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Ferreira JA, Pinto N, Maricoto T, Pato MV. Relationship between event-related potentials and cognitive dysfunction in multiple sclerosis: A systematic review. Clin Neurophysiol 2024; 163:174-184. [PMID: 38759513 DOI: 10.1016/j.clinph.2024.04.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 04/15/2024] [Accepted: 04/30/2024] [Indexed: 05/19/2024]
Abstract
OBJECTIVE This systematic review aimed to evaluate if event-related potentials (ERPs) can be a relevant tool for cognitive dysfunction diagnosis in Multiple Sclerosis (MS). METHODS Four databases were consulted (PubMed, Embase, Scielo, and Web of Science). The included studies should include adults with clear MS diagnoses, independently of having cognitive complaints, and all should have been submitted to ERPs (P300, N400 or mismatch negativity (MMN)). The main outcomes evaluated were ERPs' amplitude and/or latency. RESULTS 425 studies were obtained initially from all databases, with 26 studies fulfilling the eligibility criteria. P300 was the most used ERP (25 studies), showing a reduced amplitude or an increased latency in 84% of those. N400 was evaluated in one study, showing also abnormal results. MMN was addressed in two studies with inconsistent findings. Some studies further suggest that ERPs may show earlier abnormal results compared with neuropsychological tests. CONCLUSIONS Most MS patient groups revealed ERP abnormalities, suggesting that these neurophysiological tests may be a relevant and appropriate diagnostic aid method for cognitive impairment in MS. SIGNIFICANCE The use of ERPs in MS patients seems able to demonstrate cognitive impairment and its use should be considered as part of the regular patient evaluation.
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Affiliation(s)
- Joana Almeida Ferreira
- Faculty of Health Sciences, University of Beira Interior, Covilhã, Portugal; Neurology Department, Hospital Garcia de Orta, Almada, Portugal
| | - Nuno Pinto
- Faculty of Health Sciences, University of Beira Interior, Covilhã, Portugal; CICS-UBI - Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal; GRUBI - University of Beira Interior Systematic Reviews Group, Covilhã, Portugal.
| | - Tiago Maricoto
- Faculty of Health Sciences, University of Beira Interior, Covilhã, Portugal; CICS-UBI - Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal; GRUBI - University of Beira Interior Systematic Reviews Group, Covilhã, Portugal; Beira Ria Health Center, Aveiro Health Centre, Ílhavo, Portugal
| | - Maria Vaz Pato
- Faculty of Health Sciences, University of Beira Interior, Covilhã, Portugal; CICS-UBI - Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal; GRUBI - University of Beira Interior Systematic Reviews Group, Covilhã, Portugal
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Shaw BC, Anders VR, Tinkey RA, Habean ML, Brock OD, Frostino BJ, Williams JL. Immunity impacts cognitive deficits across neurological disorders. J Neurochem 2023:10.1111/jnc.15999. [PMID: 37899543 PMCID: PMC11056485 DOI: 10.1111/jnc.15999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 10/06/2023] [Accepted: 10/10/2023] [Indexed: 10/31/2023]
Abstract
Cognitive deficits are a common comorbidity with neurological disorders and normal aging. Inflammation is associated with multiple diseases including classical neurodegenerative dementias such as Alzheimer's disease (AD) and autoimmune disorders such as multiple sclerosis (MS), in which over half of all patients experience some form of cognitive deficits. Other degenerative diseases of the central nervous system (CNS) including frontotemporal lobe dementia (FTLD), and Parkinson's disease (PD) as well as traumatic brain injury (TBI) and psychological disorders like major depressive disorder (MDD), and even normal aging all have cytokine-associated reductions in cognitive function. Thus, there is likely commonality between these secondary cognitive deficits and inflammation. Neurological disorders are increasingly associated with substantial neuroinflammation, in which CNS-resident cells secrete cytokines and chemokines such as tumor necrosis factor (TNF)α and interleukins (ILs) including IL-1β and IL-6. CNS-resident cells also respond to a wide variety of cytokines and chemokines, which can have both direct effects on neurons by changing the expression of ion channels and perturbing electrical properties, as well as indirect effects through glia-glia and immune-glia cross-talk. There is significant overlap in these cytokine and chemokine expression profiles across diseases, with TNFα and IL-6 strongly associated with cognitive deficits in multiple disorders. Here, we review the involvement of various cytokines and chemokines in AD, MS, FTLD, PD, TBI, MDD, and normal aging in the absence of dementia. We propose that the neuropsychiatric phenotypes observed in these disorders may be at least partially attributable to a dysregulation of immunity resulting in pathological cytokine and chemokine expression from both CNS-resident and non-resident cells.
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Affiliation(s)
- Benjamin C. Shaw
- Department of Neurosciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Victoria R. Anders
- Department of Neurosciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Rachel A. Tinkey
- Department of Neurosciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
- School of Biomedical Sciences, Kent State University, Kent, OH, USA
- Brain Health Research Institute, Kent State University, Kent, OH, USA
| | - Maria L. Habean
- Department of Neurosciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
- Department of Neuroscience, Case Western Reserve University, Cleveland, OH, USA
| | - Orion D. Brock
- Department of Neurosciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
- Molecular Medicine, Lerner Research Institute, Cleveland Clinic and Case Western Reserve University, Cleveland, OH, USA
| | - Benjamin J. Frostino
- Department of Neurosciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
- College of Science, University of Notre Dame, South Bend, IN, USA
| | - Jessica L. Williams
- Department of Neurosciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
- School of Biomedical Sciences, Kent State University, Kent, OH, USA
- Brain Health Research Institute, Kent State University, Kent, OH, USA
- Department of Neuroscience, Case Western Reserve University, Cleveland, OH, USA
- Molecular Medicine, Lerner Research Institute, Cleveland Clinic and Case Western Reserve University, Cleveland, OH, USA
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Barbosa DAN, Silva LAF, Samelli AG, da Paz JA, Matas CG. Auditory central pathways in children and adolescents with multiple sclerosis. ARQUIVOS DE NEURO-PSIQUIATRIA 2023; 81:898-904. [PMID: 37852288 PMCID: PMC10631854 DOI: 10.1055/s-0043-1775985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 08/14/2023] [Indexed: 10/20/2023]
Abstract
BACKGROUND Multiple sclerosis (MS) is an inflammatory demyelinating disease. Auditory evoked potential studies have demonstrated conduction and neural processing deficits in adults with MS, but little is known about the electrophysiological responses in children and adolescents. OBJECTIVE to evaluate the central auditory pathway with brainstem auditory evoked potentials (BAEP) and long-latency auditory evoked potentials (LLAEP) in children and adolescents with MS. METHODS The study comprised 17 individuals with MS, of both sexes, aged 9 to 18 years, and 17 healthy volunteers, matched for age and sex. All individuals had normal hearing and no middle ear impairments. They were assessed with click-BAEP and LLAEP through oddball paradigm and tone-burst stimuli. RESULTS Abnormal responses were observed in 60% of electrophysiologic assessments of individuals with MS. In BAEP, 58.82% of MS patients had abnormal responses, with longer wave V latency and therefore longer III-V and I-V interpeak latencies than healthy volunteers. In LLAEP, 52.94% of MS patients had abnormal responses. Although statistical differences were found only in P2-N2 amplitude, MS patients had longer latencies and smaller amplitudes than healthy volunteers in all components. CONCLUSION Children and adolescents with MS had abnormal BAEP responses, with delayed neural conduction between the cochlear nucleus and the lateral lemniscus. Also, abnormal LLAEP results suggest a decrease in neural processing speed and auditory sensory discrimination response.
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Affiliation(s)
| | - Liliane Aparecida Fagundes Silva
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional, São Paulo SP, Brazil
| | - Alessandra Giannella Samelli
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional, São Paulo SP, Brazil
| | - José Albino da Paz
- Universidade de São Paulo, Faculdade de Medicina, Instituto da Criança, Unidade de Neurologia, São Paulo SP, Brazil
| | - Carla Gentile Matas
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional, São Paulo SP, Brazil
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Asadollahzade E, Ghadiri F, Ebadi Z, Moghadasi AN. Comment on "Alemtuzumab improves cognitive processing speed in active multiple sclerosis - a longitudinal observational study". Rev Assoc Med Bras (1992) 2022; 68:1621-1622. [PMID: 36449809 PMCID: PMC9779974 DOI: 10.1590/1806-9282.20221037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 08/25/2022] [Indexed: 12/23/2022] Open
Affiliation(s)
- Elnaz Asadollahzade
- Tehran University of Medical Sciences, Neuroscience Institute, Multiple Sclerosis Research Center – Tehran, Iran
| | - Fereshteh Ghadiri
- Tehran University of Medical Sciences, Neuroscience Institute, Multiple Sclerosis Research Center – Tehran, Iran
| | - Zahra Ebadi
- Tehran University of Medical Sciences, Neuroscience Institute, Multiple Sclerosis Research Center – Tehran, Iran
| | - Abdorreza Naser Moghadasi
- Tehran University of Medical Sciences, Neuroscience Institute, Multiple Sclerosis Research Center – Tehran, Iran.,Corresponding author:
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Golshan F, Moss D, Sun G, Krigolson O, Cruz MT, Loehr J, Mickleborough M. ERP evidence of heightened attentional response to visual stimuli in migraine headache disorders. Exp Brain Res 2022; 240:2499-2511. [PMID: 35951096 PMCID: PMC9458682 DOI: 10.1007/s00221-022-06408-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 06/25/2022] [Indexed: 11/25/2022]
Abstract
New findings from migraine studies have indicated that this common headache disorder is associated with anomalies in attentional processing. In tandem with the previous explorations, this study will provide evidence to show that visual attention is impacted by migraine headache disorders. 43 individuals were initially recruited in the migraine group and 33 people with non-migraine headache disorders were in the control group. The event-related potentials (ERP) of the participants were calculated using data from a visual oddball paradigm task. By analyzing the N200 and P300 ERP components, migraineurs, as compared to controls, had an exaggerated oddball response showing increased amplitude in N200 and P300 difference scores for the oddball vs. standard, while the latencies of the two components remained the same in the migraine and control groups. We then looked at two classifications of migraine with and without aura compared to non-migraine controls. One-Way ANOVA analysis of the two migraine groups and the non-migraine control group showed that the different level of N200 and P300 amplitude mean scores was greater between migraineurs without aura and the control group while these components’ latency remained the same relatively in the three groups. Our results give more neurophysiological support that people with migraine headaches have altered processing of visual attention.
