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Finlayson M, Feys P, Dalgas U, Kos D. Intermediate outcomes for clinical trials of multiple sclerosis rehabilitation interventions: Conceptual and practical considerations. Mult Scler 2023; 29:1186-1194. [PMID: 37555489 PMCID: PMC10413783 DOI: 10.1177/13524585231189674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 06/06/2023] [Accepted: 06/08/2023] [Indexed: 08/10/2023]
Abstract
BACKGROUND Rehabilitation is an essential health care service and a critical component of comprehensive multiple sclerosis (MS) care. OBJECTIVE As part of a 2-day meeting hosted by the International Advisory Committee on Clinical Trials in MS in December 2022, a panel initiated a discussion on the conceptual and practical issues related to selecting intermediate outcomes for clinical trials of MS rehabilitation interventions. RESULTS The overarching goal of rehabilitation - optimal functioning - was acknowledged as a complex biopsychosocial phenomenon that varies with patient priorities and environmental context. This complexity means that multiple causal pathways and potential intermediate outcomes must be carefully considered during the design of clinical trials in MS rehabilitation that aim to improve functioning. In addition, practical issues must be considered such as psychometric properties of outcome measures, measure type, and characteristics of the target population, including severity of dysfunction. CONCLUSION This article uses the International Classification of Functioning, Disability and Health as a foundation for determining relevant intermediate outcomes for clinical trials of MS rehabilitation interventions.
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Affiliation(s)
- Marcia Finlayson
- School of Rehabilitation Therapy, Queen’s University, Kingston ON, Canada
| | - Peter Feys
- REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium; UMSC Hasselt, Pelt, Belgium
| | - Ulrik Dalgas
- Exercise Biology, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Daphne Kos
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium; National Multiple Sclerosis Center Melsbroek, Steenokkerzeel, Belgium
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2
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Liković M, Buljevac M. ‶You look really good, I don't know why you came here″: persons with multiple sclerosis´ perspectives on social support. Home Health Care Serv Q 2023:1-22. [PMID: 36913915 DOI: 10.1080/01621424.2023.2189645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/15/2023]
Abstract
The aim of this qualitative study is to gain insight into the perspectives of persons with multiple sclerosis on social support. Semi-structured interviews were conducted with eleven persons with multiple sclerosis. The results on informal support for persons with multiple sclerosis reveal perceived support and the lack of support from different persons. The results on formal support for persons with multiple sclerosis show perceived support from healthcare professionals, professionals working outside healthcare and social care systems, and associations of persons with MS, but also inadequate support from healthcare professionals and social workers. Close emotional relationship, empathy, knowledge and understanding are the basis for provision of all types of support from informal support system, while perceived support from formal support system is based on professionals´ empathy, their professionalism and knowledge. Persons with multiple sclerosis need accurate and timely emotional, informational, practical and financial support.
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Affiliation(s)
- Maja Liković
- Department of Social Work, Faculty of Law, University of Zagreb, Zagreb, Croatia
| | - Marko Buljevac
- Department of Social Work, Faculty of Law, University of Zagreb, Zagreb, Croatia
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Buyukturkoglu K, Dworkin JD, Leiva V, Provenzano FA, Guevara P, De Jager PL, Leavitt VM, Riley CS. Brain volumetric correlates of remotely versus in-person administered symbol digit modalities test in multiple sclerosis. Mult Scler Relat Disord 2022; 68:104247. [PMID: 36274283 DOI: 10.1016/j.msard.2022.104247] [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: 04/19/2022] [Revised: 09/25/2022] [Accepted: 10/15/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND Prior studies in multiple sclerosis (MS) support reliability of telehealth-delivered cognitive batteries, although, to date, none have reported relationships of cognitive test performance to neural correlates across administration modalities. In this study we aimed to compare brain-behavior relationships, using the Symbol Digit Modalities Test (SDMT), the most reliable and sensitive cognitive measure in MS, measured from patients seen via telehealth versus in-person. METHODS SDMT was administered to individuals with MS either in-person (N=60, mean age=39.7) or remotely via video conference (N=51, mean age=47.4). Magnetic resonance imaging (MRI) data was collected in 3-Tesla scanners. Using 3-dimensional T1 images cerebral, cortical, deep gray, cerebral white matter and thalamic nuclei volumes were calculated. Using a meta-analysis approach with an interaction term for participant group, individual regression models were run for each MRI measure having SDMT scores as the outcome variable in each model. In addition, the correlation and average difference between In-person and Remote group associations across the MRI measures were calculated. Finally, for each MRI variable I2 score was quantified to test the heterogeneity between the groups. RESULTS Administration modality did not affect the association of SDMT performance with MRI measures. Brain tissue volumes showing high associations with the SDMT scores in one group also showed high associations in the other (r = 0.83; 95% CI = [0.07, 0.86]). The average difference between the In-person and the Remote group associations was not significant (βRemote - βIn-person = 0.14, 95% CI = [-0.04, 0.34]). Across MRI measures, the average I2 value was 14%, reflecting very little heterogeneity in the relationship of SDMT performance to brain volume. CONCLUSION We found consistent relationships to neural correlates across in-person and remote SDMT administration modalities. Hence, our study extended the findings of the previous studies demonstrating the feasibility of remote administration of the SDMT.
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Affiliation(s)
- Korhan Buyukturkoglu
- Department of Neurology, Columbia University Irving Medical Center, 630 W. 168th Street, PH 18-324, New York, NY 10032, USA; The Center for Translational and Computational Neuroimmunology, NY, USA; Columbia University MS Center, NY, USA.
