Natural language processing analysis of the theories of people with multiple sclerosis about causes of their disease.

BACKGROUND: While potential risk factors for multiple sclerosis (MS) have been extensively researched, it remains unclear how persons with MS theorize about their MS. Such theories may affect mental health and treatment adherence. Using natural language processing techniques, we investigated large-scale text data about theories that persons with MS have about the causes of their disease. We examined the topics into which their theories could be grouped and the prevalence of each theory topic. METHODS: A total of 486 participants of the Swiss MS Registry longitudinal citizen science project provided text data on their theories about the etiology of MS. We used the transformer-based BERTopic Python library for topic modeling to identify underlying topics. We then conducted an in-depth characterization of the topics and assessed their prevalence. RESULTS: The topic modeling analysis identifies 19 distinct topics that participants theorize as causal for their MS. The topics most frequently cited are Mental Distress (31.5%), Stress (Exhaustion, Work) (29.8%), Heredity/Familial Aggregation (27.4%), and Diet, Obesity (16.0%). The 19 theory topics can be grouped into four high-level categories: physical health (mentioned by 56.2% of all participants), mental health (mentioned by 53.7%), risk factors established in the scientific literature (genetics, Epstein-Barr virus, smoking, vitamin D deficiency/low sunlight exposure; mentioned by 47.7%), and fate/coincidence (mentioned by 3.1%). Our study highlights the importance of mental health issues for theories participants have about the causes of their MS. CONCLUSIONS: Our findings emphasize the importance of communication between healthcare professionals and persons with MS about the pathogenesis of MS, the scientific evidence base and mental health.

Multiple sclerosis (MS) is a disease that affects the brain and spinal cord, causing a wide range of symptoms. Our study investigated what people living with the disease think causes MS. We analyzed the replies given by 486 people who were questioned about their MS to look for patterns in the responses. We identified 19 distinct themes, notably mental and work-related stress, genetics, and dietary factors, which we grouped into 4 categories: physical health, mental health, established scientific risk factors, and chance. We found that mental health problems were viewed as a key factor for MS. Our work highlights the need for healthcare professionals to have transparent conversations with people with MS about what is known about the disease course and potential causes. In addition, it highlights the importance of fully informing and supporting people with MS regarding their mental health.

Association of age and disease duration with comorbidities and disability: A study of the Swiss Multiple Sclerosis Registry.

BACKGROUND: While comorbidities increase with age, duration of multiple sclerosis (MS) leads to disability accumulation in persons with MS. The influence of ageing vis-a-vis MS duration remains largely unexplored. We studied the independent associations of ageing and MS duration with disability and comorbidities in the Swiss MS Registry participants. METHODS: Self-reported data was cross-sectionally analyzed using confounder-adjusted logistic regression models for 6 outcomes: cancer, type 2 diabetes (T2D), hypertension, cardiac diseases, depression, and having at least moderate or severe gait disability. Using cubic splines, we explored non-linear changes in risk shapes. RESULTS: Among 1615 participants age was associated with cardiac diseases (OR 1.05, 95% CI [1.02, 2.08]), hypertension (OR 1.08, 95% CI [1.06, 2.10]), T2D (OR 1.10, 95%CI [1.05, 1.16]) and cancer (OR 1.04, 95% CI [1.01, 1.07]). MS duration was not associated with comorbidities, except for cardiac diseases (OR 1.03, 95% CI [1.00, 1.06]). MS duration and age were independently associated with having at least moderate gait disability (OR 1.06, 95% CI [1.04, 1.07]; OR 1.04, 95% CI [1.02, 1.05], respectively), and MS duration was associated with severe gait disability (OR 1.05, 95% CI [1.03, 1.08]). The spline analysis suggested a non-linear increase of having at least moderate gait disability with age. CONCLUSIONS: Presence of comorbidities was largely associated with age only. Having at least moderate gait disability was associated with both age and MS duration, while having severe gait disabity was associated with MS duration only.

Onset Symptom Clusters in Multiple Sclerosis: Characteristics, Comorbidities, and Risk Factors.

Background: Multiple sclerosis (MS) symptoms are expected to aggregate in specific patterns across different stages of the disease. Here, we studied the clustering of onset symptoms and examined their characteristics, comorbidity patterns and associations with potential risk factors. Methods: Data stem from the Swiss Multiple Sclerosis Registry, a prospective study including 2,063 participants by November 2019. MS onset symptoms were clustered using latent class analysis (LCA). The latent classes were further examined using information on socio-demographic characteristics, MS-related features, potential risk factors, and comorbid diseases. Results: The LCA model with six classes (frequencies ranging from 12 to 24%) was selected for further analyses. The latent classes comprised a multiple symptoms class with high probabilities across several symptoms, contrasting with two classes with solitary onset symptoms: vision problems and paresthesia. Two gait classes emerged between these extremes: the gait-balance class and the gait-paralysis class. The last class was the fatigue-weakness-class, also accompanied by depression symptoms, memory, and gastro-intestinal problems. There was a moderate variation by sex and by MS types. The multiple symptoms class yielded increased comorbidity with other autoimmune disorders. Similar to the fatigue-weakness class, the multiple symptoms class showed associations with angina, skin diseases, migraine, and lifetime prevalence of smoking. Mononucleosis was more frequently reported in the fatigue-weakness and the paresthesia class. Familial aggregation did not differ among the classes. Conclusions: Clustering of MS onset symptoms provides new perspectives on the heterogeneity of MS. The clusters comprise different potential risk factors and comorbidities. They point toward different risk mechanisms.