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Affiliation(s)
- Faly Golshan
- Department of Psychology and Health Studies, University of Saskatchewan, 105 Administration Place, Saskatoon, SK, S7N 5A2, Canada.
| | - Daneil Moss
- Department of Psychology and Health Studies, University of Saskatchewan, 105 Administration Place, Saskatoon, SK, S7N 5A2, Canada
| | - Gloria Sun
- Department of Psychology and Health Studies, University of Saskatchewan, 105 Administration Place, Saskatoon, SK, S7N 5A2, Canada.,College of Medicine, University of Saskatchewan, Saskatoon, Canada
| | | | - Maria T Cruz
- Department of Psychology and Health Studies, University of Saskatchewan, 105 Administration Place, Saskatoon, SK, S7N 5A2, Canada
| | - Janeen Loehr
- Department of Psychology and Health Studies, University of Saskatchewan, 105 Administration Place, Saskatoon, SK, S7N 5A2, Canada
| | - Marla Mickleborough
- Department of Psychology and Health Studies, University of Saskatchewan, 105 Administration Place, Saskatoon, SK, S7N 5A2, Canada
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Chitnis T, Vandercappellen J, King M, Brichetto G. Symptom Interconnectivity in Multiple Sclerosis: A Narrative Review of Potential Underlying Biological Disease Processes. Neurol Ther 2022; 11:1043-1070. [PMID: 35680693 PMCID: PMC9338216 DOI: 10.1007/s40120-022-00368-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 05/16/2022] [Indexed: 11/18/2022] Open
Abstract
Introduction Fatigue, cognitive impairment, depression, and pain are highly prevalent symptoms in multiple sclerosis (MS). These often co-occur and may be explained by a common etiology. By reviewing existing literature, we aimed to identify potential underlying biological processes implicated in the interconnectivity between these symptoms. Methods A literature search was conducted to identify articles reporting research into the biological mechanisms responsible for the manifestation of fatigue, cognitive impairment, depression, and pain in MS. PubMed was used to search for articles published from July 2011 to July 2021. We reviewed and assessed findings from the literature to identify biological processes common to the symptoms of interest. Results Of 693 articles identified from the search, 252 were selected following screening of titles and abstracts and assessing reference lists of review articles. Four biological processes linked with two or more of the symptoms of interest were frequently identified from the literature: (1) direct neuroanatomical changes to brain regions linked with symptoms of interest (e.g., thalamic injury associated with cognitive impairment, fatigue, and depression), (2) pro-inflammatory cytokines associated with so-called ‘sickness behavior,’ including manifestation of fatigue, transient cognitive impairment, depression, and pain, (3) dysregulation of monoaminergic pathways leading to depressive symptoms and fatigue, and (4) hyperactivity of the hypothalamic–pituitary-adrenal (HPA) axis as a result of pro-inflammatory cytokines promoting the release of brain noradrenaline, serotonin, and tryptophan, which is associated with symptoms of depression and cognitive impairment. Conclusion The co-occurrence of fatigue, cognitive impairment, depression, and pain in MS appears to be associated with a common set of etiological factors, namely neuroanatomical changes, pro-inflammatory cytokines, dysregulation of monoaminergic pathways, and a hyperactive HPA axis. This association of symptoms and biological processes has important implications for disease management strategies and, eventually, could help find a common therapeutic pathway that will impact both inflammation and neuroprotection. Supplementary Information The online version contains supplementary material available at 10.1007/s40120-022-00368-2.
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Affiliation(s)
- Tanuja Chitnis
- Department of Neurology, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 02115, USA.
| | | | - Miriam King
- Novartis Pharma AG, Fabrikstrasse 12-2, 4056, Basel, Switzerland
| | - Giampaolo Brichetto
- Associazione Italiana Sclerosi Multipla Rehabilitation Center, Via Operai, 30, 16149, Genoa, GE, Italy
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Raimo S, Trojano L, Gaita M, d'Onofrio F, Spitaleri D, Santangelo G. Relationship between apathy and cognitive dysfunctions in Multiple Sclerosis: a 4-year prospective longitudinal study. Mult Scler Relat Disord 2022; 63:103929. [DOI: 10.1016/j.msard.2022.103929] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 05/10/2022] [Accepted: 05/27/2022] [Indexed: 12/01/2022]
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Long COVID Neuropsychological Deficits after Severe, Moderate, or Mild Infection. CLINICAL AND TRANSLATIONAL NEUROSCIENCE 2022. [DOI: 10.3390/ctn6020009] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
There is growing awareness that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, even in its mild or moderate respiratory forms, can include long-term neuropsychological deficits. Standardized neuropsychological, psychiatric, neurological, and olfactory tests were administered to 45 patients 236.51 ± 22.54 days after hospital discharge following severe, moderate, or mild respiratory severity from SARS-CoV-2 infection (severe = intensive care unit hospitalization, moderate = conventional hospitalization, mild = no hospitalization). Deficits were found in all domains of cognition, and the prevalence of psychiatric symptoms was relatively high in the three groups. The severe infection group performed more poorly on long-term episodic memory tests and exhibited greater anosognosia than did the other two groups. Those with moderate infection had poorer emotion recognition, which was positively correlated with persistent olfactory dysfunction. Individuals with mild infection were more stressed, anxious, and depressed. The data support the hypothesis that the virus targets the central nervous system (notably the limbic system) and the notion that there are different neuropsychological phenotypes.
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9
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Dziadkowiak E, Wieczorek M, Zagrajek M, Chojdak-Łukasiewicz J, Gruszka E, Budrewicz S, Pokryszko-Dragan A. Multimodal Evoked Potentials as Potential Biomarkers of Disease Activity in Patients With Clinically Isolated Syndrome. Front Neurol 2022; 12:678035. [PMID: 35211070 PMCID: PMC8860823 DOI: 10.3389/fneur.2021.678035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 12/21/2021] [Indexed: 11/13/2022] Open
Abstract
Objective There is an ongoing search for markers useful in monitoring and predicting disease activity at the early stage of multiple sclerosis (MS). The goals of this study were to prospectively evaluate the changes in parameters of multimodal evoked potentials (EP) and cognition within a 3-year follow-up period in patients with clinically isolated syndrome (CIS), and to assess the prognostic value of baseline findings with regard to the disease outcomes. Methods In 29 patients (20 women, nine men, mean age 31.1) multimodal (visual, brainstem auditory, somatosensory, event-related) EP and neuropsychological tests (NT) were performed at baseline (T0) and after 1 (T1) and 3 (T3) years. Their results were compared longitudinally between baseline, T1, and T3. Baseline results confirmed conversion of CIS into multiple sclerosis (MS) and disability level at T1 and T3 using multiple comparisons and a logistic regression model. Results Apart from mean N13/P16 SEP (somatosensory evoked potentials) amplitude (lower at T1 and T3 than at baseline (T0 1.02 ± 0.37 μV, T1 0.90 ± 0.26 μV, T3 0.74 ± 0.32 μV, p < 0.05 for both comparisons), no significant changes of EP or NT parameters were found in longitudinal assessment. Baseline P300 Pz latency was longer for the patients with MS than for those with CIS at T1 (352.69 vs. 325.56 ms). No predictive value was shown for any of the analyzed baseline variables with regard to conversion from CIS into MS. Significance Baseline ERP abnormalities were associated with their short-term conversion into MS. ERP are worth considering in multimodal EP evaluation at the early stage of MS.
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Affiliation(s)
- Edyta Dziadkowiak
- Department of Neurology, Wrocław Medical University, Wrocław, Poland
| | - Małgorzata Wieczorek
- Faculty of Earth Sciences and Environmental Management, University of Wrocław, Wrocław, Poland
| | - Mieszko Zagrajek
- Department of Neurology, Wrocław Medical University, Wrocław, Poland
| | | | - Ewa Gruszka
- Department of Neurology, Wrocław Medical University, Wrocław, Poland
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The Brief International Cognitive Assessment in Multiple Sclerosis (BICAMS): Validation in Arabic and Lebanese Normative Values. J Int Neuropsychol Soc 2022; 28:94-103. [PMID: 33563350 DOI: 10.1017/s1355617721000102] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Multiple sclerosis (MS) is often associated with cognitive deficits. Accurate evaluation of the MS patients' cognitive performance is essential for diagnosis and treatment recommendation. The Brief International Cognitive Assessment in Multiple Sclerosis (BICAMS), widely used cognitive testing battery, examines processing speed, verbal and visuospatial learning, and memory. Our study aims to examine the psychometric properties of an Arabic version of the BICAMS and to provide normative values in a Lebanese sample. METHOD The BICAMS, comprised of the Symbol Digit Modalities Test (SDMT), Brief Visuospatial Memory Test-Revised (BVMT-R), and a newly developed verbal learning/memory test, the Verbal Memory Arabic Test (VMAT), were administered on healthy subjects and MS patients. The sample consisted of 180 healthy individuals, of whom 63 were retested after 2-3 weeks. Forty-three MS patients matched with 43 healthy subjects based on age, sex, and years of education were assessed. A sample of 10 MS patients was also examined on two occasions. Test-retest reliability and criterion-related validity were examined, and regression-based norms were derived. RESULTS The test-retest correlations showed good evidence of reliability with coefficients ranging between 0.64 and 0.73 in the healthy sample, and between 0.43 and 0.92 in the MS sample. The BICAMS was able to discriminate between MS patients and matched healthy participants on the SDMT and BVMT-R. Normative data were comparable to other studies. CONCLUSIONS This new Arabic version of the BICAMS shows initial good psychometric properties. While good evidence of VMAT's reliability was shown in the healthy participants, less test-retest reliability in this tool was seen in the MS group, and partial criterion-related validity was evident. This renders further examination of the VMAT. We provide regression-based norms for a Lebanese sample and encourage the use of this battery in both research and clinical settings.
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Sarrias-Arrabal E, Eichau S, Galvao-Carmona A, Domínguez E, Izquierdo G, Vázquez-Marrufo M. Deficits in Early Sensory and Cognitive Processing Are Related to Phase and Nonphase EEG Activity in Multiple Sclerosis Patients. Brain Sci 2021; 11:brainsci11050629. [PMID: 34068315 PMCID: PMC8153279 DOI: 10.3390/brainsci11050629] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 05/10/2021] [Accepted: 05/11/2021] [Indexed: 12/05/2022] Open
Abstract
Currently, there is scarce knowledge about the relation between spectral bands modulations and the basis of cognitive impairment in multiple sclerosis (MS). In this sense, analyzing the evoked or phase activity can confirm results from traditional event-related potential (ERP) studies. However, studying the induced or nonphase activity may be necessary to elucidate hidden compensatory or affected cognitive mechanisms. In this study, 30 remitting-relapsing multiple sclerosis patients and 30 healthy controls (HCs) matched in sociodemographic variables performed a visual oddball task. The main goal was to analyze phase and nonphase alpha and gamma bands by applying temporal spectral evolution (TSE) and its potential relation with cognitive impairment in these patients. The behavioural results showed slower reaction time and poorer accuracy in MS patients compared to controls. In contrast, the time-frequency analysis of electroencephalography (EEG) revealed a delay in latency and lower amplitude in MS patients in evoked and induced alpha compared to controls. With respect to the gamma band, there were no differences between the groups. In summary, MS patients showed deficits in early sensorial (evoked alpha activity) and cognitive processing (induced alpha activity in longer latencies), whereas the induced gamma band supported the hypothesis of its role in translation of attentional focus (induced activity) and did not show strong activity in this paradigm (visual oddball).