| | - Jordan D Dworkin
- Department of Psychiatry, Columbia University and the New York State Psychiatric Institute, NY, USA
| | - Victor Leiva
- Department of Biomedical Engineering, Universidad de Concepción, Santiago, Chile
| | - Frank A Provenzano
- Department of Neurology, Columbia University Irving Medical Center, 630 W. 168th Street, PH 18-324, New York, NY 10032, USA
| | - Pamela Guevara
- Department of Biomedical Engineering, Universidad de Concepción, Santiago, Chile
| | - Philip L De Jager
- Department of Neurology, Columbia University Irving Medical Center, 630 W. 168th Street, PH 18-324, New York, NY 10032, USA; The Center for Translational and Computational Neuroimmunology, NY, USA; Columbia University MS Center, NY, USA
| | - Victoria M Leavitt
- Department of Neurology, Columbia University Irving Medical Center, 630 W. 168th Street, PH 18-324, New York, NY 10032, USA
| | - Claire S Riley
- Department of Neurology, Columbia University Irving Medical Center, 630 W. 168th Street, PH 18-324, New York, NY 10032, USA; The Center for Translational and Computational Neuroimmunology, NY, USA; Columbia University MS Center, NY, USA
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Jandric D, Parker GJM, Haroon H, Tomassini V, Muhlert N, Lipp I. A tractometry principal component analysis of white matter tract network structure and relationships with cognitive function in relapsing-remitting multiple sclerosis. Neuroimage Clin 2022; 34:102995. [PMID: 35349892 PMCID: PMC8958271 DOI: 10.1016/j.nicl.2022.102995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 03/04/2022] [Accepted: 03/23/2022] [Indexed: 10/25/2022]
Abstract
Understanding the brain changes underlying cognitive dysfunction is a key priority in multiple sclerosis (MS) to improve monitoring and treatment of this debilitating symptom. Functional connectivity network changes are associated with cognitive dysfunction, but it is less well understood how changes in normal appearing white matter relate to cognitive symptoms. If white matter tracts have network structure it would be expected that tracts within a network share susceptibility to MS pathology. In the present study, we used a tractometry approach to explore patterns of variance in white matter metrics across white matter (WM) tracts, and assessed how such patterns relate to neuropsychological test performance across cognitive domains. A sample of 102 relapsing-remitting MS patients and 27 healthy controls underwent MRI and neuropsychological testing. Tractography was performed on diffusion MRI data to extract 40 WM tracts and microstructural measures were extracted from each tract. Principal component analysis (PCA) was used to decompose metrics from all tracts to assess the presence of any co-variance structure among the tracts. Similarly, PCA was applied to cognitive test scores to identify the main cognitive domains. Finally, we assessed the ability of tract co-variance patterns to predict test performance across cognitive domains. We found that a single co-variance pattern which captured microstructure across all tracts explained the most variance (65% variance explained) and that there was little evidence for separate, smaller network patterns of pathology. Variance in this pattern was explained by effects related to lesions, but one main co-variance pattern persisted after this effect was regressed out. This main WM tract co-variance pattern contributed to explaining a modest degree of variance in one of our four cognitive domains in MS. These findings highlight the need to investigate the relationship between the normal appearing white matter and cognitive impairment further and on a more granular level, to improve the understanding of the network structure of the brain in MS.
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Affiliation(s)
- Danka Jandric
- Division of Neuroscience & Experimental Psychology, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Geoff J M Parker
- Centre for Medical Image Computing, Department of Medical Physics & Biomedical Engineering and Department of Neuroinflammation, Queen Square Institute of Neurology, University College London, London, UK; Bioxydyn Limited, Manchester, UK
| | - Hamied Haroon
- Division of Neuroscience & Experimental Psychology, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Valentina Tomassini
- Cardiff University Brain Research Imaging Centre, Cardiff University, Cardiff, UK; Institute for Advanced Biomedical Technologies (ITAB), Department of Neurosciences, Imaging and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy; Multiple Sclerosis Centre, Department of Neurology, SS. Annunziata University Hospital, Chieti, Italy
| | - Nils Muhlert
- Division of Neuroscience & Experimental Psychology, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Ilona Lipp
- Cardiff University Brain Research Imaging Centre, Cardiff University, Cardiff, UK; Department of Neurophysics, Max Planck Institute for Human Cognitive & Brain Sciences, Leipzig, Germany.
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Rivera D, Usuga DR, Mendoza EMF, Arelis AA, Barajas BVR, Islas MÁM, Krch D, Lequerica AH, Arango-Lasprilla JC. Validation of the Norma Latina neuropsychological assessment battery in individuals with multiple sclerosis in Mexico. Mult Scler Relat Disord 2022; 59:103685. [DOI: 10.1016/j.msard.2022.103685] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 01/23/2022] [Accepted: 02/11/2022] [Indexed: 10/19/2022]
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6
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Jandric D, Lipp I, Paling D, Rog D, Castellazzi G, Haroon H, Parkes L, Parker GJM, Tomassini V, Muhlert N. Mechanisms of Network Changes in Cognitive Impairment in Multiple Sclerosis. Neurology 2021; 97:e1886-e1897. [PMID: 34649879 PMCID: PMC8601205 DOI: 10.1212/wnl.0000000000012834] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 09/13/2021] [Indexed: 12/14/2022] Open
Abstract
Background and Objectives Cognitive impairment in multiple sclerosis (MS) is associated with functional connectivity abnormalities. While there have been calls to use functional connectivity measures as biomarkers, there remains to be a full understanding of why they are affected in MS. In this cross-sectional study, we tested the hypothesis that functional network regions may be susceptible to disease-related “wear and tear” and that this can be observable on co-occurring abnormalities on other magnetic resonance metrics. We tested whether functional connectivity abnormalities in cognitively impaired patients with MS co-occur with (1) overlapping, (2) local, or (3) distal changes in anatomic connectivity and cerebral blood flow abnormalities. Methods Multimodal 3T MRI and assessment with the Brief Repeatable Battery of Neuropsychological tests were performed in 102 patients with relapsing-remitting MS and 27 healthy controls. Patients with MS were classified as cognitively impaired if they scored ≥1.5 SDs below the control mean on ≥2 tests (n = 55) or as cognitively preserved (n = 47). Functional connectivity was assessed with Independent Component Analysis and dual regression of resting-state fMRI images. Cerebral blood flow maps were estimated, and anatomic connectivity was assessed with anatomic connectivity mapping and fractional anisotropy of diffusion-weighted MRI. Changes in cerebral blood flow and anatomic connectivity were assessed within resting-state networks that showed functional connectivity abnormalities in cognitively impaired patients with MS. Results Functional connectivity was significantly decreased in the anterior and posterior default mode networks and significantly increased in the right and left frontoparietal networks in cognitively impaired relative to cognitively preserved patients with MS (threshold-free cluster enhancement corrected at p ≤ 0.05, 2 sided). Networks showing functional abnormalities showed altered cerebral blood flow and anatomic connectivity locally and distally but not in overlapping locations. Discussion We provide the first evidence that functional connectivity abnormalities are accompanied by local cerebral blood flow and structural connectivity abnormalities but also demonstrate that these effects do not occur in exactly the same location. Our findings suggest a possibly shared pathologic mechanism for altered functional connectivity in brain networks in MS.
