P. Calabrese | University of Basel, Switzerland (original) (raw)
Papers by P. Calabrese
Parkinsonism & Related Disorders, 2008
Cognitive and affective dysfunctions are frequent but often neglected symptoms in Parkinson's dis... more Cognitive and affective dysfunctions are frequent but often neglected symptoms in Parkinson's disease (PD). We developed the screening tool Parkinson neuropsychometric dementia assessment (PANDA) with five cognitive tasks and a short depression questionnaire. Healthy subjects and patients without cognitive impairment (PD), mild cognitive disorder (PD-MCD), or dementia (PDD) were examined. The cognition part had a specificity of 91% and a sensitivity of 90% for PDD and 77% for PDD plus PD-MCD patients. The mood questionnaire also had high sensitivity and specificity. We conclude that the PANDA is an economical, easy-to-use and sensitive tool to detect neuropsychological dysfunctions in PD patients in clinical practice.
Fortschritte der Neurologie · Psychiatrie, 2001
BMC Neurology, 2014
Background: De-escalating natalizumab (NTZ) to interferon beta 1b (IFN B 1B) is a possible treatm... more Background: De-escalating natalizumab (NTZ) to interferon beta 1b (IFN B 1B) is a possible treatment option in multiple sclerosis (MS) patients interrupting NTZ because of increased risk of progressive multifocal leukoencephalopathy (PML). The aim of this study was to evaluate satisfaction and adherence to treatment, behavioral and fatigue changes in patients switched to IFN B 1B compared to continued NTZ treatment. Methods: A 1 year, prospective, randomized, rater-blinded, parallel-group study. Nineteen relapsing remitting (RR) MS patients, randomly assigned to undergo either NTZ (n = 10) or IFN B 1B (n = 9) treatment, who had previously received NTZ for at least 12 months with disease stability and fearing or at risk for PML were included. Patients underwent behavioral and treatment assessments at baseline, after 24-week and 1 year follow-up. Behavioral assessment included measures of cognition, fatigue and quality of life. Treatment assessment included measures of satisfaction, persistence and adherence to treatment. Clinical-radiological disease activity and safety were also assessed. Results: Baseline characteristics of patients were similar between groups except for Euro Quality Visual Analogue Scale, being higher in the NTZ group (p = 0.04). Within-group comparisons at the three time points, as well as interaction analysis of treatment effect over time did not show any statistically significant differences in behavioral or treatment assessments, but a coherent trend favoring NTZ over IFN B 1B. Conclusions: De-escalating NTZ to IFN B 1B is feasible and associated with overall good patient related outcome and persistently stable behavioral measures.
Der Nervenarzt, 2009
Ziel des Forschungsprojektes Kognitive Dysfunktionen im Rahmen der Multiplen Sklerose (MS) finden... more Ziel des Forschungsprojektes Kognitive Dysfunktionen im Rahmen der Multiplen Sklerose (MS) finden sich nahezu bei der Hälfte der MS-Patienten. Hierbei korreliert die zerebrale Läsionslast negativ mit der neuropsychologischen Leistung. Aktuellere Arbeiten stellen den potenziellen Einfluss der Läsionsverteilung auf das kognitive Defizitprofil heraus.
Journal of Neurology, Neurosurgery & Psychiatry, 1993
An industrial manager had severe retrograde and variable but usually mild anterograde amnesia fou... more An industrial manager had severe retrograde and variable but usually mild anterograde amnesia four years after a head injury. MRI showed damage of both temporal poles and the lateral portion of the right prefrontal cortex. The prefrontal and temporal cortical damage on the right side extended deeply into the white matter while the temporal cortical damage on the left side was much smaller. There was an additional left temporo-parietal lesion. The patient was of average intelligence. His attention, short term memory and learning ability were average or somewhat below average. His old memories were severely affected for the personal-episodic domain and less so for semantic remote memory abilities. Therefore an anatomical dissociation between anterograde and retrograde amnesia is possible at the anterior temporal regions, possibly interacting with the prefrontal cortex; these regions seem necessary for the retrieval of old episodic memories.
