Evaluating more naturalistic outcome measures:A 1-year smartphone study in multiple sclerosis

Objective: In this cohort of individuals with and without multiple sclerosis (MS), we illustrate some of the novel approaches that smartphones provide to monitor patients with chronic neurologic disorders in their natural setting. Methods: Thirty-eight participant pairs (MS and cohabitant) aged 18–55 years participated in the study. Each participant received an Android HTC Sensation 4G smartphone containing a custom application suite of 19 tests capturing participant performance and patient-reported outcomes (PROs). Over 1 year, participants were prompted daily to complete one assigned test. Results: A total of 22 patients with MS and 17 cohabitants completed the entire study. Among patients with MS, low scores on PROs relating to mental and visual function were associated with dropout (p < 0.05). We illustrate several novel features of a smartphone platform. First, fluctuations in MS outcomes (e.g., fatigue) were assessed against an individual's ambient environment by linking responses to meteorological data. Second, both response accuracy and speed for the Ishihara color vision test were captured, highlighting the benefits of both active and passive data collection. Third, a new trait, a person-specific learning curve in neuropsychological testing, was identified using spline analysis. Finally, averaging repeated measures over the study yielded the most robust correlation matrix of the different outcome measures. Conclusions: We report the feasibility of, and barriers to, deploying a smartphone platform to gather useful passive and active performance data at high frequency in an unstructured manner in the field. A smartphone platform may therefore enable large-scale naturalistic studies of patients with MS or other neurologic diseases

Occipital Areas Distinguish Semantic Content in Congenitally Blind but not Sighted Individuals

Early visual loss alters structural and functional networks in the brain, but specific effects upon neural representations of distinct semantic information are not well characterized

Web-based Neuro-Ophthalmic Patient Education

For many patients seeking medical information, the Internet is a mixed blessing: although information is abundant, the challenge of finding reliable, useful sources can be insurmountable

Peduncular Hallucinosis: A lesion-based network analysis

Lhermittes peduncular hallucinosis refers to complex visual hallucinations following a lesion of the caudal brainstem or thalamus.1 It is hypothesized that these lesions give rise to hallucinations by engendering increased, disinhibited extrastriate visual cortex activity

Anatomical and Physiological Correlates of Cross-modal Activation in Blindness

Early visual loss leads to changes in the brain, both structural (including visual pathway atrophy and reduced white matter diffusion anisotropy) and functional (including occipital activation during nonvisual task performance).GVSdiffusionweightedimaging, JPdiffusiontensorimagin

Cross-Modal Language Processing in the Visual Cortex of the Congenitally Blind

In congenital blindness, the visual Cortex supports novel non-visual functions through mechanisms of cross-modal plasticity. Several fMRI studies suggest that cross-modal activation is rdated to language processing, including semantic representation. However, it is unknown if these cross-modal responses reflect particular semantic categories. Further, it is unknown the extent to which these responses relate to the StruCtural and metabolic alterations of visual cottex that accompany blindness

Development of Smartphone Technology to Monitor Disease Progression in Multiple Sclerosis

In Multiple Sclerosis, the accurate assessment of disease progression is critical to delivering appropriately individualized care. Smartphones offer the potential for rich, real-time data capture that may fundamentally shift traditional paradigms of clinical monitoring

New Treatments for Multiple Sclerosis

The era of disease modifying therapy for Multiple Sclerosis (MS), which began with ACTH in the 1950s, has truly accelerated in the past 2 decades. Neuro-ophthalmologists should be aware of the important recent therapeutic advances that will impact their patients with MS.GVSmultiplesclerosisdiagnosi