Ivonne Visit 1: A 33-Year-Old Woman With Multiple Sclerosis Presenting With Cognitive Symptoms

Title:	Ivonne Visit 1: A 33-Year-Old Woman With Multiple Sclerosis Presenting With Cognitive Symptoms
Topic:	Neurology
Relevant Terms:	Cognition In Multiple Sclerosis, Multiple Sclerosis
Primary Audience:	This activity is targeted to Neurologists; Nurses; Physician Assistants; and others who specialize in the care of patients with MS.
Launch Date:	27-Oct-10
Credits:	0.5 AMA PRA Category 1 Credit™ 0.5 ANCC contact hour
Expiration Date:	The accreditation for this activity has expired.

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Learning Objectives

Upon completion of the activity, participants should be able to:

Determine which MS patients should undergo neuropsychological screening, and select appropriate assessment tools
Discuss the role of neuroimaging in detecting neurodegeneration and cognitive dysfunction in MS
Identify the impact on cognition and neuroprotection of early treatment with MS disease-modifying therapies

Faculty

Maria Pia Amato, MD
Associate Professor of Neurological and Psychiatric Sciences
Director, Multiple Sclerosis Centre
University of Florence
Florence, Italy

George H. Kraft, MD, MS
Alvord Professor of Multiple Sclerosis Research
Department of Rehabilitation Medicine and Neurology
University of Washington School of Medicine
Director
Western Multiple Sclerosis Clinical Center
University of Washington Medical Center
Seattle, Washington

George H. Kraft, MD, MS

George H. Kraft, MD, MS, is Alvord Professor of Multiple Sclerosis Research, Professor of Rehabilitation Medicine, and Adjunct Professor of Neurology at the University of Washington, Seattle, Washington; he is Director of the Western Multiple Sclerosis Center; principal investigator of the Multiple Sclerosis Rehabilitation Research and Training Center, and Co-director of the Muscular Dystrophy Clinic at the University of Washington Medical Center.

Dr. Kraft is well-known in the field of multiple sclerosis as an expert in electrodiagnosis, neurological rehabilitation, and the care and treatment of patients with MS. He is Chairperson of the American Board of Electrodiagnostic Medicine; a member of the Advisory Board of the National Center for Medical Rehabilitation and Research of the National Institutes of Health; and a member of the Medical Advisory Board of the National Multiple Sclerosis Society. He is a Past President of the American Academy of Physical Medicine and Rehabilitation (AAPM&R), the American Association of Electrodiagnostic Medicine, the Association of Academic Physiatrists, and the American Academy of Clinical Neurophysiology. Dr. Kraft is a recipient of the Frank H. Krusen Lifetime Achievement Award from the AAPM&R; Distinguished Researcher and Lifetime Achievement Awards from the American Association of Neuromuscular and Electrodiagnostic Medicine; and Distinguished Academician Award from the Association of Academic Physiatrists.

Dr. Kraft is the author or co-author of over 250 articles and chapters on MS, electrodiagnosis, and rehabilitation. He is consulting editor of Physical Medicine and Rehabilitation Clinics of North America and has been associate editor of Muscle and Nerve and a member of the editorial boards of Electroencephalography and Clinical Neurophysiology, the American Journal of Physical Medicine and Rehabilitation, and Neurorehabilitation and Neural Repair. Dr. Kraft is co-editor of Chronic Disease and Disability and co-author of The MS Workbook: Living Fully With Multiple Sclerosis and Living With MS: A Wellness Approach. He is host of "MS From A to Z," which is broadcast nationally on university television stations.

Amy Perrin Ross, APN, MSN, CNRN, MSCN
Neurosciences Program Coordinator
Department of Neurosciences
Loyola University Health System
Maywood, Illinois

DIME Editor

Rosalee Blumer, MA

Scientific Director

DIME

Chicago, Illinois

Target Audience

This activity is targeted to nurses, physician assistants, neurologists, and others who specialize in the care of patients with MS.

Activity Purpose

The purpose of this educational activity is to increase competence in the assessment and management of neuropsychological impairment in patients with multiple sclerosis.

Statement of Need

Recent studies show that more than 50% of patients with multiple sclerosis (MS) may be cognitively impaired. Most studies on cognition and MS evaluate patients in later stages of the disease who have marked physical disability. Patients in the early stages of MS or clinically isolated syndrome, or patients with minimal physical disability and mild or so-called "benign" MS, are rarely screened. Until more effective neuroprotective agents become available, neuropsychological screening and cognitive rehabilitation will remain significant components of the comprehensive care of patients with MS. However, clinicians require more education about neuropsychological assessment and management of symptoms in patients with early disease so that cognitive issues can be addressed and treated before significant, irreversible damage occurs.

