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Discriminant analysis of the cognitive performance profile of MS patients differentiates their clinical course.

OBJECTIVE: To compare the neuropsychological deficits of primary progressive multiple sclerosis with those of relapsing-remitting and secondary progressive multiple sclerosis. METHODS: Sixty-five patients with different clinical courses of MS were neuropsychologically tested for language, attention, memory and executive functions. Discriminant analysis was used to predict the type of clinical course either by clinical variables (age, EDSS and duration of illness) or neuropsychological test results. RESULTS: For single neuropsychological tests, group differences were rare between the progressive courses and the relapsing-remitting course of MS or absent between the progressive courses of MS. However, discriminant analysis correctly identified 87.7 percent of the patients' courses in general, and about 90 percent of the patients with chronic progressive MS. CONCLUSION: Using discriminant analysis, this study found neuropsychological impairment characteristic for relapsing remitting, secondary progressive and primary progressive patients.

Adult↗

The Thai version of the German Aachen Aphasia Test (AAT): description of the test and performance in normal subjects.

The Aachen Aphasia Test (AAT), originally developed as a test for aphasia language disorders in Germany, consists of six spontaneous speech rating scales and five subtests: Token Test, Repetition, Written Language, Confronting Naming and Comprehension. The study aimed to describe the linguistic properties of the AAT Thai version and to investigate the test performances of the normal subjects. In this study some problems of linguistic changes in the construction of the Thai version were discussed. The results revealed that the normal subjects' performances on the test were independent of age, sex and education level. Therefore, the Thai version of AAT is applicable to the differential diagnosis of the communicative abilities of Thai aphasic patients.

Adult↗

Consistency among commonly used procedures for assessment of abnormal children.

Administered the Stanford-Binet and/or its downward extension the Cattell Infant Intelligence Scale to 22 children in a school for severely behaviorally disordered boys and girls. Assessments also were made with the Vineland Social Maturity Scale and with a scale of language development. A subgroup of 17 children were assessed with Rimland's E-2 Scale, which is designed to assess the presence and degree of the condition of autism. Correlations among these commonly used assessment procedures are reported. Findings are discussed with respect to the construct validity of the tests and with respect to practical problems of implementation. Issues that concern the distinctiveness of specific classification dimensions and the heterogeneity of the syndrome of autism also are discussed.

Autistic Disorder↗

Visual degradation in Boston Naming Test performance.

The 60 pictures of the Boston Naming Test were degraded via a mask to be either "easy," "medium", or "hard" to process visually. The visual mask was created by cutting a 2-in. x 2-in. square from a security mailing envelope and progressively reducing the size 25% on a copy machine. Three groups of 50 undergraduates each were randomly assigned to one of these three degradation conditions, and the number of correct identifications made was measured. We expected that as degradation increased (from easy to medium to hard), Boston Naming Test performance would decrease. A one-way analysis of variance indicated that group scores differed. With "easy" degradation more pictures were identified in comparison with performance in the "hard" degradation condition, but no other differences were significant. Results were discussed from the perspective of how unknown situational variables may affect performance on psychological tests.

Adult↗

Individual differences in cerebral organization: influence of sex and familial sinistrality in the language lateralization of strongly right-handed subjects.

Sixty right-handed subjects, divided into four groups of 15 according to sex and familial sinistrality (FS), performed a test of language lateralization. A verbal-manual dual-task paradigm was employed. Results suggest that the pattern of cerebral organization may differ among right-handers in relation to both sex and FS. However, it is not merely the separate influence of these two factors, but rather their interaction which determines the pattern. It is stressed that identification of individual predictors of language laterality may provide some information on prognosis and management of aphasic patients.

Adult↗

Some evidence for distinctive language use by children with Attention Deficit Hyperactivity Disorder.

This paper reports early findings from a wider study that sought to test the hypothesis that differences in language use exist between children who have a diagnosis of Attention Deficit Hyperactivity Disorder (ADHD) and their non-ADHD peers. Twenty-two, 8 to 12 year-old children (11 with a diagnosis of ADHD and 11 matched peers) comprised the community-based sample. There were nine boys and two girls in each group. All the children were ranked at least average for their language ability on standardised language testing. This case-control study used an approach derived from Systemic Functional Linguistics (SFL) to examine and then compare spoken and written elicited language samples. SFL was thought to be particularly suitable because of its potential to richly describe language in use while taking contextual variation into account. Statistically significant overall differences between the subject and the control groups were found for the measure of grammatical intricacy (GI). Further analyses revealed these differences to be largely attributed to differences between group scores for written material. Discussion explores the potential relevance of these findings to the clinical evaluation of language ability in young school-aged children who have been diagnosed with ADHD.

