shabnam nouri-shirazi

 Evidence found the most common cognitive problem, learning disabilities, in patients with multiple sclerosis (MS) at the stage of decoding new information. Although, the effectiveness of verbal learning and enactment strategies were evaluated and compared in MS patients, the difference of their effectiveness on cognitive functions was not considered. In the present study, the effect of verbal and active learning was investigated on the change of cognitive functions in MS patients.

The present clinical study included 30 MS patients who were divided into two groups of 15 subjects for verbal and active learning. Participants completed some baseline assessments including initial psychological assessment via the Beck Depression Inventory and the Beck Anxiety Inventory, cognitive assessments in pre- and post-test evaluations by the tests of MACFIMS battery including California Verbal Learning Test, second edition (CVLT-II), Paced Auditory Serial Addition Test (PASAT), Symbol Digit Modality Test (SDMT) and Brief Visuo-spatial Memory Test – Revised (BVMT-R). The treatment consisted of six separate verbal and active learning sessions for each group. Learning materials included six lists containing 16 simple instructions consisting of a noun and a verb.

In the post-test cognitive evaluation, both groups made significant progress (p<0.05) in working memory. In addition, the active coding group showed significant improvement in verbal learning, and the verbal learning group showed significant improvement in processing speed (p<0.05).

Applying a combination of enactment and verbal learning strategies is suggested to reduce learning problems in MS patients.

Multiple Sclerosis (MS) causes brain atrophy at the early stages of the disease which leads to progressive motor and cognitive dysfunction. Brain atrophy can be diagnosed indirectly by measuring the Third Ventricle Diameter (TVD) using Trans Cranial Sonography (TCS). The purpose of the current study was evaluation of TVD in MS patients using TCS to examine its possible correlation with cognitive dysfunction and Expanded Disability Status Scale (EDSS). Seventy-four patients with a definite diagnosis of MS were enrolled in this study. Transverse diameter of the third ventricle was measured using TCS. All patients were assessed by neurological examination and the level of disability was measured via EDSS. The cognitive performance was assessed by the Brief  International Cognitive Assessment for Multiple Sclerosis (BICAMS). Pearson’s correlation was performed to evaluate possible correlations and p-value<0.05 was considered statistically significant.  From the total 74 individuals, 58.1% were diagnosed with Relapse-Remitting MS (RRMS) (n=43) and 43.9% with Secondary-Progressive MS (SPMS) (n=31). The mean EDSS score was 1.81±1.38 (Range of 0-10). The mean TVD was 5.61±1.82 cm which had no statistical correlation with the EDSS score, but it was significantly wider in group with EDSS score>3 when compared to the group with EDSS score≤3 (p-value=0.0001). The mean BICAMS score was 0.65±0.57 and there was no statistical correlation between BICAMS score and TVD.  Measuring the diameter of the third ventricle using TCS appears to be an appropriate method to diagnose brain atrophy and is associated with cognitive dysfunction in the process of MS. Our data emphasized no association between the diameter of the third ventricle and cognitive dysfunction.