ALBERT

Description: Outlined here is the development of neurophysiological procedures to monitor operators during the performance of cognitive tasks. Our approach included the use of electroencepalographic (EEG) and rheoencephalographic (REG) techniques to determine changes in cortical function associated with cognition in the operator's state. A two channel tetrapolar REG, a single channel forearm impedance plethysmograph, a Lead I electrocardiogram (ECG) and a 21 channel EEG were used to measure subject responses to various visual-motor cognitive tasks. Testing, analytical, and display procedures for EEG and REG monitoring were developed that extend the state of the art and provide a valuable tool for the study of cerebral circulatory and neural activity during cognition.

Description: To determine the acute and chronic effects of cooling therapy on patients with MS using objective functional performance measures and self-assessed measures of fatigue. Cooling demyelinated nerves can reduce conduction block, potentially improving symptoms of MS. Significant acute and chronic effects of cooling have not been demonstrated in a multi-center, controlled, blinded study using objective measures of neurologic function. Patients (N=84) with definite MS, mild to moderate disability (EDSS less than 6.0), and self-reported heat sensitivity were enrolled at 5 study sites. Acute effects of cooling were assessed by randomly assigning subjects to high-dose or low-dose cooling for one hour using an active cooling vest and cap (Life Enhancement Technologies, Santa Clara, CA). Settings were individualized to maintain the cooling garments at 55 F for the high-dose treatment and 70 F for the low-dose treatment. Both patients and examining investigators were blinded to treatment assignments. The MSFC and visual acuity/contrast sensitivity were assessed before and 30 minutes after treatment. The following week, subjects had an identical visit with the alternate cooling treatment. Chronic effects of cooling were assessed by randomly assigning the same subjects to unblinded daily home cooling or observation for 4 weeks. All subjects completed the Rochester Fatigue Diary (RFD) twice weekly and subjective measures of strength, cognition, and energy level daily. At the end of the period, subjects completed the Modified Fatigue Impact Scale (MFIS) and underwent another high-dose cooling session with assessment of the MSFC and vision. After a one-week washout period, subjects crossed over to the alternate 4-week treatment. Oral temperatures were reduced with both acute treatments (0.8 +/- .06 F, high and 0.5 +/- .06 F, low). While mean MSFC did not change significantly during individual cooling sessions, post hoc analysis pooling the 3 high-dose cooling sessions revealed an improvement in MSFC scores (acute phase 0.064 +/- 0.020, p = 0.0013; chronic phase 0.044 +/- 0.021, p = 0.0368) from before to after cooling. The change in MSFC scores during the acute cooling sessions was not related to the extent of change in oral temperatures. Both the RFD score and the MFIS indicate a significantly lower fatigue level during the cooling month compared to observation (RFD, 2.53 +/- 0.83,p = 0.0033; MFIS 7.63 +/- 1.56, p = 0.0001).