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Affiliation(s)
- Esteban Sarrias-Arrabal
- Experimental Psychology Department, Faculty of Psychology, University of Seville, 41018 Seville, Spain;
- Correspondence: ; Tel.: +34-676-182-823
| | - Sara Eichau
- Unit CSUR Multiple Sclerosis, Hospital Virgen Macarena, 41009 Seville, Spain;
| | | | - Elvira Domínguez
- Unit of Multiple Sclerosis, FISEVI, Hospital Virgen Macarena, 41009 Seville, Spain;
| | | | - Manuel Vázquez-Marrufo
- Experimental Psychology Department, Faculty of Psychology, University of Seville, 41018 Seville, Spain;
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Paolicelli D, Manni A, Iaffaldano A, Tancredi G, Ricci K, Gentile E, Viterbo RG, Quitadamo SG, de Tommaso M, Trojano M. Magnetoencephalography and High-Density Electroencephalography Study of Acoustic Event Related Potentials in Early Stage of Multiple Sclerosis: A Pilot Study on Cognitive Impairment and Fatigue. Brain Sci 2021; 11:481. [PMID: 33918861 PMCID: PMC8069556 DOI: 10.3390/brainsci11040481] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 04/06/2021] [Accepted: 04/07/2021] [Indexed: 11/16/2022] Open
Abstract
Cognitive impairment (CI) is a common and disabling symptom of Multiple Sclerosis (MS) with a negative impact on daily living. In this pilot study, we applied magnetoencephalography (MEG) and high density (hd) electroencephalography (EEG) study to evaluate acoustic P300 features in a cohort of early MS. Sixteen MS patients (pwMS) and 19 healthy controls (HCs) matched for age and gender underwent an MEG-/(hd)-EEG-co-recording, using 306-channel Vectorview and 64 scalp electrodes. CI was assessed using Rao's Brief Repeatable Battery (BRB). Moreover, we performed psychometric tests to assess depression and fatigue. In pwMS, we observed a slight latency prolongation of P300 peak compared to HCs, while P300 amplitude and scalp distribution were similar in the two groups. pwMS did not show an amplitude reduction and different scalp distribution of Event-Related Potentials (ERPs) and Event Related Fields (ERFs) related to an acoustic oddball paradigm. We found an inverse correlation between P300 amplitude and fatigue (r Spearman = -0.4; p = 0.019). In pwMS, phenomena of cortical adaptation to early dysfunction could preserve the cognitive performance of the P300 acoustic task, while the development of fatigue could prospectively lead to amplitude decline of P300, suggesting its possible role as a biomarker.
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Affiliation(s)
- Damiano Paolicelli
- Department of Basic Medical Sciences, Neurosciences, and Sense Organs, University of Bari “Aldo Moro”, 70121 Bari, Italy; (A.M.); (A.I.); (G.T.); (K.R.); (R.G.V.); (S.G.Q.); (M.d.T.); (M.T.)
| | - Alessia Manni
- Department of Basic Medical Sciences, Neurosciences, and Sense Organs, University of Bari “Aldo Moro”, 70121 Bari, Italy; (A.M.); (A.I.); (G.T.); (K.R.); (R.G.V.); (S.G.Q.); (M.d.T.); (M.T.)
| | - Antonio Iaffaldano
- Department of Basic Medical Sciences, Neurosciences, and Sense Organs, University of Bari “Aldo Moro”, 70121 Bari, Italy; (A.M.); (A.I.); (G.T.); (K.R.); (R.G.V.); (S.G.Q.); (M.d.T.); (M.T.)
| | - Giusy Tancredi
- Department of Basic Medical Sciences, Neurosciences, and Sense Organs, University of Bari “Aldo Moro”, 70121 Bari, Italy; (A.M.); (A.I.); (G.T.); (K.R.); (R.G.V.); (S.G.Q.); (M.d.T.); (M.T.)
| | - Katia Ricci
- Department of Basic Medical Sciences, Neurosciences, and Sense Organs, University of Bari “Aldo Moro”, 70121 Bari, Italy; (A.M.); (A.I.); (G.T.); (K.R.); (R.G.V.); (S.G.Q.); (M.d.T.); (M.T.)
| | - Eleonora Gentile
- Basic Health District, Family Counseling Center, ASP (Local Health Company), 85038 Senise, Italy;
| | - Rosa Gemma Viterbo
- Department of Basic Medical Sciences, Neurosciences, and Sense Organs, University of Bari “Aldo Moro”, 70121 Bari, Italy; (A.M.); (A.I.); (G.T.); (K.R.); (R.G.V.); (S.G.Q.); (M.d.T.); (M.T.)
| | - Silvia Giovanna Quitadamo
- Department of Basic Medical Sciences, Neurosciences, and Sense Organs, University of Bari “Aldo Moro”, 70121 Bari, Italy; (A.M.); (A.I.); (G.T.); (K.R.); (R.G.V.); (S.G.Q.); (M.d.T.); (M.T.)
| | - Marina de Tommaso
- Department of Basic Medical Sciences, Neurosciences, and Sense Organs, University of Bari “Aldo Moro”, 70121 Bari, Italy; (A.M.); (A.I.); (G.T.); (K.R.); (R.G.V.); (S.G.Q.); (M.d.T.); (M.T.)
| | - Maria Trojano
- Department of Basic Medical Sciences, Neurosciences, and Sense Organs, University of Bari “Aldo Moro”, 70121 Bari, Italy; (A.M.); (A.I.); (G.T.); (K.R.); (R.G.V.); (S.G.Q.); (M.d.T.); (M.T.)
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Depression and Fatigue in Patients With Multiple Sclerosis Have No Influence on the Parameters of Cognitive Evoked Potentials. J Clin Neurophysiol 2021; 38:36-42. [PMID: 31725033 DOI: 10.1097/wnp.0000000000000640] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
PURPOSE The purpose of this study was to examine if depression and fatigue affect event-related brain potentials (ERPs) in patients with relapsing-remitting multiple sclerosis, and to assess the significance of ERP as an indicator of cognitive impairment. METHODS A total of 81 relapsing-remitting multiple sclerosis patients and 32 healthy control subjects participated in the study. Cognitive functions were evaluated using a standard PASAT, the symbol digit modality test, and ERP. The degrees of depressive symptomatology and fatigue were assessed with Beck Depression Inventory, the Fatigue Severity Scale, and the Fatigue Impact Scale. RESULTS Fatigue and depression had a negative effect on the cognitive functions examined by neuropsychological tests. Depression and fatigue did not influence ERP amplitude and latency findings. Depression level was negatively correlated with symbol digit modality test score (r = -0.135, P < 0.05). Fatigue level was negatively correlated with the results for PASAT A (r = -0.225, P < 0.05) and PASAT B (r = -0.342, P < 0.01). Reaction time was positively associated with depression (r = 0.246, P = 0.01) and fatigue (r = 0.281, P = 0.01). CONCLUSIONS Depression and fatigue have no effect on ERP amplitude and latency, so they cannot participate in risk assessment for the development of cognitive impairment in patients with relapsing-remitting multiple sclerosis.
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Doskas T, Vavougios GD, Karampetsou P, Kormas C, Synadinakis E, Stavrogianni K, Sionidou P, Serdari A, Vorvolakos T, Iliopoulos I, Vadikolias Κ. Neurocognitive impairment and social cognition in multiple sclerosis. Int J Neurosci 2021; 132:1229-1244. [PMID: 33527857 DOI: 10.1080/00207454.2021.1879066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
PURPOSE/AIM OF THE STUDY The impairment of neurocognitive functions occurs in all subtypes of multiple sclerosis, even from the earliest stages of the disease. Commonly reported manifestations of cognitive impairment include deficits in attention, conceptual reasoning, processing efficiency, information processing speed, memory (episodic and working), verbal fluency (language), and executive functions. Multiple sclerosis patients also suffer from social cognition impairment, which affects their social functioning. The objective of the current paper is to assess the effect of neurocognitive impairment and its potential correlation with social cognition performance and impairment in multiple sclerosis patients. MATERIALS AND METHODS An overview of the available-to-date literature on neurocognitive impairment and social cognition performance in multiple sclerosis patients by disease subtype was performed. RESULTS It is not clear if social cognition impairment occurs independently or secondarily to neurocognitive impairment. There are associations of variable strengths between neurocognitive and social cognition deficits and their neural basis is increasingly investigated. CONCLUSIONS The prompt detection of neurocognitive predictors of social cognition impairment that may be applicable to all multiple sclerosis subtypes and intervention are crucial to prevent further neural and social cognition decline in multiple sclerosis patients.
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Affiliation(s)
- Triantafyllos Doskas
- Department of Neurology, Athens Naval Hospital, Athens, Greece.,Department of Neurology, University Hospital of Alexandroupolis, Alexandroupolis, Greece
| | | | | | | | | | | | | | - Aspasia Serdari
- Department of Psychiatry, University Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - Theofanis Vorvolakos
- Department of Psychiatry, University Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - Ioannis Iliopoulos
- Department of Neurology, University Hospital of Alexandroupolis, Alexandroupolis, Greece
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15
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Tremblay A, Charest K, Brando E, Roger E, Duquette P, Rouleau I. The effects of aging and disease duration on cognition in multiple sclerosis. Brain Cogn 2020; 146:105650. [PMID: 33212390 DOI: 10.1016/j.bandc.2020.105650] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 10/22/2020] [Accepted: 10/23/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Multiple sclerosis (MS) is a disease of the central nervous system that can interfere with cognitive functions. The purpose of this study is to document the impact of MS, aging and disease duration on cognitive functioning as both life expectancy and incidence of the disease among persons with MS (PwMS) aged 50 years and over (late-onset MS) are increasing in the last two decades. METHODS Exhaustive neuropsychological evaluation was performed in 84 PwMS (30 young, 30 elderly adult-onset, 25 elderly late-onset) and 50 control participants (25 young, 24 elderly). ANCOVAs and hierarchical linear regressions were used to meet the objectives. RESULTS Interaction effects were found between age and presence of MS on higher executive function and information processing speed/working memory. After controlling for confounding variables (fatigue, quality of life, depression, MS course, comorbidity), results demonstrated an important role of age on all cognitive functions but only a trend of disease duration on information processing speed/working memory. CONCLUSION Decline in higher executive functions and information processing speed/working memory in aging is accentuated by the presence of MS, but the impact of age and MS on memory are independent. Age appears to be the variable having the most important role on cognition.
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Affiliation(s)
- Alexandra Tremblay
- Department of Psychology, Université du Québec à Montréal, CP 8888, succ. Centre-ville, Montreal H3C 3P8, Canada
| | - Kim Charest
- Department of Psychology, Université du Québec à Montréal, CP 8888, succ. Centre-ville, Montreal H3C 3P8, Canada
| | - Estefania Brando
- Department of Psychology, Université du Québec à Montréal, CP 8888, succ. Centre-ville, Montreal H3C 3P8, Canada
| | - Elaine Roger
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal, 900 Rue Saint-Denis, Montréal, QC H2X 3H8, Canada
| | - Pierre Duquette
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal, 900 Rue Saint-Denis, Montréal, QC H2X 3H8, Canada
| | - Isabelle Rouleau
- Department of Psychology, Université du Québec à Montréal, CP 8888, succ. Centre-ville, Montreal H3C 3P8, Canada; Centre de Recherche du Centre Hospitalier de l'Université de Montréal, 900 Rue Saint-Denis, Montréal, QC H2X 3H8, Canada.
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16
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Katsari M, Kasselimis DS, Giogkaraki E, Breza M, Evangelopoulos ME, Anagnostouli M, Andreadou E, Kilidireas C, Hotary A, Zalonis I, Koutsis G, Potagas C. A longitudinal study of cognitive function in multiple sclerosis: is decline inevitable? J Neurol 2020; 267:1464-1475. [PMID: 32008073 DOI: 10.1007/s00415-020-09720-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Revised: 01/15/2020] [Accepted: 01/20/2020] [Indexed: 11/26/2022]
Affiliation(s)
- Marina Katsari
- 1st Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens, 74 Vas. Sofias Av., 11528, Athens, Greece
| | - Dimitrios S Kasselimis
- 1st Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens, 74 Vas. Sofias Av., 11528, Athens, Greece.
