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Biomedical subjects

John Deluca

Publications and source records attributed to John Deluca.

4 recordsLinked to original sources

Functional status, neuropsychological functioning, and mood in chronic fatigue syndrome (CFS): relationship to psychiatric disorder.

Individuals with chronic fatigue syndrome (CFS) face chronic physical debilitation, reduced neuropsychological functioning, and changes in emotional well-being that significantly detract from quality of life. The role of psychiatric disturbance in reducing quality of life in CFS remains unclear. In the current investigation, the role of psychiatric status in reducing health-related quality of life in CFS was examined. Four subject groups were compared on measures of functional well-being, mood, and neuropsychological status: individuals with CFS and no history of psychiatric illness, individuals who had current symptoms of psychiatric illness that began after their CFS diagnosis, individuals who had current symptoms of psychiatric illness that began before their CFS diagnosis, and a healthy sedentary control group. Overall, it was found that individuals with CFS suffer from profound physical impairment. Concurrent psychiatric illness, however, did not adversely affect physical functional capacity. Physical functional capacity was not worse in individuals with a concurrent psychiatric illness. As expected, concurrent psychiatric illness was found to reduce emotional well-being. Moreover, individuals with a psychiatric illness that predated the onset of CFS suffered the greatest emotional distress. Thus, an individual's psychiatric history should be considered when attempting to understand the factors maintaining disability in CFS.

Adaptation, Psychological↗

Self-generation as a means of maximizing learning in multiple sclerosis: an application of the generation effect.

OBJECTIVE: To examine the generation effect, the observation that items generated by subjects are better remembered than items provided, as a means of maximizing new learning in multiple sclerosis (MS). DESIGN: Prospective between-group design. SETTING: Private, nonprofit research facility. PARTICIPANTS: Population-based sample of 31 subjects with MS (MS group) and 17 healthy controls (control group), matched for age and education. INTERVENTION: Immediate, thirty-minute and 1-week assessments. MAIN OUTCOME MEASURES: Neuropsychologic tests assessing language, executive functioning, working memory, long-term memory, and the generation effect were administered. Recall and recognition of generation effect stimuli was tested immediately, 30 minutes, and 1-week after presentation. RESULTS: Recall and recognition of generated stimuli were significantly higher than provided stimuli across testing sessions. This effect was observed equally across the control and MS groups. Recall performance for generated stimuli correlated significantly with indices of episodic memory, information processing, and language but not executive control. Memory for the source of the information was deficient for generated words compared with provided words. CONCLUSIONS: The generation effect was present in MS and control subjects and may be a viable way of maximizing new learning in MS.

Adult↗

Assessing functional status: exploring the relationship between the multiple sclerosis functional composite and driving.

OBJECTIVE: To explore the relationship between the Multiple Sclerosis Functional Composite (MSFC), which is comprised of 3 clinical dimensions (arm and hand function, leg function and ambulation, cognition), and an everyday functional skill, driving performance. DESIGN: Cohort study. SETTING: Medical rehabilitation research organization. PARTICIPANTS: Twenty-nine individuals with documented multiple sclerosis (MS) and limited motor decrements. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Driving-related skills were measured by using the overall category rating from the Useful Field of View (UFOV) Test, its 3 subtests, the error and latency scores from the Neurocognitive Driving Test (NDT), subjective (self-report) and objective (Department of Motor Vehicles [DMV] reports) reported driving experience, and number of motor vehicle crashes. Within the group, differences were explored between participants rated as low risk versus moderate-high risk on the UFOV overall score and between participants who reported a change in driving habits after MS versus those who reported no change. RESULTS: The overall MSFC score correlated significantly with the UFOV overall score, the visual-information processing and selective attention subtests of the UFOV, the NDT latency score, as well as with the number of days a week the individual drove and the number of crashes reported by the DMV. An examination of the MSFC components revealed that the cognition component was significantly related to the UFOV overall score, all 3 subtests of the UFOV, and the NDT latency score. The arm and hand function component correlated significantly with NDT latency and the selective attention subtest of the UFOV. Individuals classified as low risk on the UFOV overall had more education, better MSFC scores, and lower NDT latency scores. Only the overall MSFC score distinguished those who reported a change in driving habits after onset of MS. CONCLUSIONS: Problems with everyday functional skills such as driving are accurately identified through the use of the overall MSFC and its components.

Adult↗

Motor vehicle crashes and violations among drivers with multiple sclerosis.

OBJECTIVE: To investigate differences in the incidence of motor vehicle crashes (MVCs) and violations among drivers with multiple sclerosis (MS) when cognitive impairment is present. DESIGN: Archival evaluation of Department of Motor Vehicles (DMV) records. SETTING: Medical rehabilitation research organization. PARTICIPANTS: Community-dwelling drivers, 27 subjects with documented MS (14 MS without cognitive impairment [MS-], 13 MS with cognitive impairment [MS+]) and 17 healthy control subjects, matched on age, sex, and driving experience. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Incidence of MVCs and motor vehicle violations as documented by DMV reports for the past 5 years. RESULTS: MS+ subjects showed a higher incidence of MVCs when compared with control and MS- subjects. No significant difference in the incidence of motor vehicle violations was observed between groups. CONCLUSIONS: The presence of cognitive impairment in drivers with MS can result in an increased risk of MVC involvement.

Accidents, Traffic↗