The relative rarity of primary progressive (PP) and transitional progressive (TP) multiple sclerosis has meant that little documentation of cognitive function in such patients is currently available. The aim of this study was to investigate the cognitive skills of patients with PP and TP multiple sclerosis relative to matched healthy controls, and to examine the relationship of this impairment to MRI parameters. Sixty-three patients (43 PP, 20 TP) were individually matched with healthy controls, who undertook the same cognitive tasks as the patient group. The neuropsychological assessment comprised Rao's brief repeatable battery, a reasoning test, and a measure of depression. Patients also underwent T1- and T2-weighted brain MRI. These patients were taken from a larger cohort (158 PP, 33 TP) in whom it had been demonstrated that the re were no significant differences between the mean scores of the PP and TP groups on any of the cognitive variables. The 63 patients were therefore taken as one group for comparison with the healthy controls. These patients performed significantly worse than the controls in tests of verbal memory, attention, verbal fluency and spatial reasoning. An impairment index was constructed and applied to the patient data. This correlated modestly with T2-lesion load (r = 0.45, P = 0.01), T1-hypointensity load (r = 0.45, P = 0.01) and cerebral volume (r = -0.35, P = 0.01). Thus, PP and TP multiple sclerosis patients demonstrate significant cognitive dysfunction when compared with matched healthy controls. The relationship between this impairment and MRI parameters is moderate, suggesting that cognitive dysfunction in PP and TP multiple sclerosis has a complex and multifactorial aetiology, which is not adequately explained by pathology as demonstrated on conventional MRI.

There are few longitudinal studies of cognition in patients with multiple sclerosis, and the results of these studies remain inconclusive. No serial neuropsychological data of an exclusively primary progressive series are available. Cross-sectional analyses have revealed significant correlations between cognition and magnetic resonance imaging (MRI) parameters in primary progressive multiple sclerosis (PPMS). This study investigated cognitive and MRI change in 99 PPMS patients from five European centres for 2 years. They were assessed at 12 month intervals using the Brief Repeatable Battery, a reasoning test, and a measure of depression. The MRI parameters of T1 hypointensity load, T2 lesion load, and partial brain volume were also calculated at each time point. There were no significant differences between the mean cognitive scores of the patients at year 0 and year 2. However, one-third of the patients demonstrated absolute cognitive decline on individual test scores. Results indicated that initial cognitive status on entry into the study was a good predictor of cognitive ability at 2 years. There was only a small number of significant correlations between changes in cognition and changes on MRI, notably T1 hypointensity load with the two attentional tasks (r = -0.266, P = 0.017; r = -0.303, P = 0.012). It is probable that multiple factors underlie this weak relation between the cognitive and MRI measures.

Abstract. The precision and relative accuracy of an automated system for the quantitative determination of salivary blood group substances has been defined in these studies. The system gives this form of serological quantitation a relatively high degree of accuracy in comparison with the traditional titration methods. Standard procedures have been developed from these studies to reduce errors which could arise from sample collection and processing. The magnitude of individual physiological variables has been defined. It is concluded that the method should lend itself well to studies on genetic, anthropological and pathological variables in relation to concentration of salivary blood group substances.

Extrasulcular substances such as saliva, supragingival plaque and salivary sediment may be contaminants in gingival crevicular fluid (GCF) collected with Periopaper. This report provides data obtained with salivary amylase as a marker for these substances in GCF. Amylase was a common constituent of GCF collected from sites with clinical health and with clinical signs of periodontitis. Rinsing the mouth with water reduced, but did not eliminate amylase in GCF. More frequent (p < 0.01) and greater (p < 0.001) contamination of GCF with amylase occurred in samples from periodontitis than from healthy subjects. The volume of saliva required to give the amylase in the GCF was calculated. This volume exceeded the GCF volume in 21% of samples collected without a water rinse. Thus, oral constituents other than saliva likely contribute to GCF amylase. Small quantities of plaque and salivary sediment (9.6 ± 5,9, 3.4 ± 2.0 μg protein) provided amylase from a saliva volume equal to the GCF volume in health (0.23 μl). The above and other data presented here show that extrasulcular substances likely are frequent constituents of GCF collected with Periopaper. Reporting GCF constituents as quantities/sample appears least subject to error from the contamination by extrasulcular substances.

Memory tests were often developed for healthy populations. The accuracy of these measures is reduced when administered to patients with neurological diseases, who may experience physical and/or cognitive symptoms. Also, methodological factors, for example, spanning the ability spectrum, and content/format artefacts, may contribute to a decline in test precision. The aim of this study was to develop a new test of memory, which addresses these issues. The new memory test comprises assessments of recall, paired association, and recognition, at a Task Familiarisation stage and two difficulty levels, for both the verbal and spatial modalities. It was administered to 85 healthy individuals and 100 patients with multiple sclerosis (MS). All patients were able to attempt each task of the new assessment and there was no influence of visual integrity or manual dexterity on memory test performance, supporting the applicability of the tasks to patients with multiple sclerosis. Both the standardisation and validation samples demonstrated a wide range of scores on each section of the new test suggesting that the measure spanned an acceptably broad range of abilities. It seems probable, therefore, that the new assessment offers a more exact measure of verbal and spatial recall, paired association, and recognition memory.