Post on 31-Mar-2015
Ralph H. B. Benedict, PhD, ABPP-CNProfessor of Neurology, Psychiatry and Psychology
University at Buffalo, SUNY
Brains & Gains
November 2013
[In] most of the patients affected by multi-locular sclerosis whom I have had occasion to observe … there is marked enfeeblement of the memory; conceptions are formed slowly; the intellectual and emotional faculties are blunted in their totality. The dominant feeling in the patients appears to be a sort of almost cheerful indifference in reference to all things.
Jean-Martin Charcot (1877)
Demyelination and axonopathy
cerebral cortex r = 0.65 [Amato 2004; Benedict 2006; Tekok-Kilic 2007]
3rd ventricle r = 0.71[Christodolou 2003; Benedict 2004]
mesial temporal r = 0.42 [Sicotte 2008; Benedict 2009]
thalamus r = 0.75 [Houtchens 2007]
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Job LossReduced work hours
DemotionLess Salary
Miss Promotion
WalkingUpper Extremity Function
Cognitive AbilityDepression
Negative Work EventsWork Errors
Forgetting AppointmentsSlow Work, Reduced
ProductivityUnequal Work Distribution
Social Difficulty
Accommodations/InterventionHigh Tech, Low Tech Aids
Overt, Covert AidsAdditional Time to Complete Tasks
Flexible Schedule
EmployerPatient
Coworker
Cognitive Impairment Mild
Maintain Employment
Private Disability
Social Security Disability
Early Retirement
Severe
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Hours Worked per Week
Income
Extra Time Spent Outside Work
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How to Monitor Clinical Status?
www.BICAMS.net
Published Collecting data/analysis DiscussionUSA Canada Portugal PeruIran UK Belgium OmanCzech Republic Italy Ireland Poland
Germany Hungary RomaniaAustria Australia Slovenia
Egypt SwedenEstonia TurkeyLithuania BrazilNorway MexicoColumbia
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Why do some MS Patients Fare so Well?
• Cognitive Reserve• Exercise• Personality• Cognitive Retraining
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Dimensional models of personality: the five-factor model and the DSM-5Timothy J. Trull, PhD; Thomas A. Widiger, PhD. Dialogues Clin Neurosci. 2013;15:135-146.
Conscientiousness
p = 0.023
Neuroticism
p = 0.001
Adam J. BoothJonathan D. RodgersCarolyn E. Schwartz, Sc.DBrian R. QuarantoBianca Weinstock-GuttmanRobert ZivadinovRalph H. B. Benedict
Active Cognitive Reserve Influences the Regional Atrophy to Cognition Link in Multiple SclerosisIn Press
Thank You
Bianca Weinstock-Guttman MD
Robert Zivadinov MD; Murali Ramanathan PhD
David Hojnacki MD; Channa Kolb MD
Margaret Bucello NP; Audrey Smerbeck PhD
Jonathan Rodgers PhD, Natalie Emmert BA