to more cost effective evaluation of cognition in MS have appeared in the literature. In this article, we summarize work conducted at our center over the past five years involving two specific evaluation methods, the Multiple Sclerosis Neuropsychological Screening Questionnaire (MSNQ) designed to screen for neuropsychological impairment in MS and the Minimal Assessment of Cognitive Function in MS (MACFIMS) designed to quantify cognitive function with psychometric testing. Our research shows that these methods are reliable and valid. Data show strong relationships with neuropsychiatric features of the disease, brain imaging and vocational outcomes. Work with new non-conventional brain imaging techniques and finer analysis of reliability during serial testing protocols is underway.
[Show abstract][Hide abstract] ABSTRACT: The primary goal of this study was to investigate associations between regional gray matter (GM) atrophy and neuropsychological function in multiple sclerosis (MS), while accounting for the influence of central brain atrophy (i.e. third ventricle enlargement). Using a cross-sectional design, we studied 59 MS patients with brain MRI and neuropsychological testing. Regional gray matter fractions (rGMFs) were calculated from MRI images for 11 homologous brain areas using the semiautomatic brain region extraction (SABRE) technique. Neuropsychological testing followed consensus panel guidelines and included tests emphasizing episodic memory, working memory and processing speed. The analytic approach was stepwise linear regression, with forward selection and p<0.05 threshold for significance. Consistent with previous research, there were significant correlations between third ventricle width and neuropsychological tests. Stepwise linear regression analyses controlling for third ventricle width retained rGMFs obtained from specific regions within the prefrontal cortex. Left frontal atrophy was associated with tests emphasizing auditory/verbal memory. Right frontal atrophy was associated with impairment in visual episodic and working memory. For the first time, we show an independent relationship between cortical atrophy and cognitive impairment after accounting for the effects of central atrophy.
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