Visual complaints in people with multiple sclerosis:looking beyond the optic system

The aim of this study was to provide insight in the prevalence and nature of visual complaints reported by people with multiple sclerosis (MS), to provide a better understanding of the complaints and to make first steps to improve rehabilitation care. A questionnaire (Screening Visual Complaints, SVCq) was developed and used to investigate the prevalence of visual complaints. The SVCq showed to be a valid and reliable tool to quickly screen for visual complaints and can be used in clinical practice to support referrals and further steps in clinical care. The prevalence study showed that up to 90% of people with MS report visual complaints. Frequently reported complaints were needing more time or light, being blinded by bright light and difficulties adjusting to light or dark. Examples of other complaints are double vision, difficulties with depth perception, decreased contrast sensitivity, experiencing shaky images and changes in the visual field. Almost all complaints included in the questionnaire were more frequently reported by people with MS than by people without MS or other severe conditions. The study could not show that reported visual complaints are one-to-one related to decline in visual, visuoperceptual and cognitive functions. These functions therefore may not help us understand the complaints. A diffuse decline of a vision network (comprising of the optic system and other cerebral regions) may contribute the development of visual complaints. Referrals and rehabilitation should not solely rely on measured functional decline or impairment, but an individual’s complaints and experiences should be taken into account

Does hand skill asymmetry relate to creativity, developmental and health issues and aggression as markers of fitness?

A remarkable feature of human handedness at the population level is specialization of the hands, the right hand performing usually better than the left. This specialization might have an evolutionary advantage, because it provides the individual and population with a wider range of skill. We therefore investigated the relationships between hand skill asymmetry and potential markers of Darwinian fitness that have been hypothesized to explain the bias in hand preference: creativity, aggression and developmental and health problems. Over twenty thousand participants (56% left-handers) completed an online survey, including a finger-tapping task to measure hand skill asymmetry. Left-skilled individuals were overall more aggressive than right-skilled individuals and rated themselves as more artistically creative. However, when assessed with a questionnaire, they were less creative on problem solving and equally artistically creative compared to right-skilled individuals, who reported more health problems. Conclusion: we found some evidence for current selection on the direction of lateralization of hand skill although the effect sizes were rather low. Strength of lateralization of hand skill showed only a few associations with fitness proxies. We suggest that Darwinian selection on hand preference (Zickert, Feen, van der, Geuze, & Groothuis, 2018. Fitness costs and benefits associated with hand preference in humans: A large internet study in a Dutch sample. Evolution and Human Behavior, 39, 235-248) and hand skill asymmetry (present study) may be attenuated in modern society

Independent outdoor mobility of persons with multiple sclerosis – A systematic review

Background: Multiple sclerosis (MS) can manifest itself in many ways, all of which can affect the independent outdoor mobility of persons with MS (pwMS). In most studies, mobility of pwMS is defined by the ability to walk. However, mobility comprises more than walking alone. This systematic review provides an overview of the literature on several types of independent outdoor mobility of pwMS. We aimed to identify which specific factors may influence outdoor mobility and how the lives of pwMS may be affected by a reduced mobility. Methods: A systematic literature search was performed, using three databases (PubMed, PsychInfo and Web of Science). Studies had to describe a group of pwMS sclerosis and had to concern some type of mobility other than walking. Results: The 57 studies that fulfilled the criteria included in total 10,394 pwMS and in addition, 95,300 pwMS in separate prevalence study. These studies showed that pwMS as a group have a decreased fitness to drive, make use of a wheelchair or mobility scooter more often and have difficulties making use of public transport. Mobility problems especially occur in patients with cognitive problems, secondary progressive MS or high disability scores. Conclusions: The reduced mobility may prevent pwMS participating in society. However, few studies investigating interventions or rehabilitation options to improve mobility were found in the existing literature, highlighting an until now under recognised unmet need

Recognizing visual complaints in people with multiple sclerosis:Prevalence, nature and associations with key characteristics of MS

Background Visual disturbances are common in multiple sclerosis (MS), but visual complaints may be underestimated. While these complaints decrease quality of life, they may not be discussed during clinic visits. People with MS (pwMS) may not be referred to appropriate care. We therefore investigated the prevalence, nature and associations of visual complaints of pwMS. Methods We performed a cohort study with a comparison group. PwMS (n = 493) and healthy controls (n = 661) filled out the Screening Visual Complaints questionnaire (SVCq). Primary outcomes were the percentage of pwMS and controls that reported the 19 complaints, and total scores of the SVCq. We also compared the scores on the SVCq between different groups of pwMS. Results In general, the complaints were reported more often by pwMS than by controls. PwMS especially reported experiencing complaints ‘often/always’, while controls reported the complaints primarily ‘sometimes’. PwMS with and without a history of optic neuritis showed similar complaints. PwMS with a longer disease duration and those with SPMS reported more complaints. EDSS score and disease duration only showed a limited association with discomfort of visual complaints. Conclusion The prevalence of visual complaints among pwMS is high and any person with MS may experience a wide array of different visual complaints anywhere along the disease course, regardless of a history of optic neuritis. Using the SVCq may help detect pwMS’ visual complaints and may facilitate referrals to appropriate care