Attention Deficit Disorder with Hyperactivity↗

Prediction of neuropsychological impairment in multiple sclerosis: comparison of conventional magnetic resonance imaging measures of atrophy and lesion burden.

BACKGROUND: Cognition and magnetic resonance imaging correlations are well established in patients with multiple sclerosis (MS), but it is unclear whether lesion burden or atrophy accounts for most of the predictive variance. These indices have been directly compared in only a few studies. No such study included measurement of the third ventricle, which was strongly predictive of neuropsychological competence in the early literature. Furthermore, few studies accounted for the influence of age, premorbid intelligence, or depression. OBJECTIVE: To determine if conventional measures of lesion burden or atrophy predict cognitive dysfunction in MS while accounting for age, premorbid intelligence, and depression. METHODS: We studied 37 patients with MS and 27 controls matched according to demographic variables. Correlations between neuropsychological tests and the following magnetic resonance imaging indices were considered: T1 hypointense lesion volume, fluid-attenuated inversion recovery hyperintense lesion volume, third ventricle width, bicaudate ratio, and brain parenchymal fraction. Regression models predicting neuropsychological performance controlled for the effects of age, premorbid intelligence, and depression. We included only those tests discriminating patients with MS from controls. RESULTS: In each regression model, third ventricle width was the sole magnetic resonance imaging measure retained. When this variable was removed from consideration, brain parenchymal fraction was retained in all analyses. CONCLUSIONS: Brain atrophy accounts for more variance than lesion burden in predicting cognitive impairment in MS, and central atrophy in particular is strongly associated with neuropsychological morbidity. This finding may be explained in part by atrophy of the thalamus, a deep gray matter structure that mediates cognitive function via cortical and subcortical pathways. Enthusiasm for the clinical utility of third ventricle width is tempered by modest intraobserver and interobserver reliability.

Adult↗

Cognitive function in juvenile myoclonic epilepsy.

In this study, we examined 35 patients with juvenile myoclonic epilepsy (JME) and 35 healthy volunteers. We used tests of cognitive performance (mini mental state examination, verbal and visual memory, visuospatial, frontal function, attention). In the JME group, we examined age, sex, family history, education level, age of seizure onset, seizure types, characteristics of EEG, duration of the therapy, drug dose and level, and verbal IQ level. Additionally, patients initially diagnosed as JME and patients who were initially under inappropriate drug therapy because of misdiagnosis were compared. As a result, we found statistically significant differences between JME patients and the control group with respect to verbal and visual memory. Furthermore, JME patients had impaired frontal and visuospatial function compared with the control group. We detected negative effects of younger age, family history, and absence seizures on cognitive function in JME patients.

Adolescent↗

[Specific remedial therapy in a specialist unit: evaluation of 31 children with severe, specific language or reading disorders over one academic year].

INTRODUCTION: Up to 3 percent of the children in France present severe and specific language and/or reading disorders, despite regular remedial therapies. Few studies have measured the effectiveness of treatment administered in a specialist unit. PATIENTS AND METHOD: The aims of this study, focusing on children diagnosed as dysphasic and/or dyslexic, were: During the academic year 2001-2002, 31 children (18 dyslexic and 13 dysphasic) were attending school in our unit. The teaching program and intensive speech therapy (3 hours/week) were tailored for each child according to his/her specific disorders. Reading, spelling and numeracy developmental skills of each child were evaluated by appropriate tools at the beginning and at the end of the year. Impairment was defined by measuring the gap between the observed and the expected skills, according to each child's age. Using a self-control method, progress achieved by each child throughout the year was calculated with each tool, in each subject, by subtracting the impairments disclosed at the beginning from those disclosed at the end of the year. Progression was classified within three groups according to the progress normally expected over an academic year (i.e. nine months) from children with no disabilities attending school regularly; a progression fewer than three months was considered as no progression. Uni- and multivariate analyses including age (< or= or />9), type of pathology (dysphasia/dyslexia), and intellectual quotient (IQ) as covariates was carried out to search for independent prognosticators. RESULTS: The entire group demonstrated during the year significant progress for reading (p = 0.0001), spelling (p = 0.0001) and numeracy (p = 0.0001). Nineteen children (61 percent) showed more progress in reading than normally expected over nine months. Out of the remaining 12 children, 10 demonstrated more progress in spelling and/or numeracy than normally expected over nine months. All three reading evaluation tools disclosed a progression although one was less efficient (p = 0.05). Multivariate analysis disclosed age< or=9 and dysphasia as independent progress prognosticators. CONCLUSION: Placement in a specialist unit allows children suffering from severe dyslexia and dysphasia to lessen the gap in reading, spelling and numeracy. The two prognosticators disclosed highlight the importance of early diagnosis (i.e. before nine years old) and treatment of specific language and/or reading disorders.

Aphasia↗