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Transdiagnostic hippocampal damage patterns in neuroimmunological disorders. NEUROIMAGE-CLINICAL 2020; 28:102515. [PMID: 33396002 PMCID: PMC7721635 DOI: 10.1016/j.nicl.2020.102515] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 11/14/2020] [Accepted: 11/23/2020] [Indexed: 01/31/2023]
Abstract
Hippocampal damage and associated cognitive deficits are frequently observed in neuroimmunological disorders, but comparative analyses to identify shared hippocampal damage patterns are missing. Here, we adopted a transdiagnostic analytical approach and investigated hippocampal shape deformations and associated cognitive deficits in four neuroimmunological diseases. We studied 120 patients (n = 30 in each group), including patients with multiple sclerosis (MS), neuromyelitis optica spectrum disorder (NMOSD), anti-NMDAR and anti-LGI1 encephalitis. A control group was matched to each patient sample from a pool of 79 healthy participants. We performed an MRI-based vertex-wise hippocampal shape analysis, extracted hippocampal volume estimates and scalar projection values as a measure of surface displacement. Cognitive testing included assessment of verbal memory and semantic fluency performance. Our cross-sectional analyses revealed characteristic patterns of bilateral inward deformations covering up to 32% of the hippocampal surface in MS, anti-NMDAR encephalitis, and anti-LGI1 encephalitis, whereas NMOSD patients showed no deformations compared to controls. Significant inversions were noted mainly on the hippocampal head, were accompanied by volume loss, and correlated with semantic fluency scores and verbal episodic memory in autoimmune encephalitis and MS. A deformation overlap analysis across disorders revealed a convergence zone on the left anterior hippocampus that corresponds to the CA1 subfield. This convergence zone indicates a shared downstream substrate of immune-mediated damage that appears to be particularly vulnerable to neuroinflammatory processes. Our transdiagnostic morphological view sheds light on mutual pathophysiologic pathways of cognitive deficits in neuroimmunological diseases and stimulates further research into the mechanisms of increased susceptibility of the hippocampus to autoimmunity.
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102
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Sjøgård M, Wens V, Van Schependom J, Costers L, D'hooghe M, D'haeseleer M, Woolrich M, Goldman S, Nagels G, De Tiège X. Brain dysconnectivity relates to disability and cognitive impairment in multiple sclerosis. Hum Brain Mapp 2020; 42:626-643. [PMID: 33242237 PMCID: PMC7814767 DOI: 10.1002/hbm.25247] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 09/10/2020] [Accepted: 09/29/2020] [Indexed: 12/27/2022] Open
Abstract
The pathophysiology of cognitive dysfunction in multiple sclerosis (MS) is still unclear. This magnetoencephalography (MEG) study investigates the impact of MS on brain resting-state functional connectivity (rsFC) and its relationship to disability and cognitive impairment. We investigated rsFC based on power envelope correlation within and between different frequency bands, in a large cohort of participants consisting of 99 MS patients and 47 healthy subjects. Correlations were investigated between rsFC and outcomes on disability, disease duration and 7 neuropsychological scores within each group, while stringently correcting for multiple comparisons and possible confounding factors. Specific dysconnections correlating with MS-induced physical disability and disease duration were found within the sensorimotor and language networks, respectively. Global network-level reductions in within- and cross-network rsFC were observed in the default-mode network. Healthy subjects and patients significantly differed in their scores on cognitive fatigue and verbal fluency. Healthy subjects and patients showed different correlation patterns between rsFC and cognitive fatigue or verbal fluency, both of which involved a shift in patients from the posterior default-mode network to the language network. Introducing electrophysiological rsFC in a regression model of verbal fluency and cognitive fatigue in MS patients significantly increased the explained variance compared to a regression limited to structural MRI markers (relative thalamic volume and lesion load). This MEG study demonstrates that MS induces distinct changes in the resting-state functional brain architecture that relate to disability, disease duration and specific cognitive functioning alterations. It highlights the potential value of electrophysiological intrinsic rsFC for monitoring the cognitive impairment in patients with MS.
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Affiliation(s)
- Martin Sjøgård
- Laboratoire de Cartographie fonctionnelle du Cerveau, UNI-ULB Neuroscience Institute, Université libre de Bruxelles (ULB), Brussels, Belgium
| | - Vincent Wens
- Laboratoire de Cartographie fonctionnelle du Cerveau, UNI-ULB Neuroscience Institute, Université libre de Bruxelles (ULB), Brussels, Belgium.,Department of Functional Neuroimaging, Service of Nuclear Medicine, CUB-Hôpital Erasme, Université libre de Bruxelles (ULB), Brussels, Belgium
| | - Jeroen Van Schependom
- Center for Neurosciences, Vrije Universiteit Brussel, Brussels, Belgium.,National MS Center, Belgium
| | - Lars Costers
- Center for Neurosciences, Vrije Universiteit Brussel, Brussels, Belgium
| | - Marie D'hooghe
- Center for Neurosciences, Vrije Universiteit Brussel, Brussels, Belgium.,National MS Center, Belgium
| | - Miguel D'haeseleer
- Center for Neurosciences, Vrije Universiteit Brussel, Brussels, Belgium.,National MS Center, Belgium
| | - Mark Woolrich
- Oxford Centre for Human Brain Activity, Wellcome Centre for Integrative Neuroimaging, Department of Psychiatry, University of Oxford, Oxford, UK
| | - Serge Goldman
- Laboratoire de Cartographie fonctionnelle du Cerveau, UNI-ULB Neuroscience Institute, Université libre de Bruxelles (ULB), Brussels, Belgium.,Department of Functional Neuroimaging, Service of Nuclear Medicine, CUB-Hôpital Erasme, Université libre de Bruxelles (ULB), Brussels, Belgium
| | - Guy Nagels
- Center for Neurosciences, Vrije Universiteit Brussel, Brussels, Belgium.,National MS Center, Belgium.,St Edmund Hall, University of Oxford, Oxford, UK
| | - Xavier De Tiège
- Laboratoire de Cartographie fonctionnelle du Cerveau, UNI-ULB Neuroscience Institute, Université libre de Bruxelles (ULB), Brussels, Belgium.,Department of Functional Neuroimaging, Service of Nuclear Medicine, CUB-Hôpital Erasme, Université libre de Bruxelles (ULB), Brussels, Belgium
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103
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Barros C, Fernandes A. Linking Cognitive Impairment to Neuroinflammation in Multiple Sclerosis using neuroimaging tools. Mult Scler Relat Disord 2020; 47:102622. [PMID: 33227630 DOI: 10.1016/j.msard.2020.102622] [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: 05/15/2020] [Revised: 11/08/2020] [Accepted: 11/09/2020] [Indexed: 12/24/2022]
Abstract
Multiple sclerosis (MS) is a complex chronic immune disease in the central nervous system, causing neurological disability among young and middle-aged adults. Impaired cognition is now emerging as a major clinical symptom being present in more than 50% of MS patients. Recent data support that neuroinflammation mediated by glial cells plays a key part in MS course and, particularly, microglia is responsible for the pruning of synapses possibly impacting on vital neural networks maintenance. However, the knowledge of microglia-mediated mechanisms underlying cognitive impairment in MS is poor and unfortunately, there are no medicines to overcome this "invisible" symptom. Interestingly, the use of powerful diagnostic imaging tools as structural and functional MRI as well as PET brought new insights into some biological mechanisms, but no link between the possibility to use early visible alterations to predict cognitive deficits was clarified yet. In this review, we focus on the interplay between MS-related cognitive structures and neuroinflammation, specifically the presence of microglia and their reactivity. Moreover, we also discuss new imaging tools to assess cognitive impairment and to track microglia activation. Understanding the role of microglia in cognitive impairment and how it can be prevented may be a promising contribution to innovative therapeutic strategies that culminate in the improvement of MS patients' life quality.
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Affiliation(s)
- Catarina Barros
- Neuron-Glia Biology in Health and Disease, Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, Universidade de Lisboa, Portugal
| | - Adelaide Fernandes
- Neuron-Glia Biology in Health and Disease, Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, Universidade de Lisboa, Portugal; Department of Biochemistry and Human Biology, Faculty of Pharmacy, Universidade de Lisboa, Portugal.
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104
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Nocentini U. Can we offer more for cognitive impairment in patients with chronic hepatitis C? ARQUIVOS DE NEURO-PSIQUIATRIA 2020; 78:319-320. [PMID: 32609192 DOI: 10.1590/0004-282x20200055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 05/21/2020] [Indexed: 11/22/2022]
Affiliation(s)
- Ugo Nocentini
- Università di Roma "Tor Vergata", Dipartimento di Scienze Cliniche e Medicina Traslazionale, Roma, Italia.,Fondazione "Santa Lucia" Istituto di Ricovero e Cura a Carattere Scientifico, Roma, Italia
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105
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Lopez-Soley E, Solana E, Martínez-Heras E, Andorra M, Radua J, Prats-Uribe A, Montejo C, Sola-Valls N, Sepulveda M, Pulido-Valdeolivas I, Blanco Y, Martinez-Lapiscina EH, Saiz A, Llufriu S. Impact of Cognitive Reserve and Structural Connectivity on Cognitive Performance in Multiple Sclerosis. Front Neurol 2020; 11:581700. [PMID: 33193039 PMCID: PMC7662554 DOI: 10.3389/fneur.2020.581700] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 09/30/2020] [Indexed: 01/07/2023] Open
Abstract
Background: Cognitive reserve (CR) could attenuate the impact of the brain burden on the cognition in people with multiple sclerosis (PwMS). Objective: To explore the relationship between CR and structural brain connectivity and investigate their role on cognition in PwMS cognitively impaired (PwMS-CI) and cognitively preserved (PwMS-CP). Methods: In this study, 181 PwMS (71% female; 42.9 ± 10.0 years) were evaluated using the Cognitive Reserve Questionnaire (CRQ), Brief Repeatable Battery of Neuropsychological tests, and MRI. Brain lesion and gray matter volumes were quantified, as was the structural network connectivity. Patients were classified as PwMS-CI (z scores = −1.5 SD in at least two tests) or PwMS-CP. Linear and multiple regression analyses were run to evaluate the association of CRQ and structural connectivity with cognition in each group. Hedges's effect size was used to compute the strength of associations. Results: We found a very low association between CRQ scores and connectivity metrics in PwMS-CP, while in PwMS-CI, this relation was low to moderate. The multiple regression model, adjusted for age, gender, mood, lesion volume, and graph metrics (local and global efficiency, and transitivity), indicated that the CRQ (β = 0.26, 95% CI: 0.17–0.35) was associated with cognition (adj R2 = 0.34) in PwMS-CP (55%). In PwMS-CI, CRQ (β = 0.18, 95% CI: 0.07–0.29), age, and network global efficiency were independently associated with cognition (adj R2 = 0.55). The age- and gender-adjusted association between CRQ score and global efficiency on having an impaired cognitive status was −0.338 (OR: 0.71, p = 0.036) and −0.531 (OR: 0.59, p = 0.002), respectively. Conclusions: CR seems to have a marginally significant effect on brain structural connectivity, observed in patients with more severe clinical impairment. It protects PwMS from cognitive decline regardless of their cognitive status, yet once cognitive impairment has set in, brain damage and aging are also influencing cognitive performance.
