scholarly journals Pediatric Multiple Sclerosis and Cognition: A Review of Clinical, Neuropsychologic, and Neuroradiologic Features

2017 ◽  
Vol 2017 ◽  
pp. 1-11 ◽  
Author(s):  
Ozgul Ekmekci
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
Social Life ◽  
Cognitive Rehabilitation ◽  
Neuropsychological Test ◽  
Disease Onset ◽  
Long Term Effects ◽  
Cognitive Domains

Multiple sclerosis (MS) is an inflammatory demyelinating and neurodegenerative disease. Although cognitive impairment has been well established in adult patients with MS, its occurrence in patients with pediatric-onset MS has recently been reported. In this review, I discuss the main features of cognitive impairment in pediatric MS as determined by long-term follow-up studies, neuropsychiatric test batteries, and the results of neuroradiological imaging studies that investigated the pathogenesis of pediatric MS. The most commonly affected cognitive domains in adults are attention, processing speed, and visuomotor skills; language and intelligence are also affected in pediatric MS. A young age at disease onset is the strongest risk factor for these impairments, which may be due to the effect of inflammatory demyelination and neurodegeneration on the developing central nervous system and neural networks in children. Cognitive impairment has long-term effects on patients’ academic life and the quality of their social life. Therefore, all patients with pediatric MS should be screened and monitored for cognitive impairment. This review also highlights the need for neuropsychological test batteries that assess different cognitive domains in children and adolescents with multiple sclerosis and for cognitive rehabilitation programs to improve the quality of their academic and social life.

Cognitive impairment in multiple sclerosis – a review of current knowledge and recent research

2017 ◽  
Vol 28 (8) ◽  
Author(s):  
Tomasz Grzegorski ◽  
Jacek Losy
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
Cognitive Rehabilitation ◽  
Current Knowledge ◽  
Cognitive Domains ◽  
Speed Of Information Processing ◽  
Chronic Progressive Disease ◽  
The Central Nervous System ◽  
Scientific Results ◽  
Underlying Mechanisms

AbstractMultiple sclerosis (MS) is a chronic, progressive disease of the central nervous system that is characterised by inflammatory damage to the myelin sheath. Though often neglected, cognitive impairment is a common feature of MS that affects 43–70% of patients. It has a sophisticated neuroanatomic and pathophysiologic background and disturbs such vital cognitive domains as speed of information processing, memory, attention, executive functions and visual perceptual functions. In recent years there has been growing interest in neuroimaging findings with regard to cognitive impairment in MS. The possible options of managing cognitive dysfunction in MS are pharmacologic interventions, cognitive rehabilitation and exercise training; however, not enough evidence has been presented in this field. The aim of our article is to provide current knowledge on cognitive impairment in MS based on the most recent scientific results and conclusions with regard to affected cognitive domains, neuropsychological assessment, underlying mechanisms of this disturbance, neuroimaging findings and therapeutic options.

scholarly journals Short-Term and Long-Term Effects of an Exercise-Based Patient Education Programme in People with Multiple Sclerosis: A Pilot Study

2017 ◽  
Vol 2017 ◽  
pp. 1-13 ◽  
Author(s):  
Christina Lutz ◽  
Stephanie Kersten ◽  
Christian T. Haas
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Patient Education ◽  
Education Programme ◽  
Walking Ability ◽  
Long Term Effects ◽  
Short Term ◽  
Patient Education Programme

Background.Although people with Multiple Sclerosis (pwMS) benefit from physical exercise, they still show reduced physical activity and exercise behaviour. This study aimed to investigate short- and long-term effects of an exercise-based patient education programme (ePEP) that focuses on empowering pwMS to a sustainable and self-regulated exercise training management.Methods.Fourteen pwMS were randomly assigned to immediate experimental group (EG-I:n=8) and waitlist-control group (EG-W:n=6) and attended biweekly in a six-week ePEP. All participants were measured for walking ability, quality of life, fatigue, and self-efficacy towards physical exercise before and after the ePEP, after 12 weeks, and one year after baseline. Short-term effects were analysed in a randomised control trial and long-term effects of all ePEP participants (EG-I + EG-W = EG-all) in a quasi-experimental design.Results.Only functional gait significantly improved in EG-I compared to EG-W (p=0.008,r=-0.67). Moderate to large effects were found in EG-all for walking ability. Not significant, however, relevant changes were detected for quality of life and fatigue. Self-efficacy showed no changes.Conclusion.The ePEP seems to be a feasible option to empower pwMS to a self-regulated and sustainable exercise training management shown in long-term walking improvements.

