Journal of neurology, neurosurgery, and psychiatry, Jan 26, 2017
To investigate global and lobular cerebellar volumetries in patients with progressive multiple sc... more To investigate global and lobular cerebellar volumetries in patients with progressive multiple sclerosis (MS), testing the contribution of cerebellar lobular atrophy to both motor and cognitive performances. Eighty-two patients with progressive MS and 46 healthy controls (HC) were enrolled in this cross-sectional study. Clinical evaluation included motor and cognitive testing: Expanded Disability Status Scale, cerebellar Functional System score, Timed 25-Foot Walk Test, 9-Hole Peg Test (9-HPT), Symbol Digit Modalities Test (SDMT), Brief Visuospatial Memory Test-Revised (BVMT) and California Verbal Learning Test II (CVLT). Cerebellar volumes were automatically obtained using the Spatially Unbiased Infratentorial Toolbox. A hierarchical multiple linear regression analysis was performed to assess the relationship between MRI variables of supratentorial and cerebellar damage (grey matter fraction, T2 lesion volume, metrics of cerebellar atrophy and cerebellar lesion volume) and motor/co...
Introduction: Friedreich’s Ataxia (FRDA) is an autosomal recessive disease presenting with ataxia... more Introduction: Friedreich’s Ataxia (FRDA) is an autosomal recessive disease presenting with ataxia, corticospinal signs, peripheral neuropathy, and cardiac abnormalities. Little effort has been made to understand the psychological and emotional burden of the disease. The aim of our study was to measure patients’ ability to recognize emotions using visual and non-verbal auditory hints, and to correlate this ability with psychological, neuropsychological, and neurological variables. Methods: We included 20 patients with FRDA, and 20 age, sex, and education matched healthy controls (HC). We measured emotion recognition using the Geneva Emotion Recognition Test (GERT). Neuropsychological status was assessed measuring memory, executive functions, and prosopoagnosia. Psychological tests were: Patient Health Questionnaire-9 (PHQ-9), State Trait Anxiety Inventory–state/-trait (STAI-S/-T), Structured Clinical Interview for DSM Disorders II. Results: FRDA patients scored worse at the global assessment and showed impaired immediate visuospatial memory and executive functions. Patients presented lower STAI-S scores, and similar scores at the STAI-T, and PHQ-9 as compared to HC. Three patients were identified with personality disorders. Emotion recognition was impaired in FRDA with 29% reduction at the total GERT score (95% CI -44.8%, -12.6%; p<0.001; Cohen’s d=1.2). Variables associated with poor GERT scores were the 10/36 spatial recall test, the Ray Auditory Verbal Learning Test, the Montreal Cognitive Assessment, and the STAI-T (R2=0.906; p<0.001). Conclusions: FRDA patients have impaired emotion recognition that may be secondary to neuropsychological impairment. Depression and anxiety were not higher in FRDA as compared to HC and should not be considered as part of the disease.
Dissociative Identity Disorder (DID) is a psychiatric illness, presenting with two or more person... more Dissociative Identity Disorder (DID) is a psychiatric illness, presenting with two or more personalities in the same patient, causing an alteration in the sense of self, with amnesia for events of life and personal information
Objective: Despite cognitive tests have been validated in Multiple Sclerosis (MS), a neuropsycho... more Objective: Despite cognitive tests have been validated in Multiple Sclerosis (MS), a neuropsychological evaluation is not implemented in the Expanded Disability Status Scale (EDSS) scoring. Methods: We used the Brief International Cognitive Assessment for MS (BICAMS) and orientation tests (OTs) to measure the Cognitive Functional System (CFS) score, and to evaluate its impact on the EDSS. We compared EDSS calculated as usual (Native-EDSS) and after the use of the BICAMS and OT (NPS-EDSS). Results: We tested 604 MS patients with BICAMS, OTs, and EDSS. 384 patients (63.6%) had at least one altered test at the BICAMS. Older age, lower education, higher native- EDSS, and male gender, were independently associated with at least one impaired BICAMS test. Native-EDSS was different from NPS-EDSS (-0.112;p<0.001) in 99 patients (16%). When considering patients with a Native-EDSS ≤4.0, the proportion of miscalculated EDSS was 25%. Conclusions: The use of brief neuropsychological tests leads to a more accurate CFS assessment in two-thirds of MS patients, and a more accurate EDSS calculation in 25% of patients with a score ≤4.0. This may help clinicians to better recognize cognitive impairment in everyday clinical practice, especially in the case of isolated cognitive worsening.
