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Correlation between brain magnetic resonance imaging, cognitive dysfunction and physical disability in multiple sclerosis
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Abstracts / Journal of the Neurological Sciences 405S (2019) 116542
also showed significant difference (5.36 mm in affected side vs. 5.22 mm in non-affected side; p = .018). The diameter of optic nerve did not show correlation with VEP and OCT on the same side. Conclusion Optic nerve diameter in TOUS was significantly increased in acute ON. TOUS could be considered in patients with ON in early stage as supportive tools to diagnose. doi:10.1016/j.jns.2019.10.1451
Keywords: Multiple sclerosis, Brain MRI, Cognitive impairment, MoCA test
doi:10.1016/j.jns.2019.10.1452
WCN19-2149 Journal of the Neurological Sciences 405S (2019) 105114
WCN19-2147
Poster Session 3
Journal of the Neurological Sciences 405S (2019) 105113
Unrecognised and undiagnosed parkinsonism in rehabilitation facilities
Poster Session 3 Correlation between brain magnetic resonance imaging, cognitive dysfunction and physical disability in multiple sclerosis
A. Aggarwalab, F. Sarmastb, M. Hendriksb a RPAH, Neurology, Sydney, Australia b MetroRehab, Rehabilitation Medicine, Sydney, Australia
A. Abouelmaatya, M. Flifel Elsaydb, C. Zarad Alic a Lecturer of neurology, Neurology department Helwan University, Helwan, Egypt b Lecturer of neurology, Neurology department Mansours University, Elmansora, Egypt c Lecturer of diagnostic radiology, Diagnostic radiology department port said University, Port said, Egypt
Introduction Parkinsonism refers to a range of clinical presentations and constellation of symptoms, both motor and non-motor, which are dopamine responsive. The cardinal signs of Parkinsonism are bradykinesia with rigidity, resting tremor or postural instability. It is due to degeneration of the nigrostriatal dopaminergic system.
Background Montreal Cognitive Assessment test (MoCA) is a brief, sensitive test that has been recommended as a reliable tool to detect mild cognitive impairment. Associations between brain imaging measures and cognitive functioning have been observed in patients with multiple sclerosis (MS).
Aim The aim of this study was to identify patients with undiagnosed and unrecognised Parkinsonism and assess the efficacy of dopamine replacement therapy on their functional mobility.
Objectives To evaluate cognitive dysfunction and physical disability in MS patients by making correlation between Magnetic Resonance Imaging (MRI), MoCA test and expanded disability status scale (EDSS). Methods Fifty MS Patients and twenty-five controls underwent clinical evaluation and assessment of cognitive functions using the MoCA test. In addition, all MS patients underwent conventional MRI brain and Expanded disability status scale (EDSS). Results The scores for trail making test, memory, attention, serial seven subtractions, fluency, naming and orientation in MS patients were significantly different from control (p b 0.05). There was significant inverse correlation between number of MS plaques in the temporal lobe and abstraction (p b 0.001, r = -0.52). Less inverse correlation was found between total number of MRI plaques and concentration, total number of MRI plaques and abstraction, infratentorial lesions and clock drawing test. No correlations were found between number of MS plaques in frontal, parietal, occipital, corpus callosum and neuropsychological tests. Conclusion Although conventional MRI techniques are crucial in the MS diagnostic workup, their accuracy in evaluating and predicting cognitive dysfunction is less relevant. The MoCA test would provide a brief screen for cognitive dysfunction in MS.
Method 20 patients who were admitted to MetroRehab Hospital for various reasons other than Parkinson’s Disease, from November 2017 till July 2019, with slow progress, history of frequent falls or impaired gait pattern were identified and re-examined. A trial of Levodopa was considered for patients with signs of Parkinsonism. Madopar or Sinemet was started at a small dose of half a 100/25 mg tablet twice a day and it was gradually increased to 200/50 mg tablet three times a day, depending on patients’ response and tolerance. 10MWT was selected as an outcome measure for efficacy of Levodopa. Results Results of this study will be presented. Conclusion Parkinsonism is a common neurodegenerative disorder that is unrecognised in rehabilitation settings. Patients with parkinsonism are often admitted to rehabilitation facilities with a variable range of diagnosis; they show slow progress which might be misinterpreted as deconditioning or just part of the “aging” process. A trial of Levodopa should be considered for patients with signs of Parkinsonism starting at a small dose, which is generally very well tolerated.