scholarly journals Computerized Neuropsychological Test Battery CogniSoft for Assessment of Cognition in Patients with Multiple Sclerosis

2020 ◽  
Vol 24 (4) ◽  
pp. 371-380
Author(s):  
Lyudmila Todorova ◽  
◽  
Valentina Ignatova ◽  
Jivko Surchev ◽  
◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Rehabilitation ◽  
Neuropsychological Test ◽  
Neuropsychological Testing ◽  
Poor Quality ◽  
Cognitive Status ◽  
Global Trends ◽  
Significant Difference ◽  
Overall Evaluation

Cognitive dysfunction is a leading cause of disability in multiple sclerosis (MS) and is associated with unemployment, need of assistance with daily activities and poor quality of life. The introduction of neuropsychological testing and monitoring of cognitive status as part of the overall evaluation of MS patients in parallel with clinical and paraclinical parameters is highly recommended. Recent studies have demonstrated a better perception and preference for computerized cognitive tests than classic variants, with no significant difference in results. In accordance with global trends, a bilingual computer system CogniSoft for assessment and rehabilitation of cognitive status in persons with MS has been developed, including: 1) a set of diagnostic tests for evaluation of memory and executive functions based on the nature of Brief International Cognitive Assessment for MS (BICAMS); 2) a set of games for cognitive rehabilitation. Questionnaire for depression (Beck Depression Inventory – BDI-II) will be filled before conduction of the neuropsychological tests for differentiation of possible depression which could interfere with the results. The CogniSoft information system will incorporate two approaches for evaluation of neuropsychological results which will allow early detection of cognitive impairments in these patients, which will initiate timely cognitive rehabilitation.

Cognitive impairment in patients with multiple sclerosis: association with the APOE gene and promoter polymorphisms

2007 ◽  
Vol 13 (1) ◽  
pp. 25-32 ◽  
Author(s):  
B A Parmenter ◽  
D R Denney ◽  
S G Lynch ◽  
L S Middleton ◽  
L M Harlan
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
Physical Disability ◽  
Neuropsychological Test ◽  
Disease Onset ◽  
Apoe Gene ◽  
Promoter Polymorphisms ◽  
Severe Cognitive Impairment ◽  
Ε4 Allele ◽  
Male Patients

Background Studies examining the ε4 allele of the APOE gene as a factor affecting the severity of multiple sclerosis (MS) have yielded conflicting results. The focus of these studies on physical disability to the neglect of cognitive impairment is surprising in light of the associations between the ε4 allele and other dementia conditions. Only two studies examine the relationship between the ε4 allele and cognitive impairment. Methods A neuropsychological test battery was administered to 263 MS patients, and their current disability status was evaluated. Genotypes were determined for APOE epsilon and for two promoter region polymorphisms (-219 G/T and -491 A/T). Results Although effects were generally weak, female patients with the -491 AA genotype had a later age of disease onset, lower disability scores, and somewhat higher scores on the cognitive battery. Male patients with the ε2 allele had lower disability and higher scores on the cognitive battery. The ε4 allele was not related to physical disability, and there was no difference between ε4+and ε4– patients in overall cognitive performance. However, when patients with severe cognitive impairment were identified, a greater proportion (52%) of these patients had the ε4 allele than those in the unimpaired group (27%). Conclusion An association with the ε4 allele was evident in this study, but only in cases of severe cognitive impairment.

scholarly journals Intermittent Fasting and the Possible Benefits in Obesity, Diabetes, and Multiple Sclerosis: A Systematic Review of Randomized Clinical Trials

Nutrients ◽  
2021 ◽  
Vol 13 (9) ◽  
pp. 3179
Author(s):  
María Morales-Suarez-Varela ◽  
Ester Collado Sánchez ◽  
Isabel Peraita-Costa ◽  
Agustín Llopis-Morales ◽  
José M. Soriano
Keyword(s):  
Multiple Sclerosis ◽  
Randomized Clinical Trials ◽  
Intermittent Fasting ◽  
Scientific Quality ◽  
Review Of The Literature ◽  
Long Term Effects ◽  
Beneficial Effects