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Affiliation(s)
- Elisabet Lopez-Soley
- Laboratory of Advanced Imaging in Neuroimmunological Diseases, Center of Neuroimmunology, Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Hospital Clinic Barcelona, Universitat de Barcelona, Barcelona, Spain
| | - Elisabeth Solana
- Laboratory of Advanced Imaging in Neuroimmunological Diseases, Center of Neuroimmunology, Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Hospital Clinic Barcelona, Universitat de Barcelona, Barcelona, Spain
| | - Eloy Martínez-Heras
- Laboratory of Advanced Imaging in Neuroimmunological Diseases, Center of Neuroimmunology, Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Hospital Clinic Barcelona, Universitat de Barcelona, Barcelona, Spain
| | - Magi Andorra
- Laboratory of Advanced Imaging in Neuroimmunological Diseases, Center of Neuroimmunology, Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Hospital Clinic Barcelona, Universitat de Barcelona, Barcelona, Spain
| | - Joaquim Radua
- Imaging of Mood- and Anxiety-Related Disorders (IMARD) Group, Mental Health Research Networking Center (CIBERSAM), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom.,Department of Clinical Neuroscience, Centre for Psychiatric Research and Education, Karolinska Institutet, Solna, Sweden
| | - Albert Prats-Uribe
- Centre for Statistics in Medicine, Botnar Research Centre, Nuffiel Department of Orthopeadics, rheumatology and musculoskeletal sciences (NDORMS), University of Oxford, Oxford, United Kingdom
| | - Carmen Montejo
- Laboratory of Advanced Imaging in Neuroimmunological Diseases, Center of Neuroimmunology, Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Hospital Clinic Barcelona, Universitat de Barcelona, Barcelona, Spain
| | - Nuria Sola-Valls
- Laboratory of Advanced Imaging in Neuroimmunological Diseases, Center of Neuroimmunology, Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Hospital Clinic Barcelona, Universitat de Barcelona, Barcelona, Spain
| | - Maria Sepulveda
- Laboratory of Advanced Imaging in Neuroimmunological Diseases, Center of Neuroimmunology, Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Hospital Clinic Barcelona, Universitat de Barcelona, Barcelona, Spain
| | - Irene Pulido-Valdeolivas
- Laboratory of Advanced Imaging in Neuroimmunological Diseases, Center of Neuroimmunology, Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Hospital Clinic Barcelona, Universitat de Barcelona, Barcelona, Spain
| | - Yolanda Blanco
- Laboratory of Advanced Imaging in Neuroimmunological Diseases, Center of Neuroimmunology, Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Hospital Clinic Barcelona, Universitat de Barcelona, Barcelona, Spain
| | - Elena H Martinez-Lapiscina
- Laboratory of Advanced Imaging in Neuroimmunological Diseases, Center of Neuroimmunology, Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Hospital Clinic Barcelona, Universitat de Barcelona, Barcelona, Spain
| | - Albert Saiz
- Laboratory of Advanced Imaging in Neuroimmunological Diseases, Center of Neuroimmunology, Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Hospital Clinic Barcelona, Universitat de Barcelona, Barcelona, Spain
| | - Sara Llufriu
- Laboratory of Advanced Imaging in Neuroimmunological Diseases, Center of Neuroimmunology, Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Hospital Clinic Barcelona, Universitat de Barcelona, Barcelona, Spain
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106
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Marchese E, Valentini M, Di Sante G, Cesari E, Adinolfi A, Corvino V, Ria F, Sette C, Geloso MC. Alternative splicing of neurexins 1-3 is modulated by neuroinflammation in the prefrontal cortex of a murine model of multiple sclerosis. Exp Neurol 2020; 335:113497. [PMID: 33058888 DOI: 10.1016/j.expneurol.2020.113497] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 09/21/2020] [Accepted: 10/06/2020] [Indexed: 12/23/2022]
Abstract
Mounting evidence points to immune-mediated synaptopathy and impaired plasticity as early pathogenic events underlying cognitive decline (CD) in Multiple sclerosis (MS) and in the experimental autoimmune encephalomyelitis (EAE) mouse model of the disease. However, knowledge of the neurobiology of synaptic dysfunction is still incomplete. Splicing regulation represents a flexible and powerful mechanism involved in dynamic remodeling of the synapse, which allows the expression of synaptic protein variants that dynamically control the specificity of contacts between neurons. The pre-synaptic adhesion molecules neurexins (NRXNs) 1-3 play a relevant role in cognition and are alternatively spliced to yield variants that differentially cluster specific ligands in the postsynaptic compartment and modulate functional properties of the synaptic contact. Notably, mutations in these genes or disruption of their splicing program are associated with neuropsychiatric disorders. Herein, we have investigated how inflammatory changes imposed by EAE impact on alternative splicing of the Nrxn 1-3 mouse genes in the acute phase of disease. Due to its relevance in cognition, we focused on the prefrontal cortex (PFC) of SJL/J mice, in which EAE-induced inflammatory lesions extend to the rostral forebrain. We found that inclusion of the Nrxn 1-3 AS4 exon is significantly increased in the PFC of EAE mice and that splicing changes are correlated with local Il1β-expression levels. This correlation is sustained by the concomitant downregulation of SLM2, the main splicing factor involved in skipping of the AS4 exon, in EAE mice displaying high levels of Il1β- expression. We also observed that Il1β-expression levels correlate with changes in parvalbumin (PV)-positive interneuron connectivity. Moreover, exposure to environmental enrichment (EE), a condition known to stimulate neuronal connectivity and to improve cognitive functions in mice and humans, modified PFC phenotypes of EAE mice with respect to Il1β-, Slm2-expression, Nrxn AS4 splicing and PV-expression, by limiting changes associated with high levels of inflammation. Our results reveal that local inflammation results in early splicing modulation of key synaptic proteins and in remodeling of GABAergic circuitry in the PFC of SJL/J mice. We also suggest EE as a tool to counteract these inflammation-associated events, thus highlighting potential therapeutic targets for limiting the progressive CD occurring in MS.
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Affiliation(s)
- Elisa Marchese
- Department of Neuroscience, Section of Human Anatomy, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy.
| | - Mariagrazia Valentini
- Department of Translational Medicine and Surgery, Section of General Pathology, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy.
| | - Gabriele Di Sante
- Department of Translational Medicine and Surgery, Section of General Pathology, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy; Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 1-8, 00168 Rome, Italy.
| | - Eleonora Cesari
- Department of Neuroscience, Section of Human Anatomy, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy; IRCCS Santa Lucia Foundation, Via del Fosso di Fiorano 65, 00143 Rome, Italy.
| | - Annalisa Adinolfi
- Department of Neuroscience, Section of Human Anatomy, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy.
| | - Valentina Corvino
- Department of Neuroscience, Section of Human Anatomy, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy.
| | - Francesco Ria
- Department of Translational Medicine and Surgery, Section of General Pathology, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy; Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 1-8, 00168 Rome, Italy.
| | - Claudio Sette
- Department of Neuroscience, Section of Human Anatomy, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy.
| | - Maria Concetta Geloso
- Department of Neuroscience, Section of Human Anatomy, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy.
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107
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Veréb D, Tóth E, Bozsik B, Király A, Szabó N, Kincses B, Kocsis K, Faragó P, László V, Bencsik K, Klivényi P, Kincses ZT. Altered brain network function during attention-modulated visual processing in multiple sclerosis. Mult Scler 2020; 27:1341-1349. [PMID: 33016839 DOI: 10.1177/1352458520958360] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Multiple sclerosis may damage cognitive performance in several domains, including attention. Although attention network deficits were described during rest, studies that investigate their function during task performance are scarce. OBJECTIVE To investigate connectivity within and between task-related networks in multiple sclerosis during a visual attention task as a function of cognitive performance. METHODS A total of 23 relapsing-remitting multiple sclerosis (RRMS) patients and 29 healthy controls underwent task-functional magnetic resonance imaging (fMRI) scans using a visual attention paradigm on a 3T scanner. Scans were analysed using tensor-independent component analysis (TICA). Functional connectivity was calculated within and between components. We assessed cognitive function with the Brief International Cognitive Assessment for MS (BICAMS) battery. RESULTS TICA extracted components related to visual processing, attention, executive function and the default-mode network. Subject scores of visual/attention-related and executive components were greater in healthy controls (p < 0.032, p < 0.023). Connectivity between visual/attention-related and default-mode components was higher in patients (p < 0.043), correlating with Brief Visuospatial Memory Test-Revised (BVMT-R) scores (R = -0.48, p < 0.036). Patients showed reduced connectivity between the right intraparietal sulcus (rIPS) and frontal eye field (rFEF), and bilateral frontal eye fields (p < 0.012, p < 0.003). Reduced rIPS-rFEF connectivity came with lower Symbol Digit Modalities Test (SDMT)/BVMT-R scores in patients (R = 0.53, p < 0.02, R = 0.46, p < 0.049). CONCLUSION Attention-related networks show altered connectivity during task performance in RRMS patients, scaling with cognitive disability.
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Affiliation(s)
- Dániel Veréb
- Department of Neurology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - Eszter Tóth
- Department of Neurology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - Bence Bozsik
- Department of Neurology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - András Király
- Department of Neurology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - Nikoletta Szabó
- Department of Neurology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - Bálint Kincses
- Department of Neurology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - Krisztián Kocsis
- Department of Neurology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - Péter Faragó
- Department of Neurology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - Vécsei László
- Department of Neurology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - Krisztina Bencsik
- Department of Neurology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - Péter Klivényi
- Department of Neurology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - Zsigmond Tamás Kincses
- Department of Neurology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary/Neuroimaging Research Group, Department of Radiology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
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108
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Pinto MV, Fernandes A. Microglial Phagocytosis-Rational but Challenging Therapeutic Target in Multiple Sclerosis. Int J Mol Sci 2020; 21:ijms21175960. [PMID: 32825077 PMCID: PMC7504120 DOI: 10.3390/ijms21175960] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 08/12/2020] [Accepted: 08/17/2020] [Indexed: 12/14/2022] Open
Abstract
Multiple sclerosis (MS) is the most common autoimmune and demyelinating disease of the central nervous system (CNS), characterized, in the majority of cases, by initial relapses that later evolve into progressive neurodegeneration, severely impacting patients’ motor and cognitive functions. Despite the availability of immunomodulatory therapies effective to reduce relapse rate and slow disease progression, they all failed to restore CNS myelin that is necessary for MS full recovery. Microglia are the primary inflammatory cells present in MS lesions, therefore strongly contributing to demyelination and lesion extension. Thus, many microglial-based therapeutic strategies have been focused on the suppression of microglial pro-inflammatory phenotype and neurodegenerative state to reduce disease severity. On the other hand, the contribution of myelin phagocytosis advocating the neuroprotective role of microglia in MS has been less explored. Indeed, despite the presence of functional oligodendrocyte precursor cells (OPCs), within lesioned areas, MS plaques fail to remyelinate as a result of the over-accumulation of myelin-toxic debris that must be cleared away by microglia. Dysregulation of this process has been associated with the impaired neuronal recovery and deficient remyelination. In line with this, here we provide a comprehensive review of microglial myelin phagocytosis and its involvement in MS development and repair. Alongside, we discuss the potential of phagocytic-mediated therapeutic approaches and encourage their modulation as a novel and rational approach to ameliorate MS-associated pathology.
