Cognitive function and oral health in relapsing-remitting multiple sclerosis.

OBJECTIVES: Multiple sclerosis (MS) is often associated with reduced cognitive function, and there is also emerging evidence of a heightened vulnerability to oral health problems. However, although links between cognitive function and oral health have been identified in other special populations, it remains to be established whether this relationship is also evident for people with MS. The aim of this study was to provide the first empirical test of whether there is a relationship between cognitive function and oral health in people diagnosed with relapsing-remitting multiple sclerosis (RRMS). METHODS: One hundred and eleven individuals were evaluated: 56 people diagnosed with RRMS and 55 demographically matched healthy controls. All participants completed an objective oral health assessment as well as a standardized battery that assessed six distinct neurocognitive domains. RESULTS: Relative to controls, people with RRMS presented with higher rates of decayed teeth and mild gingivitis, and also performed more poorly in three of the six neurocognitive domains assessed (language, complex attention, and executive function). However, for the RRMS group, no associations emerged between oral health with performance on any of the six neurocognitive domains. CONCLUSIONS: These data cross-validate previous research which shows people with RRMS are more likely to present with both reduced cognitive function and poorer oral health, but also extends this literature in a meaningful way by additionally showing for the first time that these clinical features are unrelated in RRMS. CLINICAL RELEVANCE: The findings emphasize the need for early assessment of both oral health and cognitive function in people with RRMS so that appropriate interventions and support can be put in place for each of these clinical symptoms.

Episodic foresight in multiple sclerosis.

OBJECTIVE: Episodic foresight refers to the ability to imagine future scenarios and to then use this imaginative capacity to guide future-directed behavior. Multiple sclerosis (MS) is associated with deficits generating the phenomenological characteristics of future events (the imaginative component of episodic foresight), but no study to date has tested whether MS is also associated with deficits using episodic foresight to appropriately guide future-directed behavior. METHOD: Forty people with relapsing-remitting MS (RRMS) and 40 demographically matched healthy participants completed a validated measure that met strict criteria for assessing the functional application of episodic foresight, Virtual-Week Foresight (VW-Foresight). RESULTS: Overall, people with RRMS did not differ significantly relative to comparison participants in how likely they were to spontaneously acquire items that would later allow a problem to be solved and were also just as likely to subsequently use these items to solve the problem. However, the latter group difference was large in magnitude and just failed to attain significance. Higher levels of depression were significantly related to performance on this same "use" component of foresight in the RRMS group, and depressed RRMS participants were significantly impaired in this aspect of foresight relative to both healthy participants and nondepressed RRMS participants. The depressed MS subgroup also differed from the nondepressed subgroup in their ability to perform instrumental activities of daily living. CONCLUSIONS: People with RRMS who present with heightened levels of depressive symptomatology also appear to be at greater risk of experiencing specific problems with episodic foresight. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

A case of Anti-LGi1 antibody positive autoimmune epilepsy following deep brain stimulator implantation for essential tremor.

We describe a 59-year-old male who developed faciobrachial dystonic seizures and serum Anti-LGi1 antibody positivity 5 weeks after subthalamic deep brain stimulation (DBS) implantation for essential tremor. Brain MRI prior to implantation was normal. Electroencephalogram was normal. A lung lesion with low PET avidity was identified and biopsied; histology was non-diagnostic. Treatment response to immunoglobulin was observed. Seizures after DBS implantation are rare, and to our knowledge not described in association with anti-LGi1 antibodies.

A case of IVIg responsive paraneoplastic SOX1 peripheral neuropathy in a male with breast carcinoma.

BACKGROUND AND AIMS: SOX1 antibodies are generally associated with small cell lung cancer and anti-Hu antibody overlap is common. This case demonstrates isolated anti-SOX1 antibodies with an uncommon tumor type, and relapse of a paraneoplastic syndrome with recurrence of tumor. METHODS: We describe a case of a 65-year-old male with a paraneoplastic peripheral neuropathy and anti-SOX1 antibody positivity in the context of a prior male breast Grade 2 ductal carcinoma, in remission at the time of the initial neurological presentation. RESULTS: Treatment response to intravenous immunoglobulin (IVIg) was demonstrated. After period of clinical stability on IVIg in the context of remission of breast carcinoma, the patient experienced a relapse of his neuropathy. This was associated with tumor recurrence and again responded to tumor excision, radiotherapy and IVIg. INTERPRETATION: Male breast carcinoma has not previously been associated with anti-SOX1 antibody positive paraneoplastic neuropathy.