1
|
Ben-Zacharia AB, Janal MN, Brody AA, Wolinsky J, Lublin F, Cutter G. The Effect of Body Mass Index on Brain Volume and Cognitive Function in Relapsing-Remitting Multiple sclerosis: A CombiRx Secondary Analysis. J Cent Nerv Syst Dis 2021; 13:11795735211042173. [PMID: 34759712 PMCID: PMC8573693 DOI: 10.1177/11795735211042173] [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: 02/04/2021] [Accepted: 08/07/2021] [Indexed: 11/22/2022] Open
Abstract
Background Multiple sclerosis (MS) is an autoimmune disease leading to physical, emotional and cognitive disability. High body mass index (BMI) may impact cognitive function and brain volume in MS. Yet, there is paucity of evidence addressing the impact of BMI on cognitive function and brain volume in MS. Objectives The purpose of this study was to examine the effects of BMI on normal appearing brain volume and cognitive function in patients with relapsing–remitting MS. Methods A secondary data analysis of the NIH CombiRx study was conducted. Multivariate regression and mixed model analyses were executed to analyze the effect of BMI on brain volume and cognitive function. Results The mean baseline age of the 768 participants was 38.2(SD = 9.4) years. 73% were female and 88.8% were Caucasian. The mean BMI was 28.8 kg/m2(SD = 6.7). The multivariate regression and mixed model analyses failed to show a clinical effect of BMI on brain volume and cognitive function. Conclusion BMI did not show an effect on cognitive function and brain volume among MS patients. Although there is increased interest in the effects of modifiable factors on the course of MS, the effects of BMI on brain volume and cognitive function are debatable and warrant further research. ClinicalTrials.gov NCT00211887
Collapse
Affiliation(s)
- Aliza Bitton Ben-Zacharia
- Mount Sinai Hospital, New York, NY, USA.,Bellevue School of Nursing, Hunter College, New York, NY, USA
| | - Malvin N Janal
- Department of Epidemiology and Health Promotion, NYU College of Dentistry, New York, NY, USA
| | | | - Jerry Wolinsky
- McGovern Medical School, University of Texas, Huston, TX, USA
| | - Fred Lublin
- Department of Medicine, Mount Sinai Icahn School of Medicine, New York, NY, USA
| | - Gary Cutter
- School of Public Health, UAB, Birmingham, AL, USA
| |
Collapse
|
2
|
Kouvatsou Z, Masoura E, Kiosseoglou G, Kimiskidis VK. Evaluating the relationship between working memory and information processing speed in multiple sclerosis. APPLIED NEUROPSYCHOLOGY-ADULT 2020; 29:695-702. [PMID: 32813544 DOI: 10.1080/23279095.2020.1804911] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The aim of the present study was to evaluate the effect of information processing speed on the functioning of specific working memory components, i.e. phonological loop, visuospatial sketchpad, central executive and episodic buffer. Cognitive tasks that assess working memory ("word lists recall" for the phonological loop, "block recall" for the spatial component of visuospatial sketchpad, "listening recall" for the central executive and "immediate story recall" for the episodic buffer) and information processing speed (symbol digit modalities test- oral form) were administered to 38 patients with multiple sclerosis. Results showed that the central executive and episodic buffer components were significantly related to information processing speed. However, when age was included in the regression model, information processing speed significantly predicted only the episodic buffer scores. Further research on the relationship between the episodic buffer and information processing speed is recommended.
Collapse
Affiliation(s)
- Zoe Kouvatsou
- School of Psychology, Department of Experimental Cognitive Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Elvira Masoura
- School of Psychology, Department of Experimental Cognitive Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Grigoris Kiosseoglou
- School of Psychology, Department of Experimental Cognitive Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Vasilios K Kimiskidis
- Laboratory of Clinical Neurophysiology, AHEPA Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| |
Collapse
|
3
|
Kouvatsou Z, Masoura E, Kiosseoglou G, Kimiskidis VK. Working memory profiles of patients with multiple sclerosis: Where does the impairment lie? J Clin Exp Neuropsychol 2019; 41:832-844. [PMID: 31204607 DOI: 10.1080/13803395.2019.1626805] [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] [Indexed: 10/26/2022]
Abstract
Introduction: Previous studies have mostly provided general estimations regarding Working Memory impairment in patients with Multiple Sclerosis. The aim of the present study was to investigate the relative degree of impairment in the four Working Memory components in Multiple Sclerosis. Method: Thirty-eight patients diagnosed with MS and 27 matched controls were assessed using 12 different cognitive tasks of the four components, i.e. phonological loop, visuospatial sketchpad, central executive and episodic buffer. More precisely, Greek translated and adapted versions of the following tasks were administered: Digit recall, Word recall, Non-word recall, Block recall, Mazes recall, Visual Patterns recall, Backward Digit recall, Backward Block recall, Listening recall, Logical Memory I-Immediate Story recall and Greek Verbal Learning Test, which is based on the California Verbal Learning Test. Results: The phonological loop, the central executive and the spatial subcomponent of the visuospatial sketchpad were found to be equally disrupted in MS patients. The episodic buffer was found to be more heavily affected. On the other hand, the visual subcomponent of the visuospatial sketchpad proved to be preserved. Conclusions: WM subcomponents are differentially affected in patients with MS. This novel finding is discussed within the framework of existing knowledge regarding WM impairment in MS.
