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Sousa C, Jacques T, Sá MJ, Alves RA. Cognitive impairment in multiple sclerosis phenotypes: Neuropsychological assessment in a portuguese sample. APPLIED NEUROPSYCHOLOGY. ADULT 2024; 31:1153-1162. [PMID: 35977707 DOI: 10.1080/23279095.2022.2112681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND Cognitive impairment affects 40-65% of MS patients, encompassing all disease stages and types of clinical courses. This estimation is based on different instruments used and population normative data. OBJECTIVE This study aims to assess the cognitive function in a hospital-based cohort of Portuguese MS patients, to allow estimating the prevalence of cognitive impairment in different phenotypes. METHODS Three hundred and thirteen patients with Multiple Sclerosis (MS) underwent neuropsychological assessment with the brief repeatable battery of neuropsychological tests (BRBN-T) and the brief international cognitive assessment for multiple sclerosis (BICAMS). RESULTS Differences were observed in the cognitive impairment profile of different disease phenotypes and of the different disease severity stages. RRMS patients performed better in the cognitive test of the BRBN-T and BICAMS than those with progressive disease phenotypes. Relationships between cognitive impairment and disability and professional status were relevant. Although similarities could be observed in the cognitive profile of the MS phenotypes, with predominant involvement of verbal memory, verbal fluency, and information processing speed, the latter was found to be more frequent as the disease progressed. CONCLUSION This study contributes to improve knowledge about the cognitive profile of the different MS phenotypes and understand the cognitive characteristics of Portuguese patients.
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Affiliation(s)
- Cláudia Sousa
- Department of Neurology, Centro Hospitalar Universitário São João Porto, EPE, Porto, Portugal
- Faculty of Psychology and Educational Sciences, University of Porto, Porto, Portugal
- Department of Psychology, Centro Hospitalar Universitário São João Porto, EPE, Porto, Portugal
| | - Teresa Jacques
- Faculty of Psychology and Educational Sciences, University of Porto, Porto, Portugal
| | - Maria José Sá
- Department of Neurology, Centro Hospitalar Universitário São João Porto, EPE, Porto, Portugal
- Faculty of Health Sciences, Universidade Fernando Pessoa, Porto, Portugal
| | - Rui A Alves
- Faculty of Psychology and Educational Sciences, University of Porto, Porto, Portugal
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Mirmosayyeb O, Nabizadeh F, Moases Ghaffary E, Yazdan Panah M, Zivadinov R, Weinstock-Guttman B, Benedict RHB, Jakimovski D. Cognitive performance and magnetic resonance imaging in people with multiple sclerosis: A systematic review and meta-analysis. Mult Scler Relat Disord 2024; 88:105705. [PMID: 38885600 DOI: 10.1016/j.msard.2024.105705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 06/03/2024] [Accepted: 06/07/2024] [Indexed: 06/20/2024]
Abstract
BACKGROUND Several studies have shown the different relationships between cognitive functions and structural magnetic resonance imaging (MRI) measurements in people with multiple sclerosis (pwMS). However, there is an ongoing debate regarding the magnitude of correlation between MRI measurements and specific cognitive function tests. This systematic review and meta-analysis aimed to synthesize the most consistent correlations between MRI measurements and cognitive function in pwMS. METHODS PubMed/MEDLINE, Embase, Scopus, and Web of Science databases were systematically searched up to February 2023, to find relevant data. The search utilized syntax and medical subject headings (MeSH) relevant to cognitive performance tests and MRI measurements in pwMS. The R software version 4.3.3 with random effect models was used to estimate the pooled effect sizes. RESULTS 13,559 studies were reviewed, of which 136 were included. The meta-analyses showed that thalamic volume had the most significant correlations with Symbol Digit Modalities Test (SDMT) r = 0.47 (95 % CI: 0.39 to 0.56, p < 0.001, I2 = 88 %), Brief Visual Memory Test-Revised-Total Recall (BVMT-TR) r = 0.51 (95 % CI: 0.36 to 0.66, p < 0.001, I2 = 81 %), California Verbal Learning Test-II-Total Recall (CVLT-TR) r = 0.47 (95 % CI: 0.34 to 0.59, p < 0.001, I2 = 69 %,), and Delis-Kaplan Executive Function System (DKEFS) r = 0.48 (95 % CI: 0.34 to 0.63, p < 0.001, I2 = 22 %,). CONCLUSION We conclude that thalamic volume exhibits highest relationships with information processing speed (IPS), visuospatial learning-memory, verbal learning-memory, and executive function in pwMS. A comprehensive understanding of the intricacies of the mechanisms underpinning this association requires additional research.
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Affiliation(s)
- Omid Mirmosayyeb
- Department of Neurology, Jacobs Comprehensive MS Treatment and Research Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, United States
| | - Fardin Nabizadeh
- School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Elham Moases Ghaffary
- Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Yazdan Panah
- Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Robert Zivadinov
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, United States; Center for Biomedical Imaging at the Clinical Translational Science Institute, University at Buffalo, State University of New York, Buffalo, NY, United States
| | - Bianca Weinstock-Guttman
- Department of Neurology, Jacobs Comprehensive MS Treatment and Research Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, United States
| | - Ralph H B Benedict
- Department of Neurology, Jacobs Comprehensive MS Treatment and Research Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, United States
| | - Dejan Jakimovski
- Department of Neurology, Jacobs Comprehensive MS Treatment and Research Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, United States; Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, United States.
