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Graphic representation of discriminant analysis using the same dataset as in Fig. 2. Note the smaller dispersion of Group 1 performances, which suggests that healthy controls and a subgroup of multiple sclerosis patients had similar cognitive performance. In contrast, Group 2 performances show greater dispersion for selected CANTAB neuropsychological tests, with the spatial distribution for Group 2 being quite distinct from that of the Group 1 dataset
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Background
It is essential to investigate cognitive deficits in multiple sclerosis (MS) to develop evidence-based cognitive rehabilitation strategies. Here we refined cognitive decline assessment using the automated tests of the Cambridge Neuropsychological Test Automated Battery (CANTAB) and hierarchical cluster analysis. Methods
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Background
As the sector of the population over 65y increases, cognitive decline and dementia become a public health issue. Interventions to improve brain health and thus, quality of life for older adults are needed.
Objective
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Citations
... Cambridge Neuropsychological Test Automated Battery (CANTAB) was developed to assess cognitive function and has been widely used in the literature (Alsuwaidi et al., 2023;Robbins et al., 1994;Sabahi et al., 2022). It has good sensitivity and accuracy to detect subtle cognitive decline in clinical conditions, e.g (Barnett et al., 2016;Cabeça et al., 2018;Sahgal et al., 1991;Van Praag et al., 2022;Wang et al., 2022) and healthy populations (Barnett et al., 2016;ROBBINS et al., 1998;Soares et al., 2014). It quantitatively assesses several cognitive domains, especially attention, memory, executive function, emotion and social cognition, and psychomotor speed (https://www.cambridgecognition. com/). ...
... Three analyzes were initially performed, one included the total sample (415 participants) and two other were intragroup analysis dedicated separately to young adults (n = 179) and older adults (236). We first estimate the multimodal index to select only bimodal or multimodal variables to be included in the hierarchical cluster analysis (MMI > 0.5) (Cabeça et al., 2018;Schweitzer & Renehan, 1997). ...
... Important to highlight that this group preserved good performances in episodic memory and working memory as all other young groups. Given the cognitive profile of this group, with a prominent decline in psychomotor speed, it would be important to monitor the progression of these individuals, considering that this profile can also be associated with demyelinating diseases (Cabeça et al., 2018;Oreja-Guevara et al., 2019). ...
... In fact, these batteries are equipped with wide range of tests designed to assess several cognitive aspects including but not limited to spatial working memory, recognition memory, episodic memory, visual information processing, spatial abilities, attention and decision making (Bick et al., 2018;Gau and Huang, 2013;Manes et al., 2002;Nieto et al., 2008;Owen et al., 1995;Saxton et al., 2009). Also, these tests already demonstrated high accuracy for detecting subtle and mild cognitive declines in different conditions such as pollutants intoxications (Hassani et al., 2016;Pino et al., 2018), neurodegenerative diseases (Cabeca et al., 2018;Egerhazi et al., 2007), aging (Soares et al., 2015), and traumatic brain injury (Maillard-Wermelinger et al., 2009). ...
The occurrence of neurotoxicity caused by xenobiotics such as pesticides (dichlorodiphenyltrichloroethane, organophosphates, pyrethroids, etc.) or metals (mercury, lead, aluminum, arsenic, etc.) is a growing concern around the world, particularly in vulnerable populations with difficulties on both detection and symptoms treatment, due to low economic status, remote access, poor infrastructure, and low educational level, among others features. Despite the numerous molecular markers and questionnaires/clinical evaluations, studying neurotoxicity and its effects on cognition in these populations faces problems with samples collection and processing, and information accuracy. Assessing cognitive changes caused by neurotoxicity, especially those that are subtle in the initial stages, is fundamentally challenging. Finding accurate, non-invasive, and low-cost strategies to detect the first signals of brain injury has the potential to support an accelerated development of the research with these populations. Saliva emerges as an ideal pool of biomarkers and potential alternative diagnostic fluid to molecularly investigate neurotoxicity. As a source of numerous neurological biomarkers, saliva has several advantages compared to blood, such as easier storage, requires less manipulation, and the procedure is cheaper, safer and well accepted by patients compared with drawing blood. Regarding cognitive dysfunction, neuropsychological batteries represent, with their friendly interface, a feasible and accurate method to evaluate the eventual cognitive deficits associated with neurotoxicity in people from diverse cultural and educational backgrounds. The association of these two tools, saliva and neuropsychological batteries, to cover the molecular and cognitive aspects of neurotoxicity in vulnerable populations, could potentially increase the prevalence of early intervention and successful treatment.
