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Background: While there is evidence of differences in the disease characteristics of multiple sclerosis (MS) across ethnic and racial groups, there has been limited research on cognitive functioning., Objective: To explore potential differences among Caucasian (CA), African-American (AA), and Hispanic (HA) adults from a clinical sample on the Minimal Assessment of Cognitive Function in MS (MACFIMS)., Methods: A total of 245 age- and disease duration-matched individuals (194 CA, 23 AA, and 28 HA) were included in the analyses. Their rates of impairment, using the criterion of two standard deviations (SD) below the normative mean, on the MACFIMS were compared using chi-square analyses with post-hoc pairwise comparisons (Bonferroni adjusted)., Results: Compared to CA, AA had higher rates of impairment on measures of complex attention (p < 0.001) and executive functions (p < 0.001)., Conclusions: These findings raise questions of whether the observed differences reflect the more aggressive disease course noted among AA or are due to discrepancies in performance on neuropsychological assessment that is associated with race/ethnicity in the general population. Future directions and implications are discussed.

Background Multiple sclerosis (MS) affects over 2.5 million individuals worldwide, yet much of the disease course is unknown. Hemispheric vulnerability in MS may elucidate part of this process but has not yet been studied. The current study assessed neuropsychological functioning as it relates to hemispheric vulnerability in MS. Methods Verbal IQ, as measured by verbal comprehension index (VCI), nonverbal IQ, as measured by perceptual reasoning index (PRI) and memory acquisition were compared in right-handed (dextral) and non-right-handed (non-dextral) persons with MS (PwMS). Results Linear mixed-effects modeling indicated a significant main effect of handedness, F (1, 195.35) = 3.95, p  = .048, for a composite measure of VCI, PRI, and memory acquisition, with better performance for dextral PwMS. In examining differences for specific neuropsychological measures, the largest effect size between dextral and non-dextral participants was seen in PRI (d  = 0.643), F (1,341) = 12.163, p  = .001. No significant interaction effect between handedness and IQ was found, F (3, 525.60) = 0.75, p  = .523. Conclusions Dextral PwMS perform better than non-dextral PwMS when assessing neuropsychological performance for memory and IQ combined. Results are suggestive of increased vulnerability in the left brain to the pathological process of MS. [ABSTRACT FROM AUTHOR]

Individuals with schizophrenia exhibit deficits in visual contrast processing, though less is known about how these deficits impact neurocognition and functional outcomes. This study investigated effects of contrast sensitivity (CS) on cognition and capacity for independent living in schizophrenia. Methods : Participants were 58 patients with schizophrenia (n = 49) and schizoaffective disorder (n = 9). Patients completed a psychophysical paradigm to obtain CS with stimuli consisting of grating patterns of low (0.5 and 1 cycles/degree) and high spatial frequencies (4, 7, 21 cycles/degree). Patients completed the MATRICS Consensus Cognitive Battery and Wechsler Adult Intelligence Scales, Third Edition to assess cognition, and the problem-solving factor of the Independent Living Scales to assess functional capacity. We computed bivariate correlation coefficients for all pairs of variables and tested mediation models with CS to low (CS–LSF) and high spatial frequencies (CS–HSF) as predictors, cognitive measures as mediators, and capacity for independent living as an outcome. Results: Cognition mediated the relationship between CS and independent living with CS–LSF a stronger predictor than CS–HSF. Mediation effects were strongest for perceptual organization and memory-related domains. In an expanded moderated mediation model, CS–HSF was found to be a significant predictor of independent living through perceptual organization as a mediator and CS–LSF as a moderator of this relationship. Conclusion: CS relates to functional capacity in schizophrenia through neurocognition. These relationships may inform novel visual remediation interventions. • Patients with schizophrenia (sz) show deficits in visual contrast detection. • First study to assess pathways from contrast sensitivity to functioning in sz. • Contrast sensitivity impacts cognition and functional outcomes in sz. • Novel treatments such as remediation of contrast detection may be helpful. [ABSTRACT FROM AUTHOR]