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Wu W, Francis H, Lucien A, Wheeler TA, Gandy M. The Prevalence of Cognitive Impairment in Relapsing-Remitting Multiple Sclerosis: A Systematic Review and Meta-analysis. Neuropsychol Rev 2024:10.1007/s11065-024-09640-8. [PMID: 38587704 DOI: 10.1007/s11065-024-09640-8] [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: 09/16/2023] [Accepted: 03/25/2024] [Indexed: 04/09/2024]
Abstract
It is increasingly recognized that cognitive symptoms are a common sequelae of relapsing-remitting multiple sclerosis and are associated with adverse functional consequences. However, estimates of cognitive impairment (CIm) prevalence vary widely. This study aimed to determine the pooled prevalence of CIm among adults with RRMS and investigate moderators of prevalence rates. Following prospective registration (PROSPERO; CRD42021281815), electronic databases (Embase, Scopus, Medline, and PsycINFO) were searched from inception until March 2023. Eligible studies reported the prevalence of CIm among adults with RRMS, as determined through standardized neuropsychological testing and defined as evidence of reduced performance across at least two cognitive domains (e.g., processing speed, attention) relative to normative samples, healthy controls, or premorbid estimates. The electronic database search yielded 8695 unique records, of which 50 met selection criteria. The pooled prevalence of cognitive impairment was 32.5% (95% confidence interval 29.3-36.0%) across 5859 participants. Mean disease duration and age were significant predictors of cognitive impairment prevalence, with samples with longer disease durations and older age reporting higher prevalence rates. Studies which administered more extensive test batteries also reported significantly higher cognitive impairment prevalence. Approximately one third of adults with RRMS experience clinical levels of CIm. This finding supports the use of routine cognitive testing to enable early detection of CIm, and to identify individuals who may benefit from additional cognitive and functional support during treatment planning.
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Affiliation(s)
- Wendy Wu
- The School of Psychological Sciences, Australian Hearing Hub, Macquarie University, North Ryde, Sydney, NSW, 2109, Australia.
| | - Heather Francis
- The School of Psychological Sciences, Australian Hearing Hub, Macquarie University, North Ryde, Sydney, NSW, 2109, Australia
- Neurology Department, Royal North Shore Hospital, St. Leonards, NSW, Australia
| | - Abbie Lucien
- The School of Psychological Sciences, Australian Hearing Hub, Macquarie University, North Ryde, Sydney, NSW, 2109, Australia
| | - Tyler-Ann Wheeler
- The School of Psychological Sciences, Australian Hearing Hub, Macquarie University, North Ryde, Sydney, NSW, 2109, Australia
| | - Milena Gandy
- The School of Psychological Sciences, Australian Hearing Hub, Macquarie University, North Ryde, Sydney, NSW, 2109, Australia
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Pérez-Miralles FC, Prefasi D, García-Merino A, Ara JR, Izquierdo G, Meca-Lallana V, Gascón-Giménez F, Martínez-Ginés ML, Ramió-Torrentà L, Costa-Frossard L, Fernández Ó, Moreno-García S, Maurino J, Carreres-Polo J, Casanova B. Brain region volumes and their relationship with disability progression and cognitive function in primary progressive multiple sclerosis. Brain Behav 2021; 11:e02044. [PMID: 33486890 PMCID: PMC8035443 DOI: 10.1002/brb3.2044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 12/04/2020] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND AND PURPOSE Evidence on regional changes resulting from neurodegenerative processes underlying primary progressive multiple sclerosis (PPMS) is still limited. We assessed brain region volumes and their relationship with disability progression and cognitive function in PPMS patients. METHODS This was an MRI analysis of 43 patients from the prospective Understanding Primary Progressive Multiple Sclerosis (UPPMS) cohort study. MRI scans were performed within 3 months before enrollment and at month 12. RESULTS Gray matter volume of declive and white matter volumes adjacent to left straight gyrus, right calcarine sulcus, and right inferior occipital gyrus significantly decreased from baseline to month 12. Baseline white matter volumes adjacent to right amygdala and left cuneus significantly differed between patients with and without disability progression, as well as baseline gray matter volumes of left cuneus, right parahippocampal gyrus, right insula, left superior frontal gyrus, declive, right inferior temporal gyrus, right superior temporal gyrus (pole), and right calcarine sulcus. Baseline gray matter volumes of right cuneus and right superior temporal gyrus positively correlated with 12-month Selective Reminding Test and Word List Generation performance, respectively. Gray matter changes in right superior semilunar lobe and white matter adjacent to left declive and right cerebellar tonsil also positively correlated with Word List Generation scores, while white matter change in left inferior semilunar lobe positively correlated with Symbol Digit Modalities Test performance after 12 months. CONCLUSIONS White and gray matter volumes of specific brain regions could predict disability progression and cognitive performance of PPMS patients after one year.