Collapse
Affiliation(s)
- Zoe Kouvatsou
- a School of Psychology, Department of Experimental Cognitive Psychology, Aristotle University of Thessaloniki , Thessaloniki , Greece
| | - Elvira Masoura
- a School of Psychology, Department of Experimental Cognitive Psychology, Aristotle University of Thessaloniki , Thessaloniki , Greece
| | - Grigoris Kiosseoglou
- a School of Psychology, Department of Experimental Cognitive Psychology, Aristotle University of Thessaloniki , Thessaloniki , Greece
| | - Vasilios K Kimiskidis
- b Laboratory of Clinical Neurophysiology, AHEPA Hospital, Aristotle University of Thessaloniki , Thessaloniki , Greece
| |
Collapse
|
4
|
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.
Collapse
|
5
|
Luerding R, Gebel S, Gebel EM, Schwab-Malek S, Weissert R. Influence of Formal Education on Cognitive Reserve in Patients with Multiple Sclerosis. Front Neurol 2016; 7:46. [PMID: 27065941 PMCID: PMC4809897 DOI: 10.3389/fneur.2016.00046] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2015] [Accepted: 03/14/2016] [Indexed: 11/13/2022] Open
Abstract
The concept of cognitive reserve (CR) and its influence on cognitive impairment has attracted increasing interest. One hundred twenty-eight patients with multiple sclerosis (MS) from Southern Germany were evaluated during the years 2000 to 2012. Twenty-seven neuropsychological (NP) tests were applied regarding basic cognitive functions, attention, executive functions, visual perception and construction, memory and learning, problem solving, and language. By this retrospective approach, a comprehensive NP profile of the investigated individuals was established. An effect of timespan of formal education on CR was observed. Enrichment by reading, physical activities, and challenging vocational practices had more profound effects in patients who had undergone a shorter educational period compared to a longer educational period. In summary, our study demonstrates that the advantage of longer formal education periods, compared to shorter formal education periods, can be counterbalanced by high frequencies of reading, physical activities, and challenging vocational practices in patients with MS.
Collapse
Affiliation(s)
- Ralf Luerding
- Department of Neurology, University of Regensburg , Regensburg , Germany
| | - Sophie Gebel
- Department of Neurology, University of Regensburg , Regensburg , Germany
| | - Eva-Maria Gebel
- Department of Neurology, University of Regensburg , Regensburg , Germany
| | | | - Robert Weissert
- Department of Neurology, University of Regensburg , Regensburg , Germany
| |
Collapse
|
6
|
Hojjat SP, Cantrell CG, Carroll TJ, Vitorino R, Feinstein A, Zhang L, Symons SP, Morrow SA, Lee L, O'Connor P, Aviv RI. Perfusion reduction in the absence of structural differences in cognitively impaired versus unimpaired RRMS patients. Mult Scler 2016; 22:1685-1694. [PMID: 26846987 DOI: 10.1177/1352458516628656] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Accepted: 12/31/2015] [Indexed: 01/15/2023]
Abstract
BACKGROUND Cognitive impairment affects 40%-68% of relapsing-remitting multiple sclerosis (RRMS) patients. Gray matter (GM) demyelination is complicit in cognitive impairment, yet cortical lesions are challenging to image clinically. We wanted to determine whether cortical cerebral blood flow (CBF), cerebral blood volume (CBV), and mean transit time (MTT) differences exist between cognitively impaired (CI) and unimpaired (NI) RRMS. METHODS Prospective study of healthy controls (n = 19), CI (n = 20), and NI (n = 19) undergoing magnetic resonance imaging (MRI) and cognitive testing <1 week apart. White matter (WM) T2 hyperintense lesions and T1 black holes were traced. General linear regression assessed the relationship between lobar WM volume and cortical and WM CBF, CBV, and MTT. Relationship between global and lobar cortical CBF, CBV, and MTT and cognitive impairment was tested using a generalized linear model. Adjusted Bonferroni p < 0.005 was considered significant. RESULTS No significant differences for age, gender, disease duration, and any fractional brain or lesion volume were demonstrated for RRMS subgroups. Expanded Disability Status Scale (EDSS) and Hospital Anxiety and Depression Scale-Depression (HADS-D) were higher in CI. Lobar cortical CBF and CBV were associated with cognitive impairment (p < 0.0001) after controlling for confounders. Cortical CBV accounted for 7.2% of cognitive impairment increasing to 8.7% with cortical CBF (p = 0.06), while WM and cortical CBF accounted for 8.2% of variance (p = 0.04). CONCLUSION Significant cortical CBF and CBV reduction was present in CI compared to NI in the absence of structural differences.