- Department of Psychiatry, School of Medicine, University of Crete, Heraklion, Greece.
| | - Erasmia Giogkaraki
- 1st Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens, 74 Vas. Sofias Av., 11528, Athens, Greece
| | - Marianthi Breza
- 1st Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens, 74 Vas. Sofias Av., 11528, Athens, Greece
| | - Maria-Eleftheria Evangelopoulos
- 1st Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens, 74 Vas. Sofias Av., 11528, Athens, Greece
| | - Maria Anagnostouli
- 1st Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens, 74 Vas. Sofias Av., 11528, Athens, Greece
| | - Elisabeth Andreadou
- 1st Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens, 74 Vas. Sofias Av., 11528, Athens, Greece
| | - Costas Kilidireas
- 1st Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens, 74 Vas. Sofias Av., 11528, Athens, Greece
| | - Alia Hotary
- School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Ioannis Zalonis
- 1st Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens, 74 Vas. Sofias Av., 11528, Athens, Greece
| | - Georgios Koutsis
- 1st Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens, 74 Vas. Sofias Av., 11528, Athens, Greece
| | - Constantin Potagas
- 1st Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens, 74 Vas. Sofias Av., 11528, Athens, Greece
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17
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Ruano L, Branco M, Severo M, Sousa A, Castelo J, Araújo I, Pais J, Cerqueira J, Amato MP, Lunet N, Cruz VT. Tracking cognitive impairment in multiple sclerosis using the Brain on Track test: a validation study. Neurol Sci 2019; 41:183-191. [PMID: 31631230 DOI: 10.1007/s10072-019-04088-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2019] [Accepted: 09/24/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND The accurate and regular monitoring cognitive performance in multiple sclerosis (MS) patients is critical to develop new prevention and management strategies for cognitive impairment (CI). The Brain on Track (BoT) test is a self-administered web-based tool developed for cognitive screening and monitoring. The objective of this study was to validate the use of the BoT in MS, by assessing its ability to distinguish between MS patients and matched controls, as well as detect CI among MS patients, by analysing its correlation with standard cognitive tests and its reliability and learning effects in repeatable use. METHODS The BoT was applied in 30 patients with MS consecutively selected and 30 age- and education-matched controls, first in a hospital clinic, under supervision, and then 1 week later from home. After these first two trials, MS patients repeated the test from home every 4 weeks for 3 months. A standard neuropsychological battery was also applied to MS patients at baseline. RESULTS The Cronbach's alpha was 0.89. Test scores were significantly different between MS patients and controls (Cohen's d = 0.87; p < 0.01). Among MS patients, scores were significantly lower in those with CI documented in the standard neuropsychological battery than in their cognitively preserved counterparts (Cohen's d = 2.0; p < 0.001). The BoT scores presented a good correlation with standard neuropsychological tests, particularly for information processing speed. Regarding test-retest reliability, 10/11 subtests presented two-way mixed single intraclass consistency correlation coefficients > 0.70. CONCLUSION The BoT showed good neuropsychological parameters in MS patients, endorsing the use of self-administered computerized tests in this setting.
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Affiliation(s)
- Luis Ruano
- Neurology Department, Centro Hospitalar de Entre Douro e Vouga, Santa Maria da Feira, Portugal. .,Departamento de Ciências da Saúde Pública e Forenses e Educação Médica Faculdade de Medicina da Universidade do Porto, Porto, Portugal. .,EPIUnit, Institute of Public Health, University of Porto, Rua das Taipas 135-139, 4050-600, Porto, Portugal.
| | - Mariana Branco
- Neurology Department, Centro Hospitalar de Entre Douro e Vouga, Santa Maria da Feira, Portugal.,Departamento de Ciências da Saúde Pública e Forenses e Educação Médica Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - Milton Severo
- Departamento de Ciências da Saúde Pública e Forenses e Educação Médica Faculdade de Medicina da Universidade do Porto, Porto, Portugal.,EPIUnit, Institute of Public Health, University of Porto, Rua das Taipas 135-139, 4050-600, Porto, Portugal
| | - Andreia Sousa
- Neurology Department, Centro Hospitalar de Entre Douro e Vouga, Santa Maria da Feira, Portugal
| | - Juliana Castelo
- Neurology Department, Centro Hospitalar de Entre Douro e Vouga, Santa Maria da Feira, Portugal
| | - Isabel Araújo
- Neurology Department, Centro Hospitalar de Entre Douro e Vouga, Santa Maria da Feira, Portugal
| | - Joana Pais
- EPIUnit, Institute of Public Health, University of Porto, Rua das Taipas 135-139, 4050-600, Porto, Portugal
| | - João Cerqueira
- 2CA Braga, Braga, Portugal.,Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal.,ICVS/3B's - PT Government Associate Laboratory, Braga, Guimarães, Portugal
| | - Maria Pia Amato
- Department NEUROFARBA, Section Neurosciences, University of Florence, Florence, Italy
| | - Nuno Lunet
- Departamento de Ciências da Saúde Pública e Forenses e Educação Médica Faculdade de Medicina da Universidade do Porto, Porto, Portugal.,EPIUnit, Institute of Public Health, University of Porto, Rua das Taipas 135-139, 4050-600, Porto, Portugal
| | - Vítor Tedim Cruz
- Neurology Department, Centro Hospitalar de Entre Douro e Vouga, Santa Maria da Feira, Portugal.,IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy.,Neurology Department, Hospital Pedro Hispano, Unidade Local de Saúde de Matosinhos, Sra. da Hora, Portugal
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18
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Svindt V, Bóna J, Hoffmann I. Changes in temporal features of speech in secondary progressive multiple sclerosis (SPMS) - case studies. CLINICAL LINGUISTICS & PHONETICS 2019; 34:339-356. [PMID: 31342810 DOI: 10.1080/02699206.2019.1645885] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Accepted: 07/16/2019] [Indexed: 06/10/2023]
Abstract
Multiple sclerosis (MS) is a chronic inflammatory disease which, in addition to affecting motor and cognitive functions, may involve language disorders. Despite the importance of speech and language disorders in the quality of life of patients, there are only a few studies about language and speech production difficulties in MS. The aim of this research is to describe the limitation patterns of speech and temporal characteristics of the suprasegmental level in two SPMS cases related to various types of spontaneous speech tasks. We assumed the change of the cognitive load has a greater effect on spontaneous speech in MS patients than in controls. Two SPMS patients, and two sex-, age- and education matched healthy controls were studied. We applied verbal fluency tests (phonemic, episodic, semantic, verb), digit span test, non-word repetition test, Corsi Block Tapping Test, Stroop Colour and Word Test, and Trail Making Test. Token Test was used to measure speech comprehension. The four speech tasks required relatively different degrees of cognitive effort: (a) spontaneous narrative about own life; (b) event description; (c) picture description; (d) narrative recall. Our results show that there are differences between MS patients and controls: MS patients produced slower speech and articulation rate, and they had more and longer pauses in every speech task. Speech tasks and the degree of the cognitive load had a greater effect on MS patients than on control speakers.
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Affiliation(s)
- Veronika Svindt
- Department of Psycholinguistics, Neurolinguistics and Sociolinguistics, Research Institute for Linguistics of the Hungarian Academy of Sciences, Budapest, Hungary
| | - Judit Bóna
- Department of Applied Linguistics and Phonetics, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Ildikó Hoffmann
- Department of Psycholinguistics, Neurolinguistics and Sociolinguistics, Research Institute for Linguistics of the Hungarian Academy of Sciences, Budapest, Hungary
- Department of Hungarian Linguistics, University of Szeged, Szeged, Hungary
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19
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Heled E, Aloni R, Achiron A. Cognitive functions and disability progression in relapsing-remitting multiple sclerosis: A longitudinal study. APPLIED NEUROPSYCHOLOGY-ADULT 2019; 28:210-219. [PMID: 31204507 DOI: 10.1080/23279095.2019.1624260] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Longitudinal studies have shown inconsistent findings regarding the association between cognition, demographic characteristics, and clinical decline in relapsing-remitting multiple sclerosis (RRMS). Our objective was to further explore these relations, over time, while also considering age and sex. A total of 183 patients with RRMS were assessed at two time points, using a neuropsychological battery and the Expanded Disability Status Scale (EDSS). For the first assessment, participants were divided by age (<29, 30-39, 40-49, 50-60) and sex. Next, they were divided according to their participation in one of three interval assessment points: 2-3, 4-5, and 6-8 years. Cognitive function was not correlated with disease duration but was negatively correlated with EDSS score. Men under 29 and women under 39 showed negative correlations between cognitive and clinical impairment. Executive functions, attention, and information processing speed (IPS) showed cognitive decline between the first and second assessments. Furthermore, at the 4-5 year interval IPS predicted EDSS scores, while at the 6-8 year interval it was IPS and visuo-spatial ability. Therefore, relation between clinical status and cognition is not consistent across different age and sex groups. Additionally, cognitive deterioration is only partially evident longitudinally; however, IPS appears to be the most sensitive in predicting one's future clinical condition.
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Affiliation(s)
- Eyal Heled
- Department of Psychology, Ariel University, Ariel, Israel.,Neurological Rehabilitation Department, Sheba Medical Center, Tel-Hashomer, Ramat Gan, Israel
| | - Roy Aloni
- Department of Psychology, Ariel University, Ariel, Israel.,Multiple Sclerosis Center, Sheba Medical Center, Tel-Hashomer, Ramat Gan, Israel
| | - Anat Achiron
- Multiple Sclerosis Center, Sheba Medical Center, Tel-Hashomer, Ramat Gan, Israel.,Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel
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20
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Cognitive Fatigue in Multiple Sclerosis: An Objective Approach to Diagnosis and Treatment by Transcranial Electrical Stimulation. Brain Sci 2019; 9:brainsci9050100. [PMID: 31052593 PMCID: PMC6562441 DOI: 10.3390/brainsci9050100] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 04/29/2019] [Accepted: 04/30/2019] [Indexed: 01/03/2023] Open
Abstract
Cognitive fatigue is one of the most frequent symptoms in multiple sclerosis (MS), associated with significant impairment in daily functioning and quality of life. Despite its clinical significance, progress in understanding and treating fatigue is still limited. This limitation is already caused by an inconsistent and heterogeneous terminology and assessment of fatigue. In this review, we integrate previous literature on fatigue and propose a unified schema aiming to clarify the fatigue taxonomy. With special focus on cognitive fatigue, we survey the significance of objective behavioral and electrophysiological fatigue parameters and discuss the controversial literature on the relationship between subjective and objective fatigue assessment. As MS-related cognitive fatigue drastically affects quality of life, the development of efficient therapeutic approaches for overcoming cognitive fatigue is of high clinical relevance. In this regard, the reliable and valid assessment of the individual fatigue level by objective parameters is essential for systematic treatment evaluation and optimization. Transcranial electrical stimulation (tES) may offer a unique opportunity to manipulate maladaptive neural activity underlying MS fatigue. Therefore, we discuss evidence for the therapeutic potential of tES on cognitive fatigue in people with MS.
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21
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Does cognitive reserve play any role in multiple sclerosis? A meta-analytic study. Mult Scler Relat Disord 2019; 30:265-276. [DOI: 10.1016/j.msard.2019.02.017] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 02/07/2019] [Accepted: 02/11/2019] [Indexed: 12/12/2022]
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22
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Drakulic SM. Neurophysiological Assessment of Cognitive Dysfunction in Patients with Multiple Sclerosis. SERBIAN JOURNAL OF EXPERIMENTAL AND CLINICAL RESEARCH 2019. [DOI: 10.1515/sjecr-2016-0056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Cognitive impairment occurs in a high percentage in all forms of multiple sclerosis, regardless of physical disability. Slowing the speed of information processing is one of the most difficult and the most frequently mentioned, but impairment of memory, attention, executive functions are included also. Long latency event related potentials (ERP) are much more objective means of cognitive functioning evaluation. Different types of immunomodulatory therapies which are used for relapsing- remitting forms of multiple sclerosis may affect the results of ERP. ERP can evaluate subclinical changes and provide important information on the evolution of cognitive changes in patients with MS.
