Orienting reaction habituation in chronic alcoholics

A polygraphic study on resistance to habituation of the somatic (EMG), autonomic (finger plethysmogram, galvanic skin reaction, respiration) and EEG (acoustic-evoked potential and EEG-blocking reaction) components of the orienting reaction elicited by a repetitive auditory stimulus was performed in 67 chronic alcoholics and in 70 matched normal subjects (control group). The study showed a significantly lower resistance to habituation of the orienting reaction in alcoholics than in normal control subjects. The severity of this habituation disturbance depended on the patients’ age, type of alcoholism, alcohol consumption intensity and chronicity, as well as the type of resting EEG.     

Hypothesis testing in patients with chronic progressive multiple sclerosis

Patients with chronic progressive MS (N = 38) were compared with an age and education matched medical control group (N = 19) on a visual discrimination task designed to evaluate hypothesis testing and focusing behavior. Thirty-three MS patients (85%) and all control patients were able to formulate and use hypotheses, but MS patients were less likely to employ strategies leading to a correct solution. Furthermore, MS patients were more likely to perseverate with one strategy despite negative verbal feedback. Five MS patients were unable to formulate hypotheses. These findings suggest that MS patients have impaired cognitive functioning in addition to previously reported problems with memory.     

Loneliness in cancer and multiple sclerosis patients

Loneliness is a universal social phenomenon often producing debilitating effects on many aspects of human functioning. The present study compared the qualitative aspects of loneliness in two terminally ill samples to that of a more healthy sample. 329 multiple sclerosis and 315 cancer patients, as well as 391 nonrandom healthy participants answered a 30-item questionnaire on loneliness. Analysis indicated the experience of loneliness which characterizes multiple sclerosis and cancer patients differs from that of the more healthy group.     

Neuropsychology of mildly disabled patients with relapsing-remitting multiple sclerosis

Previous papers have mainly demonstrated the presence of cognitive impairment in patients with multiple sclerosis (MS), these changes have been traditionally associated with the later stages of the disease. In the current study, a comprehensive neuropsychological battery was administered to 216 relapsing-remitting MS patients with mild clinical disability (EDSS相似文献   

Personality functioning in patients with a progressive course of multiple sclerosis

This study intended to describe general personality functioning in patients with a progressive course of multiple sclerosis. 55 consecutive rehabilitation inpatients with progressive course of multiple sclerosis were assessed with a multimethod test battery: the Expanded Disability Status Scale, the Beck Depression Inventory, the State-Trait Anxiety Inventory, the Rosenberg Self-esteem Scale, and the Rorschach Test administered and scored with Comprehensive System. The control group comprised 55 healthy participants with similar sociodemographic characteristics. Specific differences were found for both cognitive and affective aspects, as the patients with progressive course of multiple sclerosis had less positive self-image, less effective mediation processing, and an affective approach to reality. Present data illustrated the usefulness of examining patients with a progressive course of multiple sclerosis to identify abilities and difficulties in cognitive and affective patterns, and support better adaptation to relationships and the environment.     

Electromyographic studies of the blink reflex in patients with multiple sclerosis

The latencies of two components of the blink reflex in 90 patients with multiple sclerosis have been compared with these of 30 healthy subjects. Early response R1 was absent in 33,33% of the patients and was with prolonged latency in 41,11%. The late ipsilateral response was absent in 20,00% of the patients and in 32,22% was with prolonged latency. The late contralateral response was absent in 25,55% of the patients and was with prolonged latency in 40,00%. The latencies of all components of the reflex may be prolonged in patients with no clinical brain-stem signs as well.     

Experiences with psychosocial management of patients with multiple sclerosis in a discussion group

Patients with multiple sclerosis must come to terms with their unpredictable chronic disease. Frequently, they want to establish contacts and exchange information with others sharing the same problems. Discussion groups of outpatients offer many opportunities to further the process of coping with the disease as an interlocking web of defensive and coping patterns. The patients can learn from each other to assess their disabilities and capabilities more realistically and to deal more openly with their fears, hopes and disappointments.     

