The Utility of the INECO Frontal Screening (IFS) in the Detection of Executive Dysfunction in Patients with Traumatic Brain Injury (TBI) (P07.194) (original) (raw)
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Neurological Sciences, 2015
Several studies have reported that about 65 % of patients with relapsing-remitting multiple sclerosis (RRMS) suffer from cognitive impairment, with executive dysfunction being the most frequently described. Even if several executive screening tests have been designed to specifically detect executive deficits, few studies have investigated their ability to tackle such dysfunction particularly in multiple sclerosis (MS). The aim of the present study was to evaluate the sensitivity and specificity of the INECO frontal screening (IFS) in the detection of executive dysfunction in patients with relapsing-remitting MS (RRMS). 54 patients with RRMS were included in the study. 34 presented executive dysfunction while 20 did not. 32 control subjects matched for age, sex, and educational level were also included. All were evaluated with the IFS and with a battery of classical executive tests. A patient was considered to have executive dysfunction if he/she scored a one and a half standard deviation below the control mean in at least one of the classical executive tests. Sensitivity and specificity of the IFS in its ability to detect executive dysfunction in MS was analyzed. Using a cutoff of 25.5 points, sensitivity of the IFS was 73.53 %, and specificity 78.13 % in differentiating controls from MS patients with executive dysfunction. The IFS showed excellent concurrent validity with executive tasks. The IFS can be considered a brief, easy-to-administer, cost-less tool for the detection of executive dysfunction in patients with RRMS.
International Journal of MS Care, 2017
Background: Cognitive impairments are common in individuals with MS and adversely affect functioning. Early detection of cognitive impairment, therefore, would enable earlier, and possibly more effective, treatment. We sought to compare self-reports with a short neuropsychological test as possible screening tools for cognitive impairment. Methods: One hundred patients with MS were tested with the Minimal Assessment of Cognitive Function in Multiple Sclerosis; z scores were used to derive the Cognitive Index (CI). Receiver operator characteristic curve analyses were performed, with criteria for impairment set at −1.5 and −2.0 SD below the mean. Scores from two self-reports (the Multiple Sclerosis Neuropsychological Screening Questionnaire–Patient Version and the Behavior Rating Inventory of Executive Function–Adult Version [BRIEF-A]) and a neuropsychological test (the Symbol Digit Modalities Test [SDMT]) were entered as test variables. Exploratory regression analyses were conducted w...
Multiple Sclerosis and Related Disorders, 2018
Although cognitive impairment (CI) is common in multiple sclerosis (MS), it is difficult to suspect in patients with low disability and there is a lack of brief and effective CI screening tools with a define cutoff point to be used during routine clinic visits. This study aims to validate the Electronic Screening Cognitive Impairment in Multiple Sclerosis (SCI-MS) test for CI among MS patients. Methods: Cross-sectional, observational study that included adult patients, diagnosed with MS, Expanded Disability Status Scale (EDSS) score ≤6.5, without relapses within the last 2 months and no depression symptoms. The SCI-MS test consists of two modules: questionnaire (SCI-MS-Q) and pictogram matching tool (SCI-MS-P) measured for score and time. At inclusion, patients completed the Beck Depression Inventory (BDI-II test), the Brief Repeatable Battery of Neuropsychological Test (BRB-N) and the SCI-MS. The SCI-MS feasibility, test-retest reliability and predictive validity were assessed. Results: A total of 194 patients (59.3% female) were included: mean (SD) age of 42 (9) years, mean time since diagnosis of 10 (7) years, 89.7% relapsing-remitting MS, and median (Q1-Q3) EDSS of 2.0 (1.0-3.5). According to BRB-N, 26.8% of patients had CI. Internal consistency was high (Cronbach alpha: 0.97). The intra-class correlation coefficient was 0.88 for the SCI-MS-Q, 0.09 for the SCI-MS-P score and 0.48 for the SCI-MS-P time, corresponding to AUC of the ROC curves of 0.571, 0.574 and 0.714, respectively. For a clinically significant cutoff point of ≥60 seconds, the reached CI sensitivity of SCI-MS-P time was 0.75 and the specificity 0.51. Conclusion: SCI-MS showed good psychometric properties. SCI-MS-P time of pictogram completion had an acceptable diagnostic accuracy of CI in MS patients with low disability. SCI-MS-P time of pictogram completion tool is an easy and quick score that can help neurologists to early identify CI in MS patients that should be further assessed to confirm CI diagnosis and to describe its characteristics and mainly affected domains.
Operating Characteristics of Executive Functioning Tests Following Traumatic Brain Injury
The Clinical Neuropsychologist, 2010
The primary purposes of this study were to determine if controls, mild, and moderate/severe traumatic brain injury (TBI) patients performed differently on a battery of executive functioning (EF) tests, and to identify the operating characteristics of EF tests in this population. Participants consisted of 46 brain injured individuals and 24 healthy controls. All participants completed an extensive battery of EF tests. Results showed that mild TBI participants performed worse than controls on the Trail Making Test Part B, and that moderate/severe TBI participants consistently performed worse than either group on a variety of EF measures. Tests of EF exhibited a wide range of operating characteristics, suggesting that some EF tests are better than others in identifying TBI-related neurocognitive impairment. Predictive values were better for individuals with moderate/severe TBI than mild TBI. Overall, the Digit Span Backward Test showed the best positive predictive power in differentiating TBI. Our results provide useful data that may guide test selection in evaluating EF in patients with traumatic brain injury.