doi:10.1016/j.jns.2019.10.1453
Abstracts / Journal of the Neurological Sciences 405S (2019) 116542
also showed significant difference (5.36 mm in affected side vs. 5.22 mm in non-affected side; p = .018). The diameter of optic nerve did not show correlation with VEP and OCT on the same side. Conclusion Optic nerve diameter in TOUS was significantly increased in acute ON. TOUS could be considered in patients with ON in early stage as supportive tools to diagnose. doi:10.1016/j.jns.2019.10.1451
Keywords: Multiple sclerosis, Brain MRI, Cognitive impairment, MoCA test
doi:10.1016/j.jns.2019.10.1452
WCN19-2149 Journal of the Neurological Sciences 405S (2019) 105114
WCN19-2147
Poster Session 3
Journal of the Neurological Sciences 405S (2019) 105113
Unrecognised and undiagnosed parkinsonism in rehabilitation facilities
Poster Session 3 Correlation between brain magnetic resonance imaging, cognitive dysfunction and physical disability in multiple sclerosis
A. Aggarwalab, F. Sarmastb, M. Hendriksb a RPAH, Neurology, Sydney, Australia b MetroRehab, Rehabilitation Medicine, Sydney, Australia
A. Abouelmaatya, M. Flifel Elsaydb, C. Zarad Alic a Lecturer of neurology, Neurology department Helwan University, Helwan, Egypt b Lecturer of neurology, Neurology department Mansours University, Elmansora, Egypt c Lecturer of diagnostic radiology, Diagnostic radiology department port said University, Port said, Egypt
Introduction Parkinsonism refers to a range of clinical presentations and constellation of symptoms, both motor and non-motor, which are dopamine responsive. The cardinal signs of Parkinsonism are bradykinesia with rigidity, resting tremor or postural instability. It is due to degeneration of the nigrostriatal dopaminergic system.
Background Montreal Cognitive Assessment test (MoCA) is a brief, sensitive test that has been recommended as a reliable tool to detect mild cognitive impairment. Associations between brain imaging measures and cognitive functioning have been observed in patients with multiple sclerosis (MS).
Aim The aim of this study was to identify patients with undiagnosed and unrecognised Parkinsonism and assess the efficacy of dopamine replacement therapy on their functional mobility.
Objectives To evaluate cognitive dysfunction and physical disability in MS patients by making correlation between Magnetic Resonance Imaging (MRI), MoCA test and expanded disability status scale (EDSS). Methods Fifty MS Patients and twenty-five controls underwent clinical evaluation and assessment of cognitive functions using the MoCA test. In addition, all MS patients underwent conventional MRI brain and Expanded disability status scale (EDSS). Results The scores for trail making test, memory, attention, serial seven subtractions, fluency, naming and orientation in MS patients were significantly different from control (p b 0.05). There was significant inverse correlation between number of MS plaques in the temporal lobe and abstraction (p b 0.001, r = -0.52). Less inverse correlation was found between total number of MRI plaques and concentration, total number of MRI plaques and abstraction, infratentorial lesions and clock drawing test. No correlations were found between number of MS plaques in frontal, parietal, occipital, corpus callosum and neuropsychological tests. Conclusion Although conventional MRI techniques are crucial in the MS diagnostic workup, their accuracy in evaluating and predicting cognitive dysfunction is less relevant. The MoCA test would provide a brief screen for cognitive dysfunction in MS.
Method 20 patients who were admitted to MetroRehab Hospital for various reasons other than Parkinson’s Disease, from November 2017 till July 2019, with slow progress, history of frequent falls or impaired gait pattern were identified and re-examined. A trial of Levodopa was considered for patients with signs of Parkinsonism. Madopar or Sinemet was started at a small dose of half a 100/25 mg tablet twice a day and it was gradually increased to 200/50 mg tablet three times a day, depending on patients’ response and tolerance. 10MWT was selected as an outcome measure for efficacy of Levodopa. Results Results of this study will be presented. Conclusion Parkinsonism is a common neurodegenerative disorder that is unrecognised in rehabilitation settings. Patients with parkinsonism are often admitted to rehabilitation facilities with a variable range of diagnosis; they show slow progress which might be misinterpreted as deconditioning or just part of the “aging” process. A trial of Levodopa should be considered for patients with signs of Parkinsonism starting at a small dose, which is generally very well tolerated.
doi:10.1016/j.jns.2019.10.1453