... In previous reports (Cabral Soares et al., 2015;Bento-Torres et al., 2017;Cabeça et al., 2018) we standardized CANTAB tests procedures. Although we do not yet have a large sample to define norms and cutoff points for the Brazilian population, CANTAB tests are largely independent of cultural differences which allows appropriate comparative analysis across countries (Robbins et al., 1994;De Luca et al., 2003;Lee et al., 2013;McPhee et al., 2013). ...
Background
It has been suggested that physical inactivity and lack of stimulating cognitive activity are the two most significant modifiable risk factors to impair cognitive function. Although many studies that investigated the cognitive effects of physical exercise and cognitive stimuli in dual-task conditions showed improved cognitive performance, others have not confirmed these findings. The main aim of the present work is to analyze the effects of a dual-task multimodal physical exercise training, at moderate intensity, and cognitive stimulation on cognitive and physical function in healthy older adults.
Methods
This clinical trial was registered on the Brazilian Registry of Clinical Trials (RBR-9zrx3d). Here we tested the effects of a dual-task multimodal physical exercise training, at moderate intensity, on cognitive and physical function and quality of life in community dwelling older adults. The training protocol included 24 group sessions, 2/week, per 75 min. Cognition was assessed using CANTAB automated neuropsychological tests and Functional Capacity to Exercise tests. Performance was compared from baseline to post intervention and to a non-exercise control group using Mixed Linear Model for repeated measures.
Results
Control (CG) and dual-task (DTEx) groups progressed differentially over time on performance of episodic memory, sustained visual attention, functional mobility, cardiorespiratory fitness, lower limbs strength resistance, agility, quality of life and dual-task performance with significant improved DTEx performance. Control group did not show any significant changes on these tests except for showing a reduction in dual-task performance.
Conclusion
We suggest that the dual-task combination of multisensory cognitive stimulation and multimodal moderate physical exercise training, twice a week, may be adopted as an effective program to reduce progression of age-related cognitive decline and improve physical fitness and quality of life on healthy older adults.
Clinical Trial Registration
Brazilian Registry of Clinical Trials: https://ensaiosclinicos.gov.br/rg/RBR-9zrx3d -UTN code: U1111-1233-6349.
... In previous reports (Cabral Soares et al., 2015;Bento-Torres et al., 2017;Cabeça et al., 2018) we standardized CANTAB tests procedures. Although we do not yet have a large sample to define norms and cutoff points for the Brazilian population, CANTAB tests are largely independent of cultural differences which allows appropriate comparative analysis across countries (Robbins et al., 1994;De Luca et al., 2003;Lee et al., 2013;McPhee et al., 2013). ...
Background: It has been suggested that physical inactivity and lack of stimulating cognitive activity are the two most significant modifiable risk factors to impair cognitive function. Although many studies that investigated the cognitive effects of physical exercise and cognitive stimuli in dual-task conditions showed improved cognitive performance, others have not confirmed these findings. The main aim of the present work is to analyze the effects of a dual-task multimodal physical exercise training, at moderate intensity, and cognitive stimulation on cognitive and physical function in healthy older adults.