The Need for Screening, Assessment, and Treatment for Cognitive Dysfunction in Multiple Sclerosis
International Journal of MS Care, 2012
Cognitive dysfunction is observed in about half of people with multiple sclerosis (MS), and MS health-care professionals face the challenge of screening, assessing, and treating patients for cognitive problems. Considering the inconsistent or limited empirical evidence to assist in this task, a multidisciplinary consensus conference of MS experts, sponsored by the Consortium of Multiple Sclerosis Centers (CMSC), was held on September 24, 2010, to address these issues. Key articles from the literature on these topics were distributed prior to the meeting, and CMSC member professionals were surveyed on clinical practices related to screening, assessment, and treatment for cognitive problems. The purpose of the meeting was threefold: 1) to achieve a multidisciplinary perspective on practices for screening, monitoring, evaluating, and treating MS patients for cognitive problems; 2) to propose consensus candidate measures for screening and/or monitoring for cognitive problems in MS that ...
Scientific Reports
executive functions are crucial for performance of everyday activities. In Multiple sclerosis (Ms), executive dysfunctions can be apparent from the early onset of the disease. technology-based timeefficient and resource-saving tools for early evaluation of executive functions using an ecological approach are needed to assess functional performance in real-life. the aim was to compare the efficiency of the Picture Interpretation Test 360° (PIT 360°) with traditional measures on executive dysfunction in persons with Multiple sclerosis (pwMs) and Healthy Controls (HC). participants were 31 patients with Relapsing-Remitting MS (mean age = 44.323 ± 13.149; mean Expanded Disability status scale = 2) and 39 HC (mean age = 39.538 ± 15.728). All were tested with standard neuropsychological tests of executive functions, PIT 360°, and measures of user experience. While standard neuropsychological tests failed to differentiate between PwMS and HC group, the PIT 360° was successful in detecting executive dysfunction in PwMS. All participants reported the PIT 360° to be an engaging tool and endorsed positive reactions to their experience. Overall, the PIT 360° is a quick, sensitive, and ecological tool that captures real-world executive dysfunction in pwMs. this engaging measure is sensitive for the detection of executive deficits since the early phases of the disease. Cognitive impairment in Multiple Sclerosis (MS) includes, among other deficits, executive dysfunction, multitasking difficulties, verbal fluency declines, and visuo-spatial deficits 1-3. Cognitive impairment has been found in all disease subtypes 4 , including one-third of patients with early Relapsing-Remitting (RR) MS 5. Early onset of difficulties in simultaneous management of everyday activities is often reported in Persons with Multiple Sclerosis (PwMS) 6. Altogether, these impairments have a disruptive impact on quality of life and the ability of PwMS to actively adapt to the changing demands of the physical and social environment 7,8. Although conventional neuropsychological tests exist for assessing cognitive dysfunction in PwMS, they tend to be limited in their capacity for capturing the sorts of executive functioning deficits that are critical for functioning in real-world contexts 6. Evaluating functional performance across a range of real-life situations is the core of the function-led approach to the assessment of executive functions 9. As highlighted by Chan and colleagues 10 , this approach, rather than fractionating the executive dysfunction, aims to incorporate the complexity of real-life challenges into tasks able to tap a number of executive domains simultaneously. Using this approach, executive functions can be captured in
Journal of Alzheimer's Disease, 2014
Background: The Institute of Cognitive Neurology (INECO) Frontal Screening (IFS) is a brief neuropsychological tool recently devised for the evaluation of executive dysfunction in neurodegenerative conditions. Objective: In this study we present a cross-cultural validation of the IFS for the Portuguese population, provide normative values from a healthy sample, determine how age and education affect performance, and inspect its clinical utility in the context of Alzheimer’s disease (AD). A comparison with the Frontal Assessment Battery (FAB) was undertaken, and correlations with other well-established executive functions measures were examined. Methods: The normative sample included 204 participants varying widely in age (20–85 years) and education (3–21 years). The clinical sample (n = 21) was compared with a sample of age- and education-matched controls (n = 21). Healthy participants completed the IFS and the Mini-Mental State Examination (MMSE). In addition to these, the patients (and matched controls) completed the FAB and a battery of other executive tests. Results: IFS scores were positively affected by education and MMSE, and negatively affected by age. Patients underperformed controls on the IFS, and correlations were found with the Clock Drawing Test, Stroop test, and the Zoo Map and Rule Shift Card tests of the Behavioral Assessment of the Dysexecutive Syndrome. A cut-off of 17 optimally differentiated patients from controls. While 88% of the IFS sub-tests discriminated patients from controls, only 67% of the FAB sub-tests did so. Conclusion: Age and education should be taken into account when interpreting performance on the IFS. The IFS is useful to detect executive dysfunction in AD, showing good discriminant and concurrent validities.