Cognition in older patients with multiple sclerosis compared to patients with amnestic mild cognitive impairment and healthy older adults.

Objective: Progress in the treatment of multiple sclerosis (MS) has resulted in larger numbers of patients living to an advanced age, but little is known about the cognitive status of these individuals. The primary purpose of this study was to identify differences in the cognitive performance between elderly individuals with MS and those with amnestic mild cognitive impairment (aMCI).

Method: Three groups ranging in age from 60 to 80 were compared: patients with MS (n = 64), patients with aMCI (n = 58), and healthy adults (n = 70).

In vivo evidence of oxidative stress in brains of patients with progressive multiple sclerosis.

Background: The oxidative stress hypothesis links neurodegeneration in the later, progressive stages of multiple sclerosis (MS) to the loss of a major brain antioxidant, glutathione (GSH).

Objective: We measured GSH concentrations among major MS subtypes and examined the relationships with other indices of disease status including physical disability and magnetic resonance imaging (MRI) measures.

Methods: GSH mapping was performed on the fronto-parietal region of patients with relapsing-remitting multiple sclerosis (RRMS, n = 21), primary progressive multiple sclerosis (PPMS, n = 20), secondary progressive multiple sclerosis (SPMS, n = 20), and controls ( n = 28) using GSH chemical shift imaging.

Longitudinal changes of cerebral glutathione (GSH) levels associated with the clinical course of disease progression in patients with secondary progressive multiple sclerosis.

Background: Increased oxidative stress leads to loss of glutathione (GSH). We have reported lower cerebral GSH in patients with secondary progressive multiple sclerosis (SPMS), indicating the involvement of oxidative stress in multiple sclerosis (MS) pathophysiology.

Objective: This study expanded upon our earlier work by examining longitudinal changes in cerebral GSH in patients with SPMS in relation to their clinical status.

Information processing speed and attention in multiple sclerosis: Reconsidering the Attention Network Test (ANT).

Objective: The Attention Network Test (ANT) assesses attention in terms of discrepancies between response times to items that differ in the burden they place on some facet of attention. However, simple arithmetic difference scores commonly used to capture these discrepancies fail to provide adequate control for information processing speed, leading to distorted findings when patient and control groups differ markedly in the speed with which they process and respond to stimulus information. This study examined attention networks in patients with multiple sclerosis (MS) using simple difference scores, proportional scores, and residualized scores that control for processing speed through statistical regression.

Incidental learning during rapid information processing on the symbol-digit modalities test.

The Symbol--Digit Modalities Test (SDMT) is widely used to assess processing speed in MS patients. We developed a computerized version of the SDMT (c-SDMT) that scored participants' performance during subintervals over the course of the usual 90-s time period and also added an incidental learning test (c-ILT) to assess how well participants learned the symbol-digit associations while completing the c-SDMT. Patients with MS (n = 65) achieved lower scores than healthy controls (n = 38) on both the c-SDMT and c-ILT, and the scores on the two tests were correlated.

Dairy intake is associated with brain glutathione concentration in older adults.

Background: A reduction in key antioxidants such as glutathione has been noted in brain tissue undergoing oxidative stress in aging and neurodegeneration. To date, no dietary factor has been linked to a higher glutathione concentration. However, in an earlier pilot study, we showed evidence of a positive association between cerebral glutathione and dairy intake.

Procedural Variations in the Stroop and the Symbol Digit Modalities Test: impact on patients with multiple sclerosis.

Decreased information processing speed is often cited as the primary cognitive deficit occurring in conjunction with multiple sclerosis (MS). Two common tools for assessing this deficit are the Stroop Test and the Symbol Digit Modalities Test (SDMT). However, there are procedural variations in these rapid serial processing (RSP) tests pertaining to the response format (e.

Difficulties in planning among patients with multiple sclerosis: a relative consequence of deficits in information processing speed.

Previous 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.

Individual variability in speed of information processing: an index of cognitive impairment in multiple sclerosis.