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Affiliation(s)
- Maria V. Pinto
- Neuron-Glia Biology in Health and Disease, Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, Universidade de Lisboa, 1649-003 Lisboa, Portugal;
| | - Adelaide Fernandes
- Neuron-Glia Biology in Health and Disease, Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, Universidade de Lisboa, 1649-003 Lisboa, Portugal;
- Department of Biochemistry and Human Biology, Faculty of Pharmacy, Universidade de Lisboa, 1649-003 Lisboa, Portugal
- Correspondence: ; Tel.: +351-217946400
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109
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Tobore TO. Oxidative/Nitroxidative Stress and Multiple Sclerosis. J Mol Neurosci 2020; 71:506-514. [PMID: 32767188 DOI: 10.1007/s12031-020-01672-y] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2019] [Accepted: 07/17/2020] [Indexed: 12/15/2022]
Abstract
Multiple sclerosis (MS) is a multifactorial, central nervous system, immune-mediated disease characterized by inflammation, demyelination, and neurodegeneration. Evidence suggests a steady rise in MS prevalence over the past five decades in the United States and around the world. Even with increased understanding of immunology, the specific etiological trigger of MS remains unknown. Evidence suggests that oxidative/nitroxidative stress is an important contributor to MS etiology, progression, and clinical symptoms. A multifaceted treatment approach aimed at counteracting oxidative/nitroxidative stress including MS disease-modifying medications, Mediterranean style diet, stress-relieving activities, smoking and alcohol cessation, exercise, and peer support programs is the best way to treat the disease.
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110
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Spatial navigation in early multiple sclerosis: a neglected cognitive marker of the disease? J Neurol 2020; 268:77-89. [PMID: 32700011 DOI: 10.1007/s00415-020-10079-z] [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: 04/23/2020] [Revised: 07/06/2020] [Accepted: 07/11/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Cognitive deficits are common in early multiple sclerosis (MS), however, spatial navigation changes and their associations with brain pathology remain poorly understood. OBJECTIVE To characterize the profile of spatial navigation changes in two main navigational strategies, egocentric (self-centred) and allocentric (world-centred), and their associations with demyelinating and neurodegenerative changes in early MS. METHODS Participants with early MS after the first clinical event (n = 51) and age-, gender- and education-matched controls (n = 42) underwent spatial navigation testing in a real-space human analogue of the Morris water maze task, comprehensive neuropsychological assessment, and MRI brain scan with voxel-based morphometry and volumetric analyses. RESULTS The early MS group had lower performance in the egocentric (p = 0.010), allocentric (p = 0.004) and allocentric-delayed (p = 0.038) navigation tasks controlling for age, gender and education. Based on the applied criteria, lower spatial navigation performance was present in 26-29 and 33-41% of the participants with early MS in the egocentric and the allocentric task, respectively. Larger lesion load volume in cortical, subcortical and cerebellar regions (ß ≥ 0.29; p ≤ 0.032) unlike brain atrophy was associated with less accurate allocentric navigation performance. CONCLUSION Lower spatial navigation performance is present in up to 41% of the participants with early MS. Demyelinating lesions in early MS may disrupt neural network forming the basis of allocentric navigation.
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111
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Stampanoni Bassi M, Buttari F, Gilio L, De Paolis N, Fresegna D, Centonze D, Iezzi E. Inflammation and Corticospinal Functioning in Multiple Sclerosis: A TMS Perspective. Front Neurol 2020; 11:566. [PMID: 32733354 PMCID: PMC7358546 DOI: 10.3389/fneur.2020.00566] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 05/19/2020] [Indexed: 12/13/2022] Open
Abstract
Transcranial magnetic stimulation (TMS) has been employed in multiple sclerosis (MS) to assess the integrity of the corticospinal tract and the corpus callosum and to explore some physiological properties of the motor cortex. Specific alterations of TMS measures have been strongly associated to different pathophysiological mechanisms, particularly to demyelination and neuronal loss. Moreover, TMS has contributed to investigate the neurophysiological basis of MS symptoms, particularly those not completely explained by conventional structural damage, such as fatigue. However, variability existing between studies suggests that alternative mechanisms should be involved. Knowledge of MS pathophysiology has been enriched by experimental studies in animal models (i.e., experimental autoimmune encephalomyelitis) demonstrating that inflammation alters synaptic transmission, promoting hyperexcitability and neuronal damage. Accordingly, TMS studies have demonstrated an imbalance between cortical excitation and inhibition in MS. In particular, cerebrospinal fluid concentrations of different proinflammatory and anti-inflammatory molecules have been associated to corticospinal hyperexcitability, highlighting that inflammatory synaptopathy may represent a key pathophysiological mechanism in MS. In this perspective article, we discuss whether corticospinal excitability alterations assessed with TMS in MS patients could be useful to explain the pathophysiological correlates and their relationships with specific MS clinical characteristics and symptoms. Furthermore, we discuss evidence indicating that, in MS patients, inflammatory synaptopathy could be present since the early phases, could specifically characterize relapses, and could progressively increase during the disease course.
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Affiliation(s)
| | - Fabio Buttari
- Unit of Neurology & Neurorehabilitation, IRCCS Neuromed, Pozzilli, Italy
| | - Luana Gilio
- Unit of Neurology & Neurorehabilitation, IRCCS Neuromed, Pozzilli, Italy
| | - Nicla De Paolis
- Unit of Neurology & Neurorehabilitation, IRCCS Neuromed, Pozzilli, Italy
| | - Diego Fresegna
- Laboratory of Synaptic Immunopathology, IRCCS San Raffaele Pisana, Rome, Italy
| | - Diego Centonze
- Unit of Neurology & Neurorehabilitation, IRCCS Neuromed, Pozzilli, Italy.,Laboratory of Synaptic Immunopathology, Department of Systems Medicine, Tor Vergata University, Rome, Italy
| | - Ennio Iezzi
- Unit of Neurology & Neurorehabilitation, IRCCS Neuromed, Pozzilli, Italy
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112
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Bruno A, Dolcetti E, Rizzo FR, Fresegna D, Musella A, Gentile A, De Vito F, Caioli S, Guadalupi L, Bullitta S, Vanni V, Balletta S, Sanna K, Buttari F, Stampanoni Bassi M, Centonze D, Mandolesi G. Inflammation-Associated Synaptic Alterations as Shared Threads in Depression and Multiple Sclerosis. Front Cell Neurosci 2020; 14:169. [PMID: 32655374 PMCID: PMC7324636 DOI: 10.3389/fncel.2020.00169] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 05/19/2020] [Indexed: 12/11/2022] Open
Abstract
In the past years, several theories have been advanced to explain the pathogenesis of Major Depressive Disorder (MDD), a neuropsychiatric disease that causes disability in general population. Several theories have been proposed to define the MDD pathophysiology such as the classic "monoamine-theory" or the "glutamate hypothesis." All these theories have been recently integrated by evidence highlighting inflammation as a pivotal player in developing depressive symptoms. Proinflammatory cytokines have been indeed claimed to contribute to stress-induced mood disturbances and to major depression, indicating a widespread role of classical mediators of inflammation in emotional control. Moreover, during systemic inflammatory diseases, peripherally released cytokines circulate in the blood, reach the brain and cause anxiety, anhedonia, social withdrawal, fatigue, and sleep disturbances. Accordingly, chronic inflammatory disorders, such as the inflammatory autoimmune disease multiple sclerosis (MS), have been associated to higher risk of MDD, in comparison with overall population. Importantly, in both MS patients and in its experimental mouse model, Experimental Autoimmune Encephalomyelitis (EAE), the notion that depressive symptoms are reactive epiphenomenon to the MS pathology has been recently challenged by the evidence of their early manifestation, even before the onset of the disease. Furthermore, in association to such mood disturbance, inflammatory-dependent synaptic dysfunctions in several areas of MS/EAE brain have been observed independently of brain lesions and demyelination. This evidence suggests that a fine interplay between the immune and nervous systems can have a huge impact on several neurological functions, including depressive symptoms, in different pathological conditions. The aim of the present review is to shed light on common traits between MDD and MS, by looking at inflammatory-dependent synaptic alterations associated with depression in both diseases.
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Affiliation(s)
- Antonio Bruno
- Synaptic Immunopathology Lab, Department of Systems Medicine, Tor Vergata University of Rome, Rome, Italy
| | - Ettore Dolcetti
- Synaptic Immunopathology Lab, Department of Systems Medicine, Tor Vergata University of Rome, Rome, Italy
| | - Francesca Romana Rizzo
- Synaptic Immunopathology Lab, Department of Systems Medicine, Tor Vergata University of Rome, Rome, Italy
| | - Diego Fresegna
- Synaptic Immunopathology Lab, IRCCS San Raffaele Pisana, Rome, Italy
| | - Alessandra Musella
- Synaptic Immunopathology Lab, IRCCS San Raffaele Pisana, Rome, Italy
- Department of Human Sciences and Quality of Life Promotion, University of Rome San Raffaele, Rome, Italy
| | | | - Francesca De Vito
- Unit of Neurology, Mediterranean Neurological Institute IRCCS Neuromed, Pozzilli, Italy
| | - Silvia Caioli
- Synaptic Immunopathology Lab, Department of Systems Medicine, Tor Vergata University of Rome, Rome, Italy
| | - Livia Guadalupi
- Synaptic Immunopathology Lab, Department of Systems Medicine, Tor Vergata University of Rome, Rome, Italy
| | - Silvia Bullitta
- Synaptic Immunopathology Lab, Department of Systems Medicine, Tor Vergata University of Rome, Rome, Italy
- Synaptic Immunopathology Lab, IRCCS San Raffaele Pisana, Rome, Italy
| | - Valentina Vanni
- Synaptic Immunopathology Lab, Department of Systems Medicine, Tor Vergata University of Rome, Rome, Italy
- Synaptic Immunopathology Lab, IRCCS San Raffaele Pisana, Rome, Italy
| | - Sara Balletta
- Synaptic Immunopathology Lab, Department of Systems Medicine, Tor Vergata University of Rome, Rome, Italy
| | - Krizia Sanna
- Synaptic Immunopathology Lab, Department of Systems Medicine, Tor Vergata University of Rome, Rome, Italy
| | - Fabio Buttari
- Unit of Neurology, Mediterranean Neurological Institute IRCCS Neuromed, Pozzilli, Italy
| | | | - Diego Centonze
- Synaptic Immunopathology Lab, Department of Systems Medicine, Tor Vergata University of Rome, Rome, Italy
- Unit of Neurology, Mediterranean Neurological Institute IRCCS Neuromed, Pozzilli, Italy
| | - Georgia Mandolesi
- Synaptic Immunopathology Lab, IRCCS San Raffaele Pisana, Rome, Italy
- Department of Human Sciences and Quality of Life Promotion, University of Rome San Raffaele, Rome, Italy
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113
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Prosperini L, Di Filippo M. Beyond clinical changes: Rehabilitation-induced neuroplasticity in MS. Mult Scler 2020; 25:1348-1362. [PMID: 31469359 DOI: 10.1177/1352458519846096] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Neural plasticity represents the substrate by which the damaged central nervous system (CNS) re-learns lost behaviors in response to rehabilitation. In persons with multiple sclerosis (MS), rehabilitation can therefore exploit the potential of neural plasticity to restore CNS functions beyond the spontaneous mechanisms of recovery from MS-related damage. METHODS Here, we reviewed the currently available evidence on the occurrence of mechanisms of structural and functional plasticity following rehabilitation, motor, and/or cognitive training. We presented both data gained from basic laboratory research on animal models and data on persons with MS obtained by advanced magnetic resonance imaging (MRI) techniques. RESULTS Studies on physical and environmental enrichment in experimental MS models showed beneficial effects mediated by both immune modulation and activity-dependent plasticity, lowering tissue destruction and restoring of CNS network function. Translational researches in MS people demonstrated structural and/or functional MRI changes after various interventions, but their heterogeneity and small sample sizes (5-42 patients) raise concerns about the interpretation and generalization of the obtained results. DISCUSSION We highlighted the limitations of published studies, focusing on the knowledge gaps to be filled in terms of neuropathological correlations between changes detected in animal models and changes detected in vivo by neuroimaging.
