Bayesian Extended Redundancy Analysis: A Bayesian Approach to Component-based Regression with Dimension Reduction

Abstract

Extended redundancy analysis (ERA) combines linear regression with dimension reduction to explore the directional relationships between multiple sets of predictors and outcome variables in a parsimonious manner. It aims to extract a component from each set of predictors in such a way that it accounts for the maximum variance of outcome variables. In this article, we extend ERA into the Bayesian framework, called Bayesian ERA (BERA). The advantages of BERA are threefold. First, BERA enables to make statistical inferences based on samples drawn from the joint posterior distribution of parameters obtained from a Markov chain Monte Carlo algorithm. As such, it does not necessitate any resampling method, which is on the other hand required for (frequentist’s) ordinary ERA to test the statistical significance of parameter estimates. Second, it formally incorporates relevant information obtained from previous research into analyses by specifying informative power prior distributions. Third, BERA handles missing data by implementing multiple imputation using a Markov Chain Monte Carlo algorithm, avoiding the potential bias of parameter estimates due to missing data. We assess the performance of BERA through simulation studies and apply BERA to real data regarding academic achievement.     

Initial experiences with the Reiber 1979 determination of autochthonous IgG production within the scope of clinical and immunologic follow-up studies in multiple sclerosis treated with immunosuppressive therapy

We carried out clinical and immunological follows-up to 21 patients suffering from multiple sclerosis, 16 of whom had been immunosuppressively treated. A remission in clinical way was possible to point out with 8 of 12 patients (66%) -average remission by 1 score acc. to the Bronx-Scale- and with these patients a local formation of immunoglobulin acc. to Reiber (1979) could be proven. With 40 to 60% of the patients pathological changes were found out by determining of routine parameters by means of liquor examinations (total number of cells, sediment, total protein, electrophoresis) in which the humoral values responded not so sensitively to immunosuppressive therapy than the cellular values. For the present, liquor- and immunodiagnostic is being considered as a solid part of diagnostic programm and therapy control with regard to patients suffering from multiple sclerosis.     

Gait variability in people with neurological disorders: A systematic review and meta-analysis

There has been growing evidence showing gait variability provides unique information about gait characteristics in neurological disorders. This study systemically reviewed and quantitatively synthesized (via meta-analysis) existing evidence on gait variability in various neurological diseases, including Alzheimer’s disease (AD), amyotrophic lateral sclerosis (ALS), cerebellar ataxia (CA), Huntington’s disease (HD), multiple sclerosis (MS), and Parkinson’s disease (PD). Keyword search were conducted in PubMed, Web of science, Cumulative Index to Nursing and Allied Health Literature, and Cochrane Library. Meta-analysis was performed to estimate the pooled effect size for gait variability for each neurological group. Meta-regression was performed to compare gait variability across multiple groups with neurological diseases. Gait variability of 777 patients with AD, ALS, CA, HD, MS, or PD participating in 25 studies was included in meta-analysis. All pathological groups had increased amount of gait variability and loss of fractal structure of gait dynamics compared to healthy controls, and gait variability differentiated distinctive neurological conditions. The HD groups had the highest alterations in gait variability among all pathological groups, whereas the PD, AD and MS groups had the lowest. Interventions that aim to improve gait function in patients with neurological disorders should consider the heterogeneous relationship between gait variability and neurological conditions.     

A Protocol for Improving Loneliness in People with Multiple Sclerosis

Loneliness is a subjective and unpleasant emotional state that occurs when people feel social networks or social relationships are deficient in some way. People with multiple sclerosis are often lonely and frequently withdraw from participating in meaningful social activities. Common symptoms, such as cognitive changes, decreased physical functioning, fatigue, incontinence, visual changes, or depression, may contribute to decreased social participation, which can lead to loneliness. This article presents an intervention protocol for improving loneliness in people with multiple sclerosis. This protocol is based on Bandura’s Social Learning Theory, which focuses on improving self-efficacy to reduce loneliness in people with multiple sclerosis.     

Disorders of the neurotransmitter system in multiple sclerosis--possibilities for a therapeutic approach?

The type and extent of neurological deficits in multiple sclerosis depends on the localisation and size of the lesion and the type of neuropathological pattern of the lesion. The elective demyelinating process (loss of myeline sheath without axonal damage) brings, about a showing and faulty conduction of impulses and thereby a disturbed processing of information. It can finally come to a total (functional, reversible) conduction blockage. Additionally also disturbances in the synaptic transmission may be involved. The occurrence and extent of these disturbances in conduction and transmission depend on definite paristatic factors. Our presented concepts of the "therapeutic model" based on pathophysiological investigations in multiple sclerosis show the tendency towards a "marked symptomatic therapy", which does not however, influence the basis of the disease processes, but rather represents an extremely helpful suppression of symptoms for the patients concerned.     