Frontal lobe dysfunction and memory impairment in patients with chronic progressive multiple sclerosis

Deficits in semantic encoding have been described in patients with frontal lobe disease who also show memory impairments. As a group, patients with multiple sclerosis (MS) exhibit memory impairment, fail to make effective use of semantic encoding to aid memory, and perform poorly on verbal fluency and concept formation tests which are sensitive to frontal lobe damage. In the present study the semantic encoding capacity of MS patients was measured using a modification of Wicken's release from proactive interference (PI) paradigm. Individual patients varied considerably in the severity of their impairments on verbal fluency, verbal recognition memory and on Wisconsin Card Sorting Task, but even patients who evidenced both memory impairment and signs of frontal lobe dysfunction showed normal release from PI after a categorical shift. Memory disturbances in MS are unlikely to result from an incapacity for semantic encoding, which seems preserved in MS, but may arise instead from deficits in processing information rapidly.     

Upper limb movement analysis during gait in multiple sclerosis patients

PurposeGait disorders in multiple sclerosis (MS) are well studied; however, no previous study has described upper limb movements during gait. However, upper limb movements have an important role during locomotion and can be altered in MS patients due to direct MS lesions or mechanisms of compensation. The aim of this study was to describe the arm movements during gait in a population of MS patients with low disability compared with a healthy control group.MethodsIn this observational study we analyzed the arm movements during gait in 52 outpatients (mean age: 39.7 ± 9.6 years, female: 40%) with relapsing-remitting MS with low disability (mean EDSS: 2 ± 1) and 25 healthy age-matched controls using a 3-dimension gait analysis.ResultsMS patients walked slower, with increased mean elbow flexion and decreased amplitude of elbow flexion (ROM) compared to the control group, whereas shoulder and hand movements were similar to controls. These differences were not explained by age or disability.ConclusionUpper limb alterations in movement during gait in MS patients with low disability can be characterized by an increase in mean elbow flexion and a decrease in amplitude (ROM) for elbow flexion/extension. This upper limb movement pattern should be considered as a new component of gait disorders in MS and may reflect subtle motor deficits or the use of compensatory mechanisms.     

Dissociating perceptual and conceptual implicit memory in multiple sclerosis patients

Previous studies indicate that Multiple Sclerosis (MS) patients exhibit deficits in tests of explicit memory such as free recall, but show normal priming on implicit tests of memory such as word stem completion. However, the memory performance of patients with different MS disease subtypes has not been fully examined. In the current study, memory was assessed in Primary Progressive (PPMS), Relapsing Remitting (RRMS), and Secondary Progressive (SPMS) MS subgroups. Explicit memory as well as perceptual and conceptual implicit memory were examined using free recall, word fragment completion, and exemplar generation tests, respectively. All three groups of MS patients exhibited free recall deficits and normal priming on the exemplar generation test. However, the PPMS group exhibited a deficit in word fragment completion priming, whereas the RRMS and SPMS groups exhibited normal levels of priming on this task. Lesion load was assessed using magnetic resonance imaging and was negatively correlated with explicit memory performance, but it did not account for the observed deficits in perceptual implicit memory. The results indicate that PPMS patients exhibit a pattern of memory impairment that is distinct from that of the RRMS and SPMS groups. Moreover, the results indicate that perceptual implicit memory can be neurologically dissociated from conceptual implicit memory.     

Early signs of memory impairment among multiple sclerosis patients with clinically isolated syndrome

The study investigates primary and secondary verbal memory and motor/executive functions (response inhibition and strategy shifting ability) in multiple sclerosis (MS) patients with clinically isolated syndrome (CIS). We studied 44 CIS patients and compared them to 49 patients with relapsing remitting MS (RR-MS) displaying mild disability and to a large cohort of age- and education level-matched healthy volunteers(n=230). Results showed that both CIS and RR-MS patients evidenced a disproportionate impairment in the immediate and delayed recall of the second (as compared to the first) of two short narratives of the Logical Memory WMS-III subtest, and reduced performance on the Memory for Digits-Forward. Performance of either group on the executive tasks was not impaired, showing evidence of a reversed speed-accuracy trade-off. Illness duration emerged as a significant predictor of memory and executive task performance. Clinical, psychoemotional, and brain imaging findings were also examined as potential correlates of memory deficits and disease progression among CIS patients. These findings may signify early-onset decline of specific cognitive functions in CIS, which merits regular follow-up assessments and monitoring of psychoemotional adaptation and everyday functioning.     

Epileptic seizures in multiple sclerosis

Starting from informations in the literature, the authors deals with eight own cases, suffering from clinically certain multiple sclerosis and showing, as a further sign, epileptic seizures. Compared to the total of patients, these eight cases represent 1.78 p.c. of all patients treated for multiple sclerosis in this clinic. The features of seizures, frequency and dynamics of occurrence are referred to. The authors point out that it is necessary to differential between epileptic seizures and non-epileptic attacks, and they draw attention to the fact that here are difficulties with regard to differential diagnosis if epileptic seizure appears as a initial symptom of multiple sclerosis.     