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Affiliation(s)
- Svetlana Miletic Drakulic
- Clinic of neurology, Clinical Center Kragujevac , Kragujevac , Serbia ; Faculty of Medical Sciences , University of Kragujevac , Kragujevac , Serbia
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23
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Cognitive Functioning in Patients with Pediatric-Onset Multiple Sclerosis, an Updated Review and Future Focus. CHILDREN-BASEL 2019; 6:children6020021. [PMID: 30720736 PMCID: PMC6406784 DOI: 10.3390/children6020021] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Revised: 01/28/2019] [Accepted: 01/31/2019] [Indexed: 12/11/2022]
Abstract
Pediatric-onset multiple sclerosis (POMS) is relatively rare, but as technology and neuroimaging advance, an increasing number of cases are identified, and our understanding of how multiple sclerosis (MS) impacts the developing brain improves. There are consistent findings in the literature highlighting the impact of MS and other demyelinating diseases on cognitive functioning and cognitive development. We also have a better understanding of how POMS impacts psychosocial functioning and functional outcomes in daily living. This paper hopes to review findings associated with cognitive and psychosocial functioning in patients with POMS, as well as explore more recent advances in the field and how they relate to cognitive and psychosocial outcomes. We also discuss the ongoing need for future studies with a focus on better understanding deficits and disease correlates, but also preventative measures and potential rehabilitation.
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Guilloton L, Camdessanche JP, Latombe D, Neuschwander P, Cantalloube S, Thomas-Anterion C, Mercier B, Roggerone S, Maucort-Boulch D, Roche S, Jacquin-Courtois S. A clinical screening tool for objective and subjective cognitive disorders in multiple sclerosis. Ann Phys Rehabil Med 2019; 63:116-122. [PMID: 30703524 DOI: 10.1016/j.rehab.2018.11.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 10/24/2018] [Accepted: 11/03/2018] [Indexed: 10/27/2022]
Abstract
BACKGROUND Cognitive dysfunction is common in multiple sclerosis (MS). Deficits can affect attention, concentration, planning, and memory. They can have severe functional consequences in many domains. Cognitive complaints are frequently associated with other confounding factors (fatigue, anxiety, depression, or treatment side effects). In most cases, cognitive assessment is proposed after a spontaneous complaint, but determining the extent of discomfort perceived by the patient, the influence of coexisting factors, or the optimal timing for a more complete neuropsychological assessment is difficult. OBJECTIVE The objective of this work was to evaluate the feasibility and relevance of a fast global assessment of both objective and subjective cognitive dysfunction in MS. METHODS MS patients underwent a brief cognitive assessment including 7 visual analogue scales (VASs) asking about the patient's subjective level of discomfort in various domains, a memory test (Barbizet's lion story), a commonly used test of information processing speed (Symbol Digit Modalities Test [SDMT]) and self-reporting questionnaires for fatigue and mood (Fatigue Severity Scale [FSS] and Hospital Anxiety and Depression Scale [HADS]). Spearman correlation coefficients among scores were estimated. RESULTS The mean age of the 73 patients included was 48.3 (SD 11.1) years; 78% were females and 52.8% had the remittent-recurrent MS form, 8.3% the primary progressive form, and 38.9% the secondary progressive form. In less than 20min, this brief cognitive assessment was able to identify symptoms and quantify discomfort level. Symptoms of fatigue and anxiety frequently coexisted with cognitive complaints. We found modest correlations between scores on the VAS fatigue and the FSS and between scores on the VAS mood and the HADS. Analytical evaluation revealed that most patients had similar SDMT and recall profiles; however, a small proportion showed a dissociation between these 2 tests, which validated the inclusion of both tests in the assessment. Accounting for coexisting factors (e.g., anxiety and fatigue) and their functional repercussions is essential for prioritizing these problems within the context of multidisciplinary patient treatment. CONCLUSION Considering the possible multifactorial character of cognitive dysfunction in MS, it is essential to ask patients about their experiences and to take into account cognitive complaints in the follow-up of patients. The assessment tool we propose is simple and easy to use in a clinical setting and provides the information necessary for requesting (or not) a more complete neuropsychological assessment.
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Affiliation(s)
- Laurent Guilloton
- Rhône-Alpes MS network, GHE, hôpital Neurologique, 69500 Bron, France
| | - Jean-Philippe Camdessanche
- Rhône-Alpes MS network, GHE, hôpital Neurologique, 69500 Bron, France; Department of neurology, North hospital, university hospital of Saint-Étienne, 42055 Saint-Étienne cedex 02, France
| | - Dominique Latombe
- Rhône-Alpes MS network, GHE, hôpital Neurologique, 69500 Bron, France
| | | | | | | | | | | | - Delphine Maucort-Boulch
- Hospices civils de Lyon, service de biostatistique et bioinformatique, 69003 Lyon, France; Université de Lyon, 69000 Lyon, France; Université Lyon 1, 69100 Villeurbanne, France; CNRS, UMR 5558, laboratoire de biométrie et biologie évolutive, équipe biostatistique-santé, 69100 Villeurbanne, France
| | - Sylvain Roche
- Hospices civils de Lyon, service de biostatistique et bioinformatique, 69003 Lyon, France; Université de Lyon, 69000 Lyon, France; Université Lyon 1, 69100 Villeurbanne, France; CNRS, UMR 5558, laboratoire de biométrie et biologie évolutive, équipe biostatistique-santé, 69100 Villeurbanne, France
| | - Sophie Jacquin-Courtois
- Rhône-Alpes MS network, GHE, hôpital Neurologique, 69500 Bron, France; Neurological rehabilitation, hôpital Henry-Gabrielle, CHU de Lyon, 69230 Saint-Genis-Laval, France; Lyon 1 university, 69100 Villeurbanne, France; Centre de recherche en neuroscience de Lyon (CRNL), IMPACT Team, Inserm, U1028, CNRS, UMR5292, 69675 Bron, France.
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25
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Mulligan R, Basso MR, Lau L, Reynolds B, Whiteside DM, Combs D, Bornstein RA. Validity of the Verbal Concept Attainment Test in multiple sclerosis. J Clin Exp Neuropsychol 2019; 41:331-340. [PMID: 30642223 DOI: 10.1080/13803395.2018.1562048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVE As many as 70% of people with multiple sclerosis (MS) have clinically significant cognitive impairment, and most of these individuals exhibit executive dysfunction. Most research concerning executive dysfunction in MS has focused upon nonverbal measures. The Verbal Concept Attainment Test (VCAT) has demonstrated construct validity as an executive function measure in people infected with HIV and in people with focal brain lesions, but its validity among people with MS is unknown. The current study evaluated the VCAT's criterion, diagnostic, and ecological validity in people with MS. METHOD A comprehensive neuropsychological battery was administered to 44 healthy individuals and 97 people with MS. Based on existing norms, they were classified as impaired or unimpaired, resulting in 65 people with MS categorized as unimpaired and 32 as impaired. They were administered a battery assessing neuropsychological impairment and disability status. RESULTS The VCAT correlated with most measures of neuropsychological function, but its largest correlations occurred with measures of executive function, working memory, and verbal memory. Regarding classification accuracy, the VCAT achieved satisfactory sensitivity and specificity in identifying neuropsychological impairment in people with MS. The VCAT achieved moderate correlations with measures of disability status. CONCLUSIONS The data provide evidence for an optimal VCAT cutoff score for establishing neuropsychological impairment in people with MS, and they demonstrate that the VCAT possesses acceptable criterion, diagnostic, and ecological validity. As such, these data support the inclusion of the VCAT in research and clinical practice involving people with MS.
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Affiliation(s)
- Ryan Mulligan
- a Department of Psychology , University of Tulsa , Tulsa , OK
| | - Michael R Basso
- a Department of Psychology , University of Tulsa , Tulsa , OK
| | - Lily Lau
- a Department of Psychology , University of Tulsa , Tulsa , OK
| | | | | | - Dennis Combs
- c Department of Psychology , University of Texas at Tyler , Tyler, TX
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Mousavi S, Zare H, Etemadifar M. Evaluating the effectiveness of cognitive rehabilitation on everyday memory in multiple sclerosis patients. Neuropsychol Rehabil 2018; 30:1013-1023. [DOI: 10.1080/09602011.2018.1536608] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
| | - Hossein Zare
- Department of Psychology, Payame Noor University, Tehran, Iran
| | - Masoud Etemadifar
- Department of Neurology Medical School, Isfahan University of Medical Sciences, Isfahan, Iran
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Cui C, Wang J, Mullin AP, Caggiano AO, Parry TJ, Colburn RW, Pavlopoulos E. The antibody rHIgM22 facilitates hippocampal remyelination and ameliorates memory deficits in the cuprizone mouse model of demyelination. Brain Res 2018; 1694:73-86. [DOI: 10.1016/j.brainres.2018.05.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Revised: 05/13/2018] [Accepted: 05/14/2018] [Indexed: 12/26/2022]
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Artemiadis AK, Anagnostouli MC, Zalonis IG, Chairopoulos KG, Triantafyllou NI. Structural MRI Correlates of Cognitive Event-Related Potentials in Multiple Sclerosis. J Clin Neurophysiol 2018; 35:399-407. [DOI: 10.1097/wnp.0000000000000473] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Boa INF, Rimkus CDM, Campanholo KR, Pereira SLA, Junqueira TDF, Machado MDAR, Callegaro D, Otaduy MCG, Leite CDC, Miotto EC. Longitudinal analysis of verbal episodic memory in patients with relapsing-remitting multiple sclerosis. ARQUIVOS DE NEURO-PSIQUIATRIA 2018; 76:302-309. [PMID: 29898076 DOI: 10.1590/0004-282x20180038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Accepted: 02/22/2018] [Indexed: 11/22/2022]
Abstract
OBJECTIVE A 4.5-year follow-up study was conducted to characterize baseline verbal episodic memory (VEM) and its behavior and to assess the effects of relapsing-remitting multiple sclerosis (RRMS) on this domain. METHODS Twenty-nine patients with RRMS underwent two neuropsychological assessments performed an average of 4.5 years apart. Twenty-six control participants underwent a single neuropsychological assessment. A significance level of p < 0.005 was adopted to denote a significant difference between the groups on the Mann Whitney and Wilcoxon paired statistical analyses. RESULTS No statistical difference was found in the results of the VEM tests between the first and second neuropsychological assessments of the patients. However, a statistical difference was evident between the patient and control groups in the results of the VEM tests. CONCLUSION The patient group showed changes in the VEM relative to the control group. After approximately 4.5 years of disease, the patient performance on the VEM stabilized or improved.