Neuropsychological Rehabilitation, 2012
This study compared a high intensity working memory training (45 minutes, 4 times per week for 4 ... more This study compared a high intensity working memory training (45 minutes, 4 times per week for 4 weeks) with a distributed training (45 minutes, 2 times per week for 8 weeks) in middle-aged, healthy adults. The aim was to clarify whether a computerised working memory training is effective and whether intensity of training influences training outcome. To evaluate the efficacy and possible transfer effects, a neuropsychological test battery assessing short-and long-term memory, working memory, executive functions and mental speed was applied at baseline and at retest. Our results indicate that the distributed training led to increased performance in all cognitive domains when compared to the high intensity training and the control group without training. The most significant differences revealed by interaction contrasts were found for verbal and visual working memory, verbal short-term memory and mental speed. These results support the hypothesis that cognitive
Journal of Neurology, Neurosurgery & Psychiatry, 1996
Der Nervenarzt, 2015
BACKGROUND It is quite common that people suffering from cognitive impairment only visit a doctor... more BACKGROUND It is quite common that people suffering from cognitive impairment only visit a doctor when the symptoms have already reached an advanced stage. This is often due to a fear of Alzheimer’s disease or a dread of exhausting diagnostic procedures and exposure of personal details; however, an early diagnosis and therapy increases the chance of preserving the quality of life for a longer period of time. OBJECTIVES Evaluation of a risk assessment for Alzheimer’s disease by magnetic resonance imaging (MRI) with respect to the acceptance and value by participants. METHODS In this prospective preventive study 106 subjects between the age of 39 and 89 years (median age 68 years) with general risk factors were included and underwent a risk assessment for Alzheimer’s disease by standard MRI of the brain using a 1 T open MRI with subsequent hippocampal volumetry. Participants were stratified into two distinct subgroups according to the individual hippocampal atrophy status, one with elevated and the other with reduced risk. All participants were thoroughly interviewed regarding anxieties and mental well-being before and after the risk assessment. RESULTS As expected, participants with a reduced risk had a significant improvement in well-being and a reduction of fears and worries after the examination. Neither a significant deterioration of the mental situation nor an increase of fears and worries was found for participants with an elevated risk. Of the participants 90% stated that MRI-based risk stratification generated positive perspectives for the future. The assessment revealed a high acceptance by most of the participants (94%). CONCLUSION An MRI-based risk assessment is beneficial to the patient’s quality of life and as a low threshold approach may induce more individuals with concerns to take advantage of an early diagnosis of Alzheimer’s disease.
Multiple Sklerose, 2001
Sind die in der Kernspintomografie in vivo darstellbaren multiplen zerebralen Lasionen der Multip... more Sind die in der Kernspintomografie in vivo darstellbaren multiplen zerebralen Lasionen der Multiplen Sklerose (MS) funktionell relevant? Statistische Korrelationen zur neurologischen Symptomatik verliefen in zahlreichen Untersuchungen der letzten anderthalb Jahrzehnte eher enttauschend. Untersuchungen dieser neurologisch „stumm“ erscheinenden Hirnlasionen bezuglich Storungen der hoheren Hirnleistungen waren jedoch sehr aufschlussreich (Beatty et al. 1989; Rao et al. 1989 a; Ron et al. 1991). Hinsichtlich neuropsychologischer Storungen hatte viele Jahre lang als neurologische Lehrmeinung gegolten, dass eine MS-Erkrankung hohere Hirnleistungen durchweg intakt belasse und etwa Demenz nur vereinzelt in Spatstadien auftrete. Allerdings hatte bereits Charcot wesentliche klinische Charakteristika der Multiplen Sklerose unter Einschluss neuropsychologischer Beobachtungen beschrieben (Charcot 1877). Bei subtiler Untersuchung werden zerebral bedingte, neuropsychologische Storungen mit Schwerpunkt in attentionalen und mnestischen Funktionsbereichen bei MS in fast gleicher Haufigkeit wie einige andere neurologische Symptome berichtet. So geben Rao et al. (1991 a) 42% mnestische Defizite bei einem reprasentativen Querschnitt chronisch-progredient Kranker an, Prosiegel u. Michael (1993) resumieren im Literaturuberblick Zahlen bis zu 72%. Wahrend die international verbreitete „Expanded Disability Status Scale“ (EDSS nach Kurtzke 1983) neuropsychologische Phanomene nur marginal mit Begriffen wie „organische Wesensanderung“ abbilden kann, umfasst ein neuerer Ansatz zur Verlaufsbeurteilung der Krankheit, der MS Functional Composite (MSFC), einen quantifizierbaren kognitiven Messparameter, den auditorischen Serienadditionstest „PASAT“ (Gronwall 1977).