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Affiliation(s)
| | | | - Antonio García-Merino
- Department of Neurology, Hospital Universitario Puerta de Hierro, Majadahonda, Spain
| | - José Ramón Ara
- Department of Neurology, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - Guillermo Izquierdo
- Department of Neurology, Hospital Universitario Virgen Macarena, Seville, Spain
| | | | | | | | - Lluis Ramió-Torrentà
- Girona Neuroimmunology and Multiple Sclerosis Unit, Department of Neurology, Hospital Universitari Josep Trueta and Hospital Santa Caterina, IDIBGI, Department of Medical Sciences, Faculty of Medicine, University of Girona, Girona, Spain
| | | | - Óscar Fernández
- Department of Neurology, Hospital Regional Universitario Carlos Haya, Málaga, Spain
| | - Sara Moreno-García
- Department of Neurology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Jorge Maurino
- Department of Medical, Roche Farma S.A, Madrid, Spain
| | - Joan Carreres-Polo
- Department of Radiology, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Bonaventura Casanova
- Neuroimmunology Unit, Department of Neurology, Hospital Universitari i Politècnic La Fe, Valencia, Spain
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Golan D, Doniger GM, Srinivasan J, Sima DM, Zarif M, Bumstead B, Buhse M, Van Hecke W, Wilken J, Gudesblatt M. The association between MRI brain volumes and computerized cognitive scores of people with multiple sclerosis. Brain Cogn 2020; 145:105614. [PMID: 32927305 DOI: 10.1016/j.bandc.2020.105614] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 08/19/2020] [Accepted: 08/25/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Computerized cognitive assessment facilitates the incorporation of multi-domain cognitive monitoring into routine clinical care. The predictive validity of computerized cognitive assessment among people with multiple sclerosis (PwMS) has scarcely been investigated. OBJECTIVE To explore the associations between brain volumes and cognitive scores from a computerized cognitive assessment battery (CAB, NeuroTrax) among PwMS. METHODS PwMS were evaluated with the CAB and underwent brain MRI within 40 days. Cognitive assessment yielded age- and education-adjusted scores in 9 cognitive domains: memory, executive function, attention, information processing speed, visual spatial, verbal function, motor skills, problem solving, and working memory. The global cognitive score (GCS) is the average of all domain scores. MRI brain and lesion volumes were assessed with icobrain ms, a fully automated tissue and lesion segmentation and quantification software. RESULTS 91 PwMS were included [Age: 52.1 ± 11.7 years, 64 (70%) female, EDSS: 3.4 ± 2.0, 79 (87%) with a relapsing remitting course]. Significant correlations were found between the GCS and whole brain, white matter, grey matter, thalamic, lateral ventricles, hippocampal and lesion volumes (Correlation coefficients: 0.46, 0.40, 0.25, 0.42, -0.36, 0.21, -0.3, respectively). Regression analysis revealed that lateral ventricles and thalamic volumes were the most consistent predictors of all cognitive domain scores. CONCLUSION Computerized cognitive scores were significantly associated with quantified MRI. These findings support the predictive validity of multi-domain computerized cognitive assessment for people with multiple sclerosis.
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Affiliation(s)
- Daniel Golan
- Department of Neurology & Multiple Sclerosis Center, Lady Davis Carmel Medical Center, Haifa, Israel; Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
| | - Glen M Doniger
- Department of Clinical Research, NeuroTrax Corporation, Modiin, Israel
| | | | - Diana M Sima
- Research and Development Department, icometrix, Leuven, Belgium
| | - Myassar Zarif
- South Shore Neurologic Associates, Patchogue, NY, USA
| | | | | | - Wim Van Hecke
- Research and Development Department, icometrix, Leuven, Belgium
| | - Jeffrey Wilken
- Washington Neuropsychology Research Group, Fairfax, VA, USA; Department of Neurology, Georgetown University, Washington DC, USA
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Matias-Guiu JA, Cortés-Martínez A, Montero P, Pytel V, Moreno-Ramos T, Jorquera M, Yus M, Arrazola J, Matías-Guiu J. Structural MRI correlates of PASAT performance in multiple sclerosis. BMC Neurol 2018; 18:214. [PMID: 30572821 PMCID: PMC6300910 DOI: 10.1186/s12883-018-1223-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Accepted: 12/10/2018] [Indexed: 12/05/2022] Open
Abstract
Background The Paced Auditory Serial Addition Test (PASAT) is a useful cognitive test in patients with multiple sclerosis (MS), assessing sustained attention and information processing speed. However, the neural underpinnings of performance in the test are controversial. We aimed to study the neural basis of PASAT performance by using structural magnetic resonance imaging (MRI) in a series of 242 patients with MS. Methods PASAT (3-s) was administered together with a comprehensive neuropsychological battery. Global brain volumes and total T2-weighted lesion volumes were estimated. Voxel-based morphometry and lesion symptom mapping analyses were performed. Results Mean PASAT score was 42.98 ± 10.44; results indicated impairment in 75 cases (31.0%). PASAT score was correlated with several clusters involving the following regions: bilateral precuneus and posterior cingulate, bilateral caudate and putamen, and bilateral cerebellum. Voxel-based lesion symptom mapping showed no significant clusters. Region of interest–based analysis restricted to white matter regions revealed a correlation with the left cingulum, corpus callosum, bilateral corticospinal tracts, and right arcuate fasciculus. Correlations between PASAT scores and global volumes were weak. Conclusion PASAT score was associated with regional volumes of the posterior cingulate/precuneus and several subcortical structures, specifically the caudate, putamen, and cerebellum. This emphasises the role of both cortical and subcortical structures in cognitive functioning and information processing speed in patients with MS. Electronic supplementary material The online version of this article (10.1186/s12883-018-1223-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jordi A Matias-Guiu
- Department of Neurology, San Carlos Health Research Institute (IdISSC), Universidad Complutense de Madrid, C/ Profesor Martín Lagos s/n, 28040, Madrid, Spain.
