The Clinical Neuropsychiatry of Multiple Sclerosis

Cover......Page 1
Half-title......Page 3
Dedication......Page 4
Title......Page 5
Copyright......Page 6
Contents......Page 7
Acknowledgement......Page 8
Foreword......Page 9
Epidemiology......Page 11
Clinical features......Page 12
Pathology......Page 13
Diagnosis......Page 15
The Poser Committee’s recommendations......Page 16
The McDonald Committee’s recommendations......Page 17
Paraclinical abnormalities: what are they?......Page 19
Magnetic resonance imaging criteria to demonstrate brain abnormality and dissemination in space......Page 20
The 2005 McDonald criteria revised for multiple sclerosis......Page 21
Comparisons between the Poser and McDonald criteria......Page 22
Brainstem and spinal cord syndromes......Page 23
The significance of magnetic resonance abnormalities in patients with clinically isolated syndromes......Page 24
Differential diagnosis......Page 25
Primary progressive (PP)......Page 26
Relapsing–progressive (RP)......Page 27
Clinical severity definitions......Page 28
Benign multiple sclerosis......Page 29
Malignant multiple sclerosis......Page 30
Rating neurological impairment in multiple sclerosis......Page 31
References......Page 34
Conceptual issues......Page 38
Prevalence of depression in multiple sclerosis......Page 39
The symptoms of depression......Page 42
Rating scales for depression in MS......Page 44
Depression as a presentation of multiple sclerosis......Page 45
Suicide in multiple sclerosis......Page 46
The natural history of mood change in multiple sclerosis......Page 47
Depression and exacerbations of multiple sclerosis......Page 49
Summary......Page 51
References......Page 52
Genetics and depression......Page 56
Magnetic resonance imaging......Page 57
Functional imaging......Page 60
Psychosocial factors......Page 61
Other causes......Page 62
Treatment......Page 63
Medication......Page 64
Cognitive–behavior therapy......Page 66
Group therapy......Page 68
Herbal remedies......Page 69
Summary......Page 70
References......Page 71
Conceptual and semantic issues......Page 76
Literature review of mania and medical illness......Page 77
Prevalence of co-morbidity......Page 79
Genetics......Page 81
Steroid-induced mania......Page 82
Cerebral correlates of mania......Page 83
Euphoria......Page 84
Treatment......Page 86
Summary......Page 88
References......Page 89
Review of earlier studies......Page 92
Definition of pseudobulbar affect......Page 95
Prevalence and neurobehavioral correlates of pseudobulbar affect......Page 96
General theories of pseudobulbar affect......Page 97
Theories relating to research in patients with multiple sclerosis......Page 102
Treatment......Page 103
Summary......Page 105
References......Page 106
Introduction......Page 109
Literature review......Page 110
Clinical features......Page 112
Gender ratio......Page 114
Viral hypothesis......Page 115
Brain changes seen with magnetic resonance imaging......Page 116
Treatment......Page 119
Summary......Page 122
References......Page 123
7 Cognitive impairment in multiple sclerosis......Page 125
Prevalence of cognitive impairment......Page 126
General intelligence......Page 127
Attention and information processing speed......Page 128
Executive functions......Page 130
Memory and multiple sclerosis......Page 133
Working memory......Page 134
Long-term memory......Page 135
The relationship between short-term, working and long-term memory in multiple sclerosis......Page 137
Metamemory......Page 138
Language......Page 139
Depression......Page 140
Physical disability......Page 141
Disease course......Page 142
Genetics......Page 144
Multiple sclerosis and dementia: a summation of cognitive abnormalities......Page 145
References......Page 146
Clinically isolated syndromes of the type seen in multiple sclerosis......Page 159
Follow-up studies of patients with clinically isolated syndromes......Page 162
Short-term (up to one year) follow-up of patients with multiple sclerosis......Page 163
Medium-term (one to four years) follow-up of patients with multiple sclerosis......Page 164
Summary......Page 166
References......Page 167
9 Cognitive impairment in multiple sclerosis: detection, management and significance......Page 169
The Mini-Mental State Examination......Page 170
Brief screening batteries for patients with multiple sclerosis......Page 172
Cognitive screening procedures of intermediate length......Page 175
A Self-Report instrument of cognitive dysfunction......Page 177
Indications for comprehensive testing......Page 178
Compensatory strategies......Page 179
Remedial strategies......Page 180
Cholinergic drugs......Page 181
Symptomatic drug treatments......Page 184
The clinical significance of cognitive impairment......Page 185
Summary......Page 186
References......Page 187
Computed axial tomography......Page 192
Technique......Page 193
Magnetization transfer imaging......Page 196
Diffusion tensor imaging......Page 195
Magnetization transfer and diffusion tensor imaging......Page 198
Specificity......Page 199
Safety and serial imaging......Page 200
Cortical lesions......Page 201
Chronic–progressive disease course......Page 202
Total lesion score and cognitive dysfunction......Page 203
Corpus callosum......Page 204
Frontal lobe lesion load......Page 205
Longitudinal studies......Page 206
Relaxation times and cognition......Page 208
Magnetization transfer imaging and cognition......Page 209
Magnetic resonance spectroscopy......Page 210
Spectroscopy and cognition......Page 211
Functional magnetic resonance imaging and cognition......Page 212
Positron emission tomography and single photon emission computed tomography......Page 216
Summary......Page 217
References......Page 219
Interferon beta-1b......Page 228
Methods......Page 230
Results......Page 231
Discussion......Page 233
Interferon beta-1a......Page 234
Rebif......Page 235
Avonex......Page 236
Interferon alpha......Page 237
Interpreting the data in the light of methodological limitations......Page 238
Disease-modifying drugs and cognitive dysfunction......Page 239
Interferon beta-1a......Page 240
Glatiramer acetate......Page 241
References......Page 242
12 Multiple sclerosis: a subcortical, white matter dementia?......Page 246
Subcortical dementia......Page 247
Psychiatric features......Page 248
Fronto-subcortical circuits and behavior......Page 249
Pathogenesis of subcortical dementia......Page 251
Disorders of the cerebral white matter......Page 253
Traumatic brain injury......Page 254
Acquired immuno deficiency syndrome......Page 255
Vascular disorders: Binswanger’s disease......Page 257
Metachromatic leukodystrophy......Page 258
Multiple sclerosis and traumatic brain injury......Page 259
Multiple sclerosis and Alzheimer’s disease......Page 260
Multiple sclerosis and Huntington’s disease......Page 261
Recovery of function......Page 262
A fresh challenge to the concept of a subcortical white matter dementia......Page 263
Summary......Page 264
References......Page 265
Index......Page 271