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Affiliation(s)
- Danka Jandric
- From the Division of Neuroscience & Experimental Psychology (D.J., H.H., L.P., G.P., N.M.), School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, UK; Department of Neurophysics (I.L.), Max Planck Institute for Human Cognitive & Brain Sciences, Leipzig, Germany; Royal Hallamshire Hospital (D.P.), Sheffield Teaching Hospitals, NHS UK; Salford Royal Hospital (D.R.), Salford Royal NHS Foundation Trust, NHS UK; NMR Research Unit (G.C.), Queens Square Multiple Sclerosis Centre, and Centre for Medical Image Computing (G.C., G.P.), Department of Computer Science and Department of Neuroinflammation, Queen Square Institute of Neurology, University College London; Cardiff University Brain Research Imaging Centre (V.T.), Cardiff University, UK; Institute for Advanced Biomedical Technologies (ITAB) (V.T.), Department of Neurosciences, Imaging and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara; and Multiple Sclerosis Centre (V.T.), Department of Neurology, SS Annunziata University Hospital, Chieti, Italy
| | - Ilona Lipp
- From the Division of Neuroscience & Experimental Psychology (D.J., H.H., L.P., G.P., N.M.), School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, UK; Department of Neurophysics (I.L.), Max Planck Institute for Human Cognitive & Brain Sciences, Leipzig, Germany; Royal Hallamshire Hospital (D.P.), Sheffield Teaching Hospitals, NHS UK; Salford Royal Hospital (D.R.), Salford Royal NHS Foundation Trust, NHS UK; NMR Research Unit (G.C.), Queens Square Multiple Sclerosis Centre, and Centre for Medical Image Computing (G.C., G.P.), Department of Computer Science and Department of Neuroinflammation, Queen Square Institute of Neurology, University College London; Cardiff University Brain Research Imaging Centre (V.T.), Cardiff University, UK; Institute for Advanced Biomedical Technologies (ITAB) (V.T.), Department of Neurosciences, Imaging and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara; and Multiple Sclerosis Centre (V.T.), Department of Neurology, SS Annunziata University Hospital, Chieti, Italy
| | - David Paling
- From the Division of Neuroscience & Experimental Psychology (D.J., H.H., L.P., G.P., N.M.), School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, UK; Department of Neurophysics (I.L.), Max Planck Institute for Human Cognitive & Brain Sciences, Leipzig, Germany; Royal Hallamshire Hospital (D.P.), Sheffield Teaching Hospitals, NHS UK; Salford Royal Hospital (D.R.), Salford Royal NHS Foundation Trust, NHS UK; NMR Research Unit (G.C.), Queens Square Multiple Sclerosis Centre, and Centre for Medical Image Computing (G.C., G.P.), Department of Computer Science and Department of Neuroinflammation, Queen Square Institute of Neurology, University College London; Cardiff University Brain Research Imaging Centre (V.T.), Cardiff University, UK; Institute for Advanced Biomedical Technologies (ITAB) (V.T.), Department of Neurosciences, Imaging and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara; and Multiple Sclerosis Centre (V.T.), Department of Neurology, SS Annunziata University Hospital, Chieti, Italy
| | - David Rog
- From the Division of Neuroscience & Experimental Psychology (D.J., H.H., L.P., G.P., N.M.), School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, UK; Department of Neurophysics (I.L.), Max Planck Institute for Human Cognitive & Brain Sciences, Leipzig, Germany; Royal Hallamshire Hospital (D.P.), Sheffield Teaching Hospitals, NHS UK; Salford Royal Hospital (D.R.), Salford Royal NHS Foundation Trust, NHS UK; NMR Research Unit (G.C.), Queens Square Multiple Sclerosis Centre, and Centre for Medical Image Computing (G.C., G.P.), Department of Computer Science and Department of Neuroinflammation, Queen Square Institute of Neurology, University College London; Cardiff University Brain Research Imaging Centre (V.T.), Cardiff University, UK; Institute for Advanced Biomedical Technologies (ITAB) (V.T.), Department of Neurosciences, Imaging and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara; and Multiple Sclerosis Centre (V.T.), Department of Neurology, SS Annunziata University Hospital, Chieti, Italy
| | - Gloria Castellazzi
- From the Division of Neuroscience & Experimental Psychology (D.J., H.H., L.P., G.P., N.M.), School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, UK; Department of Neurophysics (I.L.), Max Planck Institute for Human Cognitive & Brain Sciences, Leipzig, Germany; Royal Hallamshire Hospital (D.P.), Sheffield Teaching Hospitals, NHS UK; Salford Royal Hospital (D.R.), Salford Royal NHS Foundation Trust, NHS UK; NMR Research Unit (G.C.), Queens Square Multiple Sclerosis Centre, and Centre for Medical Image Computing (G.C., G.P.), Department of Computer Science and Department of Neuroinflammation, Queen Square Institute of Neurology, University College London; Cardiff University Brain Research Imaging Centre (V.T.), Cardiff University, UK; Institute for Advanced Biomedical Technologies (ITAB) (V.T.), Department of Neurosciences, Imaging and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara; and Multiple Sclerosis Centre (V.T.), Department of Neurology, SS Annunziata University Hospital, Chieti, Italy
| | - Hamied Haroon
- From the Division of Neuroscience & Experimental Psychology (D.J., H.H., L.P., G.P., N.M.), School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, UK; Department of Neurophysics (I.L.), Max Planck Institute for Human Cognitive & Brain Sciences, Leipzig, Germany; Royal Hallamshire Hospital (D.P.), Sheffield Teaching Hospitals, NHS UK; Salford Royal Hospital (D.R.), Salford Royal NHS Foundation Trust, NHS UK; NMR Research Unit (G.C.), Queens Square Multiple Sclerosis Centre, and Centre for Medical Image Computing (G.C., G.P.), Department of Computer Science and Department of Neuroinflammation, Queen Square Institute of Neurology, University College London; Cardiff University Brain Research Imaging Centre (V.T.), Cardiff University, UK; Institute for Advanced Biomedical Technologies (ITAB) (V.T.), Department of Neurosciences, Imaging and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara; and Multiple Sclerosis Centre (V.T.), Department of Neurology, SS Annunziata University Hospital, Chieti, Italy
| | - Laura Parkes
- From the Division of Neuroscience & Experimental Psychology (D.J., H.H., L.P., G.P., N.M.), School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, UK; Department of Neurophysics (I.L.), Max Planck Institute for Human Cognitive & Brain Sciences, Leipzig, Germany; Royal Hallamshire Hospital (D.P.), Sheffield Teaching Hospitals, NHS UK; Salford Royal Hospital (D.R.), Salford Royal NHS Foundation Trust, NHS UK; NMR Research Unit (G.C.), Queens Square Multiple Sclerosis Centre, and Centre for Medical Image Computing (G.C., G.P.), Department of Computer Science and Department of Neuroinflammation, Queen Square Institute of Neurology, University College London; Cardiff University Brain Research Imaging Centre (V.T.), Cardiff University, UK; Institute for Advanced Biomedical Technologies (ITAB) (V.T.), Department of Neurosciences, Imaging and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara; and Multiple Sclerosis Centre (V.T.), Department of Neurology, SS Annunziata University Hospital, Chieti, Italy
| | - Geoff J M Parker
- From the Division of Neuroscience & Experimental Psychology (D.J., H.H., L.P., G.P., N.M.), School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, UK; Department of Neurophysics (I.L.), Max Planck Institute for Human Cognitive & Brain Sciences, Leipzig, Germany; Royal Hallamshire Hospital (D.P.), Sheffield Teaching Hospitals, NHS UK; Salford Royal Hospital (D.R.), Salford Royal NHS Foundation Trust, NHS UK; NMR Research Unit (G.C.), Queens Square Multiple Sclerosis Centre, and Centre for Medical Image Computing (G.C., G.P.), Department of Computer Science and Department of Neuroinflammation, Queen Square Institute of Neurology, University College London; Cardiff University Brain Research Imaging Centre (V.T.), Cardiff University, UK; Institute for Advanced Biomedical Technologies (ITAB) (V.T.), Department of Neurosciences, Imaging and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara; and Multiple Sclerosis Centre (V.T.), Department of Neurology, SS Annunziata University Hospital, Chieti, Italy