Introduction. Despiteneurologicalpatientsshowfrequentphysicalimpairment,timed neuropsychological ... more Introduction. Despiteneurologicalpatientsshowfrequentphysicalimpairment,timed neuropsychological tests do not take this into account during scoring procedures. Objective. We propose a normalization method based on the PATA Rate Task (PRT) and on the nine-hole pegboard test (9HPT) as a measure of dysarthria and upper limb dysfunction. Methods. We tested 65 healthy controls on timed neuropsychological tests (Attentional Matrices [AM], Trail Making Test, Symbol Digit Modalities Test, Verbal Fluencies) to determine the time spent on phonation or on hand movement during test execution. We developed correction formulas to normalize test times considering the patient’s PRT/9HPT, their normality limits, and the test timing. We tested the method on 24 patients with Friedreich Ataxia (FRDA), as a model of motor and speech impairment. Results. In healthy controls, phonation or hand movement is 13.5–61.7% of total test time. In FRDA patients, the effect of normalization improved all test results (range: 0.51– 48.4%;p < .001).FRDApatientshadworstscoresinalltestswhencomparedtocontrols, and the difference remained significant after correction except for the AM. At the individual level, the normalization method improved equivalent scores with fever patients showing impaired scores after correction. Conclusions. We propose an innovative normalization method to reduce the impact of neurological disability on timed neuropsychological tests. This could be easily integrated in a clinical setting, as it requires a simple preliminary test with the PRT and 9HPT.
Journal of neurology, neurosurgery, and psychiatry, Jan 26, 2017
To investigate global and lobular cerebellar volumetries in patients with progressive multiple sc... more To investigate global and lobular cerebellar volumetries in patients with progressive multiple sclerosis (MS), testing the contribution of cerebellar lobular atrophy to both motor and cognitive performances. Eighty-two patients with progressive MS and 46 healthy controls (HC) were enrolled in this cross-sectional study. Clinical evaluation included motor and cognitive testing: Expanded Disability Status Scale, cerebellar Functional System score, Timed 25-Foot Walk Test, 9-Hole Peg Test (9-HPT), Symbol Digit Modalities Test (SDMT), Brief Visuospatial Memory Test-Revised (BVMT) and California Verbal Learning Test II (CVLT). Cerebellar volumes were automatically obtained using the Spatially Unbiased Infratentorial Toolbox. A hierarchical multiple linear regression analysis was performed to assess the relationship between MRI variables of supratentorial and cerebellar damage (grey matter fraction, T2 lesion volume, metrics of cerebellar atrophy and cerebellar lesion volume) and motor/co...
Introduction: Friedreich’s Ataxia (FRDA) is an autosomal recessive disease presenting with ataxia... more Introduction: Friedreich’s Ataxia (FRDA) is an autosomal recessive disease presenting with ataxia, corticospinal signs, peripheral neuropathy, and cardiac abnormalities. Little effort has been made to understand the psychological and emotional burden of the disease. The aim of our study was to measure patients’ ability to recognize emotions using visual and non-verbal auditory hints, and to correlate this ability with psychological, neuropsychological, and neurological variables. Methods: We included 20 patients with FRDA, and 20 age, sex, and education matched healthy controls (HC). We measured emotion recognition using the Geneva Emotion Recognition Test (GERT). Neuropsychological status was assessed measuring memory, executive functions, and prosopoagnosia. Psychological tests were: Patient Health Questionnaire-9 (PHQ-9), State Trait Anxiety Inventory–state/-trait (STAI-S/-T), Structured Clinical Interview for DSM Disorders II. Results: FRDA patients scored worse at the global assessment and showed impaired immediate visuospatial memory and executive functions. Patients presented lower STAI-S scores, and similar scores at the STAI-T, and PHQ-9 as compared to HC. Three patients were identified with personality disorders. Emotion recognition was impaired in FRDA with 29% reduction at the total GERT score (95% CI -44.8%, -12.6%; p<0.001; Cohen’s d=1.2). Variables associated with poor GERT scores were the 10/36 spatial recall test, the Ray Auditory Verbal Learning Test, the Montreal Cognitive Assessment, and the STAI-T (R2=0.906; p<0.001). Conclusions: FRDA patients have impaired emotion recognition that may be secondary to neuropsychological impairment. Depression and anxiety were not higher in FRDA as compared to HC and should not be considered as part of the disease.
