Recommendations for cognitive screening and management in multiple sclerosis care

To promote understanding of cognitive impairment in multiple sclerosis (MS), recommend optimal screening, monitoring, and treatment strategies, and address barriers to optimal management. The National MS Society ("Society") convened experts in cognitive dysfunction (clinicians, researchers...

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Vydáno v:	Multiple sclerosis Ročník 24; číslo 13; s. 1665
Hlavní autoři:	Kalb, Rosalind, Beier, Meghan, Benedict, Ralph Hb, Charvet, Leigh, Costello, Kathleen, Feinstein, Anthony, Gingold, Jeffrey, Goverover, Yael, Halper, June, Harris, Colleen, Kostich, Lori, Krupp, Lauren, Lathi, Ellen, LaRocca, Nicholas, Thrower, Ben, DeLuca, John
Médium:	Journal Article
Jazyk:	angličtina
Vydáno:	England 01.11.2018
Témata:	remediation treatment Multiple sclerosis rehabilitation screening cognition cognitive dysfunction
ISSN:	1477-0970, 1477-0970
On-line přístup:	Zjistit podrobnosti o přístupu
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Abstract	To promote understanding of cognitive impairment in multiple sclerosis (MS), recommend optimal screening, monitoring, and treatment strategies, and address barriers to optimal management. The National MS Society ("Society") convened experts in cognitive dysfunction (clinicians, researchers, and lay people with MS) to review the published literature, reach consensus on optimal strategies for screening, monitoring, and treating cognitive changes, and propose strategies to address barriers to optimal care. Based on current evidence, the Society makes the following recommendations, endorsed by the Consortium of Multiple Sclerosis Centers and the International Multiple Sclerosis Cognition Society: Increased professional and patient awareness/education about the prevalence, impact, and appropriate management of cognitive symptoms. For adults and children (8+ years of age) with clinical or magnetic resonance imaging (MRI) evidence of neurologic damage consistent with MS: As a minimum, early baseline screening with the Symbol Digit Modalities Test (SDMT) or similarly validated test, when the patient is clinically stable; Annual re-assessment with the same instrument, or more often as needed to (1) detect acute disease activity; (2) assess for treatment effects (e.g. starting/changing a disease-modifying therapy) or for relapse recovery; (3) evaluate progression of cognitive impairment; and/or (4) screen for new-onset cognitive problems. For adults (18+ years): more comprehensive assessment for anyone who tests positive on initial cognitive screening or demonstrates significant cognitive decline, especially if there are concerns about comorbidities or the individual is applying for disability due to cognitive impairment. For children (<18 years): neuropsychological evaluation for any unexplained change in school functioning (academic or behavioral). Remedial interventions/accommodations for adults and children to improve functioning at home, work, or school.
AbstractList	To promote understanding of cognitive impairment in multiple sclerosis (MS), recommend optimal screening, monitoring, and treatment strategies, and address barriers to optimal management.PURPOSETo promote understanding of cognitive impairment in multiple sclerosis (MS), recommend optimal screening, monitoring, and treatment strategies, and address barriers to optimal management.The National MS Society ("Society") convened experts in cognitive dysfunction (clinicians, researchers, and lay people with MS) to review the published literature, reach consensus on optimal strategies for screening, monitoring, and treating cognitive changes, and propose strategies to address barriers to optimal care.METHODSThe National MS Society ("Society") convened experts in cognitive dysfunction (clinicians, researchers, and lay people with MS) to review the published literature, reach consensus on optimal strategies for screening, monitoring, and treating cognitive changes, and propose strategies to address barriers to optimal care.Based on current evidence, the Society makes the following recommendations, endorsed by the Consortium of Multiple Sclerosis Centers and the International Multiple Sclerosis Cognition Society: Increased professional and patient awareness/education about the prevalence, impact, and appropriate management of cognitive symptoms. For adults and children (8+ years of age) with clinical or magnetic resonance imaging (MRI) evidence of neurologic damage consistent with MS: As a minimum, early baseline screening with the Symbol Digit Modalities Test (SDMT) or similarly validated test, when the patient is clinically stable; Annual re-assessment with the same instrument, or more often as needed to (1) detect acute disease activity; (2) assess for treatment effects (e.g. starting/changing a disease-modifying therapy) or for relapse recovery; (3) evaluate progression of cognitive impairment; and/or (4) screen for new-onset cognitive problems. For adults (18+ years): more comprehensive assessment for anyone who tests positive on initial cognitive screening or demonstrates significant cognitive decline, especially if there are concerns about comorbidities or the individual is applying for disability due to cognitive impairment. For children (<18 years): neuropsychological evaluation for any unexplained change in school functioning (academic or behavioral). Remedial interventions/accommodations for adults and children to improve functioning at home, work, or school.RECOMMENDATIONSBased on current evidence, the Society makes the following recommendations, endorsed by the Consortium of Multiple Sclerosis Centers and the International Multiple Sclerosis Cognition Society: Increased professional and patient awareness/education about the prevalence, impact, and appropriate management of cognitive symptoms. For adults and children (8+ years of age) with clinical or magnetic resonance imaging (MRI) evidence of neurologic damage consistent with MS: As a minimum, early baseline screening with the Symbol Digit Modalities Test (SDMT) or similarly validated test, when the patient is clinically stable; Annual re-assessment with the same instrument, or more often as needed to (1) detect