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Koscik TR, van der Plas E, Long JD, Cross S, Gutmann L, Cumming SA, Monckton DG, Shields RK, Magnotta V, Nopoulos PC. Longitudinal changes in white matter as measured with diffusion tensor imaging in adult-onset myotonic dystrophy type 1. Neuromuscul Disord 2023; 33:660-669. [PMID: 37419717 PMCID: PMC10529200 DOI: 10.1016/j.nmd.2023.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 05/17/2023] [Accepted: 05/31/2023] [Indexed: 07/09/2023]
Abstract
Myotonic dystrophy type 1 is characterized by neuromuscular degeneration. Our objective was to compare change in white matter microstructure (fractional anisotropy, radial and axial diffusivity), and functional/clinical measures. Participants underwent yearly neuroimaging and neurocognitive assessments over three-years. Assessments encompassed full-scale intelligence, memory, language, visuospatial skills, attention, processing speed, and executive function, as well as clinical symptoms of muscle/motor function, apathy, and hypersomnolence. Mixed effects models were used to examine differences. 69 healthy adults (66.2% women) and 41 DM1 patients (70.7% women) provided 156 and 90 observations, respectively. There was a group by elapsed time interaction for cerebral white matter, where DM1 patients exhibited declines in white matter (all p<0.05). Likewise, DM1 patients either declined (motor), improved more slowly (intelligence), or remained stable (executive function) for functional outcomes. White matter was associated with functional performance; intelligence was predicted by axial (r = 0.832; p<0.01) and radial diffusivity (r = 0.291, p<0.05), and executive function was associated with anisotropy (r = 0.416, p<0.001), and diffusivity (axial: r = 0.237, p = 0.05 and radial: r = 0.300, p<0.05). Indices of white matter health are sensitive to progression in DM1. These results are important for clinical trial design, which utilize short intervals to establish treatment efficacy.
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Affiliation(s)
- Timothy R Koscik
- Arkansas Children's Research Institute, University of Arkansas for Medical Sciences, 13 Children's Way, Little Rock, AR 72202-3591, USA
| | - Ellen van der Plas
- Arkansas Children's Research Institute, University of Arkansas for Medical Sciences, 13 Children's Way, Little Rock, AR 72202-3591, USA
| | - Jeffrey D Long
- Department of Psychiatry, Carver College of Medicine, University of Iowa, 200 Hawkins Drive, Iowa City, IA 52242, USA; Department of Biostatistics, College of Public Health, University of Iowa, 200 Hawkins Drive, Iowa City, IA 52242, USA
| | - Stephen Cross
- Arkansas Children's Research Institute, University of Arkansas for Medical Sciences, 13 Children's Way, Little Rock, AR 72202-3591, USA
| | - Laurie Gutmann
- Department of Neurology, School of Medicine, Indiana University, 362W 15th St, Indianapolis, IN 46202, USA
| | - Sarah A Cumming
- Institute of Molecular, Cell and Systems Biology, University of Glasgow, Glasgow G12 8QQ, UK
| | - Darren G Monckton
- Institute of Molecular, Cell and Systems Biology, University of Glasgow, Glasgow G12 8QQ, UK
| | - Richard K Shields
- Department of Radiology, Carver College of Medicine, University of Iowa, 200 Hawkins Drive, Iowa City, IA 52242, USA
| | - Vincent Magnotta
- Department of Physical Therapy and Rehabilitation Science, Carver College of Medicine, University of Iowa, 200 Hawkins Drive, Iowa City, IA 52242, USA
| | - Peggy C Nopoulos
- Department of Psychiatry, Carver College of Medicine, University of Iowa, 200 Hawkins Drive, Iowa City, IA 52242, USA; Department of Neurology, School of Medicine, Indiana University, 362W 15th St, Indianapolis, IN 46202, USA; Department of Pediatrics, Carver College of Medicine, University of Iowa, 200 Hawkins Drive, Iowa City, IA 52242, USA.
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Goette WF, Schmitt AL. Examination of Regression-based Discrepancy Scores for the RBANS in Detecting Cognitive Impairment from an Archival Sample. Arch Clin Neuropsychol 2020; 34:1329-1339. [PMID: 30590396 DOI: 10.1093/arclin/acy100] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2018] [Revised: 11/16/2018] [Accepted: 12/05/2018] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE The purpose of this study was to evaluate the clinical utility of regression-based formulas for the RBANS indexes in screening for cognitive impairment. METHOD A database of neuropsychological test results was created from archival records in a memory assessment clinic. The sample consisted of 83 individuals (37 males/46 females) with an average age of 70.1 (SD = 9.8) and 14.6 years of education (SD = 2.8). Diagnostic accuracy of regression-based predictions provided by Duff and Ramezani (2015) (Duff, K., & Ramezani, A. (2015). Regression-based normative formulae for the Repeatable Battery for the Assessment of Neuropsychological Status for older adults. Archives of Clinical Neuropsychology, 30, 600-604.) and from regression of WTAR standard score were examined via receiver operator characteristic curves. Preliminary generalizability investigation was completed using two additional datasets. RESULTS The WTAR was found to mediate the relationship between education and all RBANS index scores. The WTAR standard score was also found to contribute uniquely and significantly to the prediction of RBANS performance. Results of diagnostic accuracy analyses showed similar discriminating accuracy for all scores. There was limited support for using the WTAR over demographic variables alone in the estimation of RBANS performance; however, the WTAR was found to be more predictive than education, indicating potential clinical utility to using the word-reading score over just years of attained education. CONCLUSIONS Use of these derived Total Scale score variants is recommended for the screening of cognitive impairment, particularly in individuals with superior or poor educational quality. Further research is required to evaluate the utility of these variations in more diverse samples.