Verhandlungen der Deutschen Gesellschaft für Neurologie, 1995
Fortschritte der Neurologie-Psychiatrie, 2003
A differentiation of memory is possible on the basis of chronological and contents-related aspect... more A differentiation of memory is possible on the basis of chronological and contents-related aspects. Furthermore, it is possible to make process-specific subdivisions (encoding, transfer, consolidation, retrieval). The time-related division on the one hand refers to the general differentiation into short-term and long-term memory, and, on the other, to that between anterograde and retrograde memory ("new" and "old memory"; measured from a given time point, usually that when brain damage occurred). Anterograde memory means the successful encoding and storing of new information; retrograde the ability to retrieve successfully acquired and/or stored information. On the contents-based level, memory can be divided into five basic long-term systems--episodic memory, the knowledge system, perceptual, procedural and the priming form of memory. Neural correlates for these divisions are discussed with special emphasis of the episodic and the knowledge systems, based both on...
MMW Fortschritte der Medizin, Jan 21, 2002
Neuronal Bases And Psychological Aspects Of Consciousness, 1999
Gedächtnisstörungen, 2013
Die multiple Sklerose (MS) ist eine der haufigsten neurologischen Erkrankungen des fruhen und mit... more Die multiple Sklerose (MS) ist eine der haufigsten neurologischen Erkrankungen des fruhen und mittleren Erwachsenenalters. Atiopathogenetisch wird die MS nach derzeitigem Kenntnisstand als autoimmunvermittelte Erkrankung des Zentralnervensystems angesehen, die zu multiplen, zeitlich und ortlich disseminierten Demyelinisierungen innerhalb des Zentralnervensystems fuhrt. Pathoanatomisch findet sich neben der inflammatorischen Komponente auch ein neurodegenerativer Anteil. Der bei den meisten Erkrankungsfallen anfanglich schubformige Krankheitsverlauf (schubformige MS) kann in der weiteren Krankheitsevolution in einen chronisch-progredienten Verlauf ubergehen. Neben einer Vielzahl von neurologischen Dysfunktionen konnen bereits im Fruhstadium oder im Verlauf der MS verschiedene, neuropsychiatrische Storungen auftreten. Letztere sind entscheidend fur den Arbeitsplatzerhalt und die Lebensqualitat. Im Folgenden wird auf kognitive, insbesondere im Zusammenhang mit der Gedachtnisverarbeitung stehende Defizite eingegangen.
Praxis, 2005
Neben den motorischen und vegetativen Störungen kommt es im Verlauf der Parkinsonerkrankung bei e... more Neben den motorischen und vegetativen Störungen kommt es im Verlauf der Parkinsonerkrankung bei einem nicht unerheblichen Teil der Patienten zu deutlichen kognitiven Leistungseinbussen, die im Einzelfall das Ausmass einer Demenz erreichen. Daneben können auch affektiv-emotionale Dysregulationen bis hin zu depressiven Störungen vorkommen. Diese Beeinträchtigungen erklären sich sowohl aus der zugrundeliegenden Neuropathologie sowie der parkinson-assoziierten Neurotransmitter-Imbalancen als auch aus den mit dieser Erkrankung einhergehenden Alltagsveränderungen. Nach Gifford und Cummings [21] werden bis zu 75 Prozent der moderaten bis schweren Demenzfälle von Hausärzten nicht erkannt; bei leichten kognitiven Beeinträchtigungen und affektiv-emotionalen Problemen liegt die Zahl noch höher. Aufgrund der maskierenden Symptomatik der Parkinsonkrankheit kann angenommen werden, dass diese Zahlen bei dieser Patientengruppe wahrscheinlich höher liegen. Dementsprechend sollte die Erfassung von ko...
The Clinical Neuropsychologist, 2012
The Stroop task has a long-standing history in psychological research and diagnostics, and many v... more The Stroop task has a long-standing history in psychological research and diagnostics, and many variants have emerged. Computerized versions have recently gained popularity because of their applicability in brain-imaging studies. It remains unclear, however, whether computerized versions are content valid with reference to the original task. We compare the performance in the original task with two computerized versions. All three versions show high test-retest reliability and are able to elicit interference effects, but to varying degrees. However, performances in the computerized versions and in the original task do not correlate. The transition from oral to manual response and from listed to single stimulus presentation seems not only to diminish the interference effect, but also to alter its nature in such a way that it no longer looks genuinely ''Stroop-like''. These findings have important clinical implications on the use and interpretation of computerized Stroop tasks in children and adults.