Orienting reaction,organizing for action,and emotional processes

In the first half of the sixties, general notions were formulated concerning the functional role of the orienting reaction (OR) in adaptive activity, its elicitation and habituation. These notions included the following: a) The OR is elicited only by significant changes in a situation. This implies that OR elicitation is preceded by brain processes (usually unconscious) pertaining to the evaluation of the significance of changes according to an existing hierarchy of motivations, attitudes, and goals. Therefore, the OR is of an active (vs. reactive) nature, i.e., is inevitably determined by internal factors of brain activity. b) The OR is not a unitary reaction, but a complex polyfunctional activity, different aspects of which are reflected in different OR components which can be modified rather independently. c) The OR represents the processes of organizing new (non-standard) actions: sensory, motor, or intellectual. OR habituation is a manifestation of attenuation of the active control of an action, and an increase in its automation. Thus, the emphasis in understanding the OR has shifted from a predominantly “sensualistic” platform to a predominantly “actualistic” one. In recent experiments, the role of emotional processes in the elicitation and habituation of components of the OR has been analyzed. Complex relations between the GSR and anxiety were found in a study of patients with acute alcohol withdrawal syndrome treated with different psychopharmacological agents. The study of auditory evoked potential habituation in depressive patients has shown the emotional state influence on sensory aspects of the OR with the participation of the OR brain mechanisms in perceptual defense. The possible significance of some new ideas from the field of non-linear dynamics for perspectives on future investigations of the OR are discussed.     

Using the Short Form-36 with multiple sclerosis patients in five countries: a cross-cultural comparison

Questionnaires measuring health-related quality of life are increasingly used in international studies of medical effectiveness. It is important to know if data from these instruments are comparable across countries. We initiated a collaboration among five research groups--from the USA, The Netherlands, Belgium, France, and the UK--in the field of health-related quality of life in multiple sclerosis. All groups used the 36-item Short Form Health Survey. The goal of our study was to make a cross-cultural comparison. In the five countries under study the sample size varied from 50 to 134 patients with multiple sclerosis. The survey was completed by a total of 457 patients, who were heterogeneous in relation to age, duration of illness, severity and type of multiple sclerosis. There appeared to be major differences among the samples in scores on each of the eight scales. These findings may be influenced by differences in method of recruitment, demographic and disease-related characteristics, administration, and cultural factors. After having performed a number of analyses, it appeared that the differences were mainly attributable to sampling effects; however, cultural influences could not be excluded.     

Phagocytic reactivity of granulocytes in the peripheral blood of patients with multiple sclerosis and normal probands

For estimation of phagocytic activity the uptake by granulocytes of heat-inactivated, opsonised yeast particles (Saccharomyces cerevisiae) was measured. Peripheral granulocytes of multiple sclerosis patients revealed an enhanced ability for phagocytosis in comparison to normal healthy controls, if tested with normal serum as opsonic source. An activated state of cells in multiple sclerosis is supposed. The selective influence on granulocyte phagocytosis of treatment by ultraviolet-irradiated blood in multiple sclerosis patients supports the view of altered reactivity of these cells in comparison to normal controls.     

Functional cerebral changes in multiple sclerosis patients during an autobiographical memory test

Our aim was to investigate the functional underpinnings of autobiographical memory (AM) impairment in multiple sclerosis (MS) patients. To that end, 18 patients and 18 controls underwent the autobiographical interview (AI). Subsequently, the 36 participants underwent a functional magnetic resonance imaging (fMRI) session designed to assess the construction and elaboration of AMs. A categorical control task was also presented. Patients were trained in the fMRI procedure to optimise the procedural aspects accompanying the task itself. Although the patients obtained significantly poorer AI scores (p < .001), their performance on the easier AM fMRI task was efficiently carried out, allowing relevant comparisons with healthy controls. Relatively to healthy controls, the patients showed increased and bilateral cerebral activations (p < .005) during the construction and elaboration phases. The prefrontal, temporal and posterior cerebral region activations were located within the core network sustaining AM, with the bilateral prefrontal region being centrally involved. The parametric neural responses to the difficulty of access and amount of details of memories were also significantly different for the two groups, with the right hippocampal region showing a particularly increased recruitment (p < .005). The findings suggested the presence of functional cerebral changes during AM performance and supported the presence of AM retrieval deficit in MS patients.