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Affiliation(s)
- Izadora Nogueira Fonte Boa
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Departamento de Neurologia, São Paulo SP, Brasil
| | - Carolina de Medeiros Rimkus
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Departamento de Neurologia, São Paulo SP, Brasil
| | - Kenia Repiso Campanholo
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Departamento de Neurologia, São Paulo SP, Brasil
| | - Samira Luisa Apóstolos Pereira
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Departamento de Neurologia, São Paulo SP, Brasil
| | - Thiago de Faria Junqueira
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Departamento de Neurologia, São Paulo SP, Brasil
| | | | - Dagoberto Callegaro
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Departamento de Neurologia, São Paulo SP, Brasil
| | - Maria Concepción García Otaduy
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Departamento de Neurologia, São Paulo SP, Brasil
| | - Claudia da Costa Leite
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Departamento de Neurologia, São Paulo SP, Brasil
| | - Eliane Correa Miotto
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Departamento de Neurologia, São Paulo SP, Brasil
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Grzegorski T, Losy J. Cognitive impairment in multiple sclerosis - a review of current knowledge and recent research. Rev Neurosci 2018; 28:845-860. [PMID: 28787275 DOI: 10.1515/revneuro-2017-0011] [Citation(s) in RCA: 89] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Accepted: 05/19/2017] [Indexed: 11/15/2022]
Abstract
Multiple sclerosis (MS) is a chronic, progressive disease of the central nervous system that is characterised by inflammatory damage to the myelin sheath. Though often neglected, cognitive impairment is a common feature of MS that affects 43-70% of patients. It has a sophisticated neuroanatomic and pathophysiologic background and disturbs such vital cognitive domains as speed of information processing, memory, attention, executive functions and visual perceptual functions. In recent years there has been growing interest in neuroimaging findings with regard to cognitive impairment in MS. The possible options of managing cognitive dysfunction in MS are pharmacologic interventions, cognitive rehabilitation and exercise training; however, not enough evidence has been presented in this field. The aim of our article is to provide current knowledge on cognitive impairment in MS based on the most recent scientific results and conclusions with regard to affected cognitive domains, neuropsychological assessment, underlying mechanisms of this disturbance, neuroimaging findings and therapeutic options.
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Machine Learning EEG to Predict Cognitive Functioning and Processing Speed Over a 2-Year Period in Multiple Sclerosis Patients and Controls. Brain Topogr 2018; 31:346-363. [PMID: 29380079 DOI: 10.1007/s10548-018-0620-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Accepted: 01/15/2018] [Indexed: 12/29/2022]
Abstract
Event-related potentials (ERPs) show promise to be objective indicators of cognitive functioning. The aim of the study was to examine if ERPs recorded during an oddball task would predict cognitive functioning and information processing speed in Multiple Sclerosis (MS) patients and controls at the individual level. Seventy-eight participants (35 MS patients, 43 healthy age-matched controls) completed visual and auditory 2- and 3-stimulus oddball tasks with 128-channel EEG, and a neuropsychological battery, at baseline (month 0) and at Months 13 and 26. ERPs from 0 to 700 ms and across the whole scalp were transformed into 1728 individual spatio-temporal datapoints per participant. A machine learning method that included penalized linear regression used the entire spatio-temporal ERP to predict composite scores of both cognitive functioning and processing speed at baseline (month 0), and months 13 and 26. The results showed ERPs during the visual oddball tasks could predict cognitive functioning and information processing speed at baseline and a year later in a sample of MS patients and healthy controls. In contrast, ERPs during auditory tasks were not predictive of cognitive performance. These objective neurophysiological indicators of cognitive functioning and processing speed, and machine learning methods that can interrogate high-dimensional data, show promise in outcome prediction.
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Electrophysiological and behavioral effects of frontal transcranial direct current stimulation on cognitive fatigue in multiple sclerosis. J Neurol 2018; 265:607-617. [DOI: 10.1007/s00415-018-8754-6] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Revised: 01/10/2018] [Accepted: 01/13/2018] [Indexed: 12/23/2022]
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Pérez-Martín MY, González-Platas M, Jiménez-Sosa A, Plata-Bello J, Carrillo-Padilla FJ, Franco-Maside A, Eguia-Del Río P. Can fibrinolytic system components explain cognitive impairment in multiple sclerosis? J Neurol Sci 2017; 382:66-72. [PMID: 29111023 DOI: 10.1016/j.jns.2017.09.034] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Revised: 09/12/2017] [Accepted: 09/22/2017] [Indexed: 11/25/2022]
Abstract
BACKGROUND The fibrinolytic system is capable of modulating inflammatory and degenerative events within the central nervous system. Specifically, the plasminogen activator inhibitor-1 (PAI-1) has been associated with different pathological conditions in multiple sclerosis (MS) and its role in cognitive functioning is also known. OBJECTIVES AND METHODS To study the association between plasma levels and the polymorphic variants of the PAI-1 gene and cognitive performance in MS. 176 patients were studied. Neuropsychological evaluation was performed with the Brief Repeatable Battery of Neuropsychological Tests (BRB-N). A Polymerase Chain Reaction (PCR) was used to determine PAI-1 4G/5G polymorphisms and quantification was performed using an Enzyme-Linked ImmunoSorbent Assay (ELISA). RESULTS Participants were categorized as not cognitively impaired (NCI; n=114) and cognitively impaired (CI; n=62). The NCI group had a higher percentage of heterozygous subjects but no statistical differences were found between the CI and NCI group. Neuropsychological functioning did not correlate with plasma levels of PAI-1 or its genetic polymorphism. It is noteworthy that PAI-1 plasma levels were related to neurological impairment. DISCUSSION Cognitive impairment in MS is due to strategic focal lesions affecting regions and tracts involved in cognitive processes and to diffuse damage in the white and gray matter. This complex etiology could explain the absence of a relationship between the cognitive functioning and PAI-1 in patients with MS that has been found in vascular dementia or Alzheimer's disease. Plasma curves of PAI-1 and its measures in cerebrospinal fluid could help elucidate the role of PAI-1 in MS.
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Affiliation(s)
- María Yaiza Pérez-Martín
- Department of Neurology, Complejo Hospitalario Universitario de Canarias, Santa Cruz de Tenerife, Spain.
| | | | - Alejandro Jiménez-Sosa
- Unit of Research, Complejo Hospitalario Universitario de Canarias, Santa Cruz de Tenerife, Spain
| | - Julio Plata-Bello
- Department of Physiology, Faculty of Medicine, University of La Laguna, San Cristóbal de La Laguna, Spain; Department of Neurosurgery, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain
| | | | - Andrés Franco-Maside
- Department of Immunology, Complejo Hospitalario Universitario de Canarias, Santa Cruz de Tenerife, Spain
| | - Pablo Eguia-Del Río
- Department of Neurology, Hospital Dr. José Molina Orosa, Ctra. Arrecife. Lanzarote. Las Palmas de Gran Canaria, Spain
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Hansen S, Lautenbacher S. Neuropsychological Assessment in Multiple Sclerosis. ZEITSCHRIFT FUR NEUROPSYCHOLOGIE 2017. [DOI: 10.1024/1016-264x/a000197] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Abstract. Neuropsychological deficits in multiple sclerosis (MS) are common. Over the past decades, many different procedures have been employed in diagnosing these deficits. Even though certain aspects of cognitive performance such as information processing speed and working memory may be affected more frequently than other cognitive functions, no specific deficit profile has been established in MS. This article provides an overview of the neuropsychological diagnostic procedures in MS and allows the reader to reach an informed decision on the applicability of specific procedures and the availability of study data in the context of MS. Additionally, it makes recommendations on the compilation of both screening procedures and extensive test batteries.
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Affiliation(s)
- Sascha Hansen
- Klinikum Bayreuth GmbH, Betriebsstätte Hohe Warte, Department of Neurology, Bayreuth, Germany
- Otto-Friedrich-University, Department of Physiological Psychology, Bamberg, Germany
| | - Stefan Lautenbacher
- Otto-Friedrich-University, Department of Physiological Psychology, Bamberg, Germany
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Zeng Q, Dong X, Ruan C, Hu B, Zhou B, Xue Y, Liu Y, Yang H. Cognitive impairment in Chinese IIDDs revealed by MoCA and P300. Mult Scler Relat Disord 2017; 16:1-7. [DOI: 10.1016/j.msard.2017.05.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Revised: 04/25/2017] [Accepted: 05/11/2017] [Indexed: 10/19/2022]
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Kratz AL, Murphy SL, Braley TJ. Ecological Momentary Assessment of Pain, Fatigue, Depressive, and Cognitive Symptoms Reveals Significant Daily Variability in Multiple Sclerosis. Arch Phys Med Rehabil 2017; 98:2142-2150. [PMID: 28729168 DOI: 10.1016/j.apmr.2017.07.002] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Revised: 06/26/2017] [Accepted: 07/01/2017] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To describe the daily variability and patterns of pain, fatigue, depressed mood, and cognitive function in persons with multiple sclerosis (MS). DESIGN Repeated-measures observational study of 7 consecutive days of home monitoring, including ecological momentary assessment (EMA) of symptoms. Multilevel mixed models were used to analyze data. SETTING General community. PARTICIPANTS Ambulatory adults (N=107) with MS recruited through the University of Michigan and surrounding community. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURE EMA measures of pain, fatigue, depressed mood, and cognitive function rated on a 0 to 10 scale, collected 5 times a day for 7 days. RESULTS Cognitive function and depressed mood exhibited more stable within-person patterns than pain and fatigue, which varied considerably within person. All symptoms increased in intensity across the day (all P<.02), with fatigue showing the most substantial increase. Notably, this diurnal increase varied by sex and age; women showed a continuous increase from wake to bedtime, whereas fatigue plateaued after 7 pm for men (wake-bed B=1.04, P=.004). For the oldest subgroup, diurnal increases were concentrated to the middle of the day compared with younger subgroups, which showed an earlier onset of fatigue increase and sustained increases until bed time (wake-3 pm B=.04, P=.01; wake-7 pm B=.03, P=.02). Diurnal patterns of cognitive function varied by education; those with advanced college degrees showed a more stable pattern across the day, with significant differences compared with those with bachelor-level degrees in the evening (wake-7 pm B=-.47, P=.02; wake-bed B=-.45, P=.04). CONCLUSIONS Findings suggest that chronic symptoms in MS are not static, even over a short time frame; rather, symptoms-fatigue and pain in particular-vary dynamically across and within days. Incorporation of EMA methods should be considered in the assessment of these chronic MS symptoms to enhance assessment and treatment strategies.
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Affiliation(s)
- Anna L Kratz
- Department of Physical Medicine & Rehabilitation, University of Michigan, Ann Arbor, MI.
| | - Susan L Murphy
- Department of Physical Medicine & Rehabilitation, University of Michigan, Ann Arbor, MI; Veterans Affairs Ann Arbor Health Care System, Geriatric Research, Education, and Clinical Center, Ann Arbor, MI
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Van Schependom J, Nagels G. Targeting Cognitive Impairment in Multiple Sclerosis-The Road toward an Imaging-based Biomarker. Front Neurosci 2017; 11:380. [PMID: 28713238 PMCID: PMC5491975 DOI: 10.3389/fnins.2017.00380] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Accepted: 06/19/2017] [Indexed: 12/26/2022] Open
Abstract
Multiple Sclerosis (MS) is a neuro-degenerative and -inflammatory disease leading to physical and cognitive impairment, pathological fatigue and depression, and affecting patients' quality of life and employment status. The combination of inflammation, demyelination, and neurodegeneration leads to the emergence of MS lesions, reduced white and gray matter brain volumes, a reduced conduction velocity and microstructural changes in the so-called Normal Appearing White Matter (NAWM). Currently, there are very limited options to treat cognitive impairment and its origin is only poorly understood. Therefore, several studies have attempted to relate clinical scores with features calculated either using T1- and/or FLAIR weighted MR images or using neurophysiology. The aim of those studies is not only to provide an improved understanding of the processes that underlie the different symptoms, but also to develop a biomarker—sensitive to therapy induced change—that could be used to speed up therapeutic developments (e.g., cognitive training/drug discovery/…). Here, we provide an overview of studies that have established relationships between either neuro-anatomical or neurophysiological measures and cognitive outcome scores. We discuss different avenues that may help to improve the prediction of cognitive impairment, and how well we can expect them to predict cognitive scores.