| | - Valentina Tomassini
- From the Division of Neuroscience & Experimental Psychology (D.J., H.H., L.P., G.P., N.M.), School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, UK; Department of Neurophysics (I.L.), Max Planck Institute for Human Cognitive & Brain Sciences, Leipzig, Germany; Royal Hallamshire Hospital (D.P.), Sheffield Teaching Hospitals, NHS UK; Salford Royal Hospital (D.R.), Salford Royal NHS Foundation Trust, NHS UK; NMR Research Unit (G.C.), Queens Square Multiple Sclerosis Centre, and Centre for Medical Image Computing (G.C., G.P.), Department of Computer Science and Department of Neuroinflammation, Queen Square Institute of Neurology, University College London; Cardiff University Brain Research Imaging Centre (V.T.), Cardiff University, UK; Institute for Advanced Biomedical Technologies (ITAB) (V.T.), Department of Neurosciences, Imaging and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara; and Multiple Sclerosis Centre (V.T.), Department of Neurology, SS Annunziata University Hospital, Chieti, Italy
| | - Nils Muhlert
- From the Division of Neuroscience & Experimental Psychology (D.J., H.H., L.P., G.P., N.M.), School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, UK; Department of Neurophysics (I.L.), Max Planck Institute for Human Cognitive & Brain Sciences, Leipzig, Germany; Royal Hallamshire Hospital (D.P.), Sheffield Teaching Hospitals, NHS UK; Salford Royal Hospital (D.R.), Salford Royal NHS Foundation Trust, NHS UK; NMR Research Unit (G.C.), Queens Square Multiple Sclerosis Centre, and Centre for Medical Image Computing (G.C., G.P.), Department of Computer Science and Department of Neuroinflammation, Queen Square Institute of Neurology, University College London; Cardiff University Brain Research Imaging Centre (V.T.), Cardiff University, UK; Institute for Advanced Biomedical Technologies (ITAB) (V.T.), Department of Neurosciences, Imaging and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara; and Multiple Sclerosis Centre (V.T.), Department of Neurology, SS Annunziata University Hospital, Chieti, Italy.
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Wang Z, Baharani A, Wei Z, Truong D, Bi X, Wang F, Li XM, Verge VMK, Zhang Y. Low field magnetic stimulation promotes myelin repair and cognitive recovery in chronic cuprizone mouse model. Clin Exp Pharmacol Physiol 2021; 48:1090-1102. [PMID: 33638234 DOI: 10.1111/1440-1681.13490] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 02/09/2021] [Accepted: 02/23/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Multiple sclerosis (MS) is an inflammatory demyelinating disease featured with neuroinflammation, demyelination, and the loss of oligodendrocytes. Cognitive impairment and depression are common neuropsychiatric symptoms in MS that are poorly managed with the present interventions. OBJECTIVE This study aimed to investigate the effects of low field magnetic stimulation (LFMS), a novel non-invasive neuromodulation technology, on cognitive impairment and depressive symptoms associated with MS using a mouse model of demyelination. METHODS C57BL female mice were fed with a 0.2% cuprizone diet for 12 weeks to induce a chronic demyelinating model followed by 4 weeks of cuprizone withdrawal with either sham or LFMS treatment. RESULTS Improved cognition and depression-like behaviour and restored weight gain were observed in mice with LFMS treatment. Immunohistochemical and immunoblotting data showed enhanced myelin basic protein (MBP) and myelin oligodendrocyte glycoprotein expressions (MOG) in the prefrontal cortex of mice with LFMS treatment, supporting that myelin repair was promoted. LFMS also increased the protein expression of mature oligodendrocyte biomarker glutathione-S-transferase (GST-π). In addition, expression of TGF-β and associated receptors were elevated with LFMS treatment, implicating this pathway in the response. CONCLUSION Results from the present study revealed LFMS to have neuroprotective effects, suggesting that LFMS has potential therapeutic value for treating cognitive impairment and depression related to demyelination disorders.
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Affiliation(s)
- Zitong Wang
- Department of Psychiatry, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Akanksha Baharani
- Department of Psychiatry, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Zelan Wei
- College of Dentistry, University of Saskatchewan, Saskatoon, SK, Canada
| | - Davin Truong
- College of Dentistry, University of Saskatchewan, Saskatoon, SK, Canada
| | - Xiaoying Bi
- Department of Neurology, Shanghai Changhai Hospital, the Second Military Medical University, Shanghai, China
| | - Fei Wang
- Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China
| | - Xin-Min Li
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Valerie M K Verge
- Department of Anatomy, Physiology and Pharmacology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
- Cameco MS Neuroscience Research Centre, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Yanbo Zhang
- Department of Psychiatry, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
- Cameco MS Neuroscience Research Centre, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
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8
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Ayoobi F, Khalili P, Azin H, Shahrokhabadi S, Azin M. Effects of tactile stimulation on the sensory, motor and cognitive function in people with multiple sclerosis. Clin Neurol Neurosurg 2021; 205:106643. [PMID: 33906001 DOI: 10.1016/j.clineuro.2021.106643] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 03/01/2021] [Accepted: 04/05/2021] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Multiple sclerosis (MS) is a chronic inflammatory neurodegenerative disease that causes demyelination in the brain and spinal cord. Repetitive sensory stimulation (RSS) can enhance sensory perception and motor function, improve inappropriate synaptic connections and adaptable malformations, and increase cognitive function. The purpose of this study was to specify the effect of RSS on the sensory, motor, and cognitive function in people with MS. METHODS RSS was applied to 50 people with MS. In this study, the following tests were used: two-point discrimination, 9-Hole Peg Test (9-HPT), Box and Block Test (BBT), hand mental rotation (HMR), Paced Auditory Serial Addition Test (PASAT), and Symbol Digit Modalities Test (SDMT). The tests were performed before and after the intervention. RESULTS The results of this study showed significant difference before and after the stimulation in intervention and control groups two-point discrimination threshold (both groups= 0.001), BBT score (both groups: P < 0.001) and 9-HPT score (both groups: P < 0.001), HMR ability (reaction time: both groups: P = 0.003; accuracy rate: intervention: P = 0.004, control: P < 0.001), PASAT score (intervention: P < 0.001, control: P = 0.012) and SDMT score (intervention: P = 0.008, control: P < 0.001), but there was no statistical difference observed between the two groups before and after the intervention in terms of the mentioned variables (P > 0.05). CONCLUSION The application of 30 min of RSS in the right index finger of people with MS could not improve the two-point discrimination threshold and the manual dexterity. In addition, this intervention did not improve cognitive function.