| | - Ana Cortés-Martínez
- Department of Neurology, San Carlos Health Research Institute (IdISSC), Universidad Complutense de Madrid, C/ Profesor Martín Lagos s/n, 28040, Madrid, Spain
| | - Paloma Montero
- Department of Neurology, San Carlos Health Research Institute (IdISSC), Universidad Complutense de Madrid, C/ Profesor Martín Lagos s/n, 28040, Madrid, Spain
| | - Vanesa Pytel
- Department of Neurology, San Carlos Health Research Institute (IdISSC), Universidad Complutense de Madrid, C/ Profesor Martín Lagos s/n, 28040, Madrid, Spain
| | - Teresa Moreno-Ramos
- Department of Neurology, San Carlos Health Research Institute (IdISSC), Universidad Complutense de Madrid, C/ Profesor Martín Lagos s/n, 28040, Madrid, Spain
| | - Manuela Jorquera
- Department of Radiology, IdISSC, Universidad Complutense de Madrid, Madrid, Spain
| | - Miguel Yus
- Department of Radiology, IdISSC, Universidad Complutense de Madrid, Madrid, Spain
| | - Juan Arrazola
- Department of Radiology, IdISSC, Universidad Complutense de Madrid, Madrid, Spain
| | - Jorge Matías-Guiu
- Department of Neurology, San Carlos Health Research Institute (IdISSC), Universidad Complutense de Madrid, C/ Profesor Martín Lagos s/n, 28040, Madrid, Spain
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Juźwik CA, Drake S, Lécuyer MA, Johnson RM, Morquette B, Zhang Y, Charabati M, Sagan SM, Bar-Or A, Prat A, Fournier AE. Neuronal microRNA regulation in Experimental Autoimmune Encephalomyelitis. Sci Rep 2018; 8:13437. [PMID: 30194392 PMCID: PMC6128870 DOI: 10.1038/s41598-018-31542-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Accepted: 08/21/2018] [Indexed: 01/02/2023] Open
Abstract
Multiple sclerosis (MS) is an autoimmune, neurodegenerative disease but the molecular mechanisms underlying neurodegenerative aspects of the disease are poorly understood. microRNAs (miRNAs) are powerful regulators of gene expression that regulate numerous mRNAs simultaneously and can thus regulate programs of gene expression. Here, we describe miRNA expression in neurons captured from mice subjected to experimental autoimmune encephalomyelitis (EAE), a model of central nervous system (CNS) inflammation. Lumbar motor neurons and retinal neurons were laser captured from EAE mice and miRNA expression was assessed by next-generation sequencing and validated by qPCR. We describe 14 miRNAs that are differentially regulated in both neuronal subtypes and determine putative mRNA targets though in silico analysis. Several upregulated neuronal miRNAs are predicted to target pathways that could mediate repair and regeneration during EAE. This work identifies miRNAs that are affected by inflammation and suggests novel candidates that may be targeted to improve neuroprotection in the context of pathological inflammation.
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Affiliation(s)
- Camille A Juźwik
- McGill University, Montréal Neurological Institute, Montréal, QC, H3A 2B4, Canada
| | - Sienna Drake
- McGill University, Montréal Neurological Institute, Montréal, QC, H3A 2B4, Canada
| | - Marc-André Lécuyer
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Université de Montréal, Montréal, QC, H2X 0A9, Canada
| | - Radia Marie Johnson
- McGill University, Goodman Cancer Research Centre, Montréal, H3A 1A3, Canada
| | - Barbara Morquette
- McGill University, Montréal Neurological Institute, Montréal, QC, H3A 2B4, Canada
| | - Yang Zhang
- McGill University, Montréal Neurological Institute, Montréal, QC, H3A 2B4, Canada
| | - Marc Charabati
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Université de Montréal, Montréal, QC, H2X 0A9, Canada
| | - Selena M Sagan
- McGill University, Departments of Microbiology & Immunology and Biochemistry, Montréal, QC, H3G 0B1, Canada
| | - Amit Bar-Or
- McGill University, Montréal Neurological Institute, Montréal, QC, H3A 2B4, Canada
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Alexandre Prat
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Université de Montréal, Montréal, QC, H2X 0A9, Canada
| | - Alyson E Fournier
- McGill University, Montréal Neurological Institute, Montréal, QC, H3A 2B4, Canada.
