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Background: Cognitive dysfunction is common in multiple sclerosis (MS). Deficits can affect attention, concentration, planning, and memory. They can have severe functional consequences in many domains. Cognitive complaints are frequently associated with other confounding factors (fatigue, anxiety, depression, or treatment side effects). In most cases, cognitive assessment is proposed after a spontaneous complaint, but determining the extent of discomfort perceived by the patient, the influence of coexisting factors, or the optimal timing for a more complete neuropsychological assessment is difficult., Objective: The objective of this work was to evaluate the feasibility and relevance of a fast global assessment of both objective and subjective cognitive dysfunction in MS., Methods: MS patients underwent a brief cognitive assessment including 7 visual analogue scales (VASs) asking about the patient's subjective level of discomfort in various domains, a memory test (Barbizet's lion story), a commonly used test of information processing speed (Symbol Digit Modalities Test [SDMT]) and self-reporting questionnaires for fatigue and mood (Fatigue Severity Scale [FSS] and Hospital Anxiety and Depression Scale [HADS]). Spearman correlation coefficients among scores were estimated., Results: The mean age of the 73 patients included was 48.3 (SD 11.1) years; 78% were females and 52.8% had the remittent-recurrent MS form, 8.3% the primary progressive form, and 38.9% the secondary progressive form. In less than 20min, this brief cognitive assessment was able to identify symptoms and quantify discomfort level. Symptoms of fatigue and anxiety frequently coexisted with cognitive complaints. We found modest correlations between scores on the VAS fatigue and the FSS and between scores on the VAS mood and the HADS. Analytical evaluation revealed that most patients had similar SDMT and recall profiles; however, a small proportion showed a dissociation between these 2 tests, which validated the inclusion of both tests in the assessment. Accounting for coexisting factors (e.g., anxiety and fatigue) and their functional repercussions is essential for prioritizing these problems within the context of multidisciplinary patient treatment., Conclusion: Considering the possible multifactorial character of cognitive dysfunction in MS, it is essential to ask patients about their experiences and to take into account cognitive complaints in the follow-up of patients. The assessment tool we propose is simple and easy to use in a clinical setting and provides the information necessary for requesting (or not) a more complete neuropsychological assessment., (Copyright © 2019 Elsevier Masson SAS. All rights reserved.)

Objectives To examine whether changes in the cardiac autonomic nervous system ( ANS) over time, as expressed by baroreflex sensitivity ( BRS), were associated with long-term changes in cognitive performance in elderly individuals without dementia. Design Community-based 8-year longitudinal study. Setting Clinical settings. Participants Individuals aged 66.9 ± 0.9 (N = 425). Measurements At baseline and follow-up, subjects underwent a clinical interview, autonomic and vascular measurements, and a neuropsychological evaluation including attentional, executive, and memory tests using standardized Z-scores. BRS was defined as being normal, moderate, or severe alteration at each evaluation. On the basis of the longitudinal changes subjects were stratified as being stable, moderate or improved. Results Mean attentional, executive, and memory change Z-scores were −0.41 ± 0.9, −0.15 ± 0.7, and −0.14 ± 0.8, respectively. BRS of 56% of the subjects remained unchanged, of 20% decreased, and of 24% improved. After regression analysis, the worsened BRS group was 1.88 times as likely to have greater memory change as the group with stable BRS ( P = .02). No significant association was found between longitudinal change in BRS and attentional and executive changes. Conclusion In healthy elderly individuals, BRS decrease was associated with a weak but significant decrease in memory function. The long-term effect of BRS on memory changes may suggest a role of the ANS in cognitive decline. [ABSTRACT FROM AUTHOR]

Objectives To assess the role of the cardiac autonomic nervous system ( ANS), as measured according to spontaneous cardiac baroreflex sensitivity ( BRS), in the type and degree of cognitive performance in healthy young-elderly individuals, taking into account the presence of other vascular risk factors. Design Community-based cross-sectional study. Setting In-home and clinical settings. Participants A subset of participants, aged 66.9 ± 0.9, from a prospective study that aimed to assess the influence of ANS activity on cardiovascular and cerebrovascular morbidity and mortality (N = 916). Measurements All subjects underwent a clinical interview, neuropsychological testing, and autonomic and vascular measurements. Three cognitive domains were defined: attentional ( Trail- Making Test Part A, Stroop code and parts I & II), executive ( Trail- Making Test Part B, Stroop part III, verbal fluency and similarity tests), and memory (Benton visual retention test, Grober and Buschké procedure). Subjects were stratified according to their scores into normal, low, and impaired performers. Results After adjustments to demographic and vascular data, participants with moderate autonomic dysregulation (3 < BRS ≤ 6) were determined to be 1.82 times as likely to have memory impairment (odds ratio ( OR) = 1.82, 95% confidence interval ( CI) = 1.13-3.17, P = .02) and those with severe autonomic dysregulation ( BRS ≤ 3) to be 2.65 as likely ( OR = 2.65, 95% CI = 1.40-5.59, P = .006) as participants with normal BRS (>6). Conclusion In older individuals without dementia, autonomic dysregulation seems to have a direct, gradual, and independent effect on memory. Future studies are needed to evaluate the long-term effects of BRS and other markers of the ANS on cognitive decline. [ABSTRACT FROM AUTHOR]

Background: The Neuropsychiatric Inventory (NPI) and the Frontal Behavioral Inventory (FBI) are widely used in patients with the behavioral variant of frontotemporal dementia (bvFTD). Yet, few data are available on the long-term relevance of these scales. Material and Methods: Based on a bvFTD population that participated in the Memantine Clinical Trial (NCT00200538), we studied the evolution and correlation between scores obtained on behavioral scales (NPI and FBI), cognitive scales [Mini-Mental State Examination (MMSE) and Mattis Dementia Rating Scale (MDRS)] and a burden scale [Zarit Burden Inventory (ZBI)]. The assessments were performed at 1 year in 41 patients and at 2 years in 23 patients who agreed to participate in this open-label study. Results: The 2-year scores obtained on the FBI were significantly higher than the scores at inclusion while those obtained on the NPI did not change. There were significant correlations between the FBI, and the MDRS and MMSE, especially regarding the negative items. The ZBI correlated with behavioral scales at all stages for positive items. Conclusions: This study based on a large population shows that the FBI is a better tool than the NPI for the long-term assessment of bvFTD patients. Moreover, the FBI allows a distinction to be made between behavioral disturbances that involve cognitive functions from those which have an important impact on caregiver burden. Copyright © 2012 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]