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Affiliation(s)
- Fatemeh Ayoobi
- Non-Communicable Diseases Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Parvin Khalili
- Social Determinants of Health Research Centre, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Hossein Azin
- Non-Communicable Diseases Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran; Neurology Department, School of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Shohreh Shahrokhabadi
- Physiology-pharmacology Research Center, Research Institute of Basic Medical Sciences, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Mahdieh Azin
- Physiology-pharmacology Research Center, Research Institute of Basic Medical Sciences, Rafsanjan University of Medical Sciences, Rafsanjan, Iran; Department of Physiology and Pharmacology, School of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.
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Khaw YM, Tierney A, Cunningham C, Soto-Díaz K, Kang E, Steelman AJ, Inoue M. Astrocytes lure CXCR2-expressing CD4 + T cells to gray matter via TAK1-mediated chemokine production in a mouse model of multiple sclerosis. Proc Natl Acad Sci U S A 2021; 118:e2017213118. [PMID: 33597297 PMCID: PMC7923593 DOI: 10.1073/pnas.2017213118] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Multiple sclerosis (MS) is a chronic neurological disease of the central nervous system driven by peripheral immune cell infiltration and glial activation. The pathological hallmark of MS is demyelination, and mounting evidence suggests neuronal damage in gray matter is a major contributor to disease irreversibility. While T cells are found in both gray and white matter of MS tissue, they are typically confined to the white matter of the most commonly used mouse model of MS, experimental autoimmune encephalomyelitis (EAE). Here, we used a modified EAE mouse model (Type-B EAE) that displays severe neuronal damage to investigate the interplay between peripheral immune cells and glial cells in the event of neuronal damage. We show that CD4+ T cells migrate to the spinal cord gray matter, preferentially to ventral horns. Compared to CD4+ T cells in white matter, gray matter-infiltrated CD4+ T cells were mostly immobilized and interacted with neurons, which are behaviors associated with detrimental effects to normal neuronal function. T cell-specific deletion of CXCR2 significantly decreased CD4+ T cell infiltration into gray matter in Type-B EAE mice. Further, astrocyte-targeted deletion of TAK1 inhibited production of CXCR2 ligands such as CXCL1 in gray matter, successfully prevented T cell migration into spinal cord gray matter, and averted neuronal damage and motor dysfunction in Type-B EAE mice. This study identifies astrocyte chemokine production as a requisite for the invasion of CD4+T cell into the gray matter to induce neuronal damage.
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Affiliation(s)
- Yee Ming Khaw
- Department of Comparative Biosciences, University of Illinois at Urbana-Champaign, Urbana, IL 61802
- Neuroscience Program, University of Illinois at Urbana-Champaign, Urbana, IL 61801
| | - Abbey Tierney
- Department of Comparative Biosciences, University of Illinois at Urbana-Champaign, Urbana, IL 61802
- School of Molecular and Cell Biology, University of Illinois at Urbana-Champaign, Urbana, IL 61801
| | - Claire Cunningham
- Department of Comparative Biosciences, University of Illinois at Urbana-Champaign, Urbana, IL 61802
- School of Molecular and Cell Biology, University of Illinois at Urbana-Champaign, Urbana, IL 61801
| | - Katiria Soto-Díaz
- Neuroscience Program, University of Illinois at Urbana-Champaign, Urbana, IL 61801
- Department of Animal Sciences, College of Agricultural, Consumer, and Environmental Sciences, University of Illinois Urbana-Champaign, Urbana, IL 61801
- Division of Nutritional Sciences, University of Illinois Urbana-Champaign, Urbana, IL 61801
| | - Eunjoo Kang
- Department of Comparative Biosciences, University of Illinois at Urbana-Champaign, Urbana, IL 61802
- Neuroscience Program, University of Illinois at Urbana-Champaign, Urbana, IL 61801
| | - Andrew J Steelman
- Neuroscience Program, University of Illinois at Urbana-Champaign, Urbana, IL 61801
- Department of Animal Sciences, College of Agricultural, Consumer, and Environmental Sciences, University of Illinois Urbana-Champaign, Urbana, IL 61801
- Division of Nutritional Sciences, University of Illinois Urbana-Champaign, Urbana, IL 61801
| | - Makoto Inoue
- Department of Comparative Biosciences, University of Illinois at Urbana-Champaign, Urbana, IL 61802;
- Neuroscience Program, University of Illinois at Urbana-Champaign, Urbana, IL 61801
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Gray Matter Atrophy in the Cortico-Striatal-Thalamic Network and Sensorimotor Network in Relapsing-Remitting and Primary Progressive Multiple Sclerosis. Neuropsychol Rev 2021; 31:703-720. [PMID: 33582965 DOI: 10.1007/s11065-021-09479-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 01/04/2021] [Indexed: 02/05/2023]
Abstract
Gray matter atrophy in multiple sclerosis (MS) is thought to be associated with disability and cognitive impairment, but previous studies have sometimes had discordant results, and the atrophy patterns of relapsing-remitting multiple sclerosis (RRMS) and primary progressive multiple sclerosis (PPMS) remain to be clarified. We conducted a meta-analysis using anisotropic effect-size-based algorithms (AES-SDM) to identify consistent findings from whole-brain voxel-based morphometry (VBM) studies of gray matter volume (GMV) in 924 RRMS patients and 204 PPMS patients. This study is registered with PROSPERO (number CRD42019121319). Compared with healthy controls, RRMS and PPMS patients showed gray matter atrophy in the cortico-striatal-thalamic network, sensorimotor network, and bilateral insula. RRMS patients had a larger GMV in the left insula, cerebellum, right precentral gyrus, and bilateral putamen as well as a smaller GMV in the bilateral cingulate, caudate nucleus, right thalamus, superior temporal gyrus and left postcentral gyrus than PPMS patients. The disease duration, Expanded Disability Status Scale score, Paced Auditory Serial Addition Test z-score, and T2-weighted lesion load were associated with specific gray matter regions in RRMS or PPMS. Alterations in the cortico-striatal-thalamic networks, sensorimotor network, and insula may be involved in the common pathogenesis of RRMS and PPMS. The deficits in the cingulate gyrus and caudate nucleus are more apparent in RRMS than in PPMS. The more severe cerebellum atrophy in PPMS may be a brain feature associated with its neurological manifestations. These imaging biomarkers provide morphological evidence for the pathophysiology of MS and should be verified in future research.
