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Cognitive functioning and subjective quality of life in relapsing-remitting multiple sclerosis patients before and after percutaneous transluminal angioplasty: a preliminary report.

De Pasquale C, Pistorio ML, Veroux M, Giaquinta A, Veroux P, Fornaro M - Neuropsychiatr Dis Treat (2014)

Bottom Line: Multiple sclerosis (MS) is a disease of the nervous system that has profound effects on everyday functioning and quality of life of not only the person who is diagnosed, but also her/his family and acquaintances.Despite this, the uncertainties of the actual etiological basis of MS make it difficult to reach a conclusive statement about the optimal therapeutic management of the disease, which may differ depending on the given case and phase of illness.Among other measures, those who remained in the study until completion showed a significantly better Expanded Disability Status Scale and Milan Overall Dementia Assessment autonomy profile at study entrance compared to those patients who did not remain in the study until completion.

View Article: PubMed Central - PubMed

Affiliation: Department of Education Science, University of Catania, Catania, Italy ; Vascular Surgery and Organ Transplant Unit, Department of Surgery Transplantation and Advanced Technologies, University Hospital of Catania, Catania, Italy.

ABSTRACT

Background: Multiple sclerosis (MS) is a disease of the nervous system that has profound effects on everyday functioning and quality of life of not only the person who is diagnosed, but also her/his family and acquaintances. Despite this, the uncertainties of the actual etiological basis of MS make it difficult to reach a conclusive statement about the optimal therapeutic management of the disease, which may differ depending on the given case and phase of illness. This has led to an interest in potential novel therapeutic avenues, including percutaneous transluminal angioplasty (PTA). Yet, evidence in support of PTA in the management of MS is scarce and contradictory. The aim of the present study was to provide a preliminary assessment as to whether PTA may impact subjective quality of life and cognitive functioning in severe MS.

Method: Ninety-five MS outpatients were followed-up for 24 months on a scheduled basis using the Milan Overall Dementia Assessment and the short-form 36-item scales, and were clinically evaluated by an appointed neurologist and psychiatrist.

Results: At end point (month 24), only a minority of patients were still active in the study (n=33 or 34.74%). Among other measures, those who remained in the study until completion showed a significantly better Expanded Disability Status Scale and Milan Overall Dementia Assessment autonomy profile at study entrance compared to those patients who did not remain in the study until completion. Limitations were: a lack of any active control group; small sample size; Berkson's bias; and selection by indication biases.

Conclusion: Given the burden of MS and its high attrition rate, additional studies, including bigger samples, active control groups, and Cox's regression and survival analysis in case of randomization, should shed further light on the actual usefulness of PTA for the most severe cases of MS.

No MeSH data available.


Related in: MedlinePlus

SF-36 social activity assessment trend in patients followed-up for 24 months (four observations).Notes: Higher scores indicate better outcomes. Mauchly’s test indicated that the assumption of sphericity was violated, χ2(5)=27.689, P≤0.001; therefore, Greenhouse-Geisser corrected tests are reported (ε=0.704). The results showed that SF-36 social activity was significantly affected by PTA among those being followed-up until the fourth (last) observation of the study (study completers), F(2.11, 67.59)=5.69, P=0.005.Abbreviations: PTA, percutaneous transluminal angioplasty; SF-36, short-form 36-item.
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f8-ndt-10-1039: SF-36 social activity assessment trend in patients followed-up for 24 months (four observations).Notes: Higher scores indicate better outcomes. Mauchly’s test indicated that the assumption of sphericity was violated, χ2(5)=27.689, P≤0.001; therefore, Greenhouse-Geisser corrected tests are reported (ε=0.704). The results showed that SF-36 social activity was significantly affected by PTA among those being followed-up until the fourth (last) observation of the study (study completers), F(2.11, 67.59)=5.69, P=0.005.Abbreviations: PTA, percutaneous transluminal angioplasty; SF-36, short-form 36-item.

Mentions: Selected Pearson’s correlations (P≤0.005 or P≤0.001) included the following: MODA total score at baseline and EDSS score (R=−0.292); months 6–12–24 MODA total scores and reference EDSS score, P=ns (not significant); and years elapsed since MS diagnosis and EDSS score (R=0.288). Neuropsychological functioning assessed with MODA correlated with physical activity measured by the SF-36 at baseline (R=0.339), month 6 (R=0.275), month 12 (R=0.412), and month 24 (R=0.47). Neuropsychological functioning also correlated with mental health (as measured by SF-36) at baseline (R=0.34), month 6 (R=0.233), month 12 (R=0.427), and month 24 (R=0.628). Neuropsychological functioning significantly correlated with social activity (as measured by SF-36) at month 24 (R=0.455) but not at month 6 or 12, as it was for somatic pain perception (as measured by SF-36) at month 24, R=0.385, but not at baseline, month 6 or 12. Interestingly, neuropsychological functioning assessed with MODA showed a trend of increasingly significant correlation coefficients with attention and prose memory (MODA’s domains) across different times of evaluation (respectively: baseline, R=0.360 and R=0.638; month 6, R=0.280 and R=0.620; month 12, R=0.422 and R=0.699; month 24, R=0.643 and R=ns). One-way repeated measures analysis of variance for selected MODA and SF-36 measures have been reported in Figures 1–8.