Multiple Sclerosis Journal, 2014
Objective: The objective of this paper is to investigate the relationship between total and regio... more Objective: The objective of this paper is to investigate the relationship between total and regional corpus callosum (CC) atrophy, neuropsychological test performance and fatigue in multiple sclerosis (MS) patients. Methods: We conducted a cross-sectional study in 113 MS patients: mean age 48±11 years, 75/113 women, 84/113 relapsing–remitting MS, mean disease duration 21±9 years, mean Expanded Disability Status Scale (EDSS) score 3.2±1.7. All patients underwent brain magnetic resonance imaging, standardised neurological assessment and comprehensive cognitive testing including assessments for fatigue and depression. Total and regional CC atrophy was assessed using the corpus callosum index (CCI). Results: CCI correlated more strongly with T2- and T1-lesion volume and whole brain volume than with disease duration or EDSS score. CCI correlated strongly with the verbal fluency test (VFT), Symbol Digit Modalities Test (SDMT) and Paced Auditory Serial Addition Test (PASAT). Multivariate r...
Multiple Sclerosis, 2009
Background: Multiple sclerosis (MS) is often accompanied by cognitive dysfunction. A negative cor... more Background: Multiple sclerosis (MS) is often accompanied by cognitive dysfunction. A negative correlation between cerebral lesion load and atrophy and cognitive performance has been pointed out almost consistently. Further, the distribution of lesions might be critical for the emergence of specific patterns of cognitive deficits. Objective: The current study evaluated the significance of total lesion area (TLA) and central atrophy for the prediction of general cognitive dysfunction and tested for a correspondence between lesion topography and specific cognitive deficit patterns. Methods: Thirty-seven patients with MS underwent neuropsychological assessment and magnetic resonance imaging. Lesion burden and central atrophy were quantified. Patients were classified into three groups by means of individual lesion topography (punctiform lesions/periventricular lesions/confluencing lesions in both periventricular and extra-periventricular regions). Results: TLA was significantly related t...
Parkinsonism & Related Disorders, 2008
Cognitive and affective dysfunctions are frequent but often neglected symptoms in Parkinson's dis... more Cognitive and affective dysfunctions are frequent but often neglected symptoms in Parkinson's disease (PD). We developed the screening tool Parkinson neuropsychometric dementia assessment (PANDA) with five cognitive tasks and a short depression questionnaire. Healthy subjects and patients without cognitive impairment (PD), mild cognitive disorder (PD-MCD), or dementia (PDD) were examined. The cognition part had a specificity of 91% and a sensitivity of 90% for PDD and 77% for PDD plus PD-MCD patients. The mood questionnaire also had high sensitivity and specificity. We conclude that the PANDA is an economical, easy-to-use and sensitive tool to detect neuropsychological dysfunctions in PD patients in clinical practice.
Fortschritte der Neurologie · Psychiatrie, 2001
BMC Neurology, 2014
Background: De-escalating natalizumab (NTZ) to interferon beta 1b (IFN B 1B) is a possible treatm... more Background: De-escalating natalizumab (NTZ) to interferon beta 1b (IFN B 1B) is a possible treatment option in multiple sclerosis (MS) patients interrupting NTZ because of increased risk of progressive multifocal leukoencephalopathy (PML). The aim of this study was to evaluate satisfaction and adherence to treatment, behavioral and fatigue changes in patients switched to IFN B 1B compared to continued NTZ treatment. Methods: A 1 year, prospective, randomized, rater-blinded, parallel-group study. Nineteen relapsing remitting (RR) MS patients, randomly assigned to undergo either NTZ (n = 10) or IFN B 1B (n = 9) treatment, who had previously received NTZ for at least 12 months with disease stability and fearing or at risk for PML were included. Patients underwent behavioral and treatment assessments at baseline, after 24-week and 1 year follow-up. Behavioral assessment included measures of cognition, fatigue and quality of life. Treatment assessment included measures of satisfaction, persistence and adherence to treatment. Clinical-radiological disease activity and safety were also assessed. Results: Baseline characteristics of patients were similar between groups except for Euro Quality Visual Analogue Scale, being higher in the NTZ group (p = 0.04). Within-group comparisons at the three time points, as well as interaction analysis of treatment effect over time did not show any statistically significant differences in behavioral or treatment assessments, but a coherent trend favoring NTZ over IFN B 1B. Conclusions: De-escalating NTZ to IFN B 1B is feasible and associated with overall good patient related outcome and persistently stable behavioral measures.