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Affiliation(s)
- Luca Prosperini
- Department of Neurosciences, San Camillo-Forlanini Hospital, Rome, Italy
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114
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Khaligh-Razavi SM, Sadeghi M, Khanbagi M, Kalafatis C, Nabavi SM. A self-administered, artificial intelligence (AI) platform for cognitive assessment in multiple sclerosis (MS). BMC Neurol 2020; 20:193. [PMID: 32423386 PMCID: PMC7236354 DOI: 10.1186/s12883-020-01736-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 04/20/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cognitive impairment is common in patients with multiple sclerosis (MS). Accurate and repeatable measures of cognition have the potential to be used as markers of disease activity. METHODS We developed a 5-min computerized test to measure cognitive dysfunction in patients with MS. The proposed test - named the Integrated Cognitive Assessment (ICA) - is self-administered and language-independent. Ninety-one MS patients and 83 healthy controls (HC) took part in Substudy 1, in which each participant took the ICA test and the Brief International Cognitive Assessment for MS (BICAMS). We assessed ICA's test-retest reliability, its correlation with BICAMS, its sensitivity to discriminate patients with MS from the HC group, and its accuracy in detecting cognitive dysfunction. In Substudy 2, we recruited 48 MS patients, 38 of which had received an 8-week physical and cognitive rehabilitation programme and 10 MS patients who did not. We examined the association between the level of serum neurofilament light (NfL) in these patients and their ICA scores and Symbol Digit Modalities Test (SDMT) scores pre- and post-rehabilitation. RESULTS The ICA demonstrated excellent test-retest reliability (r = 0.94), with no learning bias, and showed a high level of convergent validity with BICAMS. The ICA was sensitive in discriminating the MS patients from the HC group, and demonstrated high accuracy (AUC = 95%) in discriminating cognitively normal from cognitively impaired participants. Additionally, we found a strong association (r = - 0.79) between ICA score and the level of NfL in MS patients before and after rehabilitation. CONCLUSIONS The ICA has the potential to be used as a digital marker of cognitive impairment and to monitor response to therapeutic interventions. In comparison to standard cognitive tools for MS, the ICA is shorter in duration, does not show a learning bias, and is independent of language.
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Affiliation(s)
- Seyed-Mahdi Khaligh-Razavi
- Cognetivity Ltd, London, UK. .,Department of Brain and Cognitive Sciences, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran.
| | | | - Mahdiyeh Khanbagi
- Department of Brain and Cognitive Sciences, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran
| | - Chris Kalafatis
- Cognetivity Ltd, London, UK.,South London & Maudsley NHS Foundation Trust, London, UK.,Department of Old Age Psychiatry, King's College London, London, UK
| | - Seyed Massood Nabavi
- Department of Brain and Cognitive Sciences, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran
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115
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Treatment and management of cognitive dysfunction in patients with multiple sclerosis. Nat Rev Neurol 2020; 16:319-332. [PMID: 32372033 DOI: 10.1038/s41582-020-0355-1] [Citation(s) in RCA: 97] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/30/2020] [Indexed: 01/19/2023]
Abstract
Cognitive impairment is a common and devastating manifestation of multiple sclerosis (MS). Although disease-modifying therapies have been efficacious for reducing relapse rates in MS, such treatments are ineffective for treating cognitive dysfunction. Alternative treatment approaches for mitigating cognitive problems are greatly needed in this population. To date, cognitive rehabilitation and exercise training have been identified as possible candidates for treating MS-related cognitive impairment; however, cognitive dysfunction is still often considered to be poorly managed in patients with MS. This Review provides a comprehensive overview of recent developments in the treatment and management of cognitive impairment in people with MS. We describe the theoretical rationales, current states of the science, field-wide challenges and recent advances in cognitive rehabilitation and exercise training for treating MS-related cognitive impairment. We also discuss future directions for research into the treatment of cognitive impairment in MS that should set the stage for the inclusion of cognitive rehabilitation and exercise training into clinical practice within the next decade.
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116
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Najafi N, Peymani M. A genetic variant of pri-miR-182 may impact the risk for the onset of multiple sclerosis in the Iranian population. Am J Hum Biol 2020; 32:e23415. [PMID: 32212358 DOI: 10.1002/ajhb.23415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2019] [Revised: 03/05/2020] [Accepted: 03/11/2020] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Multiple sclerosis (MS) is the most common autoimmune disease of the central nervous system affecting young adults. SNPs can be used as genetic biomarkers to identify disease-related genes such as MS. Moreover, SNPs can be considered as important determinants for an increased risk of autoimmune diseases such as MS. Studies have shown that miR-182 is of importance in Treg cell development and function as critical regulators in autoimmune disease. So far, no study has been conducted to investigate the association between rs4541843 polymorphism in pri-miR-182 and MS. In the present study, we assessed the frequency of rs4541843 different alleles and genotypes and their association with MS risk in Iranian population. METHODS The rs4541843 was genotyped in 81 patients with MS and 89 healthy subjects, using the PCR-RFLP method. The frequency of alleles and genotypes and the association of this polymorphism with MS risk and the gender of the patients was then statistically analyzed. RESULTS Statistical analysis showed the protective role of AA genotype against MS risk (P = .031, OR = 0.348) while there was no significance correlation between the frequency of rs4541843 different alleles and the other genotypes. CONCLUSION Our findings illustrated that the pri-miR-182 rs4541843 G>A polymorphism is associated with the risk of MS in Isfahan population. However, additional large-scale association studies in various ethnicities and more molecular studies are necessary to elaborate our findings.
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Affiliation(s)
- Nadia Najafi
- Department of Biology, Faculty of Basic Sciences, Shahrekord Branch, Islamic Azad University, Shahrekord, Iran
| | - Maryam Peymani
- Department of Biology, Faculty of Basic Sciences, Shahrekord Branch, Islamic Azad University, Shahrekord, Iran
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117
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Maltby VE, Lea RA, Ribbons K, Lea MG, Schofield PW, Lechner-Scott J. Comparison of BICAMS and ARCS for assessment of cognition in multiple sclerosis and predictive value of employment status. Mult Scler Relat Disord 2020; 41:102037. [PMID: 32200339 DOI: 10.1016/j.msard.2020.102037] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 02/19/2020] [Accepted: 03/01/2020] [Indexed: 01/17/2023]
Abstract
BACKGROUND Cognitive impairment is common in multiple sclerosis (MS) but not adequately monitored by Expanded Disability Status Scale assessment. The Audio Recorded Cognitive Screen (ARCS) and Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) are easy-to-use tools to assess cognitive function in clinical practice. OBJECTIVE To compare the sensitivity of ARCS to BICAMS and their relative predictive value for employment status. METHODS MS patients and healthy controls were assessed using the ARCS and the BICAMS consecutively. Receiver Operating Characteristic (ROC) curve analyses were used to compare the two tests. A step-wise, logistic regression analysis was used to identify the cognitive test(s) that best predicted employment status and quality of life. RESULTS Total ARCS, memory and attention domain scores were moderately correlated with all BICAMS tests (r = 0.3-0.5; P ≤ 0.05). Total ARCS predicts cognitive impairment with good sensitivity and specificity relative to the BICAMS tests (AUC = 0.8; P = 0.00045). Total ARCS detects higher levels of impairment than BICAMS in MS patients (44% versus 21%). The memory domain of the ARCS and the BVMT-R were the best predictors of employment status (OR = 1.12 and 1.14, P < 0.05). CONCLUSION BICAMS and ARCS have comparable sensitivity for cognitive impairment in MS. Memory assessment from either tests is the best predictor of employment status; however, the BICAMS is a better predictor of work productivity.
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Affiliation(s)
- Vicki E Maltby
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia; Centre for Brain and Mental Health Research, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia; Department of Neurology, John Hunter Hospital, New Lambton Heights, NSW, Australia.
| | - Rodney A Lea
- Centre for Brain and Mental Health Research, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia; Institute of Health and Biomedical Innovation, School of Biomedical Sciences, Queensland University of Technology, Brisbane, QLD, Australia.
| | - Karen Ribbons
- Centre for Brain and Mental Health Research, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia; Department of Neurology, John Hunter Hospital, New Lambton Heights, NSW, Australia.
| | - Marino G Lea
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia.
| | - Peter W Schofield
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia; Department of Neurology, John Hunter Hospital, New Lambton Heights, NSW, Australia; Neuropsychiatry Service, Hunter New England Local Health District, NSW, Australia.
| | - Jeannette Lechner-Scott
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia; Centre for Brain and Mental Health Research, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia.
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118
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Nasios G, Bakirtzis C, Messinis L. Cognitive Impairment and Brain Reorganization in MS: Underlying Mechanisms and the Role of Neurorehabilitation. Front Neurol 2020; 11:147. [PMID: 32210905 PMCID: PMC7068711 DOI: 10.3389/fneur.2020.00147] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 02/14/2020] [Indexed: 12/29/2022] Open
Abstract
Multiple sclerosis (MS) is a chronic, immune-mediated, inflammatory, and degenerative disease of the central nervous system (CNS) that affects both white and gray matter. Various mechanisms throughout its course, mainly regarding gray matter lesions and brain atrophy, result in cognitive network dysfunction and can cause clinically significant cognitive impairment in roughly half the persons living with MS. Altered cognition is responsible for many negative aspects of patients' lives, independently of physical disability, such as higher unemployment and divorce rates, reduced social activities, and an overall decrease in quality of life. Despite its devastating impact it is not included in clinical ratings and decision making in the way it should be. It is interesting that only half the persons with MS exhibit cognitive dysfunction, as this implies that the other half remain cognitively intact. It appears that a dynamic balance between brain destruction and brain reorganization is taking place. This balance acts in favor of keeping brain systems functioning effectively, but this is not so in all cases, and the effect does not last forever. When these systems collapse, functional brain reorganization is not effective anymore, and clinically apparent impairments are evident. It is therefore important to reveal which factors could make provision for the subpopulation of patients in whom cognitive impairment occurs. Even if we manage to detect this subpopulation earlier, effective pharmaceutical treatments will still be lacking. Nevertheless, recent evidence shows that cognitive rehabilitation and neuromodulation, using non-invasive techniques such as transcranial magnetic or direct current stimulation, could be effective in cognitively impaired patients with MS. In this Mini Review, we discuss the mechanisms underlying cognitive impairment in MS. We also focus on mechanisms of reorganization of cognitive networks, which occur throughout the disease course. Finally, we review theoretical and practical issues of neurorehabilitation and neuromodulation for cognition in MS as well as factors that influence them and prevent them from being widely applied in clinical settings.