Familial multiple sclerosis with repetitive relapses of manic psychosis in two patients (mother and daughter)

The clinical presentation of multiple sclerosis (MS) with psychiatric symptoms is uncommon but it is believed that MS patients are twice as likely to be afflicted with bipolar disorder as the general population. We report two cases (mother and daughter) of MS presenting with bipolar disorder in the form of recurrent manic psychosis and whose outcome was favourable with neuroleptics and corticosteroids. In both cases we found multiple hypersignal lesions on brain magnetic resonance imaging (MRI), especially in the right frontal lobe where we observed signs of activity. Apart from clinical and radiological concordance, the patients exhibited similar class I HLA alleles and identical class II HLA alleles. We focused discussion on whether there may be a common genetic susceptibility to both illnesses or whether MS caused psychiatric manifestations. The coincidence of psychiatric and neurological symptoms in most relapses supports the second hypothesis.     

Interpretation of symptoms in chronic fatigue syndrome.

Chronic fatigue syndrome (CFS) is an illness characterised by fatigue and other symptoms. Both psychological and biological aetiological factors have been proposed, but the disorder is of uncertain origin. The aetiology of the symptoms is therefore ambiguous. It has been suggested (a) that patients with CFS tend to interpret their symptoms as indicating physical illness and (b) they tend not to interpret these symptoms in terms of negative emotion. In order to test these hypotheses we developed a self-report questionnaire to assess the interpretation of symptoms in patients with CFS. It was administered to patients with CFS, patients with depression, patients with multiple sclerosis (MS), and normal controls. Preliminary results suggest that the measure has acceptable psychometric properties. Patients with CFS were more likely than either depressed patients or normal controls to interpret symptoms (characteristic of CFS) in terms of physical illness, but did not differ in this from the MS patients. When compared with all three other groups (including the MS patients), the patients with CFS were least likely to interpret symptoms in terms of negative emotional states. The theoretical and clinical implications of the findings are discussed.     

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.     

Orbitofrontal dysfunction in multiple sclerosis: Iowa Gambling Task

Cognitive dysfunction has been widely studied in multiple sclerosis (MS), however decision-making has been less investigated. The current study examined the decision-making processes of patients with multiple sclerosis (MS) using a computerized version of the Iowa Gambling Task (IGT). This task was applied to 18 patients with clinically diagnosed MS and 18 healthy control subjects matched for age, sex, and years of education. The results showed that IGT scores differ significantly between patients with MS and the healthy control subjects: the patients with MS made significantly less advantageous decisions than the controls in the IGT. Possible causes of impaired decision-making in multiple sclerosis are discussed.     

Neurostructural and Neurophysiological Correlates of Multiple Sclerosis Physical Fatigue: Systematic Review and Meta-Analysis of Cross-Sectional Studies

Neuropsychology Review - Fatigue is one of the most debilitating symptoms for people with multiple sclerosis (PwMS). By consolidating a diverse and conflicting evidence-base, this systematic review...     

Dialectical Behavior Group Therapy is Feasible and Reduces Emotional Dysfunction in Multiple Sclerosis

We examined whether dialectical behavior therapy (DBT) was feasible and effective in multiple sclerosis (MS). A convenience sample of 20 patients with anxiety or depression symptoms received either DBT (n = 10) or standard medical care (n = 10). The DBT protocol was found to be feasible in the MS population studied (e.g., good retention and acceptability). For the DBT group, significant improvements were demonstrated in self-rated and clinician-rated depressive symptoms, clinician-rated anxiety symptoms, self-rated general psychopathology symptoms, and quality of life. In contrast, the standard medical care group retained for exploratory purposes showed no significant improvements. This pilot work provides preliminary support for the utility of DBT in MS, but further work is needed to clarify this benefit using a large, randomized controlled approach.     

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.     

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.     

Perceived behavioral changes in early multiple sclerosis

Acquired behavioral changes have essentially been described in advanced multiple sclerosis (MS). The present study was designed to determine whether behavioral modifications specifically related to the MS pathological process could be identified in the initial phase of the disease, as compared to control patients with chronic, relapsing and progressive inflammatory disorders not involving the central nervous system (CNS). Eighty-eight early MS patients (Expanded Disability Status Scale score 相似文献   

Endogenous task shift processes in relapsing-remitting multiple sclerosis

This paper reports a study that was aimed to evaluate executive functions in relapsing-remitting multiple sclerosis patients. The groups tested comprised 22 relapsing-remitting multiple sclerosis patients, and 22 non-brain damaged controls. When one is engaged in two speeded tasks, not simultaneously but with some form of alternation, it is slower to respond to an item of task A if it was preceded by an item of task B, than when it was preceded by an item of task A. Shifts between sets of cognitive operations can be internally or externally generated. Endogenous task shift refers to advance preparation for the new task. In the present study, we tested endogenous shift cost in relapsing-remitting multiple sclerosis patients. The results indicate a greater shift cost for patients than for non-brain damaged controls.     