Methods: This clinical trial was registered on the Brazilian Registry of Clinical Trials (RBR-9zrx3d). Here we tested the effects of a dual-task multimodal physical exercise training, at moderate intensity, on cognitive and physical function and quality of life in community dwelling older adults. The training protocol included 24 group sessions, 2/week, per 75 min. Cognition was assessed using CANTAB automated neuropsychological tests and Functional Capacity to Exercise tests. Performance was compared from baseline to post intervention and to a non-exercise control group using Mixed Linear Model for repeated measures. Results: Control (CG) and dual-task (DTEx) groups progressed differentially over time on performance of episodic memory, sustained visual attention, functional mobility, cardiorespiratory fitness, lower limbs strength resistance, agility, quality of life and dual-task performance with significant improved DTEx performance. Control group did not show any significant changes on these tests except for showing a reduction in dual-task performance. Conclusion: We suggest that the dual-task combination of multisensory cognitive stimulation and multimodal moderate physical exercise training, twice a week, may be adopted as an effective program to reduce progression of age-related cognitive decline and improve physical fitness and quality of life on healthy older adults.
Clinical Trial Registration: Brazilian Registry of Clinical Trials: https://ensaiosclinicos.gov.br/rg/RBR-9zrx3d -UTN code: U1111-1233-6349.
... CANTAB is a touchscreen-based tool that employs visuospatial stimuli to produce nonverbal reactions in the participants. As a result, it is highly appropriate for cognitive function evaluation in patients from various cultural settings [3,5]. ...
Introduction:
Changes in the levels of circulating markers of inflammation, oxidative stress, and neurotrophic factors might be a good candidate for the prediction of cognitive impairment in multiple sclerosis (MS). Here, the correlation between the mentioned circulating markers with the Cambridge neuropsychological test automated battery (CANTAB) task outcomes was determined in MS patients.
Methods:
The CANTAB (paired-associate learning (PAL), reaction time (RTI), rapid visual information processing (RVP), and spatial working memory tasks (SWM)) was completed by the patients. Accordingly, the serum levels of interferon-γ (INF-γ), C-reactive protein (CRP), ciliary neurotrophic factor (CNTF), glial cell line-derived neurotrophic factor (GDNF), and brain-derived neurotrophic factor (BDNF), malondialdehyde (MDA), total antioxidant capacity (TAC), and the acetylcholine esterase (AChE) activity were measured. Cognitive impairment status and the correlation between the circulating factors with the CANTAB outcomes were determined.
Results:
The cognitively impaired (CI) patients appropriately differentiated from not cognitively impaired (NCI) ones using the CANTAB tasks. The serum levels of MDA, TAC, CRP, INF-γ, and GDNF correlated with the cognitive scores in MS patients (p < 0.05). After adjusting for age, sex, disease duration, and disability levels (covariates in a regression model), the MDA, INF-γ, and GDNF factors levels were statistically different between CI and NCI groups (p < 0.05).
Discussion:
The mentioned markers might predict the cognitive impairment progress and be used as an index of its detection, in addition to neuropsychological assessments, in MS patients.
... The Cambridge Neuropsychological Test Automated Battery (CANTAB) is a validated nonverbal task that utilizes visuospatial stimuli and touchscreen innovation to elicit nonverbal reactions from the subjects. The CANTAB is especially appropriate for intellectual appraisals of patients from different cultural backgrounds as it includes negligible cultural interference in information obtaining tasks (Benedict et al., 2017, Cabeça et al., 2018. This battery can test various cognitive functions such as executive function, learning, memory, problem-solving, and attention in a shorter time compared with the MACFIMS battery. ...
... Also, the game-like nature of this test motivates the subjects to get engaged more rapidly (Kuzmickienė and Kaubrys, 2015). Therefore, this battery has been successfully applied to detect cognitive dysfunction in mild cognitive impairment, Alzheimer's disease (Égerházi et al., 2007), and MS (Roque et al., 2011, Cabeça et al., 2018. In this study, we aimed to determine how this battery compared to the MACFIMS in terms of sensitivity, specificity, and predictive values in the differentiation of cognitive impairment in MS patients. ...