Objective: The principal cognitive domain impacted by multiple sclerosis (MS) appears to be information processing speed. Studies have documented mean differences between MS patients and healthy controls on numerous measures of information processing speed, but the present study is one of the first to examine individual variability (i.e.

Deficits in planning time but not performance in patients with multiple sclerosis.

Studies of planning ability typically involve some version of the Tower of Hanoi or Tower of London (TOL). When these tests are administered to patients with multiple sclerosis (MS), the findings pertaining to planning "performance" have been conflicting. Possible reasons for failures to find deficits in planning performance among MS patients are: (a) the patients typically have relapsing-remitting MS (RRMS) of mild severity and short duration and thus little cognitive impairment relative to those with more advanced disease; (b) the problems composing the tests are too simple and differences between patients and controls are therefore obscured by ceiling effects; and (c) the scoring system typically used permits participants to earn points for successful solutions on later trials after failing the initial attempt on each problem, thereby further diluting the difference between patients and controls.

Reaction time and rapid serial processing measures of information processing speed in multiple sclerosis: complexity, compounding, and augmentation.

Information processing speed is frequently cited as the primary cognitive domain impacted by multiple sclerosis (MS) and is usually evaluated with reaction time (RT) or rapid serial processing (RSP) measures. The present study compared the efficacy of RT and RSP measures to distinguish between patients with MS (N = 42) and healthy controls (N = 40). The RT measure was patterned after the Computerized Tests of Information Processing and included measures of simple, choice, and semantic RT.

Deficits in processing speed in patients with multiple sclerosis: evidence from explicit and covert measures.

Cognitive slowing in individuals with multiple sclerosis (MS) has been documented by numerous studies employing explicitly timed measures in which speed of responding is an obvious focus of task performance. The present study examined information processing speed in MS patients and controls with a computerized battery of covertly timed as well as explicitly timed measures. The explicit measures were derived from two tests requiring rapid serial processing of visual stimuli, the Stroop Test and a Picture Naming Test.

A multicenter study of the predictors of adherence to self-injected glatiramer acetate for treatment of relapsing-remitting multiple sclerosis.

Treatment with disease-modifying immunomodulators is recommended for patients with relapsing-remitting MS (RRMS). However, continuous adherence to treatment with these injected therapies can be challenging. The main objective was to examine the predictors of adherence to glatiramer acetate using a study model derived from Prochaska's transtheoretical model of change.

Evaluating processing speed in multiple sclerosis: a comparison of two rapid serial processing measures.

Processing speed deficits in patients with multiple sclerosis (MS) are usually assessed with tests requiring rapid serial processing. Two such tests were compared here, the Paced Auditory Serial Addition Test (PASAT) and a computerized version of the Stroop test. The purpose of this study was to examine the concurrent validity of processing speed measures derived from the Stroop test and to relate these measures to disability ratings in a sample of 75 patients with relapsing-remitting MS.

Effect of oral antihistamine on local injection site reactions with self-administered glatiramer acetate.

Patients with multiple sclerosis often use injectable medication such as glatiramer acetate or interferons to treat their disease. Subcutaneous injections may be associated with local injection site reactions (LISRs), which can include itching, pain, swelling, or redness. Although not serious, these side effects are bothersome and can have a negative impact on adherence to the therapeutic regimen, particularly in early phases of treatment.

An fMRI study examining effects of acute D-cycloserine during symptom provocation in spider phobia.

Background: Exposure-based therapy for anxiety disorders is believed to operate on the basis of fear extinction. Studies have shown acute administration of D-cycloserine (DCS) enhances fear extinction in animals and facilitates exposure therapy in humans, but the neural mechanisms are not completely understood. To date, no study has examined neural effects of acute DCS in anxiety-disordered populations.

Cognitive aging in patients with multiple sclerosis: a cross-sectional analysis of speeded processing.