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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: 101] [Impact Index Per Article: 14.4] [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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Artemiadis A, Anagnostouli M, Zalonis I, Chairopoulos K, Triantafyllou N. Structural MRI correlates of cognitive function in multiple sclerosis. Mult Scler Relat Disord 2018; 21:1-8. [PMID: 29438835 DOI: 10.1016/j.msard.2018.02.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 02/03/2018] [Indexed: 01/26/2023]
Abstract
BACKGROUND Cognitive impairment (CI) has been associated with numerous magnetic resonance imaging (MRI) indices in multiple sclerosis (MS) patients. In this study we investigated the association of a large set of 2D and 3D MRI markers with cognitive function in MS. METHODS A sample of 61 RRMS patients (mean age 41.8 ± 10.6 years old, 44 women, mean disease duration 137.9 ± 83.9 months) along with 51 age and gender matched healthy controls was used in this cross-sectional study. Neuropsychological and other tests, along with a large set of 2D/3D MRI evaluations were made. RESULTS 44.3% of patients had CI. CI patients had more disability, physical fatigue than non-CI patients and more psychological distress than non-CI patients and HCs. Also, CI patients had significantly larger third ventricle width and volume, smaller coprus callosum index and larger lesion volume than non-CI patients. These MRI markers also significantly predicted cognitive scores after adjusting for age and education, explaining about 30.6% of the variance of the total cognitive score. CONCLUSIONS Selected linear and volumetric MRI indices predict cognitive function in MS. Future studies should expand these results by exploring longitudinal changes and producing normative data.
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Affiliation(s)
- Artemios Artemiadis
- 1st Department of Neurology, Aeginition Hospital, Faculty of Medicine, National Kapodistrian University of Athens, Vas. Sofias Ave. 72-74, GR-11528 Athens, Greece; Department of Neurology, Army Share Fund Hospital (NIMTS), Monis Petraki 10-12, GR-11521 Athens, Greece.
| | - Maria Anagnostouli
- 1st Department of Neurology, Aeginition Hospital, Faculty of Medicine, National Kapodistrian University of Athens, Vas. Sofias Ave. 72-74, GR-11528 Athens, Greece
| | - Ioannis Zalonis
- 1st Department of Neurology, Aeginition Hospital, Faculty of Medicine, National Kapodistrian University of Athens, Vas. Sofias Ave. 72-74, GR-11528 Athens, Greece
| | - Konstantinos Chairopoulos
- Department of Neurology, Army Share Fund Hospital (NIMTS), Monis Petraki 10-12, GR-11521 Athens, Greece
| | - Nikos Triantafyllou
- 1st Department of Neurology, Aeginition Hospital, Faculty of Medicine, National Kapodistrian University of Athens, Vas. Sofias Ave. 72-74, GR-11528 Athens, Greece
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Pitteri M, Magliozzi R, Bajrami A, Camera V, Calabrese M. Potential neuroprotective effect of Fingolimod in multiple sclerosis and its association with clinical variables. Expert Opin Pharmacother 2018; 19:387-395. [PMID: 29397790 DOI: 10.1080/14656566.2018.1434143] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Multiple sclerosis (MS) is a chronic inflammatory, demyelinating disease of the central nervous system affecting both white matter and grey matter in the earliest phases of its course. The crucial role of neurodegeneration in disability progression in MS, regardless of white matter damage, has been confirmed by several imaging and neuropathological studies. Fingolimod is an effective immunomodulator of the sphingosine 1-phosphate receptor, approved in relapsing remitting MS and able to cross the blood-brain barrier and to slow disability progression and brain volume loss. However, it remains unclear whether this neuroprotective action is due to a peripheral anti-inflammatory effect and/or to a direct effect on neuronal cells. AREAS COVERED In this review, the authors summarize the published preclinical and clinical studies on the effect of Fingolimod in limiting the focal and diffuse grey matter damage in MS. EXPERT OPINION Fingolimod might have a significant neuroprotective effect on relapsing remitting MS based on its modulatory effect on oligodendroglial cells and astrocytes, and on its direct effect on cortical neurons. Future clinical studies including measures of grey matter damage are required to confirm in vivo such neuroprotective effect.
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Affiliation(s)
- Marco Pitteri
- a Neurology Section, Department of Neurosciences, Biomedicine and Movement Sciences , University of Verona , Verona , Italy
| | - Roberta Magliozzi
- a Neurology Section, Department of Neurosciences, Biomedicine and Movement Sciences , University of Verona , Verona , Italy.,b Division of Brain Sciences, Imperial College Faculty of Medicine , Hammersmith Hospital , London , UK
| | - Albulena Bajrami
- a Neurology Section, Department of Neurosciences, Biomedicine and Movement Sciences , University of Verona , Verona , Italy
| | - Valentina Camera
- c Department of Biomedical, Metabolic and Neurosciences , University of Modena and Reggio Emilia , Modena , Italy
| | - Massimiliano Calabrese
- a Neurology Section, Department of Neurosciences, Biomedicine and Movement Sciences , University of Verona , Verona , Italy
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Schmidt SL, Santos da Silva M, Schmidt JJ, Carvalho ALN, Vasconcelos CCF, Paes RA, Boechat YE, Neder R, Alvarenga RP. Neuropsychiatric assessments in patients with multiple sclerosis in early phases and with low disability. Neuropsychiatr Dis Treat 2018; 14:1665-1670. [PMID: 29950848 PMCID: PMC6018925 DOI: 10.2147/ndt.s163480] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND In the early phases of multiple sclerosis (MS), patients exhibit slight neuropsychiatric deficits that can only be detected using reliable tools. AIM The present investigation aimed to examine neuropsychological performance in 35 patients with incipient MS. PATIENTS AND METHODS For the MS group, the inclusion criteria included time of disease <3 years and low disability. The neuropsychological battery consisted of Rey Auditory Learning Test, Controlled Oral Word Association Test, Hooper Visual Organization Test, and Symbol Digit Modalities Test (SDMT). RESULTS After correction for the educational level, no significant effect of MS on performance was found for all the tests except for the number of errors of the SDMT (NE-SDMT). Higher levels of education were associated with better performances in all tests, except for the NE-SDMT. MS patients made more errors than the controls. CONCLUSION The effect on the NE-SDMT may reflect difficulties in the ability to inhibit inadequate responses. Patients may exhibit impulsive control disorders in incipient MS, independent of their educational level.