Psychotherapy with multiple-sclerosis patients

We wanted to find out if psychotherapy may influence the course of the physical aspects of multiple sclerosis and the consequences of psychotherapy for coping processes. 46 patients diagnosed with multiple sclerosis who had chosen to undergo a 1-yr. group psychotherapy treatment were compared with a control group of 24 multiple-sclerosis patients without such treatment. They were given the Giessen test (personality test), the Achievement Capacities Questionnaire by Kesselring, an intensive interview as well as the content analysis scales of verbal behavior by Gottschalk and Gleser. The various tests were carried out at each of four times of measurement with a 2-yr. follow-up. There were significant changes in the area of relationships and aggressive loosening (interview) between the Therapy and Control groups. Several changes were also found with regard to physical symptoms (Achievement Capacities Questionnaire) in the Therapy group compared to the Control group, e.g., increases in physical mobility and decreases in care of the body. The decreases appear to be a known effect of therapy with psychosomatic disorders. We interpret it psychoanalytically as resistance against releasing anxiety of counter-cathected motives which multiple sclerosis helps to keep unconscious. In a follow-up, the Therapy group showed greater optimism and physical improvements, e.g., decrease in feeling cold and lack of energy. Some positive changes appeared in both groups, such as, for example, an improvement of cognitive impairment (Gottschalk & Gleser). It appears that the attention from the research itself may have affected both groups because some members of both groups were in contact and hence the Control group was also informed about the research project and its underlying hypothesis.     

Orienting reaction in patients with multiple sclerosis

A polygraphic study of the somatic (EMG), autonomic (finger plethysmogram, galvanic skin reaction, respiration, pulse, and EEG (acoustic-evoked potential and EEG-blocking reaction) components of the orienting reaction elicited by an auditory stimulus was performed in 71 patients with multiple sclerosis and in 74 matched normal subjects (control group). The study showed a significantly less intense orienting reaction in patients with multiple sclerosis than in control normal subjects. The severity of this responsiveness disturbance depended on the patients’ age at symptom onset, major symptom types on admission, and the relapse frequency. The orienting reaction changes found in patients with multiple sclerosis may be ascribed to the diffuse demyelinating lesions in the nervous system of these patients, which generate, apart from the so polymorphous clinical manifestations of this disease, also important responsiveness disturbances.     

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   

Genetic Counseling Dilemmas for a Patient with Sporadic Amyotrophic Lateral Sclerosis,Frontotemporal Degeneration & Parkinson’s Disease

Amyotrophic lateral sclerosis (ALS), frontotemporal degeneration and Parkinson’s disease may be different expressions of the same neurodegenerative disease. However, association between ALS and parkinsonism-dementia complex (ALS-PDC) has only rarely been reported apart from the cluster detected in Guam. We report a patient presenting with ALS-PDC in whom pathological mutations/expansions were investigated. No other family members were reported to have any symptoms of a neurological condition. Our case demonstrates that ALS-PDC can occur as a sporadic disorder, even though the coexistence of the three clinical features in one patient suggests a single underlying genetic cause. It is known that genetic testing should be preferentially offered to patients with ALS who have affected first or second-degree relatives. However, this case illustrates the importance of genetic counseling for family members of patients with sporadic ALC-PDC in order to provide education on the low recurrence risk. Here, we dicuss the ethical, psychological and practical consequences for patients and their relatives.     

Editorial

Fatigue is among the most common and disabling symptoms in multiple sclerosis (MS). However, the relationship of perfectionism to fatigue in MS patients remains poorly understood. One hundred and twenty MS patients (79 women, 41 men) were compared with 120 healthy individuals (79 women, 41 men) to explore whether differences exist between the two groups with respect to perfectionistic characteristics and to investigate whether dimensions of positive and negative perfectionism are related to the symptomatology of fatigue. All participants were asked to complete the positive and negative perfectionism scale (PANPS), the modified fatigue impact scale (MFIS), the fatigue severity scale (FSS) and the Beck depression inventory (BDI). The results revealed that the MS group reported lower levels of positive perfectionism and higher levels of negative perfectionism as well as depressive symptoms than the control group. Perfectionism was also significantly related to fatigue symptoms in both groups. These findings suggest that the fatigue symptoms are strongly associated with perfectionistic characteristics. The negative (maladaptive) dimension of perfectionism may play a predisposing role in the development and/or perpetuation of fatigue in MS patients. The findings are discussed within the scope of current literature and implications for clinical applications are suggested.