Word finding, prosody and social cognition in multiple sclerosis.

BACKGROUND: Impairments in speech and social cognition have been reported in people with multiple sclerosis (pwMS), although their relationships with neuropsychological outcomes and their clinical utility in MS are unclear. OBJECTIVES: To evaluate word finding, prosody and social cognition in pwMS relative to healthy controls (HC). METHODS: We recruited people with relapsing MS (RMS, n = 21), progressive MS (PMS, n = 24) and HC (n = 25) from an outpatient MS clinic. Participants completed a battery of word-finding, social cognitive, neuropsychological and clinical assessments and performed a speech task for prosodic analysis. RESULTS: Of 45 pwMS, mean (SD) age was 49.4 (9.4) years, and median (range) Expanded Disability Severity Scale score was 3.5 (1.0-6.5). Compared with HC, pwMS were older and had slower information processing speed (measured with the Symbol Digit Modalities Test, SDMT) and higher depression scores. Most speech and social cognitive measures were associated with information processing speed but not with depression. Unlike speech, social cognition consistently correlated with intelligence and memory. Visual naming test mean response time (VNT-MRT) demonstrated worse outcomes in MS versus HC (p = .034, Nagelkerke's R2  = 65.0%), and in PMS versus RMS (p = .009, Nagelkerke's R2  = 50.2%). Rapid automatised object naming demonstrated worse outcomes in MS versus HC (p = .014, Nagelkerke's R2  = 49.1%). These word-finding measures showed larger effect sizes than that of the SDMT (MS vs. HC, p = .010, Nagelkerke's R2  = 40.6%; PMS vs. RMS, p = .023, Nagelkerke's R2  = 43.5%). Prosody and social cognition did not differ between MS and HC. CONCLUSIONS: Word finding, prosody and social cognition in MS are associated with information processing speed and largely independent of mood. Impairment in visual object meaning perception is potentially a unique MS disease-related deficit that could be further explored and cautiously considered as an adjunct disability metric for MS.

Association between speech rate measures and cognitive function in people with relapsing and progressive multiple sclerosis.

Background: Cognitive impairments are well-documented in multiple sclerosis (MS), while speech impairments are often overlooked despite their significant effect on quality of life. For effective clinical management of multisystem conditions such as MS, consideration should be given to the interaction between deficits in multiple domains, such as speech and cognition. To evaluate speech rate measures of spontaneous and read speech, in people with MS and to examine the link between speech and cognition. Methods: Forty-five people with MS and 25 controls underwent an extensive cognitive battery, including executive functioning, information processing and memory tasks, and completed two speech tasks: a reading task and a picture description task, from which speech rate measures were derived. Results: The progressive MS cohort had reduced articulation (p < 0.04) and speech rate (p < 0.02) compared to controls and those with relapsing MS. Regression models also revealed information processing speed accounted for 18% to 30% of the variance of spontaneous speech rate measures, and 27% of read speech. Executive functioning accounted for a further 10% of the variance of speech rate in those with MS. Conclusions: The present study suggests that speech production is contingent on cognitive ability, with information processing speed and executive functioning linked with speech timing patterns.

Multicenter direct to vial evaluation of a liquid-based pap test.

OBJECTIVE: To estimate the efficacy of a fluid-based, thin-layer preparation (TP) compared with the conventional Pap (CP) test to detect biopsy confirmed precancerous cervical lesions. MATERIALS AND METHODS: A total of 10,226 evaluable patients at 10 separate clinical sites were screened for cervical abnormalities using the TP (ThinPrep pap test; Cytyc Corporation, Boxborough, MA). Results were compared with an historical control cohort of 20,918 patients from a similar patient population and with a similar patient profile who had received CP screening. RESULTS: The TP significantly increased the detection rate of high-grade squamous intraepithelial lesion and more severe (HSIL+) cytologic results as compared with the CP smear. Overall, the TP method yielded a 59.7% increase in the detection of HSIL+ compared with the CP smear. Overall, the TP method yielded a 59.7% increase in the detection of HSIL+ compared with the conventional method (3.9% vs. 2.4%; p < .001). There was also a significant increase in the detection of low-grade squamous intraepithelial lesions with TP (p < .01). The rates of cancer, atypical squamous cells of undetermined significance, and atypical glandular cells of undetermined significance were similar for the TP and CP groups. CONCLUSIONS: The overall cytologic detection of HSIL and low-grade squamous intraepithelial lesions with the TP method was significantly increased compared with a control group screened with the CP method. Histologic confirmation showed increased detection, not an increased false-positive cytologic interpretation.