Jason A Berard1, Marjorie Bowman2, Harold L Atkins3, Mark S Freedman3, Lisa A S Walker4. 1. University of Ottawa, School of Psychology, Ottawa, Canada; The Ottawa Hospital Research Institute, Ottawa, Canada. Electronic address: jberard@ottawahospital.on.ca. 2. The Ottawa Hospital Research Institute, Ottawa, Canada. 3. The Ottawa Hospital Research Institute, Ottawa, Canada; University of Ottawa, Faculty of Medicine, Ottawa, Canada. 4. University of Ottawa, School of Psychology, Ottawa, Canada; The Ottawa Hospital Research Institute, Ottawa, Canada; University of Ottawa, Faculty of Medicine, Ottawa, Canada; Neuropsychology Service, The Ottawa Hospital, Ottawa, Canada.
Abstract
BACKGROUND: Fatigue presents as a significant problem in multiple sclerosis (MS). Cognitive fatigue (CF) can be defined as a decrease in, or inability to maintain task performance throughout the duration of a continuous cognitive task. CF was evaluated using the Paced Auditory Serial Addition Test (PASAT) both pre- and post-immunoablation and hematopoietic stem cell transplantation (IA-HSCT) over a 3-year follow-up period. The magnitude of CF was examined and the impact of scoring methodology was evaluated. METHODS: Twenty-three individuals with rapidly progressive MS and poor prognosis underwent high dose immunosuppression and subsequent HSCT. Individuals completed the 3″ and 2″ PASAT at baseline and every 6 months thereafter over a period of 36 months. As scoring methodology can impact its sensitivity to CF, the PASAT was scored according to three scoring methods. RESULTS: CF was noted across all three scoring methods at baseline and at the majority of time points post-IA-HSCT on both the 3″ and 2″ PASAT. The magnitude of CF remained consistent both pre-and post-IA-HSCT. CONCLUSIONS: While results suggest that the procedure itself does not ameliorate an individual's susceptibility to CF; neither does it seem to negatively impact levels of CF. As such, results support the notion that the IA-HSCT procedure, despite its aggressive nature, does not exacerbate CF in this particular sample.
BACKGROUND: Fatigue presents as a significant problem in multiple sclerosis (MS). Cognitive fatigue (CF) can be defined as a decrease in, or inability to maintain task performance throughout the duration of a continuous cognitive task. CF was evaluated using the Paced Auditory Serial Addition Test (PASAT) both pre- and post-immunoablation and hematopoietic stem cell transplantation (IA-HSCT) over a 3-year follow-up period. The magnitude of CF was examined and the impact of scoring methodology was evaluated. METHODS: Twenty-three individuals with rapidly progressive MS and poor prognosis underwent high dose immunosuppression and subsequent HSCT. Individuals completed the 3″ and 2″ PASAT at baseline and every 6 months thereafter over a period of 36 months. As scoring methodology can impact its sensitivity to CF, the PASAT was scored according to three scoring methods. RESULTS: CF was noted across all three scoring methods at baseline and at the majority of time points post-IA-HSCT on both the 3″ and 2″ PASAT. The magnitude of CF remained consistent both pre-and post-IA-HSCT. CONCLUSIONS: While results suggest that the procedure itself does not ameliorate an individual's susceptibility to CF; neither does it seem to negatively impact levels of CF. As such, results support the notion that the IA-HSCT procedure, despite its aggressive nature, does not exacerbate CF in this particular sample.
Authors: Richard A Nash; George J Hutton; Michael K Racke; Uday Popat; Steven M Devine; Linda M Griffith; Paolo A Muraro; Harry Openshaw; Peter H Sayre; Olaf Stüve; Douglas L Arnold; Meagan E Spychala; Kaitlyn C McConville; Kristina M Harris; Deborah Phippard; George E Georges; Annette Wundes; George H Kraft; James D Bowen Journal: JAMA Neurol Date: 2015-02 Impact factor: 18.302
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