Cognitive functioning and subjective quality of life in relapsing-remitting multiple sclerosis patients before and after percutaneous transluminal angioplasty: a preliminary report.

De Pasquale C, Pistorio ML, Veroux M, Giaquinta A, Veroux P, Fornaro M - Neuropsychiatr Dis Treat (2014)

SF-36 social activity assessment trend in patients followed-up for 24 months (four observations).Notes: Higher scores indicate better outcomes. Mauchly’s test indicated that the assumption of sphericity was violated, χ2(5)=27.689, P≤0.001; therefore, Greenhouse-Geisser corrected tests are reported (ε=0.704). The results showed that SF-36 social activity was significantly affected by PTA among those being followed-up until the fourth (last) observation of the study (study completers), F(2.11, 67.59)=5.69, P=0.005.Abbreviations: PTA, percutaneous transluminal angioplasty; SF-36, short-form 36-item.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4061177&req=5

f8-ndt-10-1039: SF-36 social activity assessment trend in patients followed-up for 24 months (four observations).Notes: Higher scores indicate better outcomes. Mauchly’s test indicated that the assumption of sphericity was violated, χ2(5)=27.689, P≤0.001; therefore, Greenhouse-Geisser corrected tests are reported (ε=0.704). The results showed that SF-36 social activity was significantly affected by PTA among those being followed-up until the fourth (last) observation of the study (study completers), F(2.11, 67.59)=5.69, P=0.005.Abbreviations: PTA, percutaneous transluminal angioplasty; SF-36, short-form 36-item.
Mentions: Selected Pearson’s correlations (P≤0.005 or P≤0.001) included the following: MODA total score at baseline and EDSS score (R=−0.292); months 6–12–24 MODA total scores and reference EDSS score, P=ns (not significant); and years elapsed since MS diagnosis and EDSS score (R=0.288). Neuropsychological functioning assessed with MODA correlated with physical activity measured by the SF-36 at baseline (R=0.339), month 6 (R=0.275), month 12 (R=0.412), and month 24 (R=0.47). Neuropsychological functioning also correlated with mental health (as measured by SF-36) at baseline (R=0.34), month 6 (R=0.233), month 12 (R=0.427), and month 24 (R=0.628). Neuropsychological functioning significantly correlated with social activity (as measured by SF-36) at month 24 (R=0.455) but not at month 6 or 12, as it was for somatic pain perception (as measured by SF-36) at month 24, R=0.385, but not at baseline, month 6 or 12. Interestingly, neuropsychological functioning assessed with MODA showed a trend of increasingly significant correlation coefficients with attention and prose memory (MODA’s domains) across different times of evaluation (respectively: baseline, R=0.360 and R=0.638; month 6, R=0.280 and R=0.620; month 12, R=0.422 and R=0.699; month 24, R=0.643 and R=ns). One-way repeated measures analysis of variance for selected MODA and SF-36 measures have been reported in Figures 1–8.

Bottom Line: Multiple sclerosis (MS) is a disease of the nervous system that has profound effects on everyday functioning and quality of life of not only the person who is diagnosed, but also her/his family and acquaintances.Despite this, the uncertainties of the actual etiological basis of MS make it difficult to reach a conclusive statement about the optimal therapeutic management of the disease, which may differ depending on the given case and phase of illness.Among other measures, those who remained in the study until completion showed a significantly better Expanded Disability Status Scale and Milan Overall Dementia Assessment autonomy profile at study entrance compared to those patients who did not remain in the study until completion.

View Article: PubMed Central - PubMed

Affiliation: Department of Education Science, University of Catania, Catania, Italy ; Vascular Surgery and Organ Transplant Unit, Department of Surgery Transplantation and Advanced Technologies, University Hospital of Catania, Catania, Italy.

ABSTRACT

Background: Multiple sclerosis (MS) is a disease of the nervous system that has profound effects on everyday functioning and quality of life of not only the person who is diagnosed, but also her/his family and acquaintances. Despite this, the uncertainties of the actual etiological basis of MS make it difficult to reach a conclusive statement about the optimal therapeutic management of the disease, which may differ depending on the given case and phase of illness. This has led to an interest in potential novel therapeutic avenues, including percutaneous transluminal angioplasty (PTA). Yet, evidence in support of PTA in the management of MS is scarce and contradictory. The aim of the present study was to provide a preliminary assessment as to whether PTA may impact subjective quality of life and cognitive functioning in severe MS.

Method: Ninety-five MS outpatients were followed-up for 24 months on a scheduled basis using the Milan Overall Dementia Assessment and the short-form 36-item scales, and were clinically evaluated by an appointed neurologist and psychiatrist.

Results: At end point (month 24), only a minority of patients were still active in the study (n=33 or 34.74%). Among other measures, those who remained in the study until completion showed a significantly better Expanded Disability Status Scale and Milan Overall Dementia Assessment autonomy profile at study entrance compared to those patients who did not remain in the study until completion. Limitations were: a lack of any active control group; small sample size; Berkson's bias; and selection by indication biases.

Conclusion: Given the burden of MS and its high attrition rate, additional studies, including bigger samples, active control groups, and Cox's regression and survival analysis in case of randomization, should shed further light on the actual usefulness of PTA for the most severe cases of MS.

No MeSH data available.


Related in: MedlinePlus