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Affiliation(s)
- Grigorios Nasios
- Department of Speech and Language Therapy, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Christos Bakirtzis
- Department of Neurology, The Multiple Sclerosis Center, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Lambros Messinis
- Neuropsychology Section, Departments of Neurology and Psychiatry, University of Patras Medical School, Patras, Greece
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119
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Teixeira NB, Sant'Anna MB, Giardini AC, Araujo LP, Fonseca LA, Basso AS, Cury Y, Picolo G. Crotoxin down-modulates pro-inflammatory cells and alleviates pain on the MOG 35-55-induced experimental autoimmune encephalomyelitis, an animal model of multiple sclerosis. Brain Behav Immun 2020; 84:253-268. [PMID: 31843645 DOI: 10.1016/j.bbi.2019.12.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 12/10/2019] [Accepted: 12/11/2019] [Indexed: 02/07/2023] Open
Abstract
Multiple sclerosis (MS) is a Central Nervous System inflammatory demyelinating disease that has as primary symptoms losses of sensory and motor functions, including chronic pain. To date, however, few studies have investigated the mechanisms of chronic pain in animal models of MS since locomotor impairments render difficult its evaluation. It was previously demonstrated that in the MOG35-55-induced EAE, an animal model of MS, the hypernociception appears before the onset of motor disability, allowing for the study of these two phenomena separately. Here, we evaluated the effect of crotoxin (CTX), a neurotoxin isolated from the Crotalus durissus terrificus snake venom that displays, at non-toxic dose, antinociceptive, anti-inflammatory and immunomodulatory effects, in the pain and in symptoms progression of EAE. The pain threshold of female C57BL/6 mice decreased at the 4th day after immunization, while the first sign of disease appeared around the 11st-12nd days, coinciding with the onset of motor abnormalities. CTX (40 µg/kg, s.c.) administered in a single dose on the 5th day after immunization, induced a long-lasting analgesic effect (5 days), without interfering with the clinical signs of the disease. On the other hand, when crotoxin was administered for 5 consecutive days, from 5th-9th day after immunization, it induced analgesia and also reduced EAE progression. The antinociceptive effect of crotoxin was blocked by Boc-2 (0.5 mg/kg, i.p.), a selective antagonist of formyl peptide receptors, by NDGA (30 μg/kg, i.p.), a lipoxygenase inhibitor and by atropine sulfate (10 mg/kg, i.p.), an antagonist of muscarinic receptors, administered 30 min before CTX. CTX was also effective in decreasing EAE clinical signs even when administered after its onset. Regarding the interactions between neurons and immunocompetent cells, CTX, in vitro, was able to reduce T cell proliferation, decreasing Th1 and Th17 and increasing Treg cell differentiation. Furthermore, in EAE model, the treatment with 5 consecutive doses of CTX inhibited IFN-γ-producing T cells, GM-CSF-producing T cells, reduced the frequency of activated microglia/macrophages within the CNS and decreased the number of migrating cell to spinal cord and cerebellum at the peak of the disease. These results suggest that CTX is a potential treatment not only for pain alteration but also for clinical progression induced by the disease as well as an useful tool for the development of new therapeutic approaches for the multiple sclerosis control.
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Affiliation(s)
- N B Teixeira
- Laboratory of Pain and Signaling, Butantan Institute, Sao Paulo, Brazil
| | - M B Sant'Anna
- Laboratory of Pain and Signaling, Butantan Institute, Sao Paulo, Brazil
| | - A C Giardini
- Laboratory of Pain and Signaling, Butantan Institute, Sao Paulo, Brazil
| | - L P Araujo
- Department of Microbiology, Immunology and Parasitology, Paulista School of Medicine, Federal University of Sao Paulo, UNIFESP, Sao Paulo, Brazil
| | - L A Fonseca
- Laboratory of Pain and Signaling, Butantan Institute, Sao Paulo, Brazil
| | - A S Basso
- Department of Microbiology, Immunology and Parasitology, Paulista School of Medicine, Federal University of Sao Paulo, UNIFESP, Sao Paulo, Brazil
| | - Y Cury
- Laboratory of Pain and Signaling, Butantan Institute, Sao Paulo, Brazil
| | - G Picolo
- Laboratory of Pain and Signaling, Butantan Institute, Sao Paulo, Brazil.
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120
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Pape K, Tamouza R, Leboyer M, Zipp F. Immunoneuropsychiatry - novel perspectives on brain disorders. Nat Rev Neurol 2020; 15:317-328. [PMID: 30988501 DOI: 10.1038/s41582-019-0174-4] [Citation(s) in RCA: 267] [Impact Index Per Article: 66.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Immune processes have a vital role in CNS homeostasis, resilience and brain reserve. Our cognitive and social abilities rely on a highly sensitive and fine-tuned equilibrium of immune responses that involve both innate and adaptive immunity. Autoimmunity, chronic inflammation, infection and psychosocial stress can tip the scales towards disruption of higher-order networks. However, not only classical neuroinflammatory diseases, such as multiple sclerosis and autoimmune encephalitis, are caused by immune dysregulation that affects CNS function. Recent insight indicates that similar processes are involved in psychiatric diseases such as schizophrenia, autism spectrum disorder, bipolar disorder and depression. Pathways that are common to these disorders include microglial activation, pro-inflammatory cytokines, molecular mimicry, anti-neuronal autoantibodies, self-reactive T cells and disturbance of the blood-brain barrier. These discoveries challenge our traditional classification of neurological and psychiatric diseases. New clinical paths are required to identify subgroups of neuropsychiatric disorders that are phenotypically distinct but pathogenically related and to pave the way for mechanism-based immune treatments. Combined expertise from neurologists and psychiatrists will foster translation of these paths into clinical practice. The aim of this Review is to highlight outstanding findings that have transformed our understanding of neuropsychiatric diseases and to suggest new diagnostic and therapeutic criteria for the emerging field of immunoneuropsychiatry.
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Affiliation(s)
- Katrin Pape
- Department of Neurology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Ryad Tamouza
- Inserm, U955, Institut Mondor de la Recherche Biomédicale, Créteil, France.,Fondation FondaMental, Créteil, France.,AP-HP, Department of Psychiatry of Mondor University Hospital, DHU PePsy, University of Paris-Est-Créteil, Créteil, France
| | - Marion Leboyer
- Inserm, U955, Institut Mondor de la Recherche Biomédicale, Créteil, France.,Fondation FondaMental, Créteil, France.,AP-HP, Department of Psychiatry of Mondor University Hospital, DHU PePsy, University of Paris-Est-Créteil, Créteil, France
| | - Frauke Zipp
- Department of Neurology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.
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121
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das Neves SP, Santos G, Barros C, Pereira DR, Ferreira R, Mota C, Monteiro S, Fernandes A, Marques F, Cerqueira JJ. Enhanced cognitive performance in experimental autoimmune encephalomyelitis mice treated with dimethyl fumarate after the appearance of disease symptoms. J Neuroimmunol 2020; 340:577163. [PMID: 31982706 DOI: 10.1016/j.jneuroim.2020.577163] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 01/02/2020] [Accepted: 01/10/2020] [Indexed: 12/23/2022]
Abstract
In multiple sclerosis (MS), cognitive dysfunction is common but difficult to treat. We analyzed the impact of dimethyl fumarate, an MS drug with neuroprotective properties, in spatial memory performance in a mouse model of MS and looked for structural correlates in the hippocampus. Treated mice presented better cognitive performance which was not associated with structural hippocampal damage but with decreased demyelination in the fimbria. Dimethyl fumarate, even if initiated after hindlimb paralysis, ameliorated memory deficits in the MS mouse model due, at least in part, to its positive impact in the demyelination of the main hippocampal output pathway.
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Affiliation(s)
- Sofia P das Neves
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus Gualtar, 4710-057 Braga, Portugal; ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Gisela Santos
- Neuron-Glia Biology in Health and Disease, Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, Universidade de Lisboa, Portugal
| | - Catarina Barros
- Neuron-Glia Biology in Health and Disease, Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, Universidade de Lisboa, Portugal
| | - Diana Rodrigues Pereira
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus Gualtar, 4710-057 Braga, Portugal; ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Ricardo Ferreira
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus Gualtar, 4710-057 Braga, Portugal; ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Cristina Mota
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus Gualtar, 4710-057 Braga, Portugal; ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Susana Monteiro
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus Gualtar, 4710-057 Braga, Portugal; ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Adelaide Fernandes
- Neuron-Glia Biology in Health and Disease, Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, Universidade de Lisboa, Portugal; Department of Biochemistry and Human Biology, Faculty of Pharmacy, Universidade de Lisboa, Portugal
| | - Fernanda Marques
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus Gualtar, 4710-057 Braga, Portugal; ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - João José Cerqueira
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus Gualtar, 4710-057 Braga, Portugal; ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal; 2CA, Clinical Academic Center - Braga, Braga, Portugal.
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122
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Nagae M, Yamaguchi Y, Taniguchi N, Kizuka Y. 3D Structure and Function of Glycosyltransferases Involved in N-glycan Maturation. Int J Mol Sci 2020; 21:E437. [PMID: 31936666 PMCID: PMC7014118 DOI: 10.3390/ijms21020437] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 01/06/2020] [Accepted: 01/08/2020] [Indexed: 12/21/2022] Open
Abstract
Glycosylation is the most ubiquitous post-translational modification in eukaryotes. N-glycan is attached to nascent glycoproteins and is processed and matured by various glycosidases and glycosyltransferases during protein transport. Genetic and biochemical studies have demonstrated that alternations of the N-glycan structure play crucial roles in various physiological and pathological events including progression of cancer, diabetes, and Alzheimer's disease. In particular, the formation of N-glycan branches regulates the functions of target glycoprotein, which are catalyzed by specific N-acetylglucosaminyltransferases (GnTs) such as GnT-III, GnT-IVs, GnT-V, and GnT-IX, and a fucosyltransferase, FUT8s. Although the 3D structures of all enzymes have not been solved to date, recent progress in structural analysis of these glycosyltransferases has provided insights into substrate recognition and catalytic reaction mechanisms. In this review, we discuss the biological significance and structure-function relationships of these enzymes.
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Affiliation(s)
- Masamichi Nagae
- Graduate School of Pharmaceutical Sciences, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Yoshiki Yamaguchi
- Faculty of Pharmaceutical Sciences, Tohoku Medical and Pharmaceutical University, Miyagi 981-8558, Japan;
| | - Naoyuki Taniguchi
- Department of Glyco-Oncology and Medical Biochemistry, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka 541-8567, Japan;
| | - Yasuhiko Kizuka
- Center for Highly Advanced Integration of Nano and Life Sciences (G-CHAIN), Gifu University, 1-1 Yanagido, Gifu 501-1193, Japan
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123
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Musella A, Fresegna D, Rizzo FR, Gentile A, De Vito F, Caioli S, Guadalupi L, Bruno A, Dolcetti E, Buttari F, Bullitta S, Vanni V, Centonze D, Mandolesi G. 'Prototypical' proinflammatory cytokine (IL-1) in multiple sclerosis: role in pathogenesis and therapeutic targeting. Expert Opin Ther Targets 2020; 24:37-46. [PMID: 31899994 DOI: 10.1080/14728222.2020.1709823] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Introduction: It has been recognized for about 20 years that interleukin (IL)-1 signaling is implicated in Multiple Sclerosis (MS), a disabling, chronic, inflammatory and neurodegenerative disease of the central nervous system (CNS). Only recently, multifaceted roles of IL-1 emerged in MS pathophysiology as a result of both clinical and preclinical studies. Notably, drugs that directly target the IL-1 system have not been tested so far in MS.Areas covered: Recent studies in animal models, together with the development of ex vivo chimeric MS models, have disclosed a critical role for IL-1 not only at the peripheral level but also within the CNS. In the present review, we highlight the IL-1-dependent neuropathological aspects of MS, by providing an overview of the cells of the immune and CNS systems that respond to IL-1 signaling, and by emphasizing the subsequent effects on the CNS, from demyelinating processes, to synaptopathy, and excitotoxicity.Expert opinion: Drugs that act on the IL-1 system show a therapeutic potential in several autoinflammatory diseases and preclinical studies have highlighted the effects of these compounds in MS. We will discuss why anti-IL-1 therapies in MS have been neglected to date.
