The Impact of Cognitive Functioning on Daily Occupations for People with Multiple Sclerosis: A Qualitative Study

Background: Cognitive rehabilitation research in multiple sclerosis is ever-developing, but the impact of cognitive difficulties, seen in 40% to 80% of people, on daily occupations is not well known. The aim of this study is to explore the needs of people with MS who have self-reported cognitive deficits. Methods: An exploratory qualitative descriptive research design was used. Data was collected through semi-structured telephone interviews with the participants. Recordings were transcribed and analyzed thematically. Results: Seven participants were recruited (mean age 47). Three themes were developed through associations found in the data. “Neglected symptom” reported the participants’ frustrations around the importance afforded to cognition by health care providers. “Impact on participation in daily occupations” described the everyday impacts of cognitive difficulties. “Adaptations and adjustments to continued participation” reported how the participants manage, despite their difficulties. Conclusion: The findings describe how cognitive difficulties affect individuals with multiple sclerosis and their occupations, as well as the dissatisfaction felt with the progress in and access to cognitive treatment and research. The results indicate the need for occupation-focused interventions in cognition for people with multiple sclerosis that address daily challenges

Mapping dynamic interactions among cognitive biases in depression

Depression is theorized to be caused in part by biased cognitive processing of emotional information. Yet, prior research has adopted a reductionist approach that does not characterize how biases in cognitive processes such as attention and memory work together to confer risk for this complex multifactorial disorder. Grounded in affective and cognitive science, we highlight four mechanisms to understand how attention biases, working memory difficulties, and long-term memory biases interact and contribute to depression. We review evidence for each mechanism and highlight time- and context-dependent dynamics. We outline methodological considerations and recommendations for research in this area. We conclude with directions to advance the understanding of depression risk, cognitive training interventions, and transdiagnostic properties of cognitive biases and their interactions

Supporting children with genetic syndromes in the classroom: the example of 22q deletion syndrome

An increasing number of children are likely to have a known genetic cause for their special educational needs. One such genetic condition is 22q11.2 deletion syndrome (22qDS), a genetic syndrome associated with early speech and language difficulties, global and specific cognitive impairments, difficulties with attention and difficulties with social-emotional functioning. In this article the learning and behavioural strengths and needs of this genetic syndrome are described along with recommendations for classroom-based interventions. Suggested recommendations in the learning and emotional-behavioural domains for the syndrome draw on a number of approaches that have been found to be useful for children with a range of conditions including ADHD, ASD and dyscalculia. While teachers cannot be expected to know about all potential genetic causes for special educational needs, knowing that a genetic condition is likely to be associated with a pattern of relative cognitive and behavioural strengths and needs is important

Balancing the demands of two tasks: an investigation of cognitive–motor dual-tasking in relapsing remitting multiple sclerosis

Background: People with relapsing remitting multiple sclerosis (PwRRMS) suffer disproportionate decrements in gait under dual-task conditions, when walking and a cognitive task are combined. There has been much less investigation of the impact of cognitive demands on balance. Objectives: This study investigated whether: (1) PwRRMS show disproportionate decrements in postural stability under dual-task conditions compared to healthy controls, and (2) dual-task decrements are associated with everyday dual-tasking difficulties. The impact of mood, fatigue, and disease severity on dual-tasking was also examined. Methods: A total of 34 PwRRMS and 34 matched controls completed cognitive (digit span) and balance (movement of center of pressure on Biosway on stable and unstable surfaces) tasks under single- and dual-task conditions. Everyday dual-tasking was measured using the Dual-Tasking Questionnaire. Mood was measured by the Hospital Anxiety & Depression Scale. Fatigue was measured via the Modified Fatigue Index Scale. Results: No differences in age, gender, years of education, estimated pre-morbid IQ, or baseline digit span between groups. Compared with controls, PwRRMS showed significantly greater decrement in postural stability under dual-task conditions on an unstable surface (p=.007), but not a stable surface (p=.679). Balance decrement scores were not correlated with everyday dual-tasking difficulties or fatigue. Stable surface balance decrement scores were significantly associated with levels of anxiety (rho=0.527; p=.001) and depression (rho=0.451; p=.007). Conclusions: RRMS causes dual-tasking difficulties, impacting balance under challenging conditions, which may contribute to increased risk of gait difficulties and falls. The relationship between anxiety/depression and dual-task decrement suggests that emotional factors may be contributing to dual-task difficulties

Autistic trait interactions underlie sex-dependent facial recognition abilities in the normal population