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Affiliation(s)
- Jeroen Van Schependom
- Center for Neurosciences, Universitair Ziekenhuis Brussel, Vrije Universiteit BrusselBrussels, Belgium.,Radiology, Universitair Ziekenhuis Brussel, Vrije Universiteit BrusselBrussels, Belgium
| | - Guy Nagels
- Center for Neurosciences, Universitair Ziekenhuis Brussel, Vrije Universiteit BrusselBrussels, Belgium.,Neurology, National MS Center MelsbroekMelsbroek, Belgium
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Effect of Vitamin D Replacement on Cognition in Multiple Sclerosis Patients. Sci Rep 2017; 7:45926. [PMID: 28374837 PMCID: PMC5379671 DOI: 10.1038/srep45926] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Accepted: 03/06/2017] [Indexed: 11/08/2022] Open
Abstract
Multiple Sclerosis is associated with deficient serum 25 hydroxyvitamin D (25 (OH)D) level and cognitive impairment. The aim of this study is to evaluate cognitive performance in MS patients with deficient 25 (OH)D (<25 ng/ml) compared to patients with sufficient levels (>35 ng/ml), then to evaluate the change in cognitive performance after 3 months of vitamin D3 oral replacement. Eighty-eight MS patients with relapsing remitting and clinically isolated type of MS, older than 18 years treated with interferon beta were enrolled. Cognitive testing was performed at baseline and at 3 months using the Montreal Cognitive Assessment (MoCA), Stroop, Symbol Digit Modalities (SDMT) and Brief Visuospatial Memory Test (BVMT-R). Serum 25 (OH)D was measured at baseline and at the end of the study. Vitamin D3 replacement improved the MS patients' cognitive performance after 3 months on the MoCA and BVMT-Delayed Recall (DR). Sufficient serum 25 (OH)D level predicted better cognitive performance on the BVMT-DR at baseline (β: 1.74, p: <0.008) and 3 months (β: 1.93, p: <0.01) after adjusting for all measured confounding variables. Vitamin D3 replacement could improve cognitive performance in MS patients and make a significant difference in the patient's quality of life.
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Pérez-Martín MY, González-Platas M, Eguía-Del Río P, Croissier-Elías C, Jiménez Sosa A. Efficacy of a short cognitive training program in patients with multiple sclerosis. Neuropsychiatr Dis Treat 2017; 13:245-252. [PMID: 28223806 PMCID: PMC5304985 DOI: 10.2147/ndt.s124448] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Cognitive impairment is a common feature in multiple sclerosis (MS) and may have a substantial impact on quality of life. Evidence about the effectiveness of neuropsychological rehabilitation is still limited, but current data suggest that computer-assisted cognitive training improves cognitive performance. OBJECTIVE The objective of this study was to evaluate the efficacy of combined computer-assisted training supported by home-based neuropsychological training to improve attention, processing speed, memory and executive functions during 3 consecutive months. METHODS In this randomized controlled study blinded for the evaluators, 62 MS patients with clinically stable disease and mild-to-moderate levels of cognitive impairment were randomized to receive a computer-assisted neuropsychological training program (n=30) or no intervention (control group [CG]; n=32). The cognitive assessment included the Brief Repeatable Battery of Neuropsychological Test. Other secondary measures included subjective cognitive impairment, anxiety and depression, fatigue and quality of life measures. RESULTS The treatment group (TG) showed significant improvements in measures of verbal memory, working memory and phonetic fluency after intervention, and repeated measures analysis of covariance revealed a positive effect in most of the functions. The control group (CG) did not show changes. The TG showed a significant reduction in anxiety symptoms and significant improvement in quality of life. There were no improvements in fatigue levels and depressive symptoms. CONCLUSION Cognitive intervention with a computer-assisted training supported by home training between face-to-face sessions is a useful tool to treat patients with MS and improve functions such as verbal memory, working memory and phonetic fluency.
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Affiliation(s)
| | | | - Pablo Eguía-Del Río
- Service of Neurology, Doctor José Molina Orosa Hospital, Arrecife, Lanzarote
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Cognitive event-related potentials in multiple sclerosis: Correlation with MRI and neuropsychological findings. Mult Scler Relat Disord 2016; 10:192-197. [DOI: 10.1016/j.msard.2016.10.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Revised: 10/16/2016] [Accepted: 10/23/2016] [Indexed: 11/23/2022]
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Pokryszko-Dragan A, Dziadkowiak E, Zagrajek M, Slotwinski K, Gruszka E, Bilinska M, Podemski R. Cognitive performance, fatigue and event-related potentials in patients with clinically isolated syndrome. Clin Neurol Neurosurg 2016; 149:68-74. [PMID: 27484631 DOI: 10.1016/j.clineuro.2016.07.022] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Revised: 07/12/2016] [Accepted: 07/13/2016] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Cognitive impairment and fatigue are regarded as important aspects of multiple sclerosis. The aim of this study was to evaluate cognitive performance, the level of fatigue and parameters of event-related potentials (ERP) in patients diagnosed with clinically isolated syndrome (CIS). PATIENTS AND METHODS The study comprised 44 patients with CIS and 45 healthy controls. Cognitive performance was assessed using the Brief Repeatable Battery of Neuropsychological Tests (BRBNT), fatigue - using the Fatigue Severity Scale (FSS) and Modified Fatigue Impact Scale (MFIS). Auditory ERP were performed and the parameters of N200 and P300 components were analyzed. Neuropsychological and electrophysiological measures were referred to clinical and radiological features of the disease activity. RESULTS Forty five% of patients failed in at least one test from BRBNT, mainly within the domains of memory and attention. In 18% of patients FSS corresponded with moderate or severe fatigue. The mean latency of N200 and P300 was significantly longer and amplitude of P300 was lower in those patients with CIS than in the controls. Significant correlations were found between the results of MFIS and tests evaluating verbal memory and attention, as well as between N200 latency and results of tests for verbal memory. CONCLUSIONS Cognitive performance and fatigue deserve attention from the earliest clinical stage of MS. Abnormalities of event-related potentials in CIS suggest early impact of the disease on functional neural networks.
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Affiliation(s)
| | | | | | | | - Ewa Gruszka
- Department of Neurology, Medical University of Wroclaw, Poland
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Williams J, O'Rourke K, Hutchinson M, Tubridy N. The Face-Symbol Test and the Symbol-Digit Test are not reliable surrogates for the Paced Auditory Serial Addition Test in multiple sclerosis. Mult Scler 2016; 12:599-604. [PMID: 17086906 DOI: 10.1177/1352458506070752] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The Paced Auditory Serial Addition Test (PASAT) is the chosen task for cognitive assessment in the multiple sclerosis functional composite (MSFC) and a widely used task in neuropsychological studies of people with multiple sclerosis (MS), but is unpopular with patients. The Face-Symbol Test (FST) and Symbol-Digit Tests (SDT) are alternative methods of cognitive testing in MS, which are easily administered and patient-friendly. In order to evaluate the potential of the FST as a possible surrogate for the PASAT, we directly compared the FST to the PASAT and the SDT in a cohort of 50 MS patients with varying levels of disability. There was significant correlation between SDT and FST scores (Spearman’s rho 0.80, 95% CI 0.66 - 0.88), R2 65%, with moderate inter-test agreement (κ = 0.52). In contrast, SDT and FST scores were less predictive of PASAT scores. We concluded that neither the FST nor SDT are reliable surrogates for the PASAT.
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Affiliation(s)
- J Williams
- St. Vincent's University Hospital, Elm Park, Dublin 4, Republic of Ireland
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Lynch SG, Parmenter BA, Denney DR. The association between cognitive impairment and physical disability in multiple sclerosis. Mult Scler 2016; 11:469-76. [PMID: 16042232 DOI: 10.1191/1352458505ms1182oa] [Citation(s) in RCA: 81] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Background: The association between cognitive impairment and physical disability was examined in a larger, more representative sample of patients with multiple sclerosis (MS) than in previous studies. Method: Two hundred and fifty-three patients attending an MS clinic were assessed with respect to physical disability using the Expanded Disability Status Scale and cognitive impairment using a battery of neuropsychological tests. Results: Physical disability correlated with duration of disease; cognitive impairment did not. Virtually all measures derived from the cognitive battery were significantly correlated with physical disability. Three measures of speeded information processing and one involving delayed recall of verbal material were unique predictors of disability status. The relationship between cognitive impairment and physical disability was equivalent for patients with shorter (<3 years) versus longer (>10 years) disease duration. Cognitive impairment correlated with the rate of disability progression as reflected by the progression index. Conclusion: Cognitive impairment is more closely associated with physical disability than most previous studies indicate. This relationship appears to be stable throughout the duration of MS, although this conclusion is qualified by the cross-sectional design of the study. Further attention should be paid to cognitive impairment as a possible predictor of the rate of patients’ physical decline.
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Affiliation(s)
- Sharon G Lynch
- Department of Neurology, University of Kansas Medical Center, Kansas City, KS 66160, USA
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Borghi M, Carletto S, Ostacoli L, Scavelli F, Pia L, Pagani M, Bertolotto A, Malucchi S, Signori A, Cavallo M. Decline of Neuropsychological Abilities in a Large Sample of Patients with Multiple Sclerosis: A Two-Year Longitudinal Study. Front Hum Neurosci 2016; 10:282. [PMID: 27375468 PMCID: PMC4896920 DOI: 10.3389/fnhum.2016.00282] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2015] [Accepted: 05/25/2016] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE In this longitudinal study, we monitored two large groups of multiple sclerosis (MS) patients and healthy controls (HC) for 2 years, with the aim of comparing their neuropsychological profile over time. METHOD Three hundred and twenty-two patients with MS and 303 HC were administered the Brief Repeatable Battery of Neuropsychological tests (BRB-N); neuropsychiatric measures were also administered. Two follow-ups were scheduled at 1 and 2 years, respectively. RESULTS A linear mixed model (LMM) with random intercept was run by considering participants' performance on each test of the BRB-N at the three assessment points (baseline and follow-ups) as the within-subjects variable, and group (patients and controls) as the between-subjects factor. The interaction term was statistically significant for the tests: Symbol Digit Modalities test (SDMT) (p = 0.044), Paced Auditory Serial Addition test (PASAT) (p = 0.011) and Word List Generation (WLG) (p < 0.001), whereas for the PASAT-3 approached statistical significance (p = 0.05). In addition, a LMM with random intercept was also run by identifying three groups (controls, relapsing-remitting course of MS (i.e. RR-MS), and prog-MS). The interaction term was statistically significant for: PASAT-3 (p = 0.017), PASAT-2 (p = 0.0026), and WLG (p = 0.0022). CONCLUSIONS Our results corroborate on a very large scale evidence that the abilities tapped by the tasks SDMT, PASAT and WLG are particularly sensitive to MS, and further extend this issue by showing that these abilities are likely to be more sensitive than others to the progression of the disease, as compared to HC.