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Affiliation(s)
- Alessandra Musella
- Synaptic Immunopathology Lab, IRCCS San Raffaele Pisana, Rome, Italy.,San Raffaele University, Rome, Italy
| | - Diego Fresegna
- Synaptic Immunopathology Lab, IRCCS San Raffaele Pisana, Rome, Italy
| | - Francesca Romana Rizzo
- Synaptic Immunopathology Lab, Department of Systems Medicine, Tor Vergata University, Rome, Italy
| | - Antonietta Gentile
- Synaptic Immunopathology Lab, IRCCS San Raffaele Pisana, Rome, Italy.,Synaptic Immunopathology Lab, Department of Systems Medicine, Tor Vergata University, Rome, Italy
| | | | - Silvia Caioli
- Synaptic Immunopathology Lab, Department of Systems Medicine, Tor Vergata University, Rome, Italy
| | - Livia Guadalupi
- Synaptic Immunopathology Lab, Department of Systems Medicine, Tor Vergata University, Rome, Italy
| | - Antonio Bruno
- Synaptic Immunopathology Lab, Department of Systems Medicine, Tor Vergata University, Rome, Italy
| | - Ettore Dolcetti
- Synaptic Immunopathology Lab, Department of Systems Medicine, Tor Vergata University, Rome, Italy
| | - Fabio Buttari
- Unit of Neurology, IRCCS Neuromed, Pozzilli, IS, Italy
| | - Silvia Bullitta
- Synaptic Immunopathology Lab, Department of Systems Medicine, Tor Vergata University, Rome, Italy
| | - Valentina Vanni
- Synaptic Immunopathology Lab, IRCCS San Raffaele Pisana, Rome, Italy
| | - Diego Centonze
- Synaptic Immunopathology Lab, Department of Systems Medicine, Tor Vergata University, Rome, Italy.,Unit of Neurology, IRCCS Neuromed, Pozzilli, IS, Italy
| | - Georgia Mandolesi
- Synaptic Immunopathology Lab, IRCCS San Raffaele Pisana, Rome, Italy.,San Raffaele University, Rome, Italy
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124
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Azimbagirad M, Simozo FH, Senra Filho ACS, Murta Junior LO. Tsallis-Entropy Segmentation through MRF and Alzheimer anatomic reference for Brain Magnetic Resonance Parcellation. Magn Reson Imaging 2019; 65:136-145. [PMID: 31726210 DOI: 10.1016/j.mri.2019.11.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 10/17/2019] [Accepted: 11/03/2019] [Indexed: 02/04/2023]
Abstract
Quantifying the intracranial tissue volume changes in magnetic resonance imaging (MRI) assists specialists to analyze the effects of natural or pathological changes. Since these changes can be subtle, the accuracy of the automatic compartmentalization method is always criticized by specialists. We propose and then evaluate an automatic segmentation method based on modified q-entropy (Mqe) through a modified Markov Random Field (MMRF) enhanced by Alzheimer anatomic reference (AAR) to provide a high accuracy brain tissues parcellation approach (Mqe-MMRF). We underwent two strategies to evaluate Mqe-MMRF; a simulation of different levels of noise and non-uniformity effect on MRI data (7 subjects) and a set of twenty MRI data available from MRBrainS13 as patient brain tissue segmentation challenge. We accessed eleven quality metrics compared to reference tissues delineations to evaluate Mqe-MMRF. MRI segmentation scores decreased by only 4.6% on quality metrics after noise and non-uniformity simulations of 40% and 9%, respectively. We found significant mean improvements in the metrics of the five training subjects, for whole-brain 0.86%, White Matter 3.20%, Gray Matter 3.99%, and Cerebrospinal Fluid 4.16% (p-values < 0.02) when Mqe-MMRF compared to the other reference methods. We also processed the Mqe-MMRF on 15 evaluation subjects group from MRBrainS13 online challenge, and the results held a higher rank than the reference tools; FreeSurfer, SPM, and FSL. Since the proposed method improved the precision of brain segmentation, specifically, for GM, and thus one can use it in quantitative and morphological brain studies.
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Affiliation(s)
- Mehran Azimbagirad
- Department of Computing and Mathematics, FFCLRP, University of São Paulo, Ribeirao Preto, SP, Brazil; Department of Physics, FFCLRP, University of São Paulo, Ribeirao Preto, SP, Brazil
| | - Fabrício H Simozo
- Department of Computing and Mathematics, FFCLRP, University of São Paulo, Ribeirao Preto, SP, Brazil
| | - Antonio C S Senra Filho
- Department of Computing and Mathematics, FFCLRP, University of São Paulo, Ribeirao Preto, SP, Brazil
| | - Luiz O Murta Junior
- Department of Computing and Mathematics, FFCLRP, University of São Paulo, Ribeirao Preto, SP, Brazil.
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125
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Laquinimod ameliorates secondary brain inflammation. Neurobiol Dis 2019; 134:104675. [PMID: 31731041 DOI: 10.1016/j.nbd.2019.104675] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 10/21/2019] [Accepted: 11/11/2019] [Indexed: 02/07/2023] Open
Abstract
Accumulating evidence suggests that a degenerative processes within the brain can trigger the formation of new, focal inflammatory lesions in Multiple Sclerosis (MS). Here, we used a novel pre-clinical MS animal model to test whether the amelioration of degenerative brain events reduces the secondary recruitment of peripheral immune cells and, in consequence, inflammatory lesion development. Neural degeneration was induced by a 3 weeks cuprizone intoxication period. To mitigate the cuprizone-induced pathology, animals were treated with Laquinimod (25 mg/kg) during the cuprizone-intoxication period. At the beginning of week 6, encephalitogenic T cell development in peripheral lymphoid organs was induced by the immunization with myelin oligodendrocyte glycoprotein 35-55 peptide (i.e., Cup/EAE). Demyelination, axonal injury and reactive gliosis were determined by immunohistochemistry. Positron emission tomography (PET) imaging was performed to analyze glia activation in vivo. Vehicle-treated cuprizone mice displayed extensive callosal demyelination, glia activation and enhanced TSPO-ligand binding. This cuprizone-induced pathology was profoundly ameliorated in mice treated with Laquinimod. In vehicle-treated Cup/EAE mice, the cuprizone-induced pathology triggered massive peripheral immune cell recruitment into the forebrain, evidenced by multifocal perivascular inflammation, glia activation and neuro-axonal injury. While anti myelin oligodendrocyte glycoprotein 35-55 peptide immune responses were comparable in vehicle- and Laquinimod-treated Cup/EAE mice, the cuprizone-triggered immune cell recruitment was ameliorated by the Laquinimod treatment. This study clearly illustrates that amelioration of a primary brain-intrinsic degenerative process secondary halts peripheral immune cell recruitment and, in consequence, inflammatory lesion development. These findings have important consequences for the interpretation of the results of clinical studies.
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126
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Salek Esfahani B, Gharesouran J, Ghafouri-Fard S, Talebian S, Arsang-Jang S, Omrani MD, Taheri M, Rezazadeh M. Down-regulation of ERMN expression in relapsing remitting multiple sclerosis. Metab Brain Dis 2019; 34:1261-1266. [PMID: 31123898 DOI: 10.1007/s11011-019-00429-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 05/10/2019] [Indexed: 12/13/2022]
Abstract
Multiple Sclerosis (MS) is a chronic inflammatory disease causing demyelination and neurodegeneration in the central nervous system (CNS). Although the exact etiology of MS is still unclear, both genetic and environmental elements are regarded as causative factors. Environmental factors can induce a cascade of events in immune system leading to neuronal death and nerve demyelination. This paper aims to compare the peripheral transcript levels of Ermin (ERMN) (a gene with putative role in cytoskeletal rearrangements during myelinogenesis) and Listerin E3 Ubiquitin Protein Ligase 1 (LTN1) (a gene with functions in regulating innate immune system) between relapsing-remitting MS (RR-MS) patients and healthy controls. The results showed a significant decrease in ERMN expression (p = 0.022); whereas, no significant difference was detected in LTN1 expression between two groups (p = 0.935). The reduction in ERMN expression in leukocytes could be the cause of demyelinating process in RR-MS patients. Current findings might also have practical importance in prognosis and targeted therapies.
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Affiliation(s)
- Behnaz Salek Esfahani
- Department of Medical Genetics, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Jalal Gharesouran
- Department of Medical Genetics, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Medical Genetics, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Soudeh Ghafouri-Fard
- Department of Medical Genetics, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shahrzad Talebian
- Department of Medical Genetics, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Shahram Arsang-Jang
- Clinical Research Development Center (CRDU), Qom University of Medical Sciences, Qom, Iran
| | - Mir Davood Omrani
- Urogenital Stem Cell Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Taheri
- Urogenital Stem Cell Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Maryam Rezazadeh
- Department of Medical Genetics, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
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127
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McMackin R, Muthuraman M, Groppa S, Babiloni C, Taylor JP, Kiernan MC, Nasseroleslami B, Hardiman O. Measuring network disruption in neurodegenerative diseases: New approaches using signal analysis. J Neurol Neurosurg Psychiatry 2019; 90:1011-1020. [PMID: 30760643 PMCID: PMC6820156 DOI: 10.1136/jnnp-2018-319581] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Revised: 01/21/2019] [Accepted: 01/21/2019] [Indexed: 12/12/2022]
Abstract
Advanced neuroimaging has increased understanding of the pathogenesis and spread of disease, and offered new therapeutic targets. MRI and positron emission tomography have shown that neurodegenerative diseases including Alzheimer's disease (AD), Lewy body dementia (LBD), Parkinson's disease (PD), frontotemporal dementia (FTD), amyotrophic lateral sclerosis (ALS) and multiple sclerosis (MS) are associated with changes in brain networks. However, the underlying neurophysiological pathways driving pathological processes are poorly defined. The gap between what imaging can discern and underlying pathophysiology can now be addressed by advanced techniques that explore the cortical neural synchronisation, excitability and functional connectivity that underpin cognitive, motor, sensory and other functions. Transcranial magnetic stimulation can show changes in focal excitability in cortical and transcortical motor circuits, while electroencephalography and magnetoencephalography can now record cortical neural synchronisation and connectivity with good temporal and spatial resolution.Here we reflect on the most promising new approaches to measuring network disruption in AD, LBD, PD, FTD, MS, and ALS. We consider the most groundbreaking and clinically promising studies in this field. We outline the limitations of these techniques and how they can be tackled and discuss how these novel approaches can assist in clinical trials by predicting and monitoring progression of neurophysiological changes underpinning clinical symptomatology.
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Affiliation(s)
- Roisin McMackin
- Academic Unit of Neurology, Trinity College Dublin, the University of Dublin, Dublin, Ireland
| | - Muthuraman Muthuraman
- Department of Neurology, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Mainz, Germany
| | - Sergiu Groppa
- Department of Neurology, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Mainz, Germany
| | - Claudio Babiloni
- Dipartimento di Fisiologia e Farmacologia "Vittorio Erspamer", Università degli Studi di Roma "La Sapienza", Roma, Italy
- Istituto di Ricovero e Cura San Raffaele Cassino, Cassino, Italy
| | - John-Paul Taylor
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
| | - Matthew C Kiernan
- Brain & Mind Centre, University of Sydney, Sydney, Sydney, Australia
- Institute of Clinical Neurosciences, Royal Prince Alfred Hospital, Sydney, Sydney, Australia
| | - Bahman Nasseroleslami
- Academic Unit of Neurology, Trinity College Dublin, the University of Dublin, Dublin, Ireland
| | - Orla Hardiman
- Academic Unit of Neurology, Trinity College Dublin, the University of Dublin, Dublin, Ireland
- Beaumont Hospital, Dublin, Ireland
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128
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Gruchot J, Weyers V, Göttle P, Förster M, Hartung HP, Küry P, Kremer D. The Molecular Basis for Remyelination Failure in Multiple Sclerosis. Cells 2019; 8:cells8080825. [PMID: 31382620 PMCID: PMC6721708 DOI: 10.3390/cells8080825] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 07/31/2019] [Accepted: 08/01/2019] [Indexed: 12/13/2022] Open
Abstract
Myelin sheaths in the central nervous system (CNS) insulate axons and thereby allow saltatory nerve conduction, which is a prerequisite for complex brain function. Multiple sclerosis (MS), the most common inflammatory autoimmune disease of the CNS, leads to the destruction of myelin sheaths and the myelin-producing oligodendrocytes, thus leaving behind demyelinated axons prone to injury and degeneration. Clinically, this process manifests itself in significant neurological symptoms and disability. Resident oligodendroglial precursor cells (OPCs) and neural stem cells (NSCs) are present in the adult brain, and can differentiate into mature oligodendrocytes which then remyelinate the demyelinated axons. However, for multiple reasons, in MS the regenerative capacity of these cell populations diminishes significantly over time, ultimately leading to neurodegeneration, which currently remains untreatable. In addition, microglial cells, the resident innate immune cells of the CNS, can contribute further to inflammatory and degenerative axonal damage. Here, we review the molecular factors contributing to remyelination failure in MS by inhibiting OPC and NSC differentiation or modulating microglial behavior.