... This analysis showed that MS patients had lower scores in RTI, RVP, PAL, and delayed matching-to-sample tasks as opposed to the controls. This study suggested that the CANTAB might be able to expose subtle and early alterations in information processing speed and cognition in MS patients enabling clinicians to administer therapeutic measures earlier (Cabeça et al., 2018). Other findings have also shown that the CANTAB can successfully differentiate dementia of Alzheimer's type (DAT) and mild cognitive impairment (MCI) from healthy individuals (O'Connell et al., 2004(O'Connell et al., , Égerházi et al., 2007. ...
Background
We determined how the Cambridge Neuropsychological Test Automated Battery (CANTAB) compared to the Minimal Assessment of Cognitive Function in multiple sclerosis (MACFIMS) in terms of sensitivity, specificity, and predictive values in detecting cognitive impairment in multiple sclerosis (MS) patients.
Methods
Sixty MS patients were recruited, 2 of whom were lost to follow-up. On the first day of the neuropsychological examination, the standard MACFIMS battery and the day after, the CANTAB (paired-associate learning (PAL), reaction time (RTI), rapid visual information processing (RVP), and spatial working memory tasks (SWM)) were completed by the patients. The sensitivity, specificity, and predictive values of the CANTAB in the differentiation of cognitively impaired (CI) patients from not cognitively impaired (NCI) ones were compared with those of the MACFIMS battery using appropriate statistical tests.
Results
Fifty-eight patients were categorized into two groups of CI (n=16 (27.58%)) and NCI (n=42 (72.41%)) based on the MACFIMS battery standard criteria. The best reporter indices and their cut-off scores for differentiation of CI from NCI patients in each task of the CANTAB were “total errors=13” for PAL, “between errors=26” for SWM, “five-choice reaction time=368.57” for RTI, and “mean latency=522.14” for RVP. The optimal cut-off point for distinguishing CI from NCI in the CANTAB was found to be an impaired function in 3 or more tasks [(AUC (95% CI): 0.97 (0.94–1.00); p<0.001)]. Accordingly, 36.20% of the patients were CI based on the CANTAB criteria. The inter-test agreement (CANTAB and MACFIMS batteries) was found to be the highest (Cohen's κ (95% CI): 0.80 (0.64–0.96)).
Conclusion
Results confirm that the CANTAB can discriminate CI from NCI MS patients with high accuracy, and its results are comparable to those of the MACFIMS battery; thus, they might be interchangeably used in the clinical practice.
... EDSS correlations were as follows: NeuroTrax Attention r = 0.2667and Attention Network Test Overall score r = 0.48. 93 EDSS did not correlate with CANTAB Rapid Visual Processing,69Attention Network Test- Alerting,94and the Amieva Go-No-Go Test. 95 ...
Background
The proliferation of computerized neuropsychological assessment devices (CNADs) for screening and monitoring cognitive impairment is increasing exponentially. Previous reviews of computerized tests for multiple sclerosis (MS) were primarily qualitative and did not rigorously compare CNADs on psychometric properties.
Objective
We aimed to systematically review the literature on the use of CNADs in MS and identify test batteries and single tests with good evidence for reliability and validity.
Method
A search of four major online databases was conducted for publications related to computerized testing and MS. Test–retest reliability and validity coefficients and effect sizes were recorded for each CNAD test, along with administration characteristics.
Results
We identified 11 batteries and 33 individual tests from 120 peer-reviewed articles meeting the inclusion criteria. CNADs with the strongest psychometric support include the CogState Brief Battery, Cognitive Drug Research Battery, NeuroTrax, CNS-Vital Signs, and computer-based administrations of the Symbol Digit Modalities Test.
Conclusion
We identified several CNADs that are valid to screen for MS-related cognitive impairment, or to supplement full, conventional neuropsychological assessment. The necessity of testing with a technician, and in a controlled clinic/laboratory environment, remains uncertain.
