The present study examined the cognitive performance and ratings of subjective fatigue in people with advanced MS and matched healthy control participants. A continuous n-back task, involving attention (0-back), was performed at the beginning and end of one testing session; a task involving working memory (1-back) was performed at the beginning and end of another testing session. Subjective fatigue was rated at regular intervals during each session. Overall, there was limited evidence of objective cognitive fatigue in the MS group, as assessed by the change in n-back performance during the sessions. The MS group did report a greater increase, than the control group, in the level of subjective fatigue during the 1-back testing session, but change in subjective fatigue did not correlate significantly with change in cognitive performance. The implications of these findings for our understanding of cognitive fatigue in MS are discussed.

No abstract

The concept of brain disconnection derives from work in which the two cerebral hemispheres are surgically separated by division of the corpus callosum. The patient behaves as if his two half-brains function to some degree independently. The syndrome of brain disconnection is exemplified by such split-brain cases (Geschwind, 1965). Neither hemisphere shows an awareness of the functions of the other, and there is a marked failure to cross-match stimuli across the midline of the body. The integrity of the corpus callosum is essential to normal integration between the hemispheres.

This study explores family relationships and support needs when adapting to a relative's advanced-multiple sclerosis (MS) around transition into care. A multi-site qualitative study of relatives of people with advanced-MS was conducted. A purposive sample of 25 relatives was selected and interviewed either in the care home or participants' homes. Interviews were recorded, transcribed and analysed using grounded theory methodology and Atlas.ti 5.2 software. Data quality enhancement involved: a self-report questionnaire; triangulation and member-checking. Themes derived from the data were: information, communication and understanding; family relationships, roles and responsibilities; emotions, coping and support; life outlook and reflection. Provision of information and support for families around the transition into care appears to be inconsistent despite there being a need for family members to ask questions and discuss the impact of the condition. Relatives reported that as a family and as individuals they faced significant challenges and were in great need of support at times, but reflected that they would have found it very difficult to accept. Relatives were also often unsure what type of support would have helped. For care providers, there needs to be a shift from the traditional health care professional 'patient-centred' mindset towards more proactive family-centred approaches and steps to encourage this are articulated.