Reduced magnetisation transfer ratio in cognitively impaired patients at the very early stage of multiple sclerosis: a prospective, multicenter, cross-sectional study.

OBJECTIVES: Cognitive impairment belongs to the core symptoms in multiple sclerosis (MS) and can already be present at the very early stages of the disease. The present study evaluated cognitive functioning after the first clinical presentation suggestive of MS and brain tissue damage in a non-lesion focused MRI approach by using magnetisation transfer imaging (MTI). SETTING AND PARTICIPANTS: 47 patients (15 men and 32 women; mean age: 31.17 years) after the first clinical event suggestive of MS were recruited in six different MS centres in Germany and underwent a neuropsychological test battery including tests for attention, memory and executive function as well as depression and fatigue. MTI and conventional MRI measures (T1/T2 lesion load) were assessed. In addition, Magnetisation Transfer Ratio (MTR) maps were calculated. Primary outcome measure was the investigation of cognitive dysfunction in very early MS in correlation to MRI data. RESULTS: 55.3% of patients with MS failed at least one test parameter. Specifically, 6% were reduced in working memory, 14.9% in focused attention, 25.5% in figural learning and up to 14.9% in executive function. When the sample was subdivided into cognitively impaired and preserved, MTR scores within the cognitively impaired subgroup were significantly lower compared with the preserved group (t(43)=2.346, p=0.02*). No significant differences between the two groups were found in T2-weighted and T1-weighted lesion volume. CONCLUSIONS: After the first MS-related clinical event, 55.3% of patients showed distinct cognitive deficits. Cognitively impaired patients had significantly lower whole brain MTR, but no differences in focal brain lesion volumes supporting the idea that early cognitive deficits may be related to diffuse loss of brain tissue integrity.

Self-handicapping and intrinsic motivation: buffering intrinsic motivation from the threat of failure.

High and low self-handicappers (as measured by E. E. Jones & F. Rhodewalt's [1982] Self-Handicapping Scale) were asked to play a game of pinball (in a competitive or noncompetitive setting) after they had practices as much as they wanted on a related task (thus, not practicing could have served as a self-handicap). High self-handicappers who did not practice much became more involved in the game and subsequently reported enjoying the game more than high self-handicappers who practiced a lot. Furthermore, the effects on enjoyment were mediated by task involvement, suggesting that the protection afforded by self-handicapping affects intrinsic motivation by allowing the individual to become absorbed in the activity instead of focusing on performance concerns. Individuals who self-handicap may be providing themselves with the "breathing room" they need to become absorbed in an activity and to experience the activity as enjoyable.

Self-reported versus behavioral self-handicapping: empirical evidence for a theoretical distinction.

The present study was an investigation of how Ss would respond when given 2 self-handicapping options, 1 behavioral (withdrawal of practice effort) and 1 self-reported (reporting high levels of stress). Ss anticipating a diagnostic test of intellectual ability were given different instructions regarding the effects of stress and practice on test performance. Ss were told that (a) stress only, (b) practice only, (c) both stress and practice, or (d) neither stress nor practice affected test scores. Ss were then given the opportunity to self-report a handicap on a stress inventory and to behaviorally self-handicap by failing to practice before the test. High self-handicapping men and women showed evidence of self-reported handicapping, but only high self-handicapping men behaviorally self-handicapped. However, when both self-handicaps were viable, both high self-handicapping men and women preferred the self-reported over the behavioral self-handicap.

Dopa-positive cells and melanin in basal cell epithelioma (BCE).

In 47 out of 61 bce's, melanocytes were detectable with the aid of Dopa-reaction. In 24 of these cases, the percentage of tumour cells was less 5%, and in 23 it was more. The melanocytes preferred the periphery of the epithelial tumour formations. Only when the proportion of melanocytes exceeded 5% were they also to be found in the central parts of the tumours. Generally the melanocytes were more numerous in the upper parts of tumours, next to the epidermis. Our findings strengthen the opinion, that bce is a tumour of the primary hair germ.