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
People with multiple sclerosis (PwMS) often experience symptoms that can have a significant impact on psychological and cognitive functioning. Research has previously shown a significant...Show morePeople with multiple sclerosis (PwMS) often experience symptoms that can have a significant impact on psychological and cognitive functioning. Research has previously shown a significant association between these two functions. The aim of this paper was to study the association between psychological factors (depression and fatigue) and cognitive functions (memory, verbal fluency, and information processing speed). Studying fatigue, depressed mood, and the combination between them can provide important indications to how psychological status relates to cognitive functioning. Cognitive functions of memory, verbal fluency, and information processing speed were measured through Buschke Selective Reminding test, Controlled Oral Word Association test, and the Symbol Digit Modalities test, respectively. Depressed mood was measured with the Hospital Anxiety and Depression Scale, and fatigue was measured with the Fatigue Scale for Motor and Cognitive Functions. Patients (N=124; mean age = 50.77 [SD = 13.5]; 25% male, 93% female; 9.7% PPMS, 28.5% SPMS, 61.3% RRMS) were categorized into four groups based on their depression and fatigue scores using clinical cut-offs (i.e., psychologically intact [no depressive mood, not fatigued], depressive mood but not fatigued, fatigued but no depressive mood, and psychologically impaired [depressive mood and fatigued]). Group did significantly differ on MS type (p < .05), Group 1 (psychologically intact) and Group 4 (no depressive mood but fatigued) were more likely to have a relapse-remitting disease course. However, findings suggest no significant association between group and cognitive functioning. Scores on the cognitive tests were similar across all groups (p = .203). This indicates that cognitive functioning is independent of psychological status. However, in light of the limitations, it is important to build on future studies to investigate this relationship further, to indicate a next step in the treatment and intervention of MS in terms of psychological problems, cognitive deficits, or both.Show less
Apart from its motor symptoms, Parkinson´s disease (PD) is characterized by cognitive deficits; among these, executive functioning (EF) deficits are common. Stroke studies have shown a role of the...Show moreApart from its motor symptoms, Parkinson´s disease (PD) is characterized by cognitive deficits; among these, executive functioning (EF) deficits are common. Stroke studies have shown a role of the whole thalamus, and specifically the medial nuclear group (Mng), in EF. Although in PD studies have shown volume loss in the thalamus and Mng, little is known about the relationship between this phenomenon and EF deficits in PD. We aimed to address this gap and examine the relationship between thalamic and Mng volumes and EF in PD. As the thalamus is difficult to segment due to poor tissue contrast, we also aimed to explore whether using Phase-Sensitive Inversion Recovery MRI scans in addition to T1 MRI scans (T1+PSIR MRI) would optimize automatic thalamic segmentation over using T1 MRI scans alone. A total of 76 PD participants underwent T1 and PSIR MRI scans and completed tests measuring verbal fluency, resistance to cognitive interference and planning abilities, which were used to calculate an EF composite score. We found that using T1+PSIR MRI scans resulted in a more accurate thalamic segmentation as shown by less thalamic overestimation especially in the lateral and anteroventral nuclear groups, and smaller thalamic and nuclear groups volumes. We used the derived volumes to relate to global EF performance. Results showed that total thalamic and total Mng volumes were not significantly related to global EF performance (β = .08, t = 1.24, p = .22; β = .16, t = 1.71, p = .09, respectively). Results of exploratory analyses showed a positive significant relationship between left (β = .16, t = 2.26, p = .02) and right (β = .18, t = 2.67, p = .01) thalamic volumes and left (β = .25, t = 2.84, p = .01) Mng volume and verbal fluency performance. In this thesis project we demonstrated that automatic thalamic segmentation can be optimized by using PSIR MRI scans. Although the association between thalamic and Mng volumes and global EF in PD is not supported in this thesis project, volumes seem to be specifically associated with verbal fluency. We propose that this could be due to the role of the Mng in cognitive flexibility. Supported by future longitudinal studies, our findings could have implications for early diagnosis and effective management of verbal fluency deficits in PD.Show less