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Affiliation(s)
- Joel Gruchot
- Department of Neurology, Medical Faculty, Heinrich-Heine-University, 40225 Düsseldorf, Germany
| | - Vivien Weyers
- Department of Neurology, Medical Faculty, Heinrich-Heine-University, 40225 Düsseldorf, Germany
| | - Peter Göttle
- Department of Neurology, Medical Faculty, Heinrich-Heine-University, 40225 Düsseldorf, Germany
| | - Moritz Förster
- Department of Neurology, Medical Faculty, Heinrich-Heine-University, 40225 Düsseldorf, Germany
| | - Hans-Peter Hartung
- Department of Neurology, Medical Faculty, Heinrich-Heine-University, 40225 Düsseldorf, Germany
| | - Patrick Küry
- Department of Neurology, Medical Faculty, Heinrich-Heine-University, 40225 Düsseldorf, Germany
| | - David Kremer
- Department of Neurology, Medical Faculty, Heinrich-Heine-University, 40225 Düsseldorf, Germany.
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129
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Sumowski JF, Muhlert N. Dalfampridine improves slowed processing speed in MS: Picking up the pace. Neurology 2019; 93:325-326. [PMID: 31331969 DOI: 10.1212/wnl.0000000000007964] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Affiliation(s)
- James F Sumowski
- From Icahn School of Medicine at Mount Sinai (J.F.S.), New York, NY; and Division of Neuroscience & Experimental Psychology (N.M.), University of Manchester, UK.
| | - Nils Muhlert
- From Icahn School of Medicine at Mount Sinai (J.F.S.), New York, NY; and Division of Neuroscience & Experimental Psychology (N.M.), University of Manchester, UK
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130
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Kang Y, Gauthier SA. PET is necessary to make the next step forward in understanding MS pathophysiology – Commentary. Mult Scler 2019; 25:1090-1091. [DOI: 10.1177/1352458519828299] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Yeona Kang
- Department of Mathematics, Howard University, Washington, DC, USA/Laboratory of Neuroimaging at NIAAA, National Institutes of Health, Bethesda, MD, USA
| | - Susan A Gauthier
- Judith Jaffe Multiple Sclerosis Center, Department of Neurology, Weill Cornell Medicine, New York, NY, USA/Feil Family Brain and Mind Institute, Weill Cornell Medicine, New York, NY, USA/Department of Radiology, Weill Cornell Medicine, New York, NY, USA
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131
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Park J, Wang Q, Wu Q, Mao-Draayer Y, Kim CH. Bidirectional regulatory potentials of short-chain fatty acids and their G-protein-coupled receptors in autoimmune neuroinflammation. Sci Rep 2019; 9:8837. [PMID: 31222050 PMCID: PMC6586800 DOI: 10.1038/s41598-019-45311-y] [Citation(s) in RCA: 91] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Accepted: 05/31/2019] [Indexed: 01/01/2023] Open
Abstract
Microbial metabolites, produced in the intestine, have significant effects on inflammatory diseases throughout the body. Short-chain fatty acids (SCFAs) have protective effects on experimental autoimmune encephalitis (EAE) responses but the detailed roles of SCFAs and their receptors in regulating autoimmune CNS inflammation have been unclear. SCFAs metabolically regulate T cells and change the phenotype of antigen presenting cells to efficiently induce IL-10+ regulatory T cells. In line with the overall protective effect, blood levels of major SCFAs, such as acetate, propionate and butyrate, are significantly decreased in long-term active progressive multiple sclerosis (MS) patients. Importantly, SCFAs can induce CD4+ effector T cells, which are highly inflammatory when transferred into mice, suggesting that the direct effect of SCFAs on T cells can even be pro-inflammatory in the CNS. In contrast to the moderate protective effect of SCFAs, mice deficient in GPR41 or GPR43 are more resistant to EAE pathogenesis. Thus, despite the overall protective function of SCFAs, SCFAs and their receptors have the potential to regulate autoimmune CNS inflammation both positively and negatively.
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Affiliation(s)
- Jeongho Park
- Department of Comparative Pathobiology, Purdue University, West Lafayette, IN, 47907, USA
| | - Qin Wang
- Autoimmunity Center of Excellence, Multiple Sclerosis Center, Department of Neurology, University of Michigan Medical School, Ann Arbor, MI, 48109, USA
| | - Qi Wu
- Autoimmunity Center of Excellence, Multiple Sclerosis Center, Department of Neurology, University of Michigan Medical School, Ann Arbor, MI, 48109, USA
| | - Yang Mao-Draayer
- Autoimmunity Center of Excellence, Multiple Sclerosis Center, Department of Neurology, University of Michigan Medical School, Ann Arbor, MI, 48109, USA.
| | - Chang H Kim
- Laboratory of Immunology and Hematopoiesis, Department of Pathology and Mary H Weiser Food Allergy Center, University of Michigan School of Medicine, Ann Arbor, MI, 48109, USA.
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132
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Cerebrospinal fluid neurofilament light chain tracks cognitive impairment in multiple sclerosis. J Neurol 2019; 266:2157-2163. [DOI: 10.1007/s00415-019-09398-7] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 05/20/2019] [Accepted: 05/22/2019] [Indexed: 11/26/2022]
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133
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Czekóová K, Shaw DJ, Saxunová K, Dufek M, Mareček R, Vaníček J, Brázdil M. Impaired Self-Other Distinction and Subcortical Gray-Matter Alterations Characterize Socio-Cognitive Disturbances in Multiple Sclerosis. Front Neurol 2019; 10:525. [PMID: 31164860 PMCID: PMC6536606 DOI: 10.3389/fneur.2019.00525] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Accepted: 05/02/2019] [Indexed: 11/13/2022] Open
Abstract
Introduction: Recent studies of patients with multiple sclerosis (MS) have revealed disturbances in distinct components of social cognition, such as impaired mentalizing and empathy. The present study investigated this socio-cognitive profile in MS patients in more detail, by examining their performance on tasks measuring more fundamental components of social cognition and any associated disruptions to gray-matter volume (GMV). Methods: We compared 43 patients with relapse-remitting MS with 43 age- and sex-matched healthy controls (HCs) on clinical characteristics (depression, fatigue), cognitive processing speed, and three aspects of low-level social cognition; specifically, imitative tendencies, visual perspective taking, and emotion recognition. Using voxel-based morphometry, we then explored relationships between GMV and these clinical and behavioral measures. Results: Patients exhibited significantly slower processing speed, poorer perspective taking, and less imitation compared with HCs. These impairments were related to reduced GMV throughout the putamen, thalami, and anterior insula, predominantly in the left hemisphere. Surprisingly, differences between the groups in emotion recognition were not significant. Conclusion: Less imitation and poorer perspective taking indicate a cognitive self-bias when faced with conflicting self- and other-representations. This suggests that impaired self-other distinction, and an associated subcortical pattern of GM atrophy, might underlie the socio-cognitive disturbances observed in MS.
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Affiliation(s)
- Kristína Czekóová
- Behavioral and Social Neuroscience, Central European Institute of Technology (CEITEC), Masaryk University, Brno, Czechia
- Institute of Psychology, Czech Academy of Sciences, Brno, Czechia
| | - Daniel Joel Shaw
- Behavioral and Social Neuroscience, Central European Institute of Technology (CEITEC), Masaryk University, Brno, Czechia
- Department of Psychology, School of Life and Health Sciences, Aston University, Birmingham, United Kingdom
| | - Kristína Saxunová
- First Department of Neurology, Faculty of Medicine, Masaryk University and St. Anne's University Hospital, Brno, Czechia
| | - Michal Dufek
- First Department of Neurology, Faculty of Medicine, Masaryk University and St. Anne's University Hospital, Brno, Czechia
| | - Radek Mareček
- Multimodal and Functional Neuroimaging, Central European Institute of Technology (CEITEC), Masaryk University, Brno, Czechia
| | - Jiří Vaníček
- Department of Imaging Methods, Masaryk University and St. Anne's University Hospital, Brno, Czechia
| | - Milan Brázdil
- Behavioral and Social Neuroscience, Central European Institute of Technology (CEITEC), Masaryk University, Brno, Czechia
- First Department of Neurology, Faculty of Medicine, Masaryk University and St. Anne's University Hospital, Brno, Czechia
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134
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Wang J, Wang J, Wang J, Yang B, Weng Q, He Q. Targeting Microglia and Macrophages: A Potential Treatment Strategy for Multiple Sclerosis. Front Pharmacol 2019; 10:286. [PMID: 30967783 PMCID: PMC6438858 DOI: 10.3389/fphar.2019.00286] [Citation(s) in RCA: 79] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 03/08/2019] [Indexed: 12/11/2022] Open
Abstract
Multiple sclerosis (MS) is a chronic inflammatory neurodegenerative disease of the central nervous system (CNS). The early stage is characterized by relapses and the later stage, by progressive disability. Results from experimental and clinical investigations have demonstrated that microglia and macrophages play a key part in the disease course. These cells actively initiate immune infiltration and the demyelination cascade during the early phase of the disease; however, they promote remyelination and alleviate disease in later stages. This review aims to provide a comprehensive overview of the existing knowledge regarding the neuromodulatory function of macrophages and microglia in the healthy and injured CNS, and it discusses the feasibility of harnessing microglia and macrophage physiology to treat MS. The review encourages further investigations into macrophage-targeted therapy, as well as macrophage-based drug delivery, for realizing efficient treatment strategies for MS.