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Affiliation(s)
- Sergio L Schmidt
- Department of Neurophysiology, State University of Rio de Janeiro, RJ, Brazil.,Neurology Department, Federal University of the State of Rio de Janeiro, RJ, Brazil
| | | | - Juliana J Schmidt
- Neurology Department, Federal University of the State of Rio de Janeiro, RJ, Brazil
| | | | | | - Renata Alves Paes
- Neurology Department, Federal University of the State of Rio de Janeiro, RJ, Brazil
| | - Yolanda Em Boechat
- Department of Internal Medicine, Fluminense Federal University, Niteroi, Brazil
| | - Rafael Neder
- Neurology Department, Federal University of the State of Rio de Janeiro, RJ, Brazil
| | - Regina P Alvarenga
- Neurology Department, Federal University of the State of Rio de Janeiro, RJ, Brazil
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12
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Petracca M, Sumowski J, Fabian M, Miller A, Lublin F, Inglese M. Looking into cognitive impairment in primary-progressive multiple sclerosis. Eur J Neurol 2017; 25:192-195. [PMID: 29053884 DOI: 10.1111/ene.13489] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Accepted: 10/16/2017] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND PURPOSE Cognitive impairment in primary-progressive multiple sclerosis (PP-MS) is correlated with global brain atrophy. Unfortunately, brain volume computation requires processing resources that are not widely available in clinical practice. Therefore, we decided to test the predictive role of retinal atrophy metrics on cognitive decline, applying them as a proxy of gray matter atrophy in PP-MS. METHODS Twenty-five patients with PP-MS completed the Brief International Cognitive Assessment for Multiple Sclerosis and underwent spectral-domain optical coherence tomography (OCT) and 3.0-T magnetic resonance imaging. We tested, through a stepwise logistic regression, whether OCT metrics [retinal nerve fiber layer, ganglion cell + inner plexiform layer (GCIPL) and total macular volume] predicted cognitive impairment and explored the role of gray matter atrophy in mediating these correlations. RESULTS Among OCT metrics, only GCIPL was associated with cognitive impairment (rp = 0.448, P = 0.036) and predictive of objective cognitive impairment (Wald [1] = 4.40, P = 0.036). Controlling for demographics, normalized brain volume and thalamic volume were correlated with GCIPL (rp = 0.427, P = 0.047 and rp = 0.674, P = 0.001, respectively) and cognitive scores (rp = 0.593, P = 0.004 and rp = 0.501, P = 0.017, respectively), with thalamic volume nearly mediating the association between GCIPL and cognition (Sobel z = 1.86, P = 0.063). CONCLUSIONS The GCIPL thickness is a suitable measure of neurodegeneration. In comparison with brain atrophy, GCIPL offers higher histopathological specificity, being a pure correlate of neuronal loss, and may be a non-invasive, easy-to-perform way to quantitatively evaluate and monitor neuronal loss related to cognitive impairment in PP-MS.
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Affiliation(s)
- M Petracca
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Department of Neuroscience, University of Naples 'Federico II', Naples, Italy
| | - J Sumowski
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - M Fabian
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - A Miller
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - F Lublin
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - M Inglese
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Mother-Child Health, University of Genoa, Genoa, Italy
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13
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Distinct cognitive impairments in different disease courses of multiple sclerosis—A systematic review and meta-analysis. Neurosci Biobehav Rev 2017; 83:568-578. [DOI: 10.1016/j.neubiorev.2017.09.005] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Revised: 09/02/2017] [Accepted: 09/04/2017] [Indexed: 12/13/2022]
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14
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Burgetova A, Dusek P, Vaneckova M, Horakova D, Langkammer C, Krasensky J, Sobisek L, Matras P, Masek M, Seidl Z. Thalamic Iron Differentiates Primary-Progressive and Relapsing-Remitting Multiple Sclerosis. AJNR Am J Neuroradiol 2017; 38:1079-1086. [PMID: 28450431 DOI: 10.3174/ajnr.a5166] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Accepted: 01/26/2017] [Indexed: 01/07/2023]
Abstract
BACKGROUND AND PURPOSE Potential differences between primary progressive and relapsing remitting multiple sclerosis are the subject of ongoing controversial discussions. The aim of this work was to determine whether and how primary-progressive and relapsing-remitting multiple sclerosis subtypes differ regarding conventional MR imaging parameters, cerebral iron deposits, and their association with clinical status. MATERIALS AND METHODS We analyzed 24 patients with primary-progressive MS, 80 with relapsing-remitting MS, and 20 healthy controls with 1.5T MR imaging for assessment of the conventional quantitative parameters: T2 lesion load, T1 lesion load, brain parenchymal fraction, and corpus callosum volume. Quantitative susceptibility mapping was performed to estimate iron concentration in the deep gray matter. RESULTS Decreased susceptibility within the thalamus in relapsing-remitting MS compared with primary-progressive MS was the only significant MR imaging difference between these MS subtypes. In the relapsing-remitting MS subgroup, the Expanded Disability Status Scale score was positively associated with conventional parameters reflecting white matter lesions and brain atrophy and with iron in the putamen and caudate nucleus. A positive association with putaminal iron and the Expanded Disability Status Scale score was found in primary-progressive MS. CONCLUSIONS Susceptibility in the thalamus might provide additional support for the differentiation between primary-progressive and relapsing-remitting MS. That the Expanded Disability Status Scale score was associated with conventional MR imaging parameters and iron concentrations in several deep gray matter regions in relapsing-remitting MS, while only a weak association with putaminal iron was observed in primary-progressive MS suggests different driving forces of disability in these MS subtypes.
