Validity and reliability of the 10-item Connor-Davidson Resilience Scale (CD-RISC-10) in a sample of Spanish-speaking patients with Multiple Sclerosis.

BACKGROUND: It is urgent to increase studies aimed at exploring and understanding the role that psychological resilience plays in PwMS. To achieve this objective, an important requirement is to have properly validated instruments that allow exploring psychological resilience in MS patients. The aim of this study was to evaluate the validity and reliability of the 10-item CD-RISC in a sample of Spanish-speaking patients with MS (PwMS). METHODS: An online multicenter study was conducted on 214 MS patients from 11 Spanish-speaking countries (Argentina, Mexico, Dominican Republic, Chile, Spain, Cuba, Colombia, Uruguay, Paraguay, Peru, and El Salvador). Confirmatory factor analysis (CFA) was performed to assess the factor structure of the 10-item CD-RISC. Model fits were assessed through the χ2/df value, comparative fit index (CFI), and root mean square error of approximation (RMSEA). RESULTS: The 10-item CD-RISC showed good psychometric characteristics in our sample of PwMS. The single-factor model in the CFA yielded a good model fit (χ2=99.380(35), p<.001; χ2/df = 2.83; RMSEA=.090; CFI=.92). Cronbach's alpha of the CD-RISC-10 items version (Spanish version) was .88. The CD-RISC-10 was significantly correlated with quality of life scale (r = .420, p < .001), fear of relapse scale (r = -.327, p < .001), and fatigue scale (r = -.367, p < .001). CONCLUSIONS: The CD-RISC-10 has satisfactory psychometric properties and is a suitable tool for measuring resilience in Spanish-speaking patients with multiple sclerosis.

Fear of COVID-19, problems accessing medical appointments, and subjective experience of disease progression, predict anxiety and depression reactions in patients with Multiple Sclerosis.

BACKGROUND: During the current COVID-19 pandemic there are studies that have suggested a negative impact of the pandemic on the mental health of patients with multiple sclerosis (PwMS). In this sense, several factors may be related to the increase in experiences of anxiety and depression in PwMS during the current pandemic. OBJECTIVE: In this study we first explored the reactions of anxiety, depression and fear to COVID-19 in a group of PwMS that belong to the Ibero-American region. Besides, we explored whether having been positive to COVID-19, fear of COVID-19, the obstacles to attend medical appointments during the outbreak and subjective experience of MS progression, could predict the anxiety and depression reactions in our PwMS sample. MATERIALS AND METHODS: An online cross-sectional survey was conducted on 202 MS patients from six countries (Argentina, Mexico, Spain, Dominican Republic, Venezuela and Cuba). For comparisons between variables an independent-samples t-test and one-way analysis of variance were used. Multiple linear regression was used to evaluate the effects of potential predictor variables over emotional reactions. RESULTS: Our results showed that PwMS who were positive for COVID-19 reported higher levels of fear of COVID-19 (p<.001) and also higher levels of anxiety (p<.001) compared to non-positive patients. Those patients who had difficulties attending their medical appointments during the outbreak showed higher levels of depression (p=.03) and anxiety (p=.019). Levels of anxiety (p<.001) and depression (p=.006) were also higher among patients with the subjective experience of MS disease progression. The reactions of fear of COVID-19, having been positive to COVID-19, problems attending medical appointments, and subjective experience of MS disease progression showed a high association with the negative impact of the pandemic on mental health of PwMS. CONCLUSIONS: Our results show that the situation generated by the COVID-19 pandemic has had a negative impact on the mental health of PwMS in our sample. Our results also alert to the importance of offering psychological care to patients with multiple sclerosis during the current outbreak, regardless of whether they have been positive for COVID-19.

Entrenamiento cognitivo combinado con ejercicios aeróbicos en pacientes con esclerosis múltiple: estudio piloto / Cognitive training combined with aerobic exercises in multiple sclerosis patients: a pilot study

Introducción. Las evidencias científicas asociadas a la efectividad de distintas técnicas de rehabilitación cognitiva todavía resultan contradictorias. Objetivo. Comparar un programa de entrenamiento combinado (físico y cognitivo) frente a un programa de entrenamiento físico y observar su eficacia sobre la optimización de las funciones cognitivas en pacientes con esclerosis múltiple (EM). Pacientes y métodos. Se realizó un estudio experimental en 32 pacientes con EM. Los pacientes se distribuyeron en dos grupos: 16 al grupo experimental (entrenamiento cognitivo combinado con ejercicios aeróbicos) y 16 al grupo control (ejercicios aeróbicos). La intervención se planificó para seis semanas combinando tareas cognitivas mediante un juego de tablero dinámico de cubos y signos (TaDiCS ®) y un programa de ejercicios aeróbicos. Se aplicó la batería breve repetible de tests neuropsicológicos y el test de Stroop para evaluar el rendimiento cognitivo. Además, se administró el inventario de depresión de Beck. Resultados. Se encontraron diferencias significativas en el análisis intergrupo después de la intervención en las variables aprendizaje y memoria a largo plazo visuoespacial (p = 0,000), atención (p = 0,026) y control inhibitorio (p = 0,007). Asimismo, en el análisis intragrupo se encontraron diferencias significativas en estas variables y en la velocidad en el procesamiento de la información en el grupo que recibió el entrenamiento combinado. Estos pacientes también mostraron una mejoría significativa en el estado de ánimo (p = 0,043). Conclusión. El entrenamiento cognitivo combinado con los ejercicios aeróbicos resulta eficaz para mejorar el funcionamiento cognitivo (AU)