Objective: Cognitive dysfunction is prevalent in multiple sclerosis. As self-reported cognitive functioning is unreliable, brief objective screening measures are needed. Utilizing widely used full-length neuropsychological tests, this study aimed to establish the criterion validity of highly abbreviated versions of the Brief Visuospatial Memory Test – Revised (BVMT-R), Symbol Digit Modalities Test (SDMT), Delis–Kaplan Executive Function System (D-KEFS) Sorting Test, and Controlled Oral Word Association Test (COWAT) in order to begin developing an MS-specific screening battery.Method: Participants from Holy Name Medical Center and the Kessler Foundation were administered one or more of these four measures. Using test-specific criterion to identify impairment at both −1.5 and −2.0SD, receiver-operating-characteristic (ROC) analyses of BVMT-R Trial 1, Trial 2, and Trial 1 + 2 raw data (N = 286) were run to calculate the classification accuracy of the abbreviated version, as well as the sensitivity and specificity. The same methods were used for SDMT 30-s and 60-s (N = 321), D-KEFS Sorting Free Card Sort 1 (N = 120), and COWAT lettersFandA(N = 298).Results: Using these definitions of impairment, each analysis yielded high classification accuracy (89.3 to 94.3%).Conclusions: BVMT-R Trial 1, SDMT 30-s, D-KEFS Free Card Sort 1, and COWATFpossess good criterion validity in detecting impairment on their respective overall measure, capturing much of the same information as the full version. Along with the first two trials of the California Verbal Learning Test – Second Edition (CVLT-II), these five highly abbreviated measures may be used to develop a brief screening battery. [ABSTRACT FROM PUBLISHER]

Multiple sclerosis (MS) is frequently accompanied by changes in verbal memory. We hypothesized that administering an abbreviated California Verbal Learning Test-II (CVLT-II) would detect verbal memory problems in MS accurately, thus serving as a potential screening tool. We performed receiver-operating-characteristic (ROC) analyses of three trials (trial 1, trial 2, and trial 1+2 combined) for raw data against standardized total scores. The results showed that at 1.5 standard deviations (SD) from the mean, the first two trials were 96.3% accurate, while at 2 SD from the mean, the first two trials combined were 97.5% accurate. We conclude that this study demonstrates than an abbreviated CVLT-II is a valid screening tool for verbal memory impairments. [ABSTRACT FROM PUBLISHER]

Objectives: While resilience has been an area of increasing research, there are no measures that are specific to the psychological, social, and physical factors associated with resilience in persons with multiple sclerosis (PwMS). This study aimed to develop the MS Resiliency Scale (MSRS), a multidimensional measure. Items were created based on a review of the literature, with five hypothesized subscales, and then evaluated in a large sample of PwMS. Method: Participants (N = 932) were primarily recruited through the North American Research Committee on MS (NARCOMS) and completed the study electronically. Principal components analysis was utilized to determine the number of factors and whether they aligned with the theorized model. Results: Using an unforced solution with oblique (promax) rotation and Kaiser normalization, and suppressing items with coefficients below 0.4, 25 items were retained in five subscales that accounted for 42.75% of the variance: Emotional and Cognitive Strategies (13 items; α = .92), Physical Activity and Diet (3 items; α = .77), MS Peer Support (2 items; α = .82), Support from Family and Friends (5 items; α = .79), and Spirituality (2 items; α = .91). The total score was negatively correlated with depression, r = -.72, p < .001 and anxiety, r = -.56, p < .001. Implications: The 25-item MSRS assesses several psychological, social, and physical factors associated with resilience in PwMS, and may be a helpful tool in identifying individuals in need of additional assistance or support. [ABSTRACT FROM AUTHOR]

Objective: To examine how positive affect influences ability to benefit from heart rate variability (HRV) biofeedback treatment for individuals with severe brain injury. Method: Secondary data analysis of a nonrandomized experimental study that assessed the efficacy of biofeedback treatment for executive dysfunction in 13 individuals with chronic severe brain injury. Results: Bivariate correlations between the predictors (levels of HRV and positive affect) and the outcome (change in Category Test errors) showed large effect sizes for higher levels of HRV coherence (r = -.495, p = .085) but not for positive affect (r = .069, p = .824). Although positive affect had a negligible effect on Category Test improvements by itself, positive affect played a moderating role that complemented the effect of HRV coherence. HRV coherence had a stronger effect on Category Test performance among those participants who demonstrated higher positive affect. A regression model was fit that included main effects for HRV coherence and positive affect, as well as their interaction. The interaction term was significant in a 1-tailed test (b = -3.902, SE = 1.914, p = .072). Conclusions: Participants who had the most positive emotions made the most gains in the HRV biofeedback training and performed better posttreatment on a test designed to measure problem-solving ability. Results indicate that positive affect can improve cognition, specifically mental flexibility and abstract thinking. Addressing factors that shape negative affect such as irrational beliefs and self-doubt is an important target for therapeutic intervention even in those with severe, chronic deficits. [ABSTRACT FROM AUTHOR]