Der Nervenarzt, 2009
Ziel des Forschungsprojektes Kognitive Dysfunktionen im Rahmen der Multiplen Sklerose (MS) finden... more Ziel des Forschungsprojektes Kognitive Dysfunktionen im Rahmen der Multiplen Sklerose (MS) finden sich nahezu bei der Hälfte der MS-Patienten. Hierbei korreliert die zerebrale Läsionslast negativ mit der neuropsychologischen Leistung. Aktuellere Arbeiten stellen den potenziellen Einfluss der Läsionsverteilung auf das kognitive Defizitprofil heraus.
Journal of Neurology, Neurosurgery & Psychiatry, 1993
An industrial manager had severe retrograde and variable but usually mild anterograde amnesia fou... more An industrial manager had severe retrograde and variable but usually mild anterograde amnesia four years after a head injury. MRI showed damage of both temporal poles and the lateral portion of the right prefrontal cortex. The prefrontal and temporal cortical damage on the right side extended deeply into the white matter while the temporal cortical damage on the left side was much smaller. There was an additional left temporo-parietal lesion. The patient was of average intelligence. His attention, short term memory and learning ability were average or somewhat below average. His old memories were severely affected for the personal-episodic domain and less so for semantic remote memory abilities. Therefore an anatomical dissociation between anterograde and retrograde amnesia is possible at the anterior temporal regions, possibly interacting with the prefrontal cortex; these regions seem necessary for the retrieval of old episodic memories.
Neuropsychological Rehabilitation, 2012
This study compared a high intensity working memory training (45 minutes, 4 times per week for 4 ... more This study compared a high intensity working memory training (45 minutes, 4 times per week for 4 weeks) with a distributed training (45 minutes, 2 times per week for 8 weeks) in middle-aged, healthy adults. The aim was to clarify whether a computerised working memory training is effective and whether intensity of training influences training outcome. To evaluate the efficacy and possible transfer effects, a neuropsychological test battery assessing short-and long-term memory, working memory, executive functions and mental speed was applied at baseline and at retest. Our results indicate that the distributed training led to increased performance in all cognitive domains when compared to the high intensity training and the control group without training. The most significant differences revealed by interaction contrasts were found for verbal and visual working memory, verbal short-term memory and mental speed. These results support the hypothesis that cognitive
Journal of Neurology, Neurosurgery & Psychiatry, 1996
Der Nervenarzt, 2015
BACKGROUND It is quite common that people suffering from cognitive impairment only visit a doctor... more BACKGROUND It is quite common that people suffering from cognitive impairment only visit a doctor when the symptoms have already reached an advanced stage. This is often due to a fear of Alzheimer’s disease or a dread of exhausting diagnostic procedures and exposure of personal details; however, an early diagnosis and therapy increases the chance of preserving the quality of life for a longer period of time. OBJECTIVES Evaluation of a risk assessment for Alzheimer’s disease by magnetic resonance imaging (MRI) with respect to the acceptance and value by participants. METHODS In this prospective preventive study 106 subjects between the age of 39 and 89 years (median age 68 years) with general risk factors were included and underwent a risk assessment for Alzheimer’s disease by standard MRI of the brain using a 1 T open MRI with subsequent hippocampal volumetry. Participants were stratified into two distinct subgroups according to the individual hippocampal atrophy status, one with elevated and the other with reduced risk. All participants were thoroughly interviewed regarding anxieties and mental well-being before and after the risk assessment. RESULTS As expected, participants with a reduced risk had a significant improvement in well-being and a reduction of fears and worries after the examination. Neither a significant deterioration of the mental situation nor an increase of fears and worries was found for participants with an elevated risk. Of the participants 90% stated that MRI-based risk stratification generated positive perspectives for the future. The assessment revealed a high acceptance by most of the participants (94%). CONCLUSION An MRI-based risk assessment is beneficial to the patient’s quality of life and as a low threshold approach may induce more individuals with concerns to take advantage of an early diagnosis of Alzheimer’s disease.