Content Independence

This CME/CE activity has been supported by an educational grant from Bayer HealthCare Pharmaceuticals. The content was developed independently by the contributing faculty and has undergone peer review by the chairperson. All materials appear with permission of the author(s). The opinions expressed are those of the faculty and are not to be construed as those of the publisher or grantor.

Faculty Disclosures

DIME requires that all persons who were in a position to control or influence the content of this CME/CE activity disclose all relevant financial relationships with any commercial interest. This information is used to: (1) determine whether a conflict exists, (2) resolve the conflict by initiating a content validation process, and (3) advise learners of this information.

This CME/CE activity might describe the off-label, investigational, or experimental use of medications that may exceed their FDA-approved labeling. Clinicians should consult the current manufacturers' prescribing information for these products. DIME requires the speaker to disclose that a product is not labeled for the use under discussion. The provider's documentation of common practices that make the disclosure requirement known to faculty demonstrates compliance with ACCME and INA/ANCC guidelines.

Disclosures

Maria Pia Amato, MD

Sources of Funding for Research: Bayer Shering Pharma; Biogen-Dompé AG; Merck Serono S.A.; sanofi-aventis Group

Consulting Agreements: Bayer Shering Pharma; Biogen-Dompé, AG; Merck Serono S.A.; sanofi-aventis Group

Financial Interests/Stock Ownership: None

Speakers' Bureau/Honorarium Agreements: Bayer Shering Pharma; Biogen-Dompé AG; Merck Serono S.A.; sanofi-aventis Group

Discussion of Off-Label, Investigational, or Experimental Drug Use: None

George H. Kraft, MD, MS

Sources of Funding for Research: None

Consulting Agreements: Acorda Therapeutics, Inc.;Bayer HealthCare Pharmaceuticals

Speakers' Bureau/Honorarium Agreements: Acorda Therapeutics, Inc.;Bayer HealthCare Pharmaceuticals

Financial Interests/Stock Ownership: None

Discussion of Off-Label, Investigational, or Experimental Drug Use: None

Amy Perrin Ross, APN, MSN, CNRN, MSCN

Sources of Funding for Research: None

Consulting Agreements: Acorda Therapeutics, Inc.; Bayer HealthCare Pharmaceuticals; EMD Serono, Inc; Genzyme Corporation; Novartis Pharmaceuticals Corp; Pfizer Inc; Teva Neuroscience, Inc.

Speakers' Bureau/Honorarium Agreements:Acorda Therapeutics, Inc.;Bayer HealthCare Pharmaceuticals; EMD Serono, Inc.; Genzyme Corporation;Novartis Pharmaceuticals Corp; Pfizer Inc; Teva Neuroscience, Inc.

Financial Interests/Stock Ownership: None

Discussion of Off-Label, Investigational, or Experimental Drug Use: None

DIME Editor
Rosalee Blumer has nothing to disclose.

Policy Disclosure

In accordance with DIME policies, be advised that one or more presentations in this CME/CE activity might contain references to off-label or unapproved uses of drugs or devices. The use of these agents outside currently approved labeling is considered experimental, and the manufacturers' prescribing information for these products should be consulted.

This CME/CE activity was planned and produced in accordance with Accreditation Council for Continuing Medical Education (ACCME) Essential Areas and Elements and in accordance with Illinois Nurses Association (INA) Policies and Educational Design Criteria.

Continuing Medical Education

DIME is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

DIME designates this educational activity for a maximum of 0.5 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Continuing Nursing Education

DIME is an approved provider of continuing nursing education by the Illinois Nurses Association, an accredited approver by the American Nurses Credentialing Center's Commission on Accreditation.

Participants in this activity are eligible for up to 0.5 contact hours of continuing nursing education.

Credit Determination

A review committee has agreed that this material can be completed in 0.5 hours. This estimated study time in turn has determined the credit and contact hours being offered.

Instructions for Receiving Credit

By reviewing the course content and successfully completing the posttest and evaluation, clinicians are entitled to receive credit. The statement of credit will be available to print from your user history page.

Read the learning objectives and faculty disclosures
Participate in the activity
Complete the posttest and activity evaluation
Clinicians who successfully complete the posttest and evaluation will receive a CME certificate; successful completion is defined as a cumulative score of at least 60% correct
All other participants who successfully complete the posttest and evaluation will receive a certificate of participation

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This continuing medical education activity is sponsored by DIME.

www.DIMedEd.org

Commercial Support

Supported by an educational grant from Bayer HealthCare Pharmaceuticals.

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