• Higher field strength MRI may improve image quality and diagnostic accuracy. • There are few direct comparisons of 1.5 and 3 T MRI. • Theoretical doubling of the signal-to-noise ratio in practice was only 25 %. • Objective evidence of improved routine clinical diagnosis is lacking. • Other aspects of technology improved images more than field strength.
ObjectivesTo investigate the presence and the nature of cognitive impairment in a large sample of patients with Multiple Sclerosis (MS), and to identify clinical and demographic determinants of cognitive impairment in MS.Methods303 patients with MS and 279 healthy controls were administered the Brief Repeatable Battery of Neuropsychological tests (BRB-N); measures of pre-morbid verbal competence and neuropsychiatric measures were also administered.ResultsPatients and healthy controls were matched for age, gender, education and pre-morbid verbal Intelligence Quotient. Patients presenting with cognitive impairment were 108/303 (35.6%). In the overall group of participants, the significant predictors of the most sensitive BRB-N scores were: presence of MS, age, education, and Vocabulary. The significant predictors when considering MS patients only were: course of MS, age, education, vocabulary, and depression. Using logistic regression analyses, significant determinants of the presence of cognitive impairment in relapsing-remitting MS patients were: duration of illness (OR = 1.053, 95% CI = 1.010–1.097, p = 0.015), Expanded Disability Status Scale score (OR = 1.247, 95% CI = 1.024–1.517, p = 0.028), and vocabulary (OR = 0.960, 95% CI = 0.936–0.984, p = 0.001), while in the smaller group of progressive MS patients these predictors did not play a significant role in determining the cognitive outcome.ConclusionsOur results corroborate the evidence about the presence and the nature of cognitive impairment in a large sample of patients with MS. Furthermore, our findings identify significant clinical and demographic determinants of cognitive impairment in a large sample of MS patients for the first time. Implications for further research and clinical practice were discussed.
Alzheimer's disease (AD) is a neurodegenerative condition characterised by significant impairment in multiple cognitive domains. In recent years, the development of cognitive training in AD has received significant attention. In the present case study we designed a cognitive training program (GEO, Geographical Exercises for cognitive Optimization) based on an errorless paradigm and tailored to the patient's cultural interests. The aim of this training was to investigate the potential for acquiring and possibly retaining both procedural and verbal knowledge in early-stage AD. This study involved an 80-year old female patient diagnosed with early-stage AD, and 10 matched healthy subjects.Participants were asked to perform the two GEO training tasks: a 'puzzle-like' task for procedural memory, and an 'association' task for verbal memory. Both the patient and the healthy controls were subsequently trained with GEO using the same two tasks for two months. Although the patient's performance before training in both tasks was poor compared to healthy controls, after the training these differences disappeared. Our results showed that the patient was able to acquire new procedural abilities and verbal knowledge, and that her achievements were stable at the follow-up testing scheduled three months after the end of the intervention. This case study suggests a potentially useful strategy for cognitive training in AD.
Introduction: Cognitive training in Alzheimer's disease (AD) has recently started to demonstrate its efficacy. We used our ‘puzzle-like’ task (GEO) as training for a large group of early-stage AD patients, to detect its effects over time.Method: AD patients (N = 40) and healthy controls (N = 40) were involved. Participants were administered the Geographical Exercises for cognitive Optimization (GEO) task. Participants underwent individual sessions with GEO three times a week for 2 months, and then their performance was recorded again. Lastly, at the 12-month follow-up the GEO task was administered for the last time.Results: Patients’ scores were significantly worse than controls’ scores only on a few neuropsychological tests. We ran a repeated measures GLM by considering groups’ performance on the GEO task at the assessment points. Results showed a significant main effect of group, and a significant effect of the interaction between group and time: patients’ performances both at the end of the training and at the follow-up were virtually identical to controls’ performances.Conclusions: Patients effectively acquired new procedural abilities, and their achievements were stable at follow-up. This study suggests the GEO is a useful strategy for cognitive training in AD, and should prompt further investigations about the degree of generalisability of patients’ acquired skills.
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