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Renner A, Baetge SJ, Filser M, Penner IK. Working ability in individuals with different disease courses of multiple sclerosis: Factors beyond physical impairment. Mult Scler Relat Disord 2020; 46:102559. [DOI: 10.1016/j.msard.2020.102559] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 09/04/2020] [Accepted: 10/01/2020] [Indexed: 02/06/2023]
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Aktas O, Renner A, Huss A, Filser M, Baetge S, Stute N, Gasis M, Lepka K, Goebels N, Senel M, Graf J, Enzinger C, Pinter D, Antoch G, Turowski B, Hartung HP, Albrecht P, Otto M, Tumani H, Penner IK. Serum neurofilament light chain: No clear relation to cognition and neuropsychiatric symptoms in stable MS. NEUROLOGY-NEUROIMMUNOLOGY & NEUROINFLAMMATION 2020; 7:7/6/e885. [PMID: 32972970 PMCID: PMC7673283 DOI: 10.1212/nxi.0000000000000885] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 08/10/2020] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To explore the hypothesis that serum neurofilament light chain (sNfL) indicative of neuroaxonal damage may improve precise disease profiling with regard to cognition and neuropsychiatric symptoms, we analyzed potential associations of sNfL levels with cognitive test scores, fatigue, depression, and anxiety. METHODS Patients with relapsing-remitting and secondary progressive MS (SPMS) underwent an elaborated assessment including MRI, various cognitive tests, and patient-reported outcomes. We determined sNfL levels by single molecule array (Simoa) assay. Relationships between sNfL, cognition, neuropsychiatric symptoms, and demographical data were analyzed using correlations, group comparisons, and regressions. RESULTS In 45 clinically stable patients with MS (Expanded Disability Status Scale = 2.73 ± 1.12, disease duration = 10.03 ± 7.49 years), 40.0% were cognitively impaired. Mean sNfL levels were 16.02 ± 10.39 pg/mL, with higher levels in the SPMS subgroup (p = 0.038). sNfL levels did reliably link neither with the investigated cognitive and affective parameters nor with fatigue levels. The only relationship found in a small subgroup of patients with SPMS (n = 7) with visuospatial learning (r = -0.950, p = 0.001) and memory (r = -0.813; p = 0.026) disappeared when further controlling for age, educational level, and sex. CONCLUSIONS In patients with stable MS at less advanced disease stages, sNfL did not convincingly relate to cognitive performance, fatigue, depression, or anxiety and thus may not serve as a surrogate biomarker for neuropsychological status in such populations.
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Affiliation(s)
- Orhan Aktas
- From the Department of Neurology (O.A., M.G., K.L., N.G., J.G., H.-P.H., P.A., I.-K.P.), Medical Faculty, University Düsseldorf, Germany; Cogito Center for Applied Neurocognition and Neuropsychological Research (A.R., M.F., S.B., N.S., I.-K.P.), Düsseldorf, Germany; Department of Neurology (A.H., M.S., M.O., H.T.), University Hospital Ulm, Germany; Department of Neurology (C.E., D.P.), Research Unit for Neuronal Plasticity and Repair, Medical University of Graz, Austria; Division of Neuroradiology, Vascular and Interventional Radiology (C.E.), Department of Radiology, Medical University of Graz, Austria; Department of Diagnostic and Interventional Radiology (G.A., B.T.), Medical Faculty, University Düsseldorf, Germany; and Department of Neurology (H.T.), Dietenbronn, Germany
| | - Alina Renner
- From the Department of Neurology (O.A., M.G., K.L., N.G., J.G., H.-P.H., P.A., I.-K.P.), Medical Faculty, University Düsseldorf, Germany; Cogito Center for Applied Neurocognition and Neuropsychological Research (A.R., M.F., S.B., N.S., I.-K.P.), Düsseldorf, Germany; Department of Neurology (A.H., M.S., M.O., H.T.), University Hospital Ulm, Germany; Department of Neurology (C.E., D.P.), Research Unit for Neuronal Plasticity and Repair, Medical University of Graz, Austria; Division of Neuroradiology, Vascular and Interventional Radiology (C.E.), Department of Radiology, Medical University of Graz, Austria; Department of Diagnostic and Interventional Radiology (G.A., B.T.), Medical Faculty, University Düsseldorf, Germany; and Department of Neurology (H.T.), Dietenbronn, Germany
| | - André Huss
- From the Department of Neurology (O.A., M.G., K.L., N.G., J.G., H.-P.H., P.A., I.-K.P.), Medical Faculty, University Düsseldorf, Germany; Cogito Center for Applied Neurocognition and Neuropsychological Research (A.R., M.F., S.B., N.S., I.-K.P.), Düsseldorf, Germany; Department of Neurology (A.H., M.S., M.O., H.T.), University Hospital Ulm, Germany; Department of Neurology (C.E., D.P.), Research Unit for Neuronal Plasticity and Repair, Medical University of Graz, Austria; Division of Neuroradiology, Vascular and Interventional Radiology (C.E.), Department of Radiology, Medical University of Graz, Austria; Department of Diagnostic and Interventional Radiology (G.A., B.T.), Medical Faculty, University Düsseldorf, Germany; and Department of Neurology (H.T.), Dietenbronn, Germany
| | - Melanie Filser
- From the Department of Neurology (O.A., M.G., K.L., N.G., J.G., H.-P.H., P.A., I.-K.P.), Medical Faculty, University Düsseldorf, Germany; Cogito Center for Applied Neurocognition and Neuropsychological Research (A.R., M.F., S.B., N.S., I.-K.P.), Düsseldorf, Germany; Department of Neurology (A.H., M.S., M.O., H.T.), University Hospital Ulm, Germany; Department of Neurology (C.E., D.P.), Research Unit for Neuronal Plasticity and Repair, Medical University of Graz, Austria; Division of Neuroradiology, Vascular and Interventional Radiology (C.E.), Department of Radiology, Medical University of Graz, Austria; Department of Diagnostic and Interventional Radiology (G.A., B.T.), Medical Faculty, University Düsseldorf, Germany; and Department of Neurology (H.T.), Dietenbronn, Germany
| | - Sharon Baetge
