Abstract:
BACKGROUND:Cognitive deficits, especially in attention, are common in persons with MS (PwMS) and are associated with clinically meaningful outcomes, such as work disability and lower quality of life (QOL). In this study, we aimed to determine whether Cogmed Working Memory Training (CWMT) improves attention/working memory in PwMS displaying impairment in these domains. METHODS:This single blind, randomized controlled, pilot study compared the effects of CWMT, a five-week evidenced-based computer-assisted training program that is supported by weekly meetings with a coach, to standard medical care (treatment as usual). We recruited PwMS from one MS center (London (ON) Canada), aged 18-64, with an Expanded Disability Status Scale (EDSS) score of ≤ 7.0, and a visual acuity (corrected) of at least 20/70. Potential subjects had to demonstrate impaired attention on at least two of three measures (Paced Auditory Serial Addition Test [PASAT], Symbol Digit Modalities Test [SDMT], and/or DKEFS Color-Word Interference Test); these measures also served as the primary study outcomes. Subjects were randomized to either the CWMT or treatment as usual. Secondary cognitive outcomes included other measures of attention, memory, as well as a self-reported cognitive function measure. Self-reported measures of mood (depression and anxiety), pain, and QOL were also included as other secondary outcomes. Subjects received assessments at baseline, post-treatment, and 6-month follow-up, or an equivalent time period for the treatment as usual group. The two groups were compared at baseline on background measures using independent samples t-tests, Chi-Square tests, and Mann-Whitney U tests. To analyze primary and secondary outcomes, a non-parametric approach was used due the small sample size and that many of our outcomes did not meet assumptions for parametric analyses. Friedman's test was conducted followed by post hoc pairwise comparisons within each group using Wilcoxon Signed-Rank tests with Bonferroni corrected post hoc contrasts, which allowed us to examine for differences between time points. RESULTS:Of 30 subjects, 15 were assigned to CWMT. Significant training effects were noted in 1 of 3 primary attentional outcomes (DKEFS Color-Word Interference Test), 2 of 3 secondary attentional outcomes (Letter-Number Sequencing, Digit Span), and 1 mood scale (Hospital Anxiety and Depression scale (HADS) - Depression Subscale), ps < .025. No significant changes were observed in the treatment as usual group. CONCLUSION:This pilot study demonstrates that cognitive training with CWMT has the potential to improve attention/working memory in PwMS, as well as a potential positive effect on mood, in PwMS. Further exploration of this intervention in PwMS with attention/working memory impairment is warranted.
journal_name
Mult Scler Relat Disordjournal_title
Multiple sclerosis and related disordersauthors
Blair M,Goveas D,Safi A,Marshall C,Rosehart H,Orenczuk S,Morrow SAdoi
10.1016/j.msard.2021.102770subject
Has Abstractpub_date
2021-01-17 00:00:00pages
102770eissn
2211-0348issn
2211-0356pii
S2211-0348(21)00036-5journal_volume
49pub_type
杂志文章abstract:INTRODUCTION:Interferon-beta (IFNβ) is currently the most used disease-modifying treatment for relapsing-remitting multiple sclerosis (RRMS), but it can lead to the production of neutralising antibodies (NABs) against IFNβ. CLINICAL CASE:A lady with a past history of genital herpes was diagnosed with RRMS, started IFN...
journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章
doi:10.1016/j.msard.2014.11.007
更新日期:2015-01-01 00:00:00
abstract:BACKGROUND:Growing evidence supports the efficacy of restorative cognitive training in people with multiple sclerosis (PwMS), but the effects vary across individuals. Differences in treatment efficacy may be related to baseline individual differences. We investigated clinical characteristics and MRI variables to predic...
journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章
doi:10.1016/j.msard.2019.06.026
更新日期:2019-09-01 00:00:00
abstract:INTRODUCTION:All people with progressive MS in the United Kingdom should have access to physiotherapy through the National Health Service (NHS). However levels of access and delivery are unknown. Furthermore there is no research on perceived efficacy of physiotherapy or the use of complementary and alternative medicine...
journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章
doi:10.1016/j.msard.2017.01.002
更新日期:2017-02-01 00:00:00
abstract:OBJECTIVE:No available assessment tool offers a brief and psychometrically sound way for clinicians to quantify assessment of MS in a typical office visit. The objective of this study was to develop a brief clinician-reported outcome measure of MS signs and symptoms to standardize and quantify assessments that occur du...
journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章
doi:10.1016/j.msard.2019.06.024
更新日期:2019-10-01 00:00:00
abstract:BACKGROUND:The acute, fulminant type of Multiple Sclerosis (MS), known as Marburg Disease, has been shown to have poor response to conventional acute treatments typically used for demyelinating diseases. METHODS:We report a 20 y/o postpartum female who was consulted to the Neurology service given findings of subacute ...
journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章
doi:10.1016/j.msard.2019.03.014
更新日期:2019-06-01 00:00:00
abstract:BACKGROUND:Fingolimod (Gilenya, Novartis, Basel Switzerland) 0.5 mg orally once-daily is widely used for relapsing-remitting multiple sclerosis. Patients are usually screened four months after starting fingolimod for fingolimod-associated macular oedema (FAME). Large registration trials with stringent eligibility crite...
journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章
doi:10.1016/j.msard.2020.102125
更新日期:2020-07-01 00:00:00
abstract::Multiple Sclerosis (MS) is an autoimmune disease in which lymphocytes target putative myelin antigens in the CNS, causing inflammation and neurodegeneration. Fingolimod (FTY720) is an immunosuppressive drug used as a second line therapy for relapsing forms of MS due to its safety profile and good response to treatment...
journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章
doi:10.1016/j.msard.2017.05.004
更新日期:2017-11-01 00:00:00
abstract:BACKGROUND:Natalizumab is a monoclonal antibody that significantly reduces the occurrence of relapses in relapse-remitting multiple sclerosis (RRMS) patients. Early papers on the clinical use of natalizumab in RRMS patients reported erythroblastemia as occasional and transient. OBJECTIVES:to determine the prevalence a...
journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章
doi:10.1016/j.msard.2016.05.020
更新日期:2016-07-01 00:00:00
abstract:BACKGROUND:There is no evidence that disease modifying therapies (DMTs) are beneficial in progressive (non-relapsing) MS. However, these patients may benefit from multidiscipliniary interventions, and require financial and community support. Non-pharmacological needs of MS patients may be overlooked during fund allocat...
journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章,多中心研究
doi:10.1016/j.msard.2015.01.003
更新日期:2015-03-01 00:00:00
abstract::Iatrogenic demyelination is a distinct clinical subtype of central nervous system inflammatory disorders. The Janus kinase inhibitor, tofacitinib, is an oral disease-modifying antirheumatic drug that has shown contradictory effects on multiple sclerosis in animal models. In this report, we describe a novel case of rev...
journal_title:Multiple sclerosis and related disorders
pub_type: 信件
doi:10.1016/j.msard.2020.102568
更新日期:2020-11-01 00:00:00
abstract:BACKGROUND:Different walking capacity test formats are applied, but their impact on the gait pattern in persons with MS (pwMS) has not yet been investigated according to baseline velocity performance. OBJECTIVE:To assess, in pwMS with different ambulation dysfunction, the impact of speed instructions and previous walk...
journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章
doi:10.1016/j.msard.2013.01.004
更新日期:2013-07-01 00:00:00
abstract:OBJECTIVE:Review cases of positive neurologic phenomena initiated or worsened with dalfampridine in patients with multiple sclerosis. BACKGROUND:Oral, extended release dalfampridine (4-aminopyridine or 4-AP) is a potassium-channel blocker approved for the treatment of gait impairment in multiple sclerosis (MS). The en...
journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章
doi:10.1016/j.msard.2013.05.003
更新日期:2014-01-01 00:00:00
abstract:BACKGROUND:In multiple sclerosis (MS) the quantitative role of relapses in Expanded Disability Status Scale (EDSS) worsening beyond the recovery phase is not well known. Most studies have examined the predictive role of early relapses in more distant endpoints. Relapses and worsening may be associated because they coul...
journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章
doi:10.1016/j.msard.2019.04.017
更新日期:2019-07-01 00:00:00
abstract:OBJECTIVES:To examine the association between vagotomy and multiple sclerosis. METHODS:We conducted a matched cohort study of all patients who underwent truncal or super-selective vagotomy and a comparison cohort, by linking Danish population-based medical registries (1977-1995). Hazard ratios (HRs) for multiple scler...
journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章
doi:10.1016/j.msard.2017.04.009
更新日期:2017-07-01 00:00:00
abstract:BACKGROUND:In 2001, we conducted a survey on use of complementary and alternative medicine (CAM) in people with multiple sclerosis (pwMS) in Oregon and Southwest Washington to treat their disease. OBJECTIVES, METHODS:In 2018, we administered a revised survey in the same region to describe updated patterns of CAM use i...
journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章
doi:10.1016/j.msard.2020.102041
更新日期:2020-06-01 00:00:00
abstract:OBJECTIVES:To evaluate the impact of a single day of protective stepping practice in individuals with Multiple Sclerosis (MS). BACKGROUND:Multiple Sclerosis is a leading cause of disability among young adults in the United States. Gait and balance dysfunction are both widespread in MS and strong predictors of falls, d...
journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章
doi:10.1016/j.msard.2019.01.054
更新日期:2019-05-01 00:00:00
abstract:BACKGROUND:People with multiple sclerosis (MS) experience symptoms in multiple domains. High-quality patient-reported outcomes (PROs) that assess multiple domains can aid healthcare providers in assessing these symptoms and may support remote disease monitoring. The "SymptoMScreen" PRO correlates with other PROs in MS;...
journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章
doi:10.1016/j.msard.2019.01.031
更新日期:2019-04-01 00:00:00
abstract:BACKGROUND:Notoriously the treatment of multiple sclerosis (MS) is based on the use of several different drugs, characterized by a diverse mechanism of action, efficacy and safety. Recently, progress has been made towards developing new oral immunotherapies, and dimethyl fumarate is the third oral agent approved for th...
journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章
doi:10.1016/j.msard.2016.03.009
更新日期:2016-05-01 00:00:00
abstract:BACKGROUND:Multiple Sclerosis (MS) is a degenerative disease of central nervous system caused by an immune response against the myelin. About half of MS patients suffers from sleep disturbances. The circadian clock genes such as PER3 controls circadian rhythm and sleep. Due to the role of PER3 in sleep disturbances and...
journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章
doi:10.1016/j.msard.2017.07.005
更新日期:2017-10-01 00:00:00
abstract:BACKGROUND:Fatigue is a common impairment in a wide range of disorders. Numerous fatigue scales have been designed in an attempt to quantify this impairment without any clear distinction between them. The International Classification of Functioning, Disability and Health (ICF) is a useful tool for content comparison of...
journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章
doi:10.1016/j.msard.2020.102596
更新日期:2020-11-01 00:00:00
abstract::Elsberg syndrome (ES) refers to the combination of myelitis and lumbosacral radiculitis associated with infection caused by the virus of the Herpesviridae family. We present a case of a 52-year-old man with a 9 months diagnosis of Crohn's disease, in use of infliximab with good disease control, complaining of 2 months...
journal_title:Multiple sclerosis and related disorders
pub_type: 信件
doi:10.1016/j.msard.2020.102643
更新日期:2020-11-25 00:00:00
abstract:BACKGROUND:The frequency and long-term prognosis of relapsing multiple sclerosis (RMS) never receiving disease-modifying treatment (DMT) is unclear. METHODS:We included 1186 RMS patients with a mean of 17.4 years follow-up and divided them into patients treated with any DMT (DMT) and patients untreated by shared (USD)...
journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章
doi:10.1016/j.msard.2019.101908
更新日期:2019-12-23 00:00:00
abstract:BACKGROUND:Relapsing-Remitting MS (RRMS) Deep Grey Matter (DGM) 5 year changes were examined using MRI measures of volume, transverse relaxation rate (R2*) and quantitative magnetic susceptibility (QS). By applying Discriminative Analysis of Regional Evolution (DARE), R2* and QS changes from iron and non-iron sources w...
journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章
doi:10.1016/j.msard.2019.05.028
更新日期:2019-08-01 00:00:00
abstract::Visual symptoms are a common clinical manifestation of multiple sclerosis (MS) and are frequently due to acute optic neuritis (ON). However, the entire visual pathway can be involved throughout the disease course. We describe the case of a young MS patient who experienced visual symptoms that were eventually found to ...
journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章
doi:10.1016/j.msard.2017.08.008
更新日期:2017-10-01 00:00:00
abstract:BACKGROUND:Social support has been identified as a buffering or intervening variable in stressful life events. Research has demonstrated that greater social support is associated with better mental health in multiple sclerosis (MS), but little is known about its links to specific aspects of mental health. We therefore ...
journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章
doi:10.1016/j.msard.2018.09.039
更新日期:2019-01-01 00:00:00
abstract::A 34-year old Caucasian female was initially diagnosed with multiple small-vessel strokes at age 20 years which were etiologically classified as secondary to anti-phospholipid antibody syndrome (APS) although she had no history or laboratory data to suggest APS. Based on her MRI of brain findings, one of her neurologi...
journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章
doi:10.1016/j.msard.2018.04.004
更新日期:2018-05-01 00:00:00
abstract:BACKGROUND:Dysphagia is a life-threating symptom in patients with multiple sclerosis (MS) because aspiration pneumonia develops as a consequence of swallowing disorders. Dysphagia can be detected by using patient-reported outcome measures in order to prevent complications. OBJECTIVE:To identify the dysphagia prevalenc...
journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章
doi:10.1016/j.msard.2020.102397
更新日期:2020-10-01 00:00:00
abstract:BACKGROUND:To determine and compare comorbidity levels in the multiple sclerosis (MS) population in Poland using a matched cohort from the general population. METHODS:We compared our database (standardized medical histories and medical records) from a MS center at the Department of Neurology, Medical University of Bia...
journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章
doi:10.1016/j.msard.2020.102051
更新日期:2020-06-01 00:00:00
abstract:BACKGROUND:Multiple Sclerosis (MS) patients find it difficult to understand the complex risk-benefit profiles of disease-modifying drugs. An evidence-based protocol was designed to improve patient's understanding of treatment information: Benefit and Risk Information for Medication in Multiple Sclerosis (BRIMMS). OBJE...
journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章
doi:10.1016/j.msard.2021.102737
更新日期:2021-01-12 00:00:00
abstract:BACKGROUND:Cognitive impairment is highly prevalent in multiple sclerosis (MS). Due to the lack of specialized neuropsychological resources in many MS clinics, a brief cognitive monitoring tool that can be administered by other MS clinic staff is needed. BICAMS (Brief International Cognitive As-sessment for Multiple Sc...
journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章
doi:10.1016/j.msard.2019.101458
更新日期:2020-01-01 00:00:00