Introduction. The scientific evidences associated to the effectiveness of different techniques of cognitive rehabilitation are still contradictory. Aim. To compare a program of combined training (physical and cognitive) in front of a program of physical training and to observe their effectiveness about the optimization of the cognitive functions in patients with multiple sclerosis (MS). Patients and methods. It was carried out an experimental study in 32 patients with MS. The patients were distributed in two groups: 16 to the experimental group (combined cognitive training with aerobic exercises) and 16 patients to the control group (aerobic exercises). The intervention was planned for six weeks combining cognitive tasks by means of a game of dynamic board of cubes and signs (TaDiCS ®) and a program of aerobic exercises. The Brief Repeatable Battery of Neuropsychological Test and the Stroop Test were applied to evaluate the cognitive yield. Also, the Beck Depression Inventory was administered. Results. There were found significant differences in the intergrupal analysis after the intervention in the variable learning and visuoespacial long term memory (p = 0.000), attention (p = 0.026) and inhibitory control (p = 0.007). Also, in the intragroup analysis there were found significant differences in these variables and information processing speed in the group that received the combined training. These patients also showed a significant improvement in the emotional state (p = 0.043). Conclusion. The cognitive training combined with the aerobic exercises is effective to improve the cognitive performance (AU)

Reserva cognitiva en la esclerosis múltiple. Su rol en la evaluación e intervención neuropsicológica / Cognitive reserve in the multiple sclerosis. It´s roll in the evaluation and neuropsychological intervention

Fundamento: Existe una gran variabilidad del funcionamiento cognitivo en el curso de la esclerosis múltiple, incluso entre pacientes que tienen similares patrones de disfunción cerebral. Objetivo: Sintetizar los resultados científicos más representativos sobre las particularidades de la reserva cognitiva en esta patología. Desarrollo: Se sintetiza sobre los referentes teóricos y científicos relacionados con el modelo de reserva cognitiva y cerebral en la esclerosis múltiple, bases neurobiológicas de la reserva y el valor de las actividades cognitivas de ocio como proxies de la reserva cognitiva. Además, se analizan los resultados relacionados con la importancia de la intervención temprana en la prevención del deterioro cognitivo en estos pacientes. Conclusiones: La teoría de la reserva cognitiva puede resultar de gran utilidad para la práctica de la evaluación e intervención neuropsicológica en los pacientes con esclerosis múltiple; en este sentido, la reserva cognitiva puede actuar como un factor modulador (riesgo o protector) del declive cognitivo y marcador de eficiencia cerebral en este tipo de pacientes.

Background: A great variability of the cognitive functioning exists in the course of the multiple sclerosis, even among patients that have similar patterns of cerebral dysfunction. Objective: To synthesize the most representative scientific results about the particularities of the cognitive reservation in this pathology. Development: It is synthesized on the theoretical and scientific referents related with the pattern of cognitive and cerebral reservation in the multiple sclerosis, base neurobiological of the reservation and the value of the leisure cognitive activities like proxies of the cognitive reservation. Also, the results related with the importance of the early intervention are analyzed in the prevention of the cognitive deterioration in these patients. Conclusions: The theory of the cognitive reservation can be of great utility for the practice of the neuropsychological evaluation and intervention in the patients with multiple sclerosis; in this sense, the cognitive reservation can act as a modulator factor (risk or protective) of the cognitive decline and marker of cerebral efficiency in this type of patient.

Reserva cognitiva en la esclerosis múltiple. Su rol en la evaluación e intervención neuropsicológica / Cognitive reserve in the multiple sclerosis. It´s roll in the evaluation and neuropsychological intervention

Existe una gran variabilidad del funcionamiento cognitivo en el curso de la esclerosis múltiple, incluso entre pacientes que tienen similares patrones de disfunción cerebral. Objetivo: Sintetizar los resultados científicos más representativos sobre las particularidades de la reserva cognitiva en esta patología. Desarrollo: Se sintetiza sobre los referentes teóricos y científicos relacionados con el modelo de reserva cognitiva y cerebral en la esclerosis múltiple, bases neurobiológicas de la reserva y el valor de las actividades cognitivas de ocio como proxies de la reserva cognitiva. Además, se analizan los resultados relacionados con la importancia de la intervención temprana en la prevención del deterioro cognitivo en estos pacientes. Conclusiones: La teoría de la reserva cognitiva puede resultar de gran utilidad para la práctica de la evaluación e intervención neuropsicológica en los pacientes con esclerosis múltiple; en este sentido, la reserva cognitiva puede actuar como un factor modulador (riesgo o protector) del declive cognitivo y marcador de eficiencia cerebral en este tipo de pacientes(AU)

A great variability of the cognitive functioning exists in the course of the multiple sclerosis, even among patients that have similar patterns of cerebral dysfunction. Objective: To synthesize the most representative scientific results about the particularities of the cognitive reservation in this pathology. Development: It is synthesized on the theoretical and scientific referents related with the pattern of cognitive and cerebral reservation in the multiple sclerosis, base neurobiological of the reservation and the value of the leisure cognitive activities like proxies of the cognitive reservation. Also, the results related with the importance of the early intervention are analyzed in the prevention of the cognitive deterioration in these patients. Conclusions: The theory of the cognitive reservation can be of great utility for the practice of the neuropsychological evaluation and intervention in the patients with multiple sclerosis; in this sense, the cognitive reservation can act as a modulator factor (risk or protective) of the cognitive decline and marker of cerebral efficiency in this type of patient(AU)