Cognitive Changes and Quality of Life in Neurocysticercosis: A Longitudinal Study

Neurocysticercosis (NCC) is one of the most common parasitic infections of the central nervous system. Cognitive changes have been frequently reported with this disease but have not been well studied. Our study team recruited a group of new onset NCC cases and a matched set of healthy neighborhood controls and new onset epilepsy controls in Lima, Peru for this study. A neuropsychological battery was administered at baseline and at 6 months to all groups. Brain MRI studies were also obtained on NCC cases at baseline and at 6 months. Newly diagnosed patients with NCC had mild cognitive deficits and more marked decreases in quality of life at baseline compared with controls. Improvements were found in both cognitive status and quality of life in patients with NCC after treatment. This study is the first to assess cognitive status and quality of life longitudinally in patients with NCC and provides new data on an important clinical morbidity outcome

Longitudinal assessment of neurocognitive function in people with relapsing multiple sclerosis initiating alemtuzumab in routine clinical practice: LEM-COG study results

•Neurocognitive function was assessed in RMS population treated with alemtuzumab.•MS-COG composite score improved significantly from baseline to month 12 follow-up.•Improvement in MS-COG seems to be driven by improvement in processing speed.•Over 12 months, about 92% of population showed stable or improved cognitive status. Alemtuzumab is effective in reducing relapse rate and disability, but limited data exist on its effect on cognitive function in relapsing multiple sclerosis (RMS). The present study assessed neurocognitive function and safety associated with alemtuzumab treatment in RMS. This longitudinal, single-arm, prospective study included people with RMS (aged 25–55 years) who were treated with alemtuzumab in clinical practice in the United States of America and Canada. The first participant was enrolled in December 2016. The primary endpoint was the change from baseline to post-baseline (month [M] 12/24) in MS-COGnitive (MS-COG) composite score. Secondary endpoints included Paced Auditory Serial Addition Test (PASAT), Symbol Digit Modalities Test (SDMT), Brief Visuospatial Memory Test-Revised (BVMT-R), Selective Reminding Test (SRT), Controlled Oral Word Association Test (COWAT), and Automated Neuropsychological Assessment Metrics (ANAM) scores. Depression and fatigue were assessed using Hamilton Rating Scale-Depression (HAM-D) and Fatigue Severity Scale (FSS)/Modified Fatigue Impact Scale (MFIS), respectively. Magnetic resonance imaging (MRI) parameters were assessed when available. Safety was assessed throughout the study. Descriptive statistics were used for the pre-specified statistical analyses. Since the study was terminated early (November 2019) because of operational and resource difficulties, post hoc analyses for statistical inference were performed among participants who had a baseline value and at least one complete post-baseline assessment for cognitive parameters, fatigue, or depression. Of the 112 participants enrolled, 39 were considered as the primary analysis population at M12. At M12, a mean change of 0.25 (95% confidence interval [CI]: 0.04, 0.45; p = 0.0049; effect size [ES]: 0.39) was observed in the MS-COG composite score. Improvements were observed in processing speed (based on PASAT and SDMT; p < 0.0001; ES: 0.62), as well as in individual PASAT, SDMT and COWAT scores. An improvement was also noted in HAM-D (p = 0.0054; ES: –0.44), but not in fatigue scores. Among MRI parameters, decreases in burden of disease volume (BDV; ES: –0.12), new gadolinium-enhancing lesions (ES: –0.41) and newly active lesions (ES: –0.07) were observed at M12. About 92% of participants showed stable or improved cognitive status at M12. There were no new safety signals reported in the study. The most common adverse events (≥10% of participants) were headache, fatigue, nausea, insomnia, urinary tract infection, pain in extremity, chest discomfort, anxiety, dizziness, arthralgia, flushing, and rash. Hypothyroidism (3.7%) was the most frequent adverse event of special interest. The findings from this study suggest that alemtuzumab has a positive impact on cognitive function with significant improvements in processing speed and depression in people with RMS over a period of 12 months. The safety profile of alemtuzumab was consistent with previous studies

Leveraging a smartphone to perform time-gated luminescence measurements.

Empowered by advanced on-board sensors, high-performance optics packages and ever-increasing computational power, smartphones have democratized data generation, collection, and analysis. Building on this capacity, many platforms have been developed to enable its use as an optical sensing platform for colorimetric and fluorescence measurements. In this paper, we report the ability to enable a smartphone to perform laboratory quality time-resolved analysis of luminescent samples via the exploitation of the rolling shutter mechanism of the native CMOS imager. We achieve this by leveraging the smartphone's standard image capture applications, commercially available image analysis software, and housing the device within a UV-LED containing case. These low-cost modifications enable us to demonstrate the smartphone's analytical potential by performing tasks ranging from authentication and encryption to the interrogation of packaging, compounds, and physical phenomena. This approach underscores the power of repurposing existing technologies to extend the reach and inclusivity of scientific exploration, opening new avenues for data collection and analysis

Individual cognitive test scores within the processing speed composite at baseline and 6-month follow-up.

#<p>Significant difference within groups longitudinally (p≤0.05). Standard error follows mean test scores in brackets.</p

SF-36 transformed scale scores for major quality-of-life outcomes at baseline and 6-month follow-up.

<p>*Difference vs. Neighborhood Controls cross-sectionally (p≤0.07);</p><p>**Significant Difference vs. Neighborhood Controls cross-sectionally (p≤0.05);</p>#<p>Significant difference within groups longitudinally (p≤0.05). Standard error follows transformed test scores in brackets.</p

Composite age and education-adjusted test scores for major cognitive domains at baseline and 6-month follow-up.

<p>**Significant difference between NCC and Epilepsy groups cross-sectionally (p≤0.05). Standard deviation follows test scores in brackets.</p

Demographic and clinical summary of neurocysticercosis cases and controls.

<p>Abbreviations: SD: standard deviation, IR: interquartile range.</p

Neuropsychological testing battery.

<p>*Attention composite tests;</p>#<p>Processing speed composite tests;</p>¶<p>Learning composite tests;</p>§<p>Memory composite tests (see <a href="http://www.plosntds.org/article/info:doi/10.1371/journal.pntd.0001493#pntd-0001493-t003" target="_blank">Table 3</a>).</p><p>Abbreviations: WAIS: Wechsler Adult Intelligence Scale, WMS: Wechsler Memory Scale, RAVT: Raven's Progressive Matrices and Vocabulary Scales, SF-36: Short Form-36.</p