- From the Department of Neurology (O.A., M.G., K.L., N.G., J.G., H.-P.H., P.A., I.-K.P.), Medical Faculty, University Düsseldorf, Germany; Cogito Center for Applied Neurocognition and Neuropsychological Research (A.R., M.F., S.B., N.S., I.-K.P.), Düsseldorf, Germany; Department of Neurology (A.H., M.S., M.O., H.T.), University Hospital Ulm, Germany; Department of Neurology (C.E., D.P.), Research Unit for Neuronal Plasticity and Repair, Medical University of Graz, Austria; Division of Neuroradiology, Vascular and Interventional Radiology (C.E.), Department of Radiology, Medical University of Graz, Austria; Department of Diagnostic and Interventional Radiology (G.A., B.T.), Medical Faculty, University Düsseldorf, Germany; and Department of Neurology (H.T.), Dietenbronn, Germany
| | - Nathalie Stute
- From the Department of Neurology (O.A., M.G., K.L., N.G., J.G., H.-P.H., P.A., I.-K.P.), Medical Faculty, University Düsseldorf, Germany; Cogito Center for Applied Neurocognition and Neuropsychological Research (A.R., M.F., S.B., N.S., I.-K.P.), Düsseldorf, Germany; Department of Neurology (A.H., M.S., M.O., H.T.), University Hospital Ulm, Germany; Department of Neurology (C.E., D.P.), Research Unit for Neuronal Plasticity and Repair, Medical University of Graz, Austria; Division of Neuroradiology, Vascular and Interventional Radiology (C.E.), Department of Radiology, Medical University of Graz, Austria; Department of Diagnostic and Interventional Radiology (G.A., B.T.), Medical Faculty, University Düsseldorf, Germany; and Department of Neurology (H.T.), Dietenbronn, Germany
| | - Marcia Gasis
- From the Department of Neurology (O.A., M.G., K.L., N.G., J.G., H.-P.H., P.A., I.-K.P.), Medical Faculty, University Düsseldorf, Germany; Cogito Center for Applied Neurocognition and Neuropsychological Research (A.R., M.F., S.B., N.S., I.-K.P.), Düsseldorf, Germany; Department of Neurology (A.H., M.S., M.O., H.T.), University Hospital Ulm, Germany; Department of Neurology (C.E., D.P.), Research Unit for Neuronal Plasticity and Repair, Medical University of Graz, Austria; Division of Neuroradiology, Vascular and Interventional Radiology (C.E.), Department of Radiology, Medical University of Graz, Austria; Department of Diagnostic and Interventional Radiology (G.A., B.T.), Medical Faculty, University Düsseldorf, Germany; and Department of Neurology (H.T.), Dietenbronn, Germany
| | - Klaudia Lepka
- From the Department of Neurology (O.A., M.G., K.L., N.G., J.G., H.-P.H., P.A., I.-K.P.), Medical Faculty, University Düsseldorf, Germany; Cogito Center for Applied Neurocognition and Neuropsychological Research (A.R., M.F., S.B., N.S., I.-K.P.), Düsseldorf, Germany; Department of Neurology (A.H., M.S., M.O., H.T.), University Hospital Ulm, Germany; Department of Neurology (C.E., D.P.), Research Unit for Neuronal Plasticity and Repair, Medical University of Graz, Austria; Division of Neuroradiology, Vascular and Interventional Radiology (C.E.), Department of Radiology, Medical University of Graz, Austria; Department of Diagnostic and Interventional Radiology (G.A., B.T.), Medical Faculty, University Düsseldorf, Germany; and Department of Neurology (H.T.), Dietenbronn, Germany
| | - Norbert Goebels
- From the Department of Neurology (O.A., M.G., K.L., N.G., J.G., H.-P.H., P.A., I.-K.P.), Medical Faculty, University Düsseldorf, Germany; Cogito Center for Applied Neurocognition and Neuropsychological Research (A.R., M.F., S.B., N.S., I.-K.P.), Düsseldorf, Germany; Department of Neurology (A.H., M.S., M.O., H.T.), University Hospital Ulm, Germany; Department of Neurology (C.E., D.P.), Research Unit for Neuronal Plasticity and Repair, Medical University of Graz, Austria; Division of Neuroradiology, Vascular and Interventional Radiology (C.E.), Department of Radiology, Medical University of Graz, Austria; Department of Diagnostic and Interventional Radiology (G.A., B.T.), Medical Faculty, University Düsseldorf, Germany; and Department of Neurology (H.T.), Dietenbronn, Germany
| | - Makbule Senel
- From the Department of Neurology (O.A., M.G., K.L., N.G., J.G., H.-P.H., P.A., I.-K.P.), Medical Faculty, University Düsseldorf, Germany; Cogito Center for Applied Neurocognition and Neuropsychological Research (A.R., M.F., S.B., N.S., I.-K.P.), Düsseldorf, Germany; Department of Neurology (A.H., M.S., M.O., H.T.), University Hospital Ulm, Germany; Department of Neurology (C.E., D.P.), Research Unit for Neuronal Plasticity and Repair, Medical University of Graz, Austria; Division of Neuroradiology, Vascular and Interventional Radiology (C.E.), Department of Radiology, Medical University of Graz, Austria; Department of Diagnostic and Interventional Radiology (G.A., B.T.), Medical Faculty, University Düsseldorf, Germany; and Department of Neurology (H.T.), Dietenbronn, Germany
| | - Jonas Graf
- From the Department of Neurology (O.A., M.G., K.L., N.G., J.G., H.-P.H., P.A., I.-K.P.), Medical Faculty, University Düsseldorf, Germany; Cogito Center for Applied Neurocognition and Neuropsychological Research (A.R., M.F., S.B., N.S., I.-K.P.), Düsseldorf, Germany; Department of Neurology (A.H., M.S., M.O., H.T.), University Hospital Ulm, Germany; Department of Neurology (C.E., D.P.), Research Unit for Neuronal Plasticity and Repair, Medical University of Graz, Austria; Division of Neuroradiology, Vascular and Interventional Radiology (C.E.), Department of Radiology, Medical University of Graz, Austria; Department of Diagnostic and Interventional Radiology (G.A., B.T.), Medical Faculty, University Düsseldorf, Germany; and Department of Neurology (H.T.), Dietenbronn, Germany
| | - Christian Enzinger
- From the Department of Neurology (O.A., M.G., K.L., N.G., J.G., H.-P.H., P.A., I.-K.P.), Medical Faculty, University Düsseldorf, Germany; Cogito Center for Applied Neurocognition and Neuropsychological Research (A.R., M.F., S.B., N.S., I.-K.P.), Düsseldorf, Germany; Department of Neurology (A.H., M.S., M.O., H.T.), University Hospital Ulm, Germany; Department of Neurology (C.E., D.P.), Research Unit for Neuronal Plasticity and Repair, Medical University of Graz, Austria; Division of Neuroradiology, Vascular and Interventional Radiology (C.E.), Department of Radiology, Medical University of Graz, Austria; Department of Diagnostic and Interventional Radiology (G.A., B.T.), Medical Faculty, University Düsseldorf, Germany; and Department of Neurology (H.T.), Dietenbronn, Germany
