{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T17:38:17Z","timestamp":1793813897568,"version":"4.6.1"},"reference-count":34,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2025,3,20]],"date-time":"2025-03-20T00:00:00Z","timestamp":1742428800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Mult Scler"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>People living with multiple sclerosis (PwMS) are at risk of experiencing communication difficulties that can limit their vocational outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To investigate clinical and cognitive variables that may contribute to communication restrictions in PwMS, and to evaluate how these factors affect vocational status.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>In this cross-sectional study, 502 PwMS underwent clinical and cognitive assessment tasks and were administered self-reported measures assessing fatigue and mood. The communication and language assessment questionnaire for persons with multiple sclerosis (CLAMS) was also administered.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Performance in information processing speed (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001), the presence of dysarthria (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001) and levels of self-reported fatigue (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001) were independent predictors of communication difficulties. Higher levels of communication difficulties were associated with a higher risk of unemployment and allowance (area under the receiver operating characteristic curve 0.649,\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001 and 0.749,\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001, respectively).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Cognitive deficits, high levels of fatigue and the presence of dysarthria may independently contribute to communication difficulties in PwMS regardless of disease type or disability levels. These factors are associated with poorer vocational outcomes, highlighting the need for targeted interventions to support effective communication and improve employment prospects for this population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/13524585251328556","type":"journal-article","created":{"date-parts":[[2025,3,20]],"date-time":"2025-03-20T05:27:55Z","timestamp":1742448475000},"page":"587-594","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":6,"title":["Communication deficits in multiple sclerosis: Interactions with cognitive dysfunction and their impact on employment status"],"prefix":"10.1177","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4737-3707","authenticated-orcid":false,"given":"Christos","family":"Bakirtzis","sequence":"first","affiliation":[{"name":"Multiple Sclerosis Center, Second Department of Neurology, Aristotle University of Thessaloniki, Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5770-4303","authenticated-orcid":false,"given":"Nefeli","family":"Dimitriou","sequence":"additional","affiliation":[{"name":"Department of Speech and Language Therapy, University of Ioannina, Ioannina, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theodoros","family":"Moysiadis","sequence":"additional","affiliation":[{"name":"Department of Computer Science, School of Sciences and Engineering, University of Nicosia, Nicosia, Cyprus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"El-Wahsh","sequence":"additional","affiliation":[{"name":"Discipline of Speech Pathology, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Athina","family":"Andravizou","sequence":"additional","affiliation":[{"name":"Multiple Sclerosis Center, Second Department of Neurology, Aristotle University of Thessaloniki, Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elli","family":"Nteli","sequence":"additional","affiliation":[{"name":"Multiple Sclerosis Center, Second Department of Neurology, Aristotle University of Thessaloniki, Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marina-Kleopatra","family":"Boziki","sequence":"additional","affiliation":[{"name":"Multiple Sclerosis Center, Second Department of Neurology, Aristotle University of Thessaloniki, Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grigorios","family":"Nasios","sequence":"additional","affiliation":[{"name":"Department of Speech and Language Therapy, University of Ioannina, Ioannina, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lambros","family":"Messinis","sequence":"additional","affiliation":[{"name":"Laboratory of Neuropsychology and Behavioral Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikolaos","family":"Grigoriadis","sequence":"additional","affiliation":[{"name":"Multiple Sclerosis Center, Second Department of Neurology, Aristotle University of Thessaloniki, Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,3,20]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.msard.2020.102206"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bandl.2018.08.002"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1186\/s40001-023-01230-3"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.7224\/1537-2073.2020-023"},{"key":"e_1_3_2_6_2","volume-title":"Motor speech disorders: Substrates, differential diagnosis, and management","author":"Duffy JR","year":"2020","unstructured":"Duffy JR. Motor speech disorders: Substrates, differential diagnosis, and management. 4th ed. Edinburgh; London; New York; Oxford: Elsevier, 2020.","edition":"4"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.7551\/mitpress\/4252.001.0001"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(08)70259-X"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.7224\/1537-2073.2019-091"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2014.00177"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1080\/09638280701869629"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.30773\/pi.2019.0106"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.msard.2016.06.011"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1093\/arclin\/acs099"},{"key":"e_1_3_2_15_2","article-title":"Adaptation and validation of the Greek version of the communication and language assessment questionnaire for persons with multiple sclerosis (CLAMS)","volume":"2024","author":"Dimitriou N","year":"2024","unstructured":"Dimitriou N, Nasios G, Nousia A, et al. Adaptation and validation of the Greek version of the communication and language assessment questionnaire for persons with multiple sclerosis (CLAMS). Arch Clin Neuropsychol 2024; 2024: acae015.","journal-title":"Arch Clin Neuropsychol"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1097\/MRR.0000000000000057"},{"key":"e_1_3_2_17_2","volume-title":"Manual for the Beck Depression Inventory: Fast screen for medical patients","author":"Beck AT","year":"2003","unstructured":"Beck AT, Steer RA, Brown GK. Manual for the Beck Depression Inventory: Fast screen for medical patients. San Antonio, TX: Psychological Corporation; 2003."},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1159\/000367614"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.7224\/1537-2073.2020-096"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcomdis.2014.05.005"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.4274\/csmedj.galenos.2022.2022-11-11"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1017\/S1355617712001166"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jocn.2019.04.018"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.msard.2020.102159"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1044\/2018_AJSLP-17-0174"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.7224\/1537-2073-6.2.39"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1044\/1058-0360(2001\/013)"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1177\/1352458517694432"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.msard.2018.09.018"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1177\/1352458517740212"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.1044\/1058-0360(2009\/08-0087)"},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-1331.2011.03538.x"},{"key":"e_1_3_2_33_2","doi-asserted-by":"publisher","DOI":"10.2174\/1874205X01812010019"},{"key":"e_1_3_2_34_2","doi-asserted-by":"publisher","DOI":"10.1080\/17549507.2021.1973101"},{"key":"e_1_3_2_35_2","doi-asserted-by":"publisher","DOI":"10.1111\/1460-6984.12017"}],"container-title":["Multiple Sclerosis Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/13524585251328556","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/13524585251328556","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/13524585251328556","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T04:18:02Z","timestamp":1777695482000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/13524585251328556"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,20]]},"references-count":34,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025,4]]}},"alternative-id":["10.1177\/13524585251328556"],"URL":"https:\/\/doi.org\/10.1177\/13524585251328556","relation":{},"ISSN":["1352-4585","1477-0970"],"issn-type":[{"value":"1352-4585","type":"print"},{"value":"1477-0970","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,20]]}}}