Verbal fluency refers to the ability to generate words or speech in an efficient manner. Some literature states having a verbal fluency deficit is a core symptom of Multiple Sclerosis (MS), whereas...Show moreVerbal fluency refers to the ability to generate words or speech in an efficient manner. Some literature states having a verbal fluency deficit is a core symptom of Multiple Sclerosis (MS), whereas other literature report no verbal fluency deficits in People with MS (PwMS). Therefore, the aim of the current paper is to investigate the frequency and underlying factors of verbal fluency deficits in individuals with MS. Data was retrospectively collected from patient charts. This data contained neuropsychological assessments that were performed to measure verbal fluency, depression, fatigue, and information processing speed. These were measured by the Controlled Oral Word Association test (COWAT), the depression subscale of the Hospital Anxiety and Depression Scale (HADS-D), Fatigue Scale for Motor and Cognitive Functions (FSMC) and Symbol Digit Modalities Test (SDMT). A total of 224 PwMS were included in the study. PwMS had a mean age of 52.2, 164 were female (73%), 138 had Relapsing Remitting MS (RRMS) (61.6%), 66 had Secondary Progressive MS (SPMS) (29.5%) and 20 had Primary Progressive MS (PPMS) (8.9%). Someone is considered to have a verbal fluency deficit when they have a COWAT score of 25 or lower (5th percentile). Results show that 34% (76/224) of PwMS show verbal fluency deficits. Furthermore, verbal fluency is affected more severely in people with SPMS than in people with RRMS (t(186)= 2.094, p = .019). Information processing speed significantly influences verbal fluency (F(1, 188) = 59,734, p = <.001). No effect of fatigue or depression was found on verbal fluency deficits. The findings from this study contribute to a better understanding of the frequency of verbal fluency deficits in MS and their relationship with depression, fatigue and information processing speed. The finding of a relatively high occurrence of verbal fluency deficits in PwMS should encourage neuropsychologists to be mindful of this deficit to increase cognitive care for PwMS.Show less
A high number (55-59%) of people with multiple sclerosis (MS) lose their job due to complex interactions between disease related factors, the working environment, job demands and personal factors....Show moreA high number (55-59%) of people with multiple sclerosis (MS) lose their job due to complex interactions between disease related factors, the working environment, job demands and personal factors. Identifying factors that will help provide a sustainable and healthy working life is essential. Our aim was to examine the association between cognitive fatigue and work functioning. The study included 225 individuals with relapsing-remitting MS in paid employment (>12 hours a week) (75.6 % female, median age: 42.5 years, median EDSS: 2.0). Five multiple regression analyses were conducted while accounting for known correlates (age, gender, education, duration of disease, MSrelated disability, job type) to examine the relationship between both subjective and objective measures of cognitive fatigue and work functioning in employees with MS. Secondly, a correlation analysis was conducted to examine the relationship between objective and subjective cognitive fatigue. Subjective cognitive fatigue is obtained by self-report questionnaires (Visual Analogue Scale (VAS)/Modified Fatigue Impact Scale (MFIS)) and objective cognitive fatigue is obtained by using a neuropsychological test, the Paced Auditory Serial Addition Test (PASAT). The outcome variables are (1) current work ability compared to lifetime's best measured by the Work Ability Index (WAI) and (2) work functioning measured by the 4 subscales of the Work Role Functioning Questionnaire-2 (WRFQ-2). No association was found between objective cognitive fatigue and work functioning. An explanation could be that objective and subjective measures are often only weakly correlated with each other. A lower subjective cognitive fatigue (MFIS: β = -.18, p = .041; VAS: β = -.39, p = < .001) was associated with better work ability. No association was found between subjective cognitive fatigue and the 4 subscales of the WRFQ-2 measuring work functioning. Lastly, no association was found between objective cognitive fatigue and subjective cognitive fatigue. In conclusion, subjective cognitive fatigue was associated with self-reported work ability in persons with relapsing-remitting MS with mild disability, while objective cognitive fatigue was not associated with self-reported work functioning. Further research should focus on objective measures of work functioning and other objective measures of cognitive fatigue.Show less