Exact Local Correlations and Full Counting Statistics for Arbitrary States of the One-Dimensional Interacting Bose Gas.

We derive exact analytic expressions for the n-body local correlations in the one-dimensional Bose gas with contact repulsive interactions (Lieb-Liniger model) in the thermodynamic limit. Our results are valid for arbitrary states of the model, including ground and thermal states, stationary states after a quantum quench, and nonequilibrium steady states arising in transport settings. Calculations for these states are explicitly presented and physical consequences are critically discussed. We also show that the n-body local correlations are directly related to the full counting statistics for the particle-number fluctuations in a short interval, for which we provide an explicit analytic result.

Multiparticle Bound-State Formation following a Quantum Quench to the One-Dimensional Bose Gas with Attractive Interactions.

We consider quantum quenches from an ideal Bose condensate to the Lieb-Liniger model with an arbitrary attractive interaction strength. We focus on the properties of the stationary state reached at late times after the quench. Using recently developed methods based on integrability, we obtain an exact description of the stationary state for a large number of bosons. A distinctive feature of this state is the presence of a hierarchy of multiparticle bound states. We determine the dependence of their densities on interaction strength and obtain an exact expression for the stationary value of the local pair correlation g_{2}. We discuss ramifications of our results for cold atom experiments.

The perception of facial emotions--cues from the left amygdaloid complex.

The history and the behavioral profile of 2 patients with brain abnormalities in the region of the left amygdaloidal complex might suggest that the dysfunction of the neural pathways related to the left amygdala has to occur at an early developmental stage to result in impaired emotional judgments of facial expressions. This is in line with the hypothesis that emotional information processing is based on a distributed neural network which, during ontogenesis, gradually expands from the amygdala and the amygdaloidal complex to further components of the limbic system.

Long-term cognitive function, neuroimaging, and quality of life in primary CNS lymphoma.

OBJECTIVE: To describe and correlate neurotoxicity indicators in long-term primary CNS lymphoma (PCNSL) survivors who were treated with high-dose methotrexate-based regimens with or without whole-brain radiotherapy (WBRT). METHODS: Eighty PCNSL survivors from 4 treatment groups (1 with WBRT and 3 without WBRT) who were a minimum of 2 years after diagnosis and in complete remission underwent prospective neuropsychological, quality-of-life (QOL), and brain MRI evaluation. Clinical characteristics were compared among treatments by using the χ(2) test and analysis of variance. The association among neuroimaging, neuropsychological, and QOL outcomes was assessed by using the Pearson correlation coefficient. RESULTS: The median interval from diagnosis to evaluation was 5.5 years (minimum, 2 years; maximum, 26 years). Survivors treated with WBRT had lower mean scores in attention/executive function (p = 0.0011), motor skills (p = 0.0023), and neuropsychological composite score (p = 0.0051) compared with those treated without WBRT. Verbal memory was better in survivors with longer intervals from diagnosis to evaluation (p = 0.0045). On brain imaging, mean areas of total T2 abnormalities were different among treatments (p = 0.0006). Total T2 abnormalities after WBRT were more than twice the mean of any non-WBRT group and were associated with poorer neuropsychological and QOL outcomes. CONCLUSIONS: Our results suggest that in patients treated for PCNSL achieving complete remission and surviving at least 2 years, the addition of WBRT to methotrexate-based chemotherapy increases the risk of treatment-related neurotoxicity. Verbal memory may improve over time. CLASSIFICATION OF EVIDENCE: This study provides Class III evidence that in patients treated for PCNSL achieving complete remission and surviving at least 2 years, the addition of WBRT to methotrexate-based chemotherapy increases the risk of treatment-related neurotoxicity.

Equilibration of a Tonks-Girardeau gas following a trap release.

We study the nonequilibrium dynamics of a Tonks-Girardeau gas released from a parabolic trap to a circle. We present the exact analytic solution of the many body dynamics and prove that, for large times and in a properly defined thermodynamic limit, the reduced density matrix of any finite subsystem converges to a generalized Gibbs ensemble. The equilibration mechanism is expected to be the same for all one-dimensional systems.

Computer-based assessment of cognitive functions in brain tumor patients.