Multiple Sklerose, 2001
Sind die in der Kernspintomografie in vivo darstellbaren multiplen zerebralen Lasionen der Multip... more Sind die in der Kernspintomografie in vivo darstellbaren multiplen zerebralen Lasionen der Multiplen Sklerose (MS) funktionell relevant? Statistische Korrelationen zur neurologischen Symptomatik verliefen in zahlreichen Untersuchungen der letzten anderthalb Jahrzehnte eher enttauschend. Untersuchungen dieser neurologisch „stumm“ erscheinenden Hirnlasionen bezuglich Storungen der hoheren Hirnleistungen waren jedoch sehr aufschlussreich (Beatty et al. 1989; Rao et al. 1989 a; Ron et al. 1991). Hinsichtlich neuropsychologischer Storungen hatte viele Jahre lang als neurologische Lehrmeinung gegolten, dass eine MS-Erkrankung hohere Hirnleistungen durchweg intakt belasse und etwa Demenz nur vereinzelt in Spatstadien auftrete. Allerdings hatte bereits Charcot wesentliche klinische Charakteristika der Multiplen Sklerose unter Einschluss neuropsychologischer Beobachtungen beschrieben (Charcot 1877). Bei subtiler Untersuchung werden zerebral bedingte, neuropsychologische Storungen mit Schwerpunkt in attentionalen und mnestischen Funktionsbereichen bei MS in fast gleicher Haufigkeit wie einige andere neurologische Symptome berichtet. So geben Rao et al. (1991 a) 42% mnestische Defizite bei einem reprasentativen Querschnitt chronisch-progredient Kranker an, Prosiegel u. Michael (1993) resumieren im Literaturuberblick Zahlen bis zu 72%. Wahrend die international verbreitete „Expanded Disability Status Scale“ (EDSS nach Kurtzke 1983) neuropsychologische Phanomene nur marginal mit Begriffen wie „organische Wesensanderung“ abbilden kann, umfasst ein neuerer Ansatz zur Verlaufsbeurteilung der Krankheit, der MS Functional Composite (MSFC), einen quantifizierbaren kognitiven Messparameter, den auditorischen Serienadditionstest „PASAT“ (Gronwall 1977).
Verhandlungen der Deutschen Gesellschaft für Neurologie, 1995
Fortschritte der Neurologie-Psychiatrie, 2003
A differentiation of memory is possible on the basis of chronological and contents-related aspect... more A differentiation of memory is possible on the basis of chronological and contents-related aspects. Furthermore, it is possible to make process-specific subdivisions (encoding, transfer, consolidation, retrieval). The time-related division on the one hand refers to the general differentiation into short-term and long-term memory, and, on the other, to that between anterograde and retrograde memory ("new" and "old memory"; measured from a given time point, usually that when brain damage occurred). Anterograde memory means the successful encoding and storing of new information; retrograde the ability to retrieve successfully acquired and/or stored information. On the contents-based level, memory can be divided into five basic long-term systems--episodic memory, the knowledge system, perceptual, procedural and the priming form of memory. Neural correlates for these divisions are discussed with special emphasis of the episodic and the knowledge systems, based both on...
MMW Fortschritte der Medizin, Jan 21, 2002
Neuronal Bases And Psychological Aspects Of Consciousness, 1999
Gedächtnisstörungen, 2013
Die multiple Sklerose (MS) ist eine der haufigsten neurologischen Erkrankungen des fruhen und mit... more Die multiple Sklerose (MS) ist eine der haufigsten neurologischen Erkrankungen des fruhen und mittleren Erwachsenenalters. Atiopathogenetisch wird die MS nach derzeitigem Kenntnisstand als autoimmunvermittelte Erkrankung des Zentralnervensystems angesehen, die zu multiplen, zeitlich und ortlich disseminierten Demyelinisierungen innerhalb des Zentralnervensystems fuhrt. Pathoanatomisch findet sich neben der inflammatorischen Komponente auch ein neurodegenerativer Anteil. Der bei den meisten Erkrankungsfallen anfanglich schubformige Krankheitsverlauf (schubformige MS) kann in der weiteren Krankheitsevolution in einen chronisch-progredienten Verlauf ubergehen. Neben einer Vielzahl von neurologischen Dysfunktionen konnen bereits im Fruhstadium oder im Verlauf der MS verschiedene, neuropsychiatrische Storungen auftreten. Letztere sind entscheidend fur den Arbeitsplatzerhalt und die Lebensqualitat. Im Folgenden wird auf kognitive, insbesondere im Zusammenhang mit der Gedachtnisverarbeitung stehende Defizite eingegangen.