Intermittent fasting has become popular in recent years and is controversially presented as a possible therapeutic adjunct. A bibliographic review of the literature on intermittent fasting and obesity, diabetes, and multiple sclerosis was carried out. The scientific quality of the methodology and the results obtained were evaluated in pairs. Intermittent fasting has beneficial effects on the lipid profile, and it is associated with weight loss and a modification of the distribution of abdominal fat in people with obesity and type 2 diabetes as well as an improvement in the control of glycemic levels. In patients with multiple sclerosis, the data available are too scarce to draw any firm conclusions, but it does appear that intermittent fasting may be a safe and feasible intervention. However, it is necessary to continue investigating its long-term effects since so far, the studies carried out are small and of short duration.

scholarly journals Cognitive trajectories in multiple sclerosis: a long-term follow-up study

2021 ◽  
Author(s):  
Antonio Carotenuto ◽  
Teresa Costabile ◽  
Giuseppe Pontillo ◽  
Moccia Moccia ◽  
Fabrizia Falco ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
Cognitive Rehabilitation ◽  
Trajectory Analysis ◽  
Disease Onset ◽  
Disease Diagnosis ◽  
Cognitive Status ◽  
Grey Matter Volume ◽  
Disease Course

Abstract Background Cognitive impairment occurs in multiple sclerosis (MS) and undergoes a progressive worsening over disease course. However, clinicians still struggle to predict the course of cognitive function. To evaluate baseline clinical and imaging predictors of cognitive abilities worsening over time, we performed a latent trajectory analysis for cognitive performances in MS patients, up to 15 years from disease onset. Methods We collected age, sex, education, dominant and non-dominant 9-hole peg test (9HP) and timed 25-foot walk (T25-FW) as well as MRI measures (grey matter volume and lesion load) within 6 months from disease diagnosis for relapsing–remitting MS (RR-MS) patients. At diagnosis and over the follow-up, we also assessed cognitive status through the symbol digit modalities test (SDMT). Cognitive impairment was defined by applying age-, gender- and education-adjusted normative values. Group-based trajectory analysis was performed to determine trajectories, and the predictive value of clinical and imaging variables at baseline was assessed through multinomial logistic regression. Results We included 148 RR-MS (98 females and 50 males). Over 11 ± 4 year follow-up, 51.4% remained cognitively stable whereas 48.6% cognitively worsened. Cognitively worsening patients had a higher T25FW time (p = 0.004) and a reduced hippocampal volume at baseline (p = 0.04). Conclusion Physical disability as well as hippocampal atrophy might depict patients at risk of cognitive worsening over the disease course. Therefore, using such predictors, clinicians may select patients to carefully evaluate for cognitive impairment as to eventually introduce cognitive rehabilitation treatments.

ANALYSIS OF THE IMPACT OF MINDFULNESS ON QUALITY OF LIFE IN PATIENTS WITH MULTIPLE SCLEROSIS: SYSTEMATIC REVIEW

2021 ◽  
Vol 9 (06) ◽  
pp. 378-388
Author(s):  
Vitória Mallmann Fedeger ◽  
Erica Pedri ◽  
Rosiane Guetter Mello ◽  
Alexandre Leal Laux
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Systematic Review ◽  
Long Term Effects ◽  
General Quality ◽  
Detailed Assessment ◽  
The Impact ◽  
Brazilian Studies

This study aimed to investigate the impact of the mindfulness-based interventions program on the quality of life of patients with Multiple Sclerosis. A systematic review was carried out based on the PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-Analyzes). For an updated perspective on the topic, the selected articles were published from March 2014 to March 2019. Thus, 10 articles were included in the review and were thoroughly compared. A detailed assessment was carried out to measure the impact of the mindfulness protocol both on the general quality of life and on its specific domains. It can be observed that there is some homogeneity of the results regarding the benefits of the practice of mindfulness in the patients’ general quality of life. Moreover, there was greater evidence of the effects of meditative practice on the psychological domain when compared to the physical domain. Hence, the present study considers the mindfulness program a viable tool to address quality of life in patients with Multiple Sclerosis. The lack of Brazilian studies in the area is highlighted. Also, further studies to evaluate the practice of mindfulness continuously, such as cohort studies, are necessary to elucidate the long-term effects of the protocol. 

