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   

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.     

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.     

Influence of IQ in interpreting MMSE scores in patients with multiple sclerosis

The Mini-Mental State Examination (MMSE) and Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV) were administered to 46 outpatients diagnosed with multiple sclerosis (MS). MMSE total raw score was significantly and positively correlated with all WAIS-IV indexes, even when controlling for the effects of participant educational level, with the strongest relationship being with Full Scale IQ. These results suggest that clinicians consider patient intellectual functioning, in particular Full Scale IQ, when diagnosing neurocognitive impairment based on screening with the MMSE in individuals with MS.     

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.     

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.     

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.     

Reinforcer pathology,probabilistic choice,and medication adherence in patients with multiple sclerosis

The reinforcer pathology model posits that core behavioral economic mechanisms, including delay discounting and behavioral economic demand, underlie adverse health decisions and related clinical disorders. Extensions beyond substance use disorder and obesity, however, are limited. Using a reinforcer pathology framework, this study evaluates medical adherence decisions in patients with multiple sclerosis. Participants completed behavioral economic measures, including delay discounting, probability discounting, and a medication purchase task. A medical decision-making task was also used to evaluate how sensitivity to mild side effect risk and efficacy contributed to the likelihood of taking a hypothetical disease-modifying therapy. Less steep delay discounting and more intense (greater) medication demand were independently associated with greater adherence to the medication decision-making procedure. More generally, the pattern of interrelations between the medication-specific and general behavioral economic metrics was consistent with and contributes to the reinforcer pathology model. Additional research is warranted to expand these models to different populations and health behaviors, including those of a positive health orientation (i.e., medication adherence).     

Giving meaning to illness: An investigation of self-defining memories in patients with relapsing-remitting multiple sclerosis patients

Multiple sclerosis (MS) patients are often unable to adequately fulfill their established roles due to physical disabilities and cognitive changes, making this chronic illness particularly threatening to personal identity. Twenty-five MS patients and 25 healthy controls were asked to recall five self-defining memories (SDM). Overall characteristics of SDM did not differ between patients and controls; MS patients displayed preserved capacity to draw meaning upon past events. Moreover, almost two-thirds of MS patients mentioned at least one illness related SDM and about 25% of patients’ SDM referred to MS. These memories were experienced as more negative and associated with more tension than other SDM but led toward more positive emotion and less negative emotion over time; they were also more central and more integrated to the personal identity. We concluded that self-challenging events due to MS may trigger both cognitive and emotional processes enabling the integration of illness in patients’ self-representations.     

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.