Objective
To test the null hypothesis that oral intake of the dietary supplement carboxy alkyl ester (CAE) would have no effect on attention as revealed by mean rapid visual information processing (RVIP) scores.
Methods
In a randomized double‐blind cross‐over placebo‐controlled trial, healthy participants (age 19–66 years) of both sexes were randomly assigned to consume 700 mg of CAE or 700 mg of placebo. They received baseline attention testing via the RVIP task. Then they consumed CAE or placebo followed by RVIP testing. Participants were then given a washout period where they did not consume CAE or placebo. Afterward, individuals who initially consumed CAE were given the placebo and those who initially consumed the placebo were given CAE. Finally, all participants were tested again via RVIP.
Results
A priori statistical computation revealed that 30‐day oral intake of CAE improved mean RVIP test scores ( t = 2.4, p < .05) relative to that at baseline, which resulted in a rejection of the null hypothesis.
Conclusions
Daily oral intake of the CAE dietary supplement may boost attention and further research is now needed to confirm this observation.
We used network analysis to identify subtypes of relapsing-remitting multiple sclerosis subjects based on their cumulative signs and symptoms. The electronic medical records of 113 subjects with relapsing-remitting multiple sclerosis were reviewed, signs and symptoms were mapped to classes in a neuro-ontology, and classes were collapsed into sixteen superclasses by subsumption. After normalization and vectorization of the data, bipartite (subject-feature) and unipartite (subject-subject) network graphs were created using NetworkX and visualized in Gephi. Degree and weighted degree were calculated for each node. Graphs were partitioned into communities using the modularity score. Feature maps visualized differences in features by community. Network analysis of the unipartite graph yielded a higher modularity score (0.49) than the bipartite graph (0.25). The bipartite network was partitioned into five communities which were named fatigue, behavioral, hypertonia/weakness, abnormal gait/sphincter, and sensory, based on feature characteristics. The unipartite network was partitioned into five communities which were named fatigue, pain, cognitive, sensory, and gait/weakness/hypertonia based on features. Although we did not identify pure subtypes (e.g., pure motor, pure sensory, etc.) in this cohort of multiple sclerosis subjects, we demonstrated that network analysis could partition these subjects into different subtype communities. Larger datasets and additional partitioning algorithms are needed to confirm these findings and elucidate their significance. This study contributes to the literature investigating subtypes of multiple sclerosis by combining feature reduction by subsumption with network analysis.
Resumo: O presente estudo tem o objetivo de revisar artigos científicos que abordam sobre a Esclerose Múltipla na perspectiva da Logoterapia por meio de uma Revisão Integrativa da Literatura. As buscas foram realizadas nas bases: Biblioteca Virtual em Saúde - Brasil (BVS Brasil); Scientific Electronic Library Online (SciElo); Serviço da Biblioteca Nacional de Medicina dos Estados Unidos para acesso gratuito ao Medline (PubMed) e Revista Logos & Existência, vinculada à Associação Brasileira de Logoterapia e Análise Existencial (ABLAE). A revisão aponta como resultados o quanto ainda se pode avançar nos estudos da Esclerose Múltipla na perspectiva da Logoterapia e como a Logoterapia pode ser eficaz para o tratamento de quadros de ansiedade de pessoas com Esclerose Múltipla. Abstract:The present study aims to review scientific articles that address Multiple Sclerosis from the perspective of Logotherapy through an Integrative Literature Review. The searches were carried out in the following databases: Virtual Health Library - Brazil (BVS Brazil); Scientific Electronic Library Online (SciElo); Service of the National Library of Medicine of the United States for free access to Medline (PubMed) and Revista Logos & Existência, linked to the Brazilian Association of Logotherapy and Existential Analysis (ABLAE). The review points out as results how much progress can still be made in Multiple Sclerosis studies from the perspective of Logotherapy and how Logotherapy can be effective for the treatment of anxiety in people with Multiple Sclerosis.Keywords: Multiple Sclerosis; Logotherapy; Psychotherapy