scholarly journals Long-term Impact of Adenotonsillectomy on the Quality of Life of Children with Sleep-disordered breathing

2020 ◽  
Author(s):  
Juliana Alves Sousa Caixeta ◽  
Jessica Caixeta Silva Sampaio ◽  
Vanessa Vaz Costa ◽  
Isadora Milhomem Bruno da Silveira ◽  
Carolina Ribeiro Fernandes de Oliveira ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Sleep Disordered Breathing ◽  
Long Term Effects ◽  
Obstructive Sleep ◽  
Long Term Impact ◽  
Disordered Breathing

Abstract Introduction Adenotonsillectomy is the first-line treatment for obstructive sleep apnea secondary to adenotonsillar hypertrophy in children. The physical benefits of this surgery are well known as well as its impact on the quality of life (QoL), mainly according to short-term evaluations. However, the long-term effects of this surgery are still unclear. Objective To evaluate the long-term impact of adenotonsillectomy on the QoL of children with sleep-disordered breathing (SDB). Method This was a prospective non-controlled study. Children between 3 and 13 years of age with symptoms of SDB for whom adenotonsillectomy had been indicated were included. Children with comorbities were excluded. Quality of life was evaluated using the obstructive sleep apnea questionnaire (OSA-18), which was completed prior to, 10 days, 6 months, 12 months and, at least, 18 months after the procedure. For statistical analysis, p-values lower than 0.05 were defined as statistically significant. Results A total of 31 patients were enrolled in the study. The average age was 5.2 years, and 16 patients were male. The OSA-18 scores improved after the procedure in all domains, and this result was maintained until the last evaluation, done 22 ± 3 months after the procedure. Improvement in each domain was not superior to achieved in other domains. No correlation was found between tonsil or adenoid size and OSA-18 scores. Conclusion This is the largest prospective study that evaluated the long-term effects of the surgery on the QoL of children with SDB using the OSA-18. Our results show adenotonsillectomy has a positive impact in children's QoL.

scholarly journals Cognitive Issues in Pediatric Multiple Sclerosis

2021 ◽  
Vol 11 (4) ◽  
pp. 442
Author(s):  
Emilio Portaccio ◽  
Ermelinda De Meo ◽  
Angelo Bellinvia ◽  
Maria Pia Amato
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
Cognitive Decline ◽  
Pediatric Patients ◽  
Leisure Activities ◽  
Disease Onset ◽  
Cognitive Profiles ◽  
Brain Growth ◽  
Network Activation ◽  
Definition Of

Multiple sclerosis (MS) is one of the leading causes of disability in young adults. The onset of MS during developmental age makes pediatric patients particularly susceptible to cognitive impairment, resulting from both disease-related damage and failure of age-expected brain growth. Despite different test batteries and definitions, cognitive impairment has been consistently reported in approximately one-third of pediatric patients with MS. However, the lack of a uniform definition of cognitive impairment and the adoption of different test batteries have led to divergent results in terms of cognitive domains more frequently affected across the cohorts explored. This heterogeneity has hampered large international collaborative studies. Moreover, research aimed at the identification of risk factors (e.g., demographic, clinical, and radiological features) or protective factors (e.g., cognitive reserve, leisure activities) for cognitive decline is still scanty. Mood disorders, such as depression and anxiety, can be detected in these patients alongside cognitive decline or in isolation, and can negatively affect quality of life scores as well as academic performances. By using MRI, cognitive impairment was attributed to damage to specific brain compartments as well as to abnormal network activation patterns. However, multimodal MRI studies are still needed in order to assess the contribution of each MRI metric to cognitive impairment. Importantly, longitudinal studies have recently demonstrated failure of age-expected brain growth and of white matter (WM) and gray matter (GM) maturation plays a relevant role in determining cognitive dysfunction, in addition to MS-related direct damage. Whether these growth retardations might result in specific cognitive profiles according to the age at disease onset has not been studied, yet. A better characterization of cognitive profiles in pediatric MS patients, as well as the definition of neuroanatomical substrates of cognitive impairment and their longitudinal evolution are needed to develop efficient therapeutic strategies against cognitive impairment in this patient population.

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