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Affiliation(s)
- Jiaying Wang
- Zhejiang Province Key Laboratory of Anti-Cancer Drug Research, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, China
| | - Jiajia Wang
- Zhejiang Province Key Laboratory of Anti-Cancer Drug Research, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, China
| | - Jincheng Wang
- Zhejiang Province Key Laboratory of Anti-Cancer Drug Research, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, China
| | - Bo Yang
- Zhejiang Province Key Laboratory of Anti-Cancer Drug Research, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, China
| | - Qinjie Weng
- Zhejiang Province Key Laboratory of Anti-Cancer Drug Research, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, China.,Center for Drug Safety Evaluation and Research, Zhejiang University, Hangzhou, China
| | - Qiaojun He
- Zhejiang Province Key Laboratory of Anti-Cancer Drug Research, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, China.,Center for Drug Safety Evaluation and Research, Zhejiang University, Hangzhou, China
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135
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Kumar V. Toll-like receptors in the pathogenesis of neuroinflammation. J Neuroimmunol 2019; 332:16-30. [PMID: 30928868 DOI: 10.1016/j.jneuroim.2019.03.012] [Citation(s) in RCA: 216] [Impact Index Per Article: 43.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 03/19/2019] [Accepted: 03/19/2019] [Indexed: 12/17/2022]
Abstract
Toll-like receptors (TLRs) are discovered as crucial pattern recognition receptors (PRRs) involved in the recognition of pathogen-associated molecular patterns (PAMPs). Later studies showed their involvement in the recognition of various damage/danger-associated molecular patterns (DAMPs) generated by host itself. Thus, TLRs are capable of recognizing wide-array of patterns/molecules derived from pathogens and host as well and initiating a proinflammatory immune response through the activation of NF-κB and other transcription factors causing synthesis of proinflammatory molecules. The process of neuroinflammation is seen under both sterile and infectious inflammatory diseases of the central nervous system (CNS) and may lead to the development of neurodegeneration. The present article is designed to highlight the importance of TLRs in the pathogenesis of neuroinflammation under diverse conditions. TLRs are expressed by various immune cells present in CNS along with neurons. However out of thirteen TLRs described in mammals, some are present and active in these cells, while some are absent and are described in detail in main text. The role of various immune cells present in the brain and their role in the pathogenesis of neuroinflammation depending on the type of TLR expressed is described. Thereafter the role of TLRs in bacterial meningitis, viral encephalitis, stroke, Alzheimer's disease (AD), Parkinson's disease (PD), and autoimmune disease including multiple sclerosis (MS) is described. The article is designed for both neuroscientists needing information regarding TLRs in neuroinflammation and TLR biologists or immunologists interested in neuroinflammation.
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Affiliation(s)
- V Kumar
- Children Health Clinical Unit, School of Clinical Medicine, Faculty of Medicine, Mater Research, University of Queensland, ST Lucia, Brisbane, Queensland 4078, Australia; School of Biomedical Sciences, Faculty of Medicine, University of Queensland, ST Lucia, Brisbane, Queensland 4078, Australia.
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136
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Brochet B, Ruet A. Cognitive Impairment in Multiple Sclerosis With Regards to Disease Duration and Clinical Phenotypes. Front Neurol 2019; 10:261. [PMID: 30949122 PMCID: PMC6435517 DOI: 10.3389/fneur.2019.00261] [Citation(s) in RCA: 119] [Impact Index Per Article: 23.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Accepted: 02/27/2019] [Indexed: 12/26/2022] Open
Abstract
The relationships between cognitive impairment that exist during the clinical course of multiple sclerosis (MS) remain poorly described. The effect of disease duration has been studied in a few longitudinal cohorts and some cross-sectional studies that suggest that cognitive deficits tend to extend with disease duration. However, the effect of disease duration seems to be confounded by the effect of age. At the pre-clinical stage, cognitive deficits have been observed in patients with radiologically isolated syndromes, and their profile is similar than in clinically isolated syndromes (CIS) and relapsing-remitting MS (RRMS). The frequency of cognitive impairment tends to be higher in RRMS than in CIS. In these phenotypes, slowness of information processing speed (IPS) and episodic verbal and visuo-spatial memory deficits are frequently observed, but executive functions, and in particular verbal fluency, could also be impaired. More frequent and severe deficits are reported in SPMS than in RRMS with more severe deficits for memory tests, working memory and IPS. Similarly to what is observed in SPMS, patients with primary progressive MS (PPMS) present with a wide range of cognitive deficits in IPS, attention, working memory, executive functions, and verbal episodic memory with more tests and domains impaired than RRMS patients. Altogether these data suggested that not only the duration of the disease and age play an important role in the cognitive profile of patients, but also the phenotype itself, probably because of its specific pathological mechanism.
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Affiliation(s)
- Bruno Brochet
- Service de Neurologie, CHU de Bordeaux, Bordeaux, France.,Team Glia-Neuron Interactions, Neurocentre Magendie, INSERM U1215, Université de Bordeaux, Bordeaux, France
| | - Aurélie Ruet
- Service de Neurologie, CHU de Bordeaux, Bordeaux, France.,Team Glia-Neuron Interactions, Neurocentre Magendie, INSERM U1215, Université de Bordeaux, Bordeaux, France
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137
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Macías Islas MÁ, Ciampi E. Assessment and Impact of Cognitive Impairment in Multiple Sclerosis: An Overview. Biomedicines 2019; 7:E22. [PMID: 30893874 PMCID: PMC6466345 DOI: 10.3390/biomedicines7010022] [Citation(s) in RCA: 66] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Revised: 03/13/2019] [Accepted: 03/14/2019] [Indexed: 12/30/2022] Open
Abstract
Cognitive impairment affects 40⁻60% of patients with multiple sclerosis. It may be present early in the course of the disease and has an impact on a patient's employability, social interactions, and quality of life. In the last three decades, an increasing interest in diagnosis and management of cognitive impairment has arisen. Neuropsychological assessment and neuroimaging studies focusing on cognitive impairment are now being incorporated as primary outcomes in clinical trials. However, there are still key uncertainties concerning the underlying mechanisms of damage, neural basis, sensitivity and validity of neuropsychological tests, and efficacy of pharmacological and non-pharmacological interventions. The present article aimed to present an overview of the assessment, neural correlates, and impact of cognitive impairment in multiple sclerosis.
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Affiliation(s)
| | - Ethel Ciampi
- Neurology, Pontificia Universidad Católica de Chile, Neurology, Hospital Dr. Sótero del Río, Santiago 8320000, Chile.
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138
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Henstridge CM, Tzioras M, Paolicelli RC. Glial Contribution to Excitatory and Inhibitory Synapse Loss in Neurodegeneration. Front Cell Neurosci 2019; 13:63. [PMID: 30863284 PMCID: PMC6399113 DOI: 10.3389/fncel.2019.00063] [Citation(s) in RCA: 82] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2018] [Accepted: 02/08/2019] [Indexed: 12/12/2022] Open
Abstract
Synapse loss is an early feature shared by many neurodegenerative diseases, and it represents the major correlate of cognitive impairment. Recent studies reveal that microglia and astrocytes play a major role in synapse elimination, contributing to network dysfunction associated with neurodegeneration. Excitatory and inhibitory activity can be affected by glia-mediated synapse loss, resulting in imbalanced synaptic transmission and subsequent synaptic dysfunction. Here, we review the recent literature on the contribution of glia to excitatory/inhibitory imbalance, in the context of the most common neurodegenerative disorders. A better understanding of the mechanisms underlying pathological synapse loss will be instrumental to design targeted therapeutic interventions, taking in account the emerging roles of microglia and astrocytes in synapse remodeling.
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Affiliation(s)
- Christopher M Henstridge
- Centre for Discovery Brain Sciences, The University of Edinburgh, Edinburgh, United Kingdom.,Dementia Research Institute UK, The University of Edinburgh, Edinburgh, United Kingdom
| | - Makis Tzioras
- Centre for Discovery Brain Sciences, The University of Edinburgh, Edinburgh, United Kingdom.,Dementia Research Institute UK, The University of Edinburgh, Edinburgh, United Kingdom
| | - Rosa C Paolicelli
- Department of Physiology, University of Lausanne, Lausanne, Switzerland
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139
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Liguori M, Nuzziello N, Simone M, Amoroso N, Viterbo RG, Tangaro S, Consiglio A, Giordano P, Bellotti R, Trojano M. Association between miRNAs expression and cognitive performances of Pediatric Multiple Sclerosis patients: A pilot study. Brain Behav 2019; 9:e01199. [PMID: 30656857 PMCID: PMC6379516 DOI: 10.1002/brb3.1199] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Accepted: 11/28/2018] [Indexed: 12/11/2022] Open
Abstract
INTRODUCTION The Pediatric onset of Multiple Sclerosis (PedMS) occurs in up to 10% of all cases. Cognitive impairment is one of the frequent symptoms, exerting severe impact in patients' quality of life and school performances. The underlying pathogenic mechanisms are not fully understood, and molecular markers predictive of cognitive dysfunctions need to be identified. On these grounds, we searched for molecular signature/s (i.e., miRNAs and target genes) associated with cognitive impairment in a selected population of PedMS patients. Additionally, changes of their regional brain volumes associated with the miRNAs of interest were investigated. METHODS Nineteen PedMS subjects received a full cognitive evaluation; total RNA from peripheral blood samples was processed by next-generation sequencing followed by a bioinformatics/biostatistics analysis. RESULTS The expression of 11 miRNAs significantly correlated with the scores obtained at different cognitive tests; among the others, eight miRNAs correlated with the Trail Making Tests. The computational target prediction identified 337 genes targeted by the miRNAs of interest; a tangled network of molecular connections was hypothesized, where genes like BST1, NTNG2, SPTB, and STAB1, already associated with cognitive dysfunctions, were nodes of the net. Furthermore, the expression of some miRNAs significantly correlated with cerebral volumes, for example, four miRNAs with the cerebellum cortex. CONCLUSIONS As far as we know, this is the first evaluation exploring miRNAs in the cognitive performances of PedMS. Although none of these results survived the multiple tests' corrections, we believe that they may represent a step forward the identification of biomarkers useful for monitoring and targeting the onset/progression of cognitive impairments in MS.
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Affiliation(s)
- Maria Liguori
- National Research CouncilBari UnitInstitute of Biomedical TechnologiesBariItaly
| | - Nicoletta Nuzziello
- National Research CouncilBari UnitInstitute of Biomedical TechnologiesBariItaly
| | - Marta Simone
- Unit for Severe Disabilities in Developmental Age and Young Adults, Developmental Neurology and NeurorehabilitationScientific Institute IRCCS E. MedeaBrindisiItaly
- Department of Basic Sciences, Neurosciences and Sense OrgansUniversity of BariBariItaly
| | - Nicola Amoroso
- Dipartimento Interateneo di Fisica “M. Merlin”Università degli studi di Bari “A. Moro”BariItaly
- Istituto Nazionale di Fisica Nucleare, Sezione di BariBariItaly
| | - Rosa Gemma Viterbo
- Department of Basic Sciences, Neurosciences and Sense OrgansUniversity of BariBariItaly
| | - Sabina Tangaro
- Istituto Nazionale di Fisica Nucleare, Sezione di BariBariItaly
| | - Arianna Consiglio
- National Research CouncilBari UnitInstitute of Biomedical TechnologiesBariItaly
| | - Paola Giordano
- General Paediatric Unit “B. Trambusti”, Azienda Policlinico‐Giovanni XXIIIUniversity of BariBariItaly
| | - Roberto Bellotti
- Dipartimento Interateneo di Fisica “M. Merlin”Università degli studi di Bari “A. Moro”BariItaly
- Istituto Nazionale di Fisica Nucleare, Sezione di BariBariItaly
| | - Maria Trojano
- Department of Basic Sciences, Neurosciences and Sense OrgansUniversity of BariBariItaly
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140
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Microglia in Central Nervous System Inflammation and Multiple Sclerosis Pathology. Trends Mol Med 2018; 25:112-123. [PMID: 30578090 DOI: 10.1016/j.molmed.2018.11.005] [Citation(s) in RCA: 302] [Impact Index Per Article: 50.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Revised: 11/22/2018] [Accepted: 11/26/2018] [Indexed: 02/06/2023]
Abstract
Microglia are the resident macrophages of the central nervous system (CNS). They have important physiological functions in maintaining tissue homeostasis but also contribute to CNS pathology. Microglia respond to changes in the microenvironment, and the resulting reactive phenotype can be very diverse, with both neuroinflammatory and neuroprotective properties, illustrating the plasticity of these cells. Recent progress in understanding the autoimmune neuroinflammatory disease multiple sclerosis (MS) and its animal model experimental autoimmune encephalomyelitis suggests major roles for microglia in the disease, which have drastically changed our view on the function of microglia in MS.
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