Longitudinal associations between MRI and cognitive changes in very early MS.

Objectives: Cognitive dysfunction in multiple sclerosis (MS) has been primarily examined in patients with advanced disease. Our objective was to study the longitudinal associations between brain magnetic resonance imaging (MRI) metrics and neuropsychological outcomes in patients with early MS.

Methods: Relapsing MS patients within 12 months of onset were enrolled in a neuroprotection trial of riluzole versus placebo with up to 36 months of follow-up.

Magnetic resonance imaging correlates of clinical outcomes in early multiple sclerosis.

Objectives: To study the association between changes in brain magnetic resonance imaging (MRI) and clinical outcomes in early MS.

Methods: MS patients within 12 months of onset were enrolled and followed up to 3 years. Clinical measures included Symbol Digit Modalities Test (SDMT), MS Functional Composite (MSFC) and low contrast letter acuity (LCLA).

Cardiovascular disease and cognitive dysfunction in systemic lupus erythematosus.

Objective: Cognitive dysfunction and cardiovascular disease are common and debilitating manifestations of systemic lupus erythematosus (SLE). In this study, we evaluated the relationship between cardiovascular events, traditional cardiovascular risk factors, and SLE-specific risk factors as predictors of cognitive dysfunction in a large cohort of participants with SLE.

Methods: Subjects included 694 participants from the Lupus Outcomes Study (LOS), a longitudinal study of SLE outcomes based on an annual telephone survey querying demographic and clinical variables.

Validity of brief screening tools for cognitive impairment in rheumatoid arthritis and systemic lupus erythematosus.

Objective: To determine the validity of standardized screening assessments of cognitive functioning to detect neuropsychological impairment evaluated using a comprehensive battery in systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA).

Methods: This is a cross-sectional study using a combined cohort of 139 persons with SLE and 82 persons with RA. Screening cut points were empirically derived using receiver operating characteristic curves and threshold selection methods.

Cardiovascular and disease-related predictors of depression in systemic lupus erythematosus.

Objective: Depression and cardiovascular disease are common and debilitating comorbidities associated with systemic lupus erythematosus (SLE). In this study, history of cardiovascular events, cardiovascular risk factors, and SLE disease-related factors were evaluated as longitudinal predictors of depression in a large cohort of patients with SLE.

Methods: Data were derived from 663 adult participants in the 2004-2008 Lupus Outcomes Study, who were followed for up to 5 annual interviews.

Cognitive functioning in multiple sclerosis.

In this article, the nature and course of cognitive dysfunction in MS are reviewed, particularly in the context of recent advances in our understanding of the diffuse nature of neuropathology in MS, and in the context of specific factors that may confer risk or protection for the development of cognitive impairment. In addition, assessment and screening approaches of MS-related cognitive dysfunction are discussed. MS is a condition not only restricted to the adult population, and this article includes a brief description of cognition in pediatric-onset MS.

Using the Center for Epidemiologic Studies Depression Scale to screen for depression in systemic lupus erythematosus.

Objective: Identifying persons with systemic lupus erythematosus (SLE) at risk for depression would facilitate the identification and treatment of an important comorbidity conferring additional risk for poor outcomes. The purpose of this study was to determine the utility of a brief screening measure, the Center for Epidemiologic Studies Depression Scale (CES-D), in detecting mood disorders in persons with SLE.

Methods: This cross-sectional study examined 150 persons with SLE.

COPD and cognitive impairment: the role of hypoxemia and oxygen therapy.

Background: several studies have shown an association between chronic obstructive pulmonary disease (COPD) and cognitive impairment. These studies have been limited by methodological issues such as diagnostic uncertainty, cross-sectional design, small sample size, or lack of appropriate referent group. This study aimed to elucidate the association between COPD and the risk of cognitive impairment compared to referent subjects without COPD.

Health-related quality of life is reduced in pediatric multiple sclerosis.

The health-related quality of life of children with multiple sclerosis was compared with that of healthy children and of those with other neurologic diseases. The Pediatric Quality of Life Inventory Version 4.0 was administered to children with multiple sclerosis and clinically isolated syndrome and their parents (proxy reporters) at the University of California, San Francisco (UCSF), Regional Pediatric Multiple Sclerosis Center.

Provision of preventive health care in systemic lupus erythematosus: data from a large observational cohort study.

Introduction: Cancer and infections are leading causes of mortality in systemic lupus erythematosus (SLE) after diseases of the circulatory system, and therefore preventing these complications is important. In this study, we examined two categories of preventive services in SLE: cancer surveillance (cervical, breast, and colon) and immunizations (influenza and pneumococcal). We compared the receipt of these services in SLE to the general population, and identified subgroups of patients who were less likely to receive these services.

Screening for depression in chronic obstructive pulmonary disease.

Depression and chronic obstructive pulmonary disease (COPD) are major causes of disability. Identifying COPD patients at risk for depression would facilitate the alleviation of an important comorbidity conferring additional risk for poor outcomes. The purpose of this study was to determine the utility of a brief screening measure, the 15-item Geriatric Depression Scale (GDS-15), in detecting the mood disorders in persons with COPD.

The impact of disability on depression among individuals with COPD.

Background: Both disability and depression are common in COPD, but limited information is available on the time-ordered relationship between increases in disability and depression onset.

Methods: Subjects were members of a longitudinal cohort with self-reported physician-diagnosed COPD, emphysema, or chronic bronchitis. Data were collected through three annual structured telephone interviews (T1, T2, and T3).

Relationships among anxiety, depression, and executive functioning in multiple sclerosis.

Anxiety is a common psychiatric symptom among patients with multiple sclerosis (MS), however compared to depression it is relatively under-studied. The relative contribution of anxiety and depression to cognitive functioning was evaluated among 77 persons with MS. Participants completed the Chicago Multiscale Depression Inventory, the State-Trait Anxiety Inventory, and neuropsychological measures of executive functioning.

Depression, medication adherence, and service utilization in systemic lupus erythematosus.

Objective: Forgetting to take medications is an important cause of nonadherence. This study evaluated factors associated with forgetting to take medications in a large cohort of persons with systemic lupus erythematosus (SLE) participating in the University of California, San Francisco Lupus Outcomes Study (LOS). Relationships among adherence problems and service utilization (outpatient visits, emergency department visits, and hospitalizations) were also evaluated.

Employment in multiple sclerosis. Exiting and re-entering the work force.

Multiple sclerosis (MS) is associated with significant economic burden and high rates of unemployment. This investigation evaluated patient and disease characteristics associated with work loss and work initiation using the NARCOMS patient registry. Patient and disease characteristics associated with transitions to unemployment or employment were evaluated cross-sectionally and prospectively over the course of two assessment periods (mean interval of 1.

The role of neighborhood and individual socioeconomic status in outcomes of systemic lupus erythematosus.

Objective: To determine if neighborhood socioeconomic status (SES) is independently related to physical and mental health outcomes in systemic lupus erythematosus (SLE).

Methods: Data derived from the first 3 waves of the Lupus Outcomes Study, a telephone survey of 957 patients with confirmed SLE diagnoses, recruited from clinical and non-clinical sources. Residential addresses were geocoded to U.

Cognitive predictors of response to treatment for depression in multiple sclerosis.

Cognitive impairment, particularly in the domain of executive functioning, has been demonstrated to predict poorer antidepressant medication treatment response. In this investigation, neuropsychological functioning was evaluated as a predictor of depression treatment response among 59 patients with multiple sclerosis. Performance on a Stroop task accounted for 28.