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Affiliation(s)
- A Burgetova
- From the Departments of Radiology (A.B., M.V., J.K., P.M., M.M., Z.S.)
| | - P Dusek
- Neurology (P.D., D.H.), Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
- Institute of Neuroradiology (P.D.), University Medicine Göttingen, Göttingen, Germany
| | - M Vaneckova
- From the Departments of Radiology (A.B., M.V., J.K., P.M., M.M., Z.S.)
| | - D Horakova
- Neurology (P.D., D.H.), Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - C Langkammer
- Department of Neurology (C.L.), Medical University of Graz, Graz, Austria
| | - J Krasensky
- From the Departments of Radiology (A.B., M.V., J.K., P.M., M.M., Z.S.)
| | - L Sobisek
- Department of Statistics and Probability (L.S.), University of Economics, Prague, Czech Republic
| | - P Matras
- From the Departments of Radiology (A.B., M.V., J.K., P.M., M.M., Z.S.)
| | - M Masek
- From the Departments of Radiology (A.B., M.V., J.K., P.M., M.M., Z.S.)
| | - Z Seidl
- From the Departments of Radiology (A.B., M.V., J.K., P.M., M.M., Z.S.)
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15
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Petracca M, Saiote C, Bender HA, Arias F, Farrell C, Magioncalda P, Martino M, Miller A, Northoff G, Lublin F, Inglese M. Synchronization and variability imbalance underlie cognitive impairment in primary-progressive multiple sclerosis. Sci Rep 2017; 7:46411. [PMID: 28429774 PMCID: PMC5399449 DOI: 10.1038/srep46411] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Accepted: 03/15/2017] [Indexed: 12/03/2022] Open
Abstract
We aimed to investigate functional connectivity and variability across multiple frequency bands in brain networks underlying cognitive deficits in primary-progressive multiple sclerosis (PP-MS) and to explore how they are affected by the presence of cortical lesions (CLs). We analyzed functional connectivity and variability (measured as the standard deviation of BOLD signal amplitude) in resting state networks (RSNs) associated with cognitive deficits in different frequency bands in 25 PP-MS patients (12 M, mean age 50.9 ± 10.5 years) and 20 healthy subjects (9 M, mean age 51.0 ± 9.8 years). We confirmed the presence of a widespread cognitive deterioration in PP-MS patients, with main involvement of visuo-spatial and executive domains. Cognitively impaired patients showed increased variability, reduced synchronicity between networks involved in the control of cognitive macro-domains and hyper-synchronicity limited to the connections between networks functionally more segregated. CL volume was higher in patients with cognitive impairment and was correlated with functional connectivity and variability. We demonstrate, for the first time, that a functional reorganization characterized by hypo-synchronicity of functionally-related/hyper-synchronicity of functionally-segregated large scale networks and an abnormal pattern of neural activity underlie cognitive dysfunction in PP-MS, and that CLs possibly play a role in variability and functional connectivity abnormalities.