Collapse
Affiliation(s)
- Seyed-Parsa Hojjat
- Department of Medical Imaging, Sunnybrook Health Sciences Centre, Toronto, ON, Canada .,University of Toronto, Toronto, ON, Canada
| | | | - Timothy J Carroll
- Department of Radiology, Northwestern University, Chicago, IL, USA.,Department of Biomedical Engineering, Northwestern University, Chicago, IL, USA.,Department of Medical Imaging, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Rita Vitorino
- Department of Medical Imaging, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Anthony Feinstein
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,University of Toronto, Toronto, ON, Canada
| | - Lying Zhang
- Department of Medical Imaging, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Sean P Symons
- Department of Medical Imaging, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,University of Toronto, Toronto, ON, Canada
| | - Sarah A Morrow
- Department of Clinical Neurological Sciences, Western University, London, ON, Canada
| | - Liesly Lee
- Department of Neurology, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,University of Toronto, Toronto, ON, Canada
| | - Paul O'Connor
- Department of Medical Imaging, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,University of Toronto, Toronto, ON, Canada
| | - Richard I Aviv
- Department of Medical Imaging, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,University of Toronto, Toronto, ON, Canada
| |
Collapse
|
7
|
Pinter D, Sumowski J, DeLuca J, Fazekas F, Pichler A, Khalil M, Langkammer C, Fuchs S, Enzinger C. Higher education moderates the effect of T2 lesion load and third ventricle width on cognition in multiple sclerosis. PLoS One 2014; 9:e87567. [PMID: 24475309 PMCID: PMC3903771 DOI: 10.1371/journal.pone.0087567] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2013] [Accepted: 12/20/2013] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Previous work suggested greater intellectual enrichment might moderate the negative impact of brain atrophy on cognition. This awaits confirmation in independent cohorts including investigation of the role of T2-lesion load (T2-LL), which is another important determinant of cognition in MS. We here thus aimed to test this cognitive reserve hypothesis by investigating whether educational attainment (EA) moderates the negative effects of both brain atrophy and T2-LL on cognitive function in a large sample of MS patients. METHODS 137 patients participated in the study. Cognition was assessed by the "Brief Repeatable Battery of Neuropsychological Tests." T2-LL, normalized brain volume (global volume loss) and third ventricle width (regional volume loss) served as MRI markers. RESULTS Both T2-LL and atrophy predicted worse cognition, with a stronger effect of T2-LL. Higher EA (as assessed by years of education) also predicted better cognition. Interactions showed that the negative effects of T2-LL and regional brain atrophy were moderated by EA. CONCLUSIONS In a cohort with different stages of MS, higher EA attenuated the negative effects of white matter lesion burden and third ventricle width (suggestive of thalamic atrophy) on cognitive performance. Actively enhancing cognitive reserve might thus be a means to reduce or prevent cognitive problems in MS in parallel to disease modifying drugs.
Collapse
Affiliation(s)
- Daniela Pinter
- Department of Neurology, Medical University of Graz, Graz, Austria
| | - James Sumowski
- Neuropsychology & Neuroscience Laboratory, Kessler Foundation Research Center in West Orange, New Jersey, United States of America
| | - John DeLuca
- Department of Physical Medicine and Rehabilitation & Neurology and Neurosciences, Kessler Foundation Research Center in West Orange, New Jersey, United States of America
| | - Franz Fazekas
- Department of Neurology, Medical University of Graz, Graz, Austria
| | | | - Michael Khalil
- Department of Neurology, Medical University of Graz, Graz, Austria
| | | | - Siegrid Fuchs
- Department of Neurology, Medical University of Graz, Graz, Austria
| | - Christian Enzinger
- Department of Neurology, Medical University of Graz, Graz, Austria
- Division of Neuroradiology, Medical University of Graz, Graz, Austria
| |
Collapse
|