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Affiliation(s)
- Martina Borghi
- Clinical Psychology and Psychosomatics Service, University Hospital San Luigi Gonzaga, University of Turin Orbassano, Italy
| | - Sara Carletto
- Clinical Psychology and Psychosomatics Service, University Hospital San Luigi Gonzaga, University of Turin Orbassano, Italy
| | - Luca Ostacoli
- Clinical Psychology and Psychosomatics Service, University Hospital San Luigi Gonzaga, University of Turin Orbassano, Italy
| | - Francesco Scavelli
- Clinical Psychology and Psychosomatics Service, University Hospital San Luigi Gonzaga, University of Turin Orbassano, Italy
| | - Lorenzo Pia
- SAMBA (SpAtial, Motor and Bodily Awareness) Research Group, Department of Psychology, University of TurinTurin, Italy; Neuroscience Institute of Turin (NIT), University of TurinTurin, Italy
| | - Marco Pagani
- Institute of Cognitive Sciences and Technologies, Consiglio Nazionale delle Ricerche (CNR), Rome Italy
| | - Antonio Bertolotto
- Neurologia 2 - CRESM (Regional Reference Centre for Multiple Sclerosis), "San Luigi Gonzaga" Hospital Medical School Orbassano, Italy
| | - Simona Malucchi
- Neurologia 2 - CRESM (Regional Reference Centre for Multiple Sclerosis), "San Luigi Gonzaga" Hospital Medical School Orbassano, Italy
| | - Alessio Signori
- Department of Health Sciences (DISSAL), Section of Biostatistics, University of Genoa Genoa, Italy
| | - Marco Cavallo
- Faculty of Psychology, eCampus UniversityNovedrate, Italy; Department of Mental Health, Azienda Sanitaria Locale Torino 3Collegno, Italy
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Jacques FH, Harel BT, Schembri AJ, Paquette C, Bilodeau B, Kalinowski P, Roy R. Cognitive evolution in natalizumab-treated multiple sclerosis patients. Mult Scler J Exp Transl Clin 2016; 2:2055217316657116. [PMID: 28607732 PMCID: PMC5408753 DOI: 10.1177/2055217316657116] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Accepted: 06/06/2016] [Indexed: 11/23/2022] Open
Abstract
Background Cognitive dysfunction affects up to 65% of multiple sclerosis (MS) patients and progresses over time. Natalizumab has been shown to be superior to placebo in preserving cognition for the first two years of therapy. Objectives The objectives of this study are to understand the impact of natalizumab on cognition beyond two years of therapy and to investigate whether baseline characteristics are predictive of clinical response. Methods This is a single-center, 24-month, observational study. Sixty-three patients treated with natalizumab were assessed prior to monthly infusions using a Cogstate battery and the Symbol Digit Modalities Test (SDMT). Patient demographics were collected at baseline. A linear mixed model was conducted with duration of natalizumab therapy as a between-subjects factor (≤2 or >2 years), assessment as a within-subjects factor, and Multiple Sclerosis Severity Score (MSSS) as a covariate. Results Aside from the MSSS (p = 0.0074), the two groups were identical. No patient showed evidence of sustained cognitive deterioration over the 24-month period. Baseline parameters including impaired cognition did not influence the trajectory of cognitive change over 24 months. Conclusions Our results suggest that natalizumab preserves cognition following four to seven years of continuous therapy. This occurs irrespective of baseline characteristics, including impaired cognition.
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Event-related potentials and cognitive performance in multiple sclerosis patients with fatigue. Neurol Sci 2016; 37:1545-56. [PMID: 27271940 PMCID: PMC4992503 DOI: 10.1007/s10072-016-2622-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Accepted: 05/23/2016] [Indexed: 11/27/2022]
Abstract
The aim of this study was to evaluate event-related potentials (ERP) and cognition in multiple sclerosis (MS) patients with regard to fatigue and disease-related variables. The study comprised 86 MS patients and 40 controls. Fatigue was assessed using the Fatigue Severity Scale (FSS/FSS-5) and the Modified Fatigue Impact Scale (MFIS/MFISmod). N200 and P300 components of auditory ERP were analyzed. Cognition was evaluated by means of Brief Repeatable Battery of Neuropsychological Tests (BRBNT). The results of ERP and BRBNT were compared between non-fatigued, moderately and severely fatigued MS patients and controls. P300 latency was significantly longer in the whole MS group and in the fatigued patients than in the controls. A positive correlation was found between P300 latency and MFIS/MFISmod results, independent from age and MS-related variables. The fatigued patients scored less than non-fatigued ones in tests evaluating memory, visuomotor abilities and attention. Results of these tests correlated significantly with fatigue measures, independently from MS-related variables. Fatigue in MS patients showed significant relationships with impairment within the memory and attention domains. Parameters of auditory ERP, as electrophysiological biomarkers of cognitive performance, were not independently linked to fatigue.
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Roy S, Benedict RHB, Drake AS, Weinstock-Guttman B. Impact of Pharmacotherapy on Cognitive Dysfunction in Patients with Multiple Sclerosis. CNS Drugs 2016; 30:209-25. [PMID: 26884145 DOI: 10.1007/s40263-016-0319-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Cognitive impairment is a common symptom of multiple sclerosis (MS), adversely impacting many spheres of daily functioning. Yet the effectiveness of pharmacological interventions for cognitive impairment in MS is unclear. Clinicians and patients alike would benefit from formal guidelines regarding effective management of cognitive symptoms. We reviewed the background on the measurement, pathophysiology and risk factors for cognitive dysfunction in MS, and then examined the published clinical trials of pharmacotherapy, including both disease-modifying treatments (DMTs) and symptom-management therapies (SMTs). Our review of DMTs revealed only a single well-designed, randomized, controlled trial where intramuscular interferon (IFN)-β1a, administered once weekly, was compared with placebo. The results showed significant benefits in terms of cognitive processing speed and memory. Less convincing but promising data have shown the potential benefits of IFN-β1b and natalizumab. The literature on SMTs is replete with placebo-controlled, single-centre studies, with a failure to replicate initially promising results. The results for SMTs such as acetylcholinesterase inhibitors and psychostimulants are mixed. Some encouraging data show promise but not to a threshold of indication for standard clinical use. Numerous methodological factors hamper research in this area. Acknowledging the lack of firm conclusions, we argue that all DMTs are likely to benefit cognition and that, if otherwise safe, SMTs with some empirical support may be attempted at the discretion of the treating clinician. We offer some guidance on the assessment and monitoring of cognitive function to inform off-license treatment of cognitive impairment in MS patients.
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Affiliation(s)
- Shumita Roy
- Department of Neurology, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York (SUNY), Buffalo, NY, USA
| | - Ralph H B Benedict
- Department of Neurology, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York (SUNY), Buffalo, NY, USA.
| | - Allison S Drake
- Department of Neurology, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York (SUNY), Buffalo, NY, USA
| | - Bianca Weinstock-Guttman
- Department of Neurology, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York (SUNY), Buffalo, NY, USA
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Halder S, Käthner I, Kübler A. Training leads to increased auditory brain–computer interface performance of end-users with motor impairments. Clin Neurophysiol 2016; 127:1288-1296. [DOI: 10.1016/j.clinph.2015.08.007] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Revised: 07/16/2015] [Accepted: 08/05/2015] [Indexed: 11/28/2022]
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Pinto J, Lopes E, Gonçalves G, Silva Â, Carnero-Pardo, Peixoto B. Phototest for neurocognitive screening in multiple sclerosis. Dement Neuropsychol 2016; 10:12-18. [PMID: 29213425 PMCID: PMC5674908 DOI: 10.1590/s1980-57642016dn10100003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Multiple Sclerosis (MS) is one of the most common neurological disorders. Cognitive dysfunction is considered a clinical marker of MS, where approximately half of patients with MS have cognitive impairment. Objective The Phototest (PT) is a brief cognitive test with high diagnostic sensitivity, accuracy and cost-effectiveness for detecting cognitive deterioration. Our aim was to test the utility of the PT as a neurocognitive screening instrument for MS. Methods The study enrolled 30 patients with different types of MS from an outpatient clinic as well as 19 healthy participants. In conjunction with the PT, the Montreal Cognitive Assessment (MoCA), Barthel Index (BI), Expanded Disability Status Scale (EDSS), and Fatigue Severity Scale (FSS) were administered. Results The MS group obtained significantly lower results on all domains of the PT, except for the naming task. The PT showed good concurrent validity with the MoCA. In direct comparison to the MoCA, PT showed a greater area under the curve and higher levels of sensitivity and specificity for MS neurocognitive impairments. A cut-off score of 31 on the Phototest was associated with sensitivity of 100% and specificity of 76.7%. Conclusion The PT is a valid, specific, sensitive and brief test that is not dependent on motor functions. The instrument could be an option for neurocognitive screening in MS, especially in identifying cases for further neuropsychological assessment and intervention.
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Affiliation(s)
- Joana Pinto
- CESPU, Instituto de Investigação e Formação Avançada em Ciências e Tecnologias da Saúde, Gandra, Portugal.,Centro Hospitalar do Alto Ave, Guimarães, Portugal
| | | | | | - Ângela Silva
- Centro Hospitalar do Alto Ave, Guimarães, Portugal
| | - Carnero-Pardo
- Cognitive Behavioral Neurology Unit of the Hospital Universitario Virgen de las Nieves, Granada, Spain.,FIDYAN Neurocenter, Granada, Spain
| | - Bruno Peixoto
- CESPU, Instituto Superior de Ciências da Saúde - Norte (Sciences Department), Gandra, Portugal
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Dejanović M, Ivetić V, Nestorović V, Erić M, Stanojević Z, Leštarević S. The role of P300 event-related potentials in the cognitive recovery after the stroke. Acta Neurol Belg 2015; 115:589-95. [PMID: 25578637 DOI: 10.1007/s13760-015-0428-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2014] [Accepted: 01/05/2015] [Indexed: 11/25/2022]
Abstract
The aim of this study was to elucidate the effects of an ischemic stroke on the amplitude and latency of the P300 wave and evaluate their changes over a prospective 1-year follow-up period. We recorded the P300 wave using an auditory oddball paradigm in 60 consecutive brain infarct patients at baseline (i.e., within 4 weeks after the stroke), after 3 months, after 12 months and in 30 healthy control subjects. The P300 latencies in stroke patients were significantly longer and the P300 amplitudes were significantly smaller than those of the control group. The latency of P300 showed a highly significant average improvement 12 months after the stroke compared to the baseline. There was no significant change observed for the P300 amplitude during the same period. The P3 latency is initially more increased in the patients with hemispheric brain infarction but shows a better recovery compared to the patients with brainstem infarction. Also, the results of the P300 latency of patients with the left-sided lesions was significantly longer compared to the patients with right-sided lesions on the beginning of the study but not 3 and 12 months after the stroke. The results of our study show the importance of P300 event-related potentials in the detection and follow-up of cognitive changes after ischemic stroke.
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Affiliation(s)
- Mirjana Dejanović
- Department of Physiology, Faculty of Medicine, University of Priština, Anri Dinana bb, 38 220, Kosovska Mitrovica, Serbia.
| | - Vesna Ivetić
- Laboratory of Neurophysiology, Department of Physiology, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - Vojkan Nestorović
- Department of Physiology, Faculty of Medicine, University of Priština, Anri Dinana bb, 38 220, Kosovska Mitrovica, Serbia
| | - Mirela Erić
- Department of Anatomy, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - Zorica Stanojević
- Department of Pharmacology, Faculty of Medicine, University of Priština, Kosovska Mitrovica, Serbia
| | - Snežana Leštarević
- Department of Histology, Faculty of Medicine, University of Priština, Kosovska Mitrovica, Serbia
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