Faculty Bibliography
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254
Hereditary Spastic Paraplegia: The Relationships of Patient Perceived Functional Impact and Objective Quantified Multi-Dimensional Gait Analysis [Meeting Abstract]
ISI:000475965904300
ISSN: 0028-3878
CID: 5344122
Investigation into to the Relationship between Digital Brain Volume and Computerized Screening Assessment of Cognitive Function in People with Multiple Sclerosis: Objective Analytics to Quantify Disease Impact - Cross Sectional Relationship [Meeting Abstract]
ISI:000475965905042
ISSN: 0028-3878
CID: 5344132
Validity of a multi-domain computerized cognitive assessment battery for patients with multiple sclerosis
BACKGROUND:Computerized cognitive batteries may facilitate the integration of neuropsychological assessments into routine clinical care of patients with multiple sclerosis (PwMS). OBJECTIVE:To assess the construct and criterion validity of a computerized, multi-domain cognitive assessment battery (CAB, NeuroTrax) in MS. METHODS:81 PwMS and 15 healthy controls (HC) completed the CAB and a set of traditional neuropsychological tests recommended for MS on the same day. Principal component factor analysis was used to assess construct validity. For criterion validity, the gold standard definition of cognitive impairment was a score of ≥1.5SD below average on at least one cognitive domain, based upon traditional test normative data. Receiver operating characteristic (ROC) analysis was used to examine the ability of the CAB to discriminate cognitively impaired PwMS. RESULTS:Traditional and computerized tests of memory, processing speed, visuospatial and executive function converged by factor analysis. Computerized tests detected cognitive impairment with 85% sensitivity and 70% specificity. PwMS classified as impaired on only the computerized battery had significantly prolonged response times and a higher rate of unemployment compared with PwMS classified as unimpaired on both batteries. Poor executive function was more likely to be revealed by the CAB. CONCLUSION/CONCLUSIONS:The specific computerized assessment battery evaluated is valid for cognitive screening of people with MS and may be more likely to detect prolonged response times and impaired executive function.
PMID: 30772674
ISSN: 2211-0356
CID: 5342232
Among Real-world Multiple Sclerosis Patients That Experience Delayed-release Dimethyl Fumarate-associated Lymphopenia, Meaningful Lymphocyte Reconstitution Occurs Approximately 3 Months After Discontinuation of Delayed-release Dimethyl Fumarate [Meeting Abstract]
ISI:000475965903355
ISSN: 0028-3878
CID: 5344112
The Relationship between Obstructive Sleep Apnea and Age, Gender, EDSS, Disease Duration, and BMI in People with Multiple Sclerosis Who Report Fatigue: More than Size Matters [Meeting Abstract]
ISI:000475965907024
ISSN: 0028-3878
CID: 5344142
Monitoring cognitive function in people with multiple sclerosis: a 2 year longitudinal comparison of traditional and computerized cognitive testing [Meeting Abstract]
ISI:000485303100315
ISSN: 1352-4585
CID: 5344152
Computerized neuropsychological assessment devices in multiple sclerosis: A systematic review
BACKGROUND/UNASSIGNED: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/UNASSIGNED: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/UNASSIGNED: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/UNASSIGNED: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/UNASSIGNED: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.
PMID: 31637963
ISSN: 1477-0970
CID: 4147242
Siponimod versus placebo in secondary progressive multiple sclerosis (EXPAND): a double-blind, randomised, phase 3 study
BACKGROUND:modulator, on disability progression in patients with SPMS. METHODS:This event-driven and exposure-driven, double-blind, phase 3 trial was done at 292 hospital clinics and specialised multiple sclerosis centres in 31 countries. Using interactive response technology to assign numbers linked to treatment arms, patients (age 18-60 years) with SPMS and an Expanded Disability Status Scale score of 3·0-6·5 were randomly assigned (2:1) to once daily oral siponimod 2 mg or placebo for up to 3 years or until the occurrence of a prespecified number of confirmed disability progression (CDP) events. The primary endpoint was time to 3-month CDP. Efficacy was assessed for the full analysis set (ie, all randomly assigned and treated patients); safety was assessed for the safety set. This trial is registered with ClinicalTrials.gov, number NCT01665144. FINDINGS:1651 patients were randomly assigned between Feb 5, 2013, and June 2, 2015 (1105 to the siponimod group, and 546 to the placebo group). One patient did not sign the consent form, and five patients did not receive study drug, all of whom were in the siponimod group. 1645 patients were included in the analyses (1099 in the siponimod group and 546 in the placebo). At baseline, the mean time since first multiple sclerosis symptoms was 16·8 years (SD 8·3), and the mean time since conversion to SPMS was 3·8 years (SD 3·5); 1055 (64%) patients had not relapsed in the previous 2 years, and 918 (56%) of 1651 needed walking assistance. 903 (82%) patients receiving siponimod and 424 (78%) patients receiving placebo completed the study. 288 (26%) of 1096 patients receiving siponimod and 173 (32%) of 545 patients receiving placebo had 3-month CDP (hazard ratio 0·79, 95% CI 0·65-0·95; relative risk reduction 21%; p=0·013). Adverse events occurred in 975 (89%) of 1099 patients receiving siponimod versus 445 (82%) of 546 patients receiving placebo; serious adverse events were reported for 197 (18%) patients in the siponimod group versus 83 (15%) patients in the placebo group. Lymphopenia, increased liver transaminase concentration, bradycardia and bradyarrhythmia at treatment initiation, macular oedema, hypertension, varicella zoster reactivation, and convulsions occurred more frequently with siponimod than with placebo. Initial dose titration mitigated cardiac first-dose effects. Frequencies of infections, malignancies, and fatalities did not differ between groups. INTERPRETATION:Siponimod reduced the risk of disability progression with a safety profile similar to that of other S1P modulators and is likely to be a useful treatment for SPMS. FUNDING:Novartis Pharma AG.
PMID: 29576505
ISSN: 1474-547x
CID: 5348122
PML in immunocompromised patient populations : historical context
ORIGINAL:0016173
ISSN: 1075-4598
CID: 5347912
Manual dexterity and computerized cognitive testing in people with multiple sclerosis: motor domain reflects more than just what is in the hand [Meeting Abstract]
ISI:000446861400251
ISSN: 1352-4585
CID: 5343782