Praxis, 2005
Neben den motorischen und vegetativen Störungen kommt es im Verlauf der Parkinsonerkrankung bei e... more Neben den motorischen und vegetativen Störungen kommt es im Verlauf der Parkinsonerkrankung bei einem nicht unerheblichen Teil der Patienten zu deutlichen kognitiven Leistungseinbussen, die im Einzelfall das Ausmass einer Demenz erreichen. Daneben können auch affektiv-emotionale Dysregulationen bis hin zu depressiven Störungen vorkommen. Diese Beeinträchtigungen erklären sich sowohl aus der zugrundeliegenden Neuropathologie sowie der parkinson-assoziierten Neurotransmitter-Imbalancen als auch aus den mit dieser Erkrankung einhergehenden Alltagsveränderungen. Nach Gifford und Cummings [21] werden bis zu 75 Prozent der moderaten bis schweren Demenzfälle von Hausärzten nicht erkannt; bei leichten kognitiven Beeinträchtigungen und affektiv-emotionalen Problemen liegt die Zahl noch höher. Aufgrund der maskierenden Symptomatik der Parkinsonkrankheit kann angenommen werden, dass diese Zahlen bei dieser Patientengruppe wahrscheinlich höher liegen. Dementsprechend sollte die Erfassung von ko...
The Clinical Neuropsychologist, 2012
The Stroop task has a long-standing history in psychological research and diagnostics, and many v... more The Stroop task has a long-standing history in psychological research and diagnostics, and many variants have emerged. Computerized versions have recently gained popularity because of their applicability in brain-imaging studies. It remains unclear, however, whether computerized versions are content valid with reference to the original task. We compare the performance in the original task with two computerized versions. All three versions show high test-retest reliability and are able to elicit interference effects, but to varying degrees. However, performances in the computerized versions and in the original task do not correlate. The transition from oral to manual response and from listed to single stimulus presentation seems not only to diminish the interference effect, but also to alter its nature in such a way that it no longer looks genuinely ''Stroop-like''. These findings have important clinical implications on the use and interpretation of computerized Stroop tasks in children and adults.
Multiple Sclerosis Journal, 2014
Objective: The objective of this paper is to investigate the relationship between total and regio... more Objective: The objective of this paper is to investigate the relationship between total and regional corpus callosum (CC) atrophy, neuropsychological test performance and fatigue in multiple sclerosis (MS) patients. Methods: We conducted a cross-sectional study in 113 MS patients: mean age 48±11 years, 75/113 women, 84/113 relapsing–remitting MS, mean disease duration 21±9 years, mean Expanded Disability Status Scale (EDSS) score 3.2±1.7. All patients underwent brain magnetic resonance imaging, standardised neurological assessment and comprehensive cognitive testing including assessments for fatigue and depression. Total and regional CC atrophy was assessed using the corpus callosum index (CCI). Results: CCI correlated more strongly with T2- and T1-lesion volume and whole brain volume than with disease duration or EDSS score. CCI correlated strongly with the verbal fluency test (VFT), Symbol Digit Modalities Test (SDMT) and Paced Auditory Serial Addition Test (PASAT). Multivariate r...
Multiple Sclerosis, 2009
Background: Multiple sclerosis (MS) is often accompanied by cognitive dysfunction. A negative cor... more Background: Multiple sclerosis (MS) is often accompanied by cognitive dysfunction. A negative correlation between cerebral lesion load and atrophy and cognitive performance has been pointed out almost consistently. Further, the distribution of lesions might be critical for the emergence of specific patterns of cognitive deficits. Objective: The current study evaluated the significance of total lesion area (TLA) and central atrophy for the prediction of general cognitive dysfunction and tested for a correspondence between lesion topography and specific cognitive deficit patterns. Methods: Thirty-seven patients with MS underwent neuropsychological assessment and magnetic resonance imaging. Lesion burden and central atrophy were quantified. Patients were classified into three groups by means of individual lesion topography (punctiform lesions/periventricular lesions/confluencing lesions in both periventricular and extra-periventricular regions). Results: TLA was significantly related t...