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Affiliation(s)
- Maria Petracca
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, 10029, NY, USA
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, Naples, 80131, Italy
| | - Catarina Saiote
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, 10029, NY, USA
| | - Heidi A. Bender
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, 10029, NY, USA
| | - Franchesca Arias
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, 10029, NY, USA
| | - Colleen Farrell
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, 10029, NY, USA
| | - Paola Magioncalda
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Mother-Child health, University of Genoa, Genoa, 16132, Italy
| | - Matteo Martino
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Mother-Child health, University of Genoa, Genoa, 16132, Italy
| | - Aaron Miller
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, 10029, NY, USA
| | - Georg Northoff
- Institute of Mental Health Research, University of Ottawa, Ottawa, K1Z 7K4, Canada
| | - Fred Lublin
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, 10029, NY, USA
| | - Matilde Inglese
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, 10029, NY, USA
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Mother-Child health, University of Genoa, Genoa, 16132, Italy
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, 10029, NY, USA
- Department of Neuroscience, Icahn School of Medicine at Mount Sinai, 10029, NY, USA
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16
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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: 28] [Impact Index Per Article: 3.5] [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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17
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Urban KJ, Riggs L, Wells GD, Keightley M, Chen JK, Ptito A, Fait P, Taha T, Sinopoli KJ. Cortical Thickness Changes and Their Relationship to Dual-Task Performance following Mild Traumatic Brain Injury in Youth. J Neurotrauma 2016; 34:816-823. [PMID: 27629883 DOI: 10.1089/neu.2016.4502] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Mild traumatic brain injury (mTBI) is common in youth, especially in those who participate in sport. Recent investigations from our group have shown that asymptomatic children and adolescents with mTBI continue to exhibit alterations in neural activity and cognitive performance compared with those without a history of mTBI. This is an intriguing finding, given that current return-to-learn and return-to-play protocols rely predominately on subjective symptom reports, which may not be sensitive enough to detect subtle injury-related changes. As a result, youth may be at greater risk for re-injury and long-term consequences if they are cleared for activity while their brains continue to be compromised. It is currently unknown whether mTBI also affects brain microstructure in the developing brain, particularly cortical thickness, and whether such changes are also related to cognitive performance. The present study examined cortical thickness in 13 asymptomatic youth (10-14 years old) who had sustained an mTBI 3-8 months prior to testing compared with 14 age-matched typically developing controls. Cortical thickness was also examined in relation to working memory performance during single and dual task paradigms. The results show that youth who had sustained an mTBI had thinner cortices in the left dorsolateral prefrontal region and right anterior and posterior inferior parietal lobes. Additionally, cortical thinning was associated with slower reaction time during the dual-task condition in the injured youth only. The results also point to a possible relationship between functional and structural alterations as a result of mTBI in youth, and lend evidence for neural changes beyond symptom resolution.
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Affiliation(s)
- Karolina J Urban
- 1 Bloorview Research Institute , Toronto, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada .,2 Department of Rehabilitation Sciences, University of Toronto , Toronto, Ontario, Canada
| | - Lily Riggs
- 1 Bloorview Research Institute , Toronto, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
| | - Greg D Wells
- 3 Department of Kinesiology and Physical Education, University of Toronto , Toronto, Ontario, Canada .,4 Department of Physiology and Experimental Medicine, the Hospital for Sick Children , Toronto, Ontario, Canada
| | - Michelle Keightley
- 1 Bloorview Research Institute , Toronto, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada .,2 Department of Rehabilitation Sciences, University of Toronto , Toronto, Ontario, Canada
| | - Jen-Kai Chen
- 5 McGill University Health Centre and Montreal Neurological Institute , Montreal, Quebec, Canada
| | - Alain Ptito
- 5 McGill University Health Centre and Montreal Neurological Institute , Montreal, Quebec, Canada
| | - Philippe Fait
- 6 Department of Human Kinetic, University of Quebec at Trois-Rivieres (UQTR) , Quebec, Canada .,7 Research Group on Neuromusculoskeletal Dysfunctions (GRAN), University of Quebec at Trois-Rivieres (UQTR) , Quebec, Canada
| | - Tim Taha
- 3 Department of Kinesiology and Physical Education, University of Toronto , Toronto, Ontario, Canada
| | - Katia J Sinopoli
- 8 Department of Psychology, Division of Neurology, the Hospital for Sick Children , Toronto, Ontario, Canada
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18
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Pitteri M, Romualdi C, Magliozzi R, Monaco S, Calabrese M. Cognitive impairment predicts disability progression and cortical thinning in MS: An 8-year study. Mult Scler 2016; 23:848-854. [PMID: 27527906 DOI: 10.1177/1352458516665496] [Citation(s) in RCA: 81] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Multiple sclerosis (MS) is a chronic immune-mediated disease of the central nervous system (CNS). Although cognitive impairment (CI) affects a large proportion of MS patients, only few data are available about its prognostic value associated with advanced magnetic resonance imaging (MRI) metrics. OBJECTIVES We aimed at investigating the relationship between the early CI and the disease progression over 8-year follow-up in MS patients. METHODS We conducted a retrospective 8-year longitudinal study involving 78 patients with relapsing-remitting MS, who completed neuropsychological examination and structural MRI at the time of diagnosis. Each patient was clinically evaluated every 6 months, and cortical thickness was quantified at baseline and at the end of the follow-up. Patients were classified as having normal cognition and mild or severe CI. RESULTS The results show that CI at the time of diagnosis is a good predictor of conversion to definite MS ( p < 0.001), disability progression ( p < 0.001), as well as of transition to secondary progressive phase ( p < 0.001) and of cortical thinning ( p < 0.001). CONCLUSION We confirmed and extended the evidence that early CI might be helpful in the identification of MS patients at high risk of disability progression and poor clinical outcome and should be considered as a marker of most aggressive pathology.
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Affiliation(s)
- Marco Pitteri
- Neurology B, Department of Neurosciences, Biomedicine and Movement, University of Verona, Verona, Italy
| | | | - Roberta Magliozzi
- Neurology B, Department of Neurosciences, Biomedicine and Movement, University of Verona, Verona, Italy/Division of Brain Sciences, Imperial College Faculty of Medicine, Hammersmith Hospital, London, UK
| | - Salvatore Monaco
- Neurology B, Department of Neurosciences, Biomedicine and Movement, University of Verona, Verona, Italy
| | - Massimiliano Calabrese
- Neurology B, Department of Neurosciences, Biomedicine and Movement, University of Verona, Policlinico "G.B. Rossi" Borgo Roma, Piazzale L.A. Scuro, 10, 37134 Verona, Italy
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