acute disease activity; (2) assess for treatment effects (e.g. starting/changing a disease-modifying therapy) or for relapse recovery; (3) evaluate progression of cognitive impairment; and/or (4) screen for new-onset cognitive problems. For adults (18+ years): more comprehensive assessment for anyone who tests positive on initial cognitive screening or demonstrates significant cognitive decline, especially if there are concerns about comorbidities or the individual is applying for disability due to cognitive impairment. For children (<18 years): neuropsychological evaluation for any unexplained change in school functioning (academic or behavioral). Remedial interventions/accommodations for adults and children to improve functioning at home, work, or school. To promote understanding of cognitive impairment in multiple sclerosis (MS), recommend optimal screening, monitoring, and treatment strategies, and address barriers to optimal management. The National MS Society ("Society") convened experts in cognitive dysfunction (clinicians, researchers, and lay people with MS) to review the published literature, reach consensus on optimal strategies for screening, monitoring, and treating cognitive changes, and propose strategies to address barriers to optimal care. Based on current evidence, the Society makes the following recommendations, endorsed by the Consortium of Multiple Sclerosis Centers and the International Multiple Sclerosis Cognition Society: Increased professional and patient awareness/education about the prevalence, impact, and appropriate management of cognitive symptoms. For adults and children (8+ years of age) with clinical or magnetic resonance imaging (MRI) evidence of neurologic damage consistent with MS: As a minimum, early baseline screening with the Symbol Digit Modalities Test (SDMT) or similarly validated test, when the patient is clinically stable; Annual re-assessment with the same instrument, or more often as needed to (1) detect acute disease activity; (2) assess for treatment effects (e.g. starting/changing a disease-modifying therapy) or for relapse recovery; (3) evaluate progression of cognitive impairment; and/or (4) screen for new-onset cognitive problems. For adults (18+ years): more comprehensive assessment for anyone who tests positive on initial cognitive screening or demonstrates significant cognitive decline, especially if there are concerns about comorbidities or the individual is applying for disability due to cognitive impairment. For children (<18 years): neuropsychological evaluation for any unexplained change in school functioning (academic or behavioral). Remedial interventions/accommodations for adults and children to improve functioning at home, work, or school.
Author	Kostich, Lori Halper, June Goverover, Yael Benedict, Ralph Hb DeLuca, John Gingold, Jeffrey Krupp, Lauren LaRocca, Nicholas Beier, Meghan Charvet, Leigh Kalb, Rosalind Lathi, Ellen Costello, Kathleen Harris, Colleen Thrower, Ben Feinstein, Anthony
Author_xml	– sequence: 1 givenname: Rosalind surname: Kalb fullname: Kalb, Rosalind organization: National Multiple Sclerosis Society, New York, NY, USA – sequence: 2 givenname: Meghan surname: Beier fullname: Beier, Meghan organization: Division of Rehabilitation Psychology and Neuropsychology, Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD, USA – sequence: 3 givenname: Ralph Hb surname: Benedict fullname: Benedict, Ralph Hb organization: Department of Neurology, University at Buffalo, Buffalo, NY, USA – sequence: 4 givenname: Leigh surname: Charvet fullname: Charvet, Leigh organization: Department of Neurology, Langone Medical Center, New York University, New York, NY, USA – sequence: 5 givenname: Kathleen surname: Costello fullname: Costello, Kathleen organization: National Multiple Sclerosis Society, New York, NY, USA – sequence: 6 givenname: Anthony surname: Feinstein fullname: Feinstein, Anthony organization: Department of Psychiatry, University of Toronto, Toronto, ON, Canada – sequence: 7 givenname: Jeffrey surname: Gingold fullname: Gingold, Jeffrey organization: National Multiple Sclerosis Society, New York, NY, USA – sequence: 8 givenname: Yael surname: Goverover fullname: Goverover, Yael organization: New York University, New York, NY, USA – sequence: 9 givenname: June surname: Halper fullname: Halper, June organization: The Consortium of Multiple Sclerosis Centers and International Organization of Multiple Sclerosis Nurses, Multiple Sclerosis Nurses International Certification Board, Hackensack, NJ, USA – sequence: 10 givenname: Colleen surname: Harris fullname: Harris, Colleen organization: Multiple Sclerosis Center, University of Calgary, Calgary, AB, Canada – sequence: 11 givenname: Lori surname: Kostich fullname: Kostich, Lori organization: The Mandell Center for Multiple Sclerosis, Mount Sinai Rehabilitation Hospital, Hartford, CT, USA – sequence: 12 givenname: Lauren surname: Krupp fullname: Krupp, Lauren organization: Department of Neurology, NYU Langone Health, New York University, New York, NY, USA – sequence: 13 givenname: Ellen surname: Lathi fullname: Lathi, Ellen organization: The Elliot Lewis Center for Multiple Sclerosis Care, Wellesley, MA, USA – sequence: 14 givenname: Nicholas surname: LaRocca fullname: LaRocca, Nicholas organization: National Multiple Sclerosis Society, New York, NY, USA – sequence: 15 givenname: Ben surname: Thrower fullname: Thrower, Ben organization: Emory University, Atlanta, GA, USA/Andrew C. Carlos Multiple Sclerosis Institute at Shepherd Center, Atlanta, GA, USA – sequence: 16 givenname: John surname: DeLuca fullname: DeLuca, John organization: Department of Physical Medicine and Rehabilitation and Department of Neurology, Rutgers New Jersey Medical School, Newark, NJ, USA
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PublicationTitle	Multiple sclerosis
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Snippet	To promote understanding of cognitive impairment in multiple sclerosis (MS), recommend optimal screening, monitoring, and treatment strategies, and address...
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Title	Recommendations for cognitive screening and management in multiple sclerosis care
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