Autistic face processing difficulties are either uniquely social or due to a piecemeal cognitive "style". Co-morbidity of social deficits and piecemeal cognition in autism makes teasing apart these accounts difficult. These traits vary normally, and are more separable in the general population, suggesting another way to compare accounts. Participants completed the Autism Quotient survey of autistic traits, and one of three face recognition tests: full-face, eyes-only, or mouth-only. Social traits predicted performance in the full-face condition in both sexes. Eyes-only males’ performance was predicted by a social × cognitive trait interaction: attention to detail boosted face recognition in males with few social traits, but hindered performance in those reporting many social traits. This suggests social/non-social Autism Spectrum Conditions (ASC) trait interactions at the behavioral level. In the presence of few ASC-like difficulties in social reciprocity, an ASC-like attention to detail may confer advantages on typical males’ face recognition skills. On the other hand, when attention to detail co-occurs with difficulties in social reciprocity, a detailed focus may exacerbate such already present social difficulties, as is thought to occur in autism

The still under-investigated role of cognitive deficits in PML diagnosis

Background: Despite cognitive deficits frequently represent the first clinical manifestations of Progressive Multifocal Leukoencephalopathy (PML) in Natalizumab-treated MS patients, the importance of cognitive deficits in PML diagnosis is still under-investigated. The aim of the current study is to investigate the cognitive deficits at PML diagnosis in a group of Italian patients with PML. Methods: Thirty-four PML patients were included in the study. The demographic and clinical data, the lesion load and localization, and the longitudinal clinical course was compared between patients with (n = 13) and without (n = 15) cognitive deficit upon PML suspicion (the remaining six patients were asymptomatic). Clinical presentation of cognitive symptoms was described in detail. Result: After symptoms detection, the time to diagnosis resulted to be shorter for patients presenting with cognitive than for patients with non cognitive onset (p = 0.03). Within patients with cognitive onset, six patients were presenting with language and/or reading difficulties (46.15%); five patients with memory difficulties (38.4%); three patients with apraxia (23.1%); two patients with disorientation (15.3%); two patients with neglect (15.3%); one patients with object agnosia (7.7%), one patient with perseveration (7.7%) and one patient with dementia (7.7%). Frontal lesions were less frequent (p = 0.03), whereas temporal lesions were slightly more frequent (p = 0.06) in patients with cognitive deficits. The longitudinal PML course seemed to be more severe in cognitive than in non cognitive patients (F = 2.73, p = 0.03), but differences disappeared (F = 1.24, p = 0.29) when balancing for the incidence of immune reconstitution syndrome and for other treatments for PML (steroids, plasma exchange (PLEX) and other therapies (Mefloquine, Mirtazapine, Maraviroc). Conclusion: Cognitive deficits at PML onset manifest with symptoms which are absolutely rare in MS. Their appearance in MS patients should strongly suggest PML. Clinicians should be sensitive to the importance of formal neuropsychological evaluation, with particular focus on executive function, which are not easily detected without a formal assessment

Children's naming and word-finding difficulties: descriptions and explanations

Purpose: There are a substantial minority of children for whom lexical retrieval problems impede the normal pattern of language development and use. These problems include accurately producing the correct word even when the word?s meaning is understood; such children are often referred to as having word-finding difficulties (WFDs). This review examines the nature of naming and lexical retrieval difficulties in these and other groups of children. Method: A review of the relevant literature on lexical access difficulties in children with word finding difficulties was conducted. Studies were examined in the terms of population parameters and comparison groups included in the study. Results and Conclusions: Most discussions of the cognitive processes causing lexical retrieval difficulties have referred to semantics, phonology and processing speed. It is argued that our understanding of these topics will be further advanced by the use of appropriate methodology to test developmental models that both identify the processes in successfully performing different lexical retrieval tasks and more precisely locating the difficulties experienced by children with such tasks

Did social cognition evolve by cultural group selection?

Abstract Cognitive gadgets puts forward an ambitious claim: language, mindreading, and imitation evolved by cultural group selection. Defending this claim requires more than Heyes' spirited and effective critique of nativist claims. The latest human “cognitive gadgets,” such as literacy, did not spread through cultural group selection. Why should social cognition be different? The book leaves this question pending. It also makes strong assumptions regarding cultural evolution: it is moved by selection rather than transformation; it relies on high-fidelity imitation; it requires specific cognitive adaptations to cultural learning. Each of these assumptions raises crucial yet unaddressed difficulties

Cognitive ability and continuous measures of relative hand-skill. a note

This note re-examines a finding by Crow et al. (1998) that equal skill of right and left hands is associated with deficits in cognitive ability. This is consistent with the idea that failure to develop dominance of one hemisphere is associated with various pathologies such as learning difficulties. Using the same data source but utilising additional data, evidence is found of a more complex relationship between cognitive ability and relative hand skill.