Studies have identified generalized slowing in information processing speed as the primary cognitive deficit in multiple sclerosis (MS). Similar changes are also commonly observed in healthy cognitive aging. The present study is the first to examine the combined impact of aging and disease on the course of cognitive slowing.

The impact of multiple sclerosis on patients' performance on the Stroop Test: processing speed versus interference.

Deficits in multiple sclerosis (MS) patients' performance on the Stroop Test have been attributed to problems with processing speed and selective attention. Data for 248 MS patients and 178 controls on all three trials of the Stroop were combined using various scoring formulas proposed for assessing processing speed, color difficulty, and interference. The greatest differences between patients and controls involved processing speed.

Impact of warm compresses on local injection-site reactions with self-administered glatiramer acetate.

Patients with multiple sclerosis (MS) report a number of adverse events related to immunomodulator injections, including local injection-site reactions (LISRs). Reactions characterized by pain, swelling, redness, or inflammation have been experienced by patients who self-inject glatiramer acetate, interferon beta-1b, or interferon beta-1a. Although these reactions rarely are serious, they can foster negative attitudes about self-injection and undermine a patient's commitment to treatment, especially in the early stages of therapy.

Rapid serial processing in patients with multiple sclerosis: the role of peripheral deficits.

This study compared speed of information processing in patients with relapsing-remitting or secondary progressive multiple sclerosis (MS) and healthy controls using the Stroop Test and a Picture Naming Test (PNT). While both tests evaluated processing speed within a format calling for rapid serial processing of stimulus information, the PNT included trials designed to impose greater verbal-motor and ocular-motor challenges by using novel rather than repeated pictures and by presenting the pictures in distributed locations rather than always centered on the screen. The results confirmed that a decrease in the speed of information processing is a key feature of the cognitive impairment occurring in conjunction with MS.

Omega-3 fatty acids and multiple sclerosis: relationship to depression.

Depression is a common problem among patients with multiple sclerosis (MS). Previous research has shown differences between MS patients and controls in the levels of certain fatty acids, and differences in many of these same fatty acids have also been reported in psychiatric patients with major depression. The current study sought to determine whether fatty acid levels in MS patients might be associated with depression.

A 3-year longitudinal study of cognitive impairment in patients with primary progressive multiple sclerosis: speed matters.

Background: The few controlled longitudinal studies of cognitive performance in MS patients all provide evidence of deterioration in at least a subset of the patients sampled. Only one of these studies has focused on primary progressive MS, and little attention has been paid to the specific domains of cognitive functioning that change over time. The present study examined three principal cognitive domains in samples of primary progressive MS patients and healthy controls followed over a period of 3 years.

Regulation of emotions during experimental stress in alexithymia.

Objective: The aim of this study was to examine whether deficits in emotion regulation manifest as a relative lack of congruence between subjective reports of emotion and autonomic activity when confronted with stressors.

Methods: A pool of 830 university students was screened using the Toronto Alexithymia Scale-Revised for deficits in emotion regulation associated with alexithymia. Those meeting a criterion floor cutoff and other inclusion criteria composed the experimental group and were matched on age, gender, and race to those in the control group.

The relationship between perceived and objective cognitive functioning in multiple sclerosis.

The relationship between perceived cognitive functioning and objective cognitive functioning was studied in 221 patients with multiple sclerosis. Perceptions of global cognitive functioning as well as perceptions of performance on specific cognitive tests were assessed. Patients' perceptions of global cognitive functioning in their daily lives were unrelated to their objective performance on the full cognitive test battery.

The association between cognitive impairment and physical disability in multiple sclerosis.

Background: The association between cognitive impairment and physical disability was examined in a larger, more representative sample of patients with multiple sclerosis (MS) than in previous studies.

Method: Two hundred and fifty-three patients attending an MS clinic were assessed with respect to physical disability using the Expanded Disability Status Scale and cognitive impairment using a battery of neuropsychological tests.

Results: Physical disability correlated with duration of disease; cognitive impairment did not.