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Affiliation(s)
- William F Goette
- Department of Psychology and Counseling, University of Texas at Tyler, Tyler, TX, USA
| | - Andrew L Schmitt
- Department of Psychiatry and Behavioral Medicine, University of Texas Health Northeast, TX, USA
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Gorny I, Krause K, Albert A, Schneider S, Möller L, Habermehl L, Strzelczyk A, Rosenow F, Hermsen A, Knake S, Menzler K. Limitations of a Short Demographic Questionnaire for Bedside Estimation of Patients’ Global Cognitive Functioning in Epilepsy Patients. Front Neurol 2018; 9:85. [PMID: 29545768 PMCID: PMC5838021 DOI: 10.3389/fneur.2018.00085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Accepted: 02/06/2018] [Indexed: 12/02/2022] Open
Abstract
Objectives The German socio-demographic estimation scale was developed by Jahn et al. (1) to quickly predict premorbid global cognitive functioning in patients. So far, it has been validated in healthy adults and has shown a good correlation with the full and verbal IQ of the Wechsler Adult Intelligence Scale (WAIS) in this group. However, there are no data regarding its use as a bedside test in epilepsy patients. Methods Forty native German speaking adult patients with refractory epilepsy were included. They completed a neuropsychological assessment, including a nine scale short form of the German version of the WAIS-III and the German socio-demographic estimation scale by Jahn et al. (1) during their presurgical diagnostic stay in our center. We calculated means, correlations, and the rate of concordance (range ±5 and ±7.5 IQ score points) between these two measures for the whole group, and a subsample of 19 patients with a global cognitive functioning level within 1 SD of the mean (IQ score range 85–115) and who had completed their formal education before epilepsy onset. Results The German demographic estimation scale by Jahn et al. (1) showed a significant mean overestimation of the global cognitive functioning level of eight points in the epilepsy patient sample compared with the short form WAIS-III score. The accuracy within a range of ±5 or ±7.5 IQ score points for each patient was similar to that of the healthy controls reported by Jahn et al. (1) in our subsample, but not in our whole sample. Conclusion Our results show that the socio-demographic scale by Jahn et al. (1) is not sufficiently reliable as an estimation tool of global cognitive functioning in epilepsy patients. It can be used to estimate global cognitive functioning in a subset of patients with a normal global cognitive functioning level who have completed their formal education before epilepsy onset, but it does not reliably predict global cognitive functioning in epilepsy patients in general, who often do not fulfill these criteria. It is therefore not a useful tool to be applied in the general neuropsychological presurgical evaluation of epilepsy patients.
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Affiliation(s)
- Iris Gorny
- Epilepsy Center Hessen, Philipps-University, Marburg, Germany
- *Correspondence: Iris Gorny,
| | - Kristina Krause
- Epilepsy Center Hessen, Philipps-University, Marburg, Germany
| | - Anita Albert
- Epilepsy Center Hessen, Philipps-University, Marburg, Germany
| | | | - Leona Möller
- Epilepsy Center Hessen, Philipps-University, Marburg, Germany
| | - Lena Habermehl
- Epilepsy Center Hessen, Philipps-University, Marburg, Germany
| | - Adam Strzelczyk
- Epilepsy Center Hessen, Philipps-University, Marburg, Germany
- Epilepsy Center Frankfurt Rhine-Main, Goethe University, Frankfurt, Germany
| | - Felix Rosenow
- Epilepsy Center Hessen, Philipps-University, Marburg, Germany
- Epilepsy Center Frankfurt Rhine-Main, Goethe University, Frankfurt, Germany
| | - Anke Hermsen
- Epilepsy Center Hessen, Philipps-University, Marburg, Germany
- Epilepsy Center Frankfurt Rhine-Main, Goethe University, Frankfurt, Germany
| | - Susanne Knake
- Epilepsy Center Hessen, Philipps-University, Marburg, Germany
| | - Katja Menzler
- Epilepsy Center Hessen, Philipps-University, Marburg, Germany
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Keifer E, Duff K, Beglinger LJ, Barstow E, Andersen A, Moser DJ. Predictors of neuropsychological recovery in treatment for anorexia nervosa. Eat Disord 2010; 18:302-17. [PMID: 20603731 DOI: 10.1080/10640266.2010.490120] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Previous research indicates that individuals with Anorexia Nervosa (AN) often experience some degree of neuropsychological dysfunction. Although most aspects of cognition improve with treatment, factors that predict neuropsychological improvement remain elusive. The present study investigated whether cognitive reserve, the estimated level of premorbid cognitive functioning, and AN subtype predicted neuropsychological improvement during inpatient treatment for AN. Neuropsychological functioning was assessed pre- and post-hospitalization in 28 women with AN (18 with restricting type and 10 with binge-eating/purging type), and cognitive reserve was estimated at admission using a word reading test. Level of cognitive reserve and AN subtype were both significant predictors of neuropsychological improvement in this sample. Cognitive reserve was significantly associated with improvements in verbal memory, semantic fluency, basic auditory attention and visuospatial construction. Participants with AN binge-eating/purging type demonstrated significantly greater neuropsychological improvement during treatment than did participants with AN restricting type. Information about cognitive reserve and AN subtype may provide clinicians with valuable prognostic information and help guide treatment.
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Affiliation(s)
- Ekaterina Keifer
- Department of Counseling Psychology, University of Iowa, Iowa City, Iowa, USA
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