Dissociative Identity Disorder (DID) is a psychiatric illness, presenting with two or more person... more Dissociative Identity Disorder (DID) is a psychiatric illness, presenting with two or more personalities in the same patient, causing an alteration in the sense of self, with amnesia for events of life and personal information
Objective: Despite cognitive tests have been validated in Multiple Sclerosis (MS), a neuropsycho... more Objective: Despite cognitive tests have been validated in Multiple Sclerosis (MS), a neuropsychological evaluation is not implemented in the Expanded Disability Status Scale (EDSS) scoring. Methods: We used the Brief International Cognitive Assessment for MS (BICAMS) and orientation tests (OTs) to measure the Cognitive Functional System (CFS) score, and to evaluate its impact on the EDSS. We compared EDSS calculated as usual (Native-EDSS) and after the use of the BICAMS and OT (NPS-EDSS). Results: We tested 604 MS patients with BICAMS, OTs, and EDSS. 384 patients (63.6%) had at least one altered test at the BICAMS. Older age, lower education, higher native- EDSS, and male gender, were independently associated with at least one impaired BICAMS test. Native-EDSS was different from NPS-EDSS (-0.112;p<0.001) in 99 patients (16%). When considering patients with a Native-EDSS ≤4.0, the proportion of miscalculated EDSS was 25%. Conclusions: The use of brief neuropsychological tests leads to a more accurate CFS assessment in two-thirds of MS patients, and a more accurate EDSS calculation in 25% of patients with a score ≤4.0. This may help clinicians to better recognize cognitive impairment in everyday clinical practice, especially in the case of isolated cognitive worsening.
Introduction. Despiteneurologicalpatientsshowfrequentphysicalimpairment,timed neuropsychological ... more Introduction. Despiteneurologicalpatientsshowfrequentphysicalimpairment,timed neuropsychological tests do not take this into account during scoring procedures. Objective. We propose a normalization method based on the PATA Rate Task (PRT) and on the nine-hole pegboard test (9HPT) as a measure of dysarthria and upper limb dysfunction. Methods. We tested 65 healthy controls on timed neuropsychological tests (Attentional Matrices [AM], Trail Making Test, Symbol Digit Modalities Test, Verbal Fluencies) to determine the time spent on phonation or on hand movement during test execution. We developed correction formulas to normalize test times considering the patient’s PRT/9HPT, their normality limits, and the test timing. We tested the method on 24 patients with Friedreich Ataxia (FRDA), as a model of motor and speech impairment. Results. In healthy controls, phonation or hand movement is 13.5–61.7% of total test time. In FRDA patients, the effect of normalization improved all test results (range: 0.51– 48.4%;p < .001).FRDApatientshadworstscoresinalltestswhencomparedtocontrols, and the difference remained significant after correction except for the AM. At the individual level, the normalization method improved equivalent scores with fever patients showing impaired scores after correction. Conclusions. We propose an innovative normalization method to reduce the impact of neurological disability on timed neuropsychological tests. This could be easily integrated in a clinical setting, as it requires a simple preliminary test with the PRT and 9HPT.
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Methods: We included 20 patients with FRDA, and 20 age, sex, and education matched healthy controls (HC). We measured emotion recognition using the Geneva Emotion Recognition Test (GERT). Neuropsychological status was assessed measuring memory, executive functions, and prosopoagnosia. Psychological tests were: Patient Health Questionnaire-9 (PHQ-9), State Trait Anxiety Inventory–state/-trait (STAI-S/-T), Structured Clinical Interview for DSM Disorders II.
Results: FRDA patients scored worse at the global assessment and showed impaired immediate visuospatial memory and executive functions. Patients presented lower STAI-S scores, and similar scores at the STAI-T, and PHQ-9 as compared to HC. Three patients were identified with personality disorders. Emotion recognition was impaired in FRDA with 29% reduction at the total GERT score (95% CI -44.8%, -12.6%; p<0.001; Cohen’s d=1.2). Variables associated with poor GERT scores were the 10/36 spatial recall test, the Ray Auditory Verbal Learning Test, the Montreal Cognitive Assessment, and the STAI-T (R2=0.906; p<0.001).
Conclusions: FRDA patients have impaired emotion recognition that may be secondary to neuropsychological impairment. Depression and anxiety were not higher in FRDA as compared to HC and should not be considered as part of the disease.
Methods: We used the Brief International Cognitive Assessment for MS (BICAMS) and orientation tests (OTs) to measure the Cognitive Functional System (CFS) score, and to evaluate its impact on the EDSS. We compared EDSS calculated as usual (Native-EDSS) and after the use of the BICAMS and OT (NPS-EDSS).
Results: We tested 604 MS patients with BICAMS, OTs, and EDSS. 384 patients (63.6%) had at least one altered test at the BICAMS. Older age, lower education, higher native- EDSS, and male gender, were independently associated with at least one impaired BICAMS test. Native-EDSS was different from NPS-EDSS (-0.112;p<0.001) in 99 patients (16%). When considering patients with a Native-EDSS ≤4.0, the proportion of miscalculated EDSS was 25%.
Conclusions: The use of brief neuropsychological tests leads to a more accurate CFS assessment in two-thirds of MS patients, and a more accurate EDSS calculation in 25% of patients with a score ≤4.0. This may help clinicians to better recognize cognitive impairment in everyday clinical practice, especially in the case of isolated cognitive worsening.