NeuroCogFX is a short yet comprehensive computer-based neuropsychological battery of tests developed to investigate neurological patients for cognitive dysfunction after potentially neurotoxic therapy. NeuroCogFX had been standardized in a group of 242 healthy controls (Fliessbach et al., Fortschr Neurol Psychiatr 74:643-650, 2006). The present study was conducted to assess the practicability, reliability, and validity of NeuroCogFX in brain tumor patients without active disease after tumor-directed therapy. To evaluate its validity, neuropsychological testing with NeuroCogFX was completed parallel to a battery of established neuropsychological tests in 54 patients with different types of brain tumors and without active disease for at least 6 months. Retest reliability was assessed in a different sample of 49 patients with gliomas. Results showed good practicability with a median test duration of 28 min (range 16-51 min). Most subtests showed medium-sized retest reliability in healthy controls and tumor patients, with the exception of the 2-back test and reaction time measures in tumor patients. Convergent validity was confirmed for the domains psychomotor speed, verbal memory, and verbal short-term memory. NeuroCogFX enables serial scientific neuropsychological assessment of brain tumor patients. It can be carried out within a short period of time by non-academic personnel and is therefore applicable to large cohorts, e.g., within clinical trials.

Neurotoxicity of treatment.

With the advent of effective treatment regimes increasing survival rates, delayed treatment-related cognitive dysfunction has been recognized as a significant problem. It is considered the most frequent complication among long-term survivors. WBRT may lead to deep brain atrophy and leukoencephalopathy associated with severe cognitive dysfunction, single-fraction dosages of greater than 2 Gy are related to an increased risk of late neurotoxicity, and other factors such as old age, concomitant chemotherapy and preexisting neurological disease increase this risk. However, the potential of focal radiotherapy (RT) with single dosages of 2 Gy or less to a maximal total dose of 60 Gy to produce significant neurotoxicity is less clear. There is a need for a concise neuropsychological test battery to be included in clinical trials, which should meet the following criteria: assess several domains found to be most sensitive to tumor and treatment effects, have standardized stimuli and administration procedures, have published normative data, have moderate to high test-retest reliability, have alternate forms or be relatively insensitive to practice effects, and therefore be suitable to monitor changes in cognitive function over time, include tests that have been translated into several Languages, which can be administered by a trained psychometrician or clinical research associate under supervision of a neuropsychologist, and have a relatively short total administration time. The neuropsychological domains to be evaluated should comprise the cognitive core deficit in brain-tumor patients, namely attention, executive functions (i.e., working memory, processing speed, sequencing abilities), verbal memory, and motor speed.

Correlation functions of the one-dimensional attractive Bose gas.

The zero-temperature correlation functions of the one-dimensional attractive Bose gas with a delta-function interaction are calculated analytically for any value of the interaction parameter and number of particles, directly from the integrability of the model. We point out a number of interesting features, including zero recoil energy for a large number of particles, analogous to the Mössbauer effect.

Role of the prefrontal cortex in attentional control over bistable vision.

The primary source of top-down attentional control in object perception is the prefrontal cortex. This region is involved in the maintenance of goal-related information as well as in attentional selection and set shifting. Recent approaches have emphasized the role of top-down processes during elementary visual processes as exemplified in bistable vision where perception oscillates automatically between two mutually exclusive states. The prefrontal cortex might influence this process either by maintaining the dominant pattern while protecting it against the competing representation, or by facilitating perceptual switches between the two competing representations. To address this issue, we investigated reported perceptual reversals in patients with circumscribed lesions of the prefrontal cortex and healthy control participants in three experimental conditions: hold (maintaining the dominant view), speed (inducing as many perceptual switches as possible), and neutral (no intervention). Results indicated that although the patients showed normal switching rates in the neutral condition and were able to control perceptual switches in the hold condition as much as control subjects were, they were less able to facilitate reversals specifically in the speed condition. These results suggest that the prefrontal cortex is necessary to bias the selection of visual representations in accord with current goals, but is less essential for maintaining selected information active that is continuously available in the environment. As for attentional selection, the present results suggest that the prefrontal cortex initiates perceptual reversals by withdrawing top-down support from the dominant representation without (or prior to) boosting the suppressed view.

The Rapid Dementia Screening Test (RDST): a new economical tool for detecting possible patients with dementia.

The Rapid Dementia Screening Test (RDST) is a new psychometric screening tool to support the diagnosis of dementia. It includes two parts--a word generation task and a number transcoding task; it is short (taking approximately 3 min) and easy to administer, and it is well accepted by patients. After transformation of the raw scores in two age groups (under and over 60 years), the assessed cognitive abilities can be interpreted as age-appropriate or below average with good sensitivity and specificity, and subsequent diagnostic measures can be determined accordingly. The RDST is thus an economical tool for detecting demented patients by general practitioners.