Objective. We propose a normalization method based on the PATA Rate Task (PRT) and on the nine-hole pegboard test (9HPT) as a measure of dysarthria and upper limb dysfunction.
Methods. We tested 65 healthy controls on timed neuropsychological tests (Attentional Matrices [AM], Trail Making Test, Symbol Digit Modalities Test, Verbal Fluencies) to determine the time spent on phonation or on hand movement during test execution. We developed correction formulas to normalize test times considering the patient’s PRT/9HPT, their normality limits, and the test timing. We tested the method on 24 patients with Friedreich Ataxia (FRDA), as a model of motor and speech impairment.
Results. In healthy controls, phonation or hand movement is 13.5–61.7% of total test time. In FRDA patients, the effect of normalization improved all test results (range: 0.51– 48.4%;p < .001).FRDApatientshadworstscoresinalltestswhencomparedtocontrols, and the difference remained significant after correction except for the AM. At the individual level, the normalization method improved equivalent scores with fever patients showing impaired scores after correction.
Conclusions. We propose an innovative normalization method to reduce the impact of neurological disability on timed neuropsychological tests. This could be easily integrated in a clinical setting, as it requires a simple preliminary test with the PRT and 9HPT.
Methods: We included 20 patients with FRDA, and 20 age, sex, and education matched healthy controls (HC). We measured emotion recognition using the Geneva Emotion Recognition Test (GERT). Neuropsychological status was assessed measuring memory, executive functions, and prosopoagnosia. Psychological tests were: Patient Health Questionnaire-9 (PHQ-9), State Trait Anxiety Inventory–state/-trait (STAI-S/-T), Structured Clinical Interview for DSM Disorders II.
Results: FRDA patients scored worse at the global assessment and showed impaired immediate visuospatial memory and executive functions. Patients presented lower STAI-S scores, and similar scores at the STAI-T, and PHQ-9 as compared to HC. Three patients were identified with personality disorders. Emotion recognition was impaired in FRDA with 29% reduction at the total GERT score (95% CI -44.8%, -12.6%; p<0.001; Cohen’s d=1.2). Variables associated with poor GERT scores were the 10/36 spatial recall test, the Ray Auditory Verbal Learning Test, the Montreal Cognitive Assessment, and the STAI-T (R2=0.906; p<0.001).
Conclusions: FRDA patients have impaired emotion recognition that may be secondary to neuropsychological impairment. Depression and anxiety were not higher in FRDA as compared to HC and should not be considered as part of the disease.
Methods: We used the Brief International Cognitive Assessment for MS (BICAMS) and orientation tests (OTs) to measure the Cognitive Functional System (CFS) score, and to evaluate its impact on the EDSS. We compared EDSS calculated as usual (Native-EDSS) and after the use of the BICAMS and OT (NPS-EDSS).
Results: We tested 604 MS patients with BICAMS, OTs, and EDSS. 384 patients (63.6%) had at least one altered test at the BICAMS. Older age, lower education, higher native- EDSS, and male gender, were independently associated with at least one impaired BICAMS test. Native-EDSS was different from NPS-EDSS (-0.112;p<0.001) in 99 patients (16%). When considering patients with a Native-EDSS ≤4.0, the proportion of miscalculated EDSS was 25%.
Conclusions: The use of brief neuropsychological tests leads to a more accurate CFS assessment in two-thirds of MS patients, and a more accurate EDSS calculation in 25% of patients with a score ≤4.0. This may help clinicians to better recognize cognitive impairment in everyday clinical practice, especially in the case of isolated cognitive worsening.
Objective. We propose a normalization method based on the PATA Rate Task (PRT) and on the nine-hole pegboard test (9HPT) as a measure of dysarthria and upper limb dysfunction.
Methods. We tested 65 healthy controls on timed neuropsychological tests (Attentional Matrices [AM], Trail Making Test, Symbol Digit Modalities Test, Verbal Fluencies) to determine the time spent on phonation or on hand movement during test execution. We developed correction formulas to normalize test times considering the patient’s PRT/9HPT, their normality limits, and the test timing. We tested the method on 24 patients with Friedreich Ataxia (FRDA), as a model of motor and speech impairment.
Results. In healthy controls, phonation or hand movement is 13.5–61.7% of total test time. In FRDA patients, the effect of normalization improved all test results (range: 0.51– 48.4%;p < .001).FRDApatientshadworstscoresinalltestswhencomparedtocontrols, and the difference remained significant after correction except for the AM. At the individual level, the normalization method improved equivalent scores with fever patients showing impaired scores after correction.
Conclusions. We propose an innovative normalization method to reduce the impact of neurological disability on timed neuropsychological tests. This could be easily integrated in a clinical setting, as it requires a simple preliminary test with the PRT and 9HPT.