| | - Daniela Pinter
- From the Department of Neurology (O.A., M.G., K.L., N.G., J.G., H.-P.H., P.A., I.-K.P.), Medical Faculty, University Düsseldorf, Germany; Cogito Center for Applied Neurocognition and Neuropsychological Research (A.R., M.F., S.B., N.S., I.-K.P.), Düsseldorf, Germany; Department of Neurology (A.H., M.S., M.O., H.T.), University Hospital Ulm, Germany; Department of Neurology (C.E., D.P.), Research Unit for Neuronal Plasticity and Repair, Medical University of Graz, Austria; Division of Neuroradiology, Vascular and Interventional Radiology (C.E.), Department of Radiology, Medical University of Graz, Austria; Department of Diagnostic and Interventional Radiology (G.A., B.T.), Medical Faculty, University Düsseldorf, Germany; and Department of Neurology (H.T.), Dietenbronn, Germany
| | - Gerald Antoch
- From the Department of Neurology (O.A., M.G., K.L., N.G., J.G., H.-P.H., P.A., I.-K.P.), Medical Faculty, University Düsseldorf, Germany; Cogito Center for Applied Neurocognition and Neuropsychological Research (A.R., M.F., S.B., N.S., I.-K.P.), Düsseldorf, Germany; Department of Neurology (A.H., M.S., M.O., H.T.), University Hospital Ulm, Germany; Department of Neurology (C.E., D.P.), Research Unit for Neuronal Plasticity and Repair, Medical University of Graz, Austria; Division of Neuroradiology, Vascular and Interventional Radiology (C.E.), Department of Radiology, Medical University of Graz, Austria; Department of Diagnostic and Interventional Radiology (G.A., B.T.), Medical Faculty, University Düsseldorf, Germany; and Department of Neurology (H.T.), Dietenbronn, Germany
| | - Bernd Turowski
- From the Department of Neurology (O.A., M.G., K.L., N.G., J.G., H.-P.H., P.A., I.-K.P.), Medical Faculty, University Düsseldorf, Germany; Cogito Center for Applied Neurocognition and Neuropsychological Research (A.R., M.F., S.B., N.S., I.-K.P.), Düsseldorf, Germany; Department of Neurology (A.H., M.S., M.O., H.T.), University Hospital Ulm, Germany; Department of Neurology (C.E., D.P.), Research Unit for Neuronal Plasticity and Repair, Medical University of Graz, Austria; Division of Neuroradiology, Vascular and Interventional Radiology (C.E.), Department of Radiology, Medical University of Graz, Austria; Department of Diagnostic and Interventional Radiology (G.A., B.T.), Medical Faculty, University Düsseldorf, Germany; and Department of Neurology (H.T.), Dietenbronn, Germany
| | - Hans-Peter Hartung
- From the Department of Neurology (O.A., M.G., K.L., N.G., J.G., H.-P.H., P.A., I.-K.P.), Medical Faculty, University Düsseldorf, Germany; Cogito Center for Applied Neurocognition and Neuropsychological Research (A.R., M.F., S.B., N.S., I.-K.P.), Düsseldorf, Germany; Department of Neurology (A.H., M.S., M.O., H.T.), University Hospital Ulm, Germany; Department of Neurology (C.E., D.P.), Research Unit for Neuronal Plasticity and Repair, Medical University of Graz, Austria; Division of Neuroradiology, Vascular and Interventional Radiology (C.E.), Department of Radiology, Medical University of Graz, Austria; Department of Diagnostic and Interventional Radiology (G.A., B.T.), Medical Faculty, University Düsseldorf, Germany; and Department of Neurology (H.T.), Dietenbronn, Germany
| | - Philipp Albrecht
- From the Department of Neurology (O.A., M.G., K.L., N.G., J.G., H.-P.H., P.A., I.-K.P.), Medical Faculty, University Düsseldorf, Germany; Cogito Center for Applied Neurocognition and Neuropsychological Research (A.R., M.F., S.B., N.S., I.-K.P.), Düsseldorf, Germany; Department of Neurology (A.H., M.S., M.O., H.T.), University Hospital Ulm, Germany; Department of Neurology (C.E., D.P.), Research Unit for Neuronal Plasticity and Repair, Medical University of Graz, Austria; Division of Neuroradiology, Vascular and Interventional Radiology (C.E.), Department of Radiology, Medical University of Graz, Austria; Department of Diagnostic and Interventional Radiology (G.A., B.T.), Medical Faculty, University Düsseldorf, Germany; and Department of Neurology (H.T.), Dietenbronn, Germany
| | - Markus Otto
- From the Department of Neurology (O.A., M.G., K.L., N.G., J.G., H.-P.H., P.A., I.-K.P.), Medical Faculty, University Düsseldorf, Germany; Cogito Center for Applied Neurocognition and Neuropsychological Research (A.R., M.F., S.B., N.S., I.-K.P.), Düsseldorf, Germany; Department of Neurology (A.H., M.S., M.O., H.T.), University Hospital Ulm, Germany; Department of Neurology (C.E., D.P.), Research Unit for Neuronal Plasticity and Repair, Medical University of Graz, Austria; Division of Neuroradiology, Vascular and Interventional Radiology (C.E.), Department of Radiology, Medical University of Graz, Austria; Department of Diagnostic and Interventional Radiology (G.A., B.T.), Medical Faculty, University Düsseldorf, Germany; and Department of Neurology (H.T.), Dietenbronn, Germany
| | - Hayrettin Tumani
- From the Department of Neurology (O.A., M.G., K.L., N.G., J.G., H.-P.H., P.A., I.-K.P.), Medical Faculty, University Düsseldorf, Germany; Cogito Center for Applied Neurocognition and Neuropsychological Research (A.R., M.F., S.B., N.S., I.-K.P.), Düsseldorf, Germany; Department of Neurology (A.H., M.S., M.O., H.T.), University Hospital Ulm, Germany; Department of Neurology (C.E., D.P.), Research Unit for Neuronal Plasticity and Repair, Medical University of Graz, Austria; Division of Neuroradiology, Vascular and Interventional Radiology (C.E.), Department of Radiology, Medical University of Graz, Austria; Department of Diagnostic and Interventional Radiology (G.A., B.T.), Medical Faculty, University Düsseldorf, Germany; and Department of Neurology (H.T.), Dietenbronn, Germany
| | - Iris-Katharina Penner
- From the Department of Neurology (O.A., M.G., K.L., N.G., J.G., H.-P.H., P.A., I.-K.P.), Medical Faculty, University Düsseldorf, Germany; Cogito Center for Applied Neurocognition and Neuropsychological Research (A.R., M.F., S.B., N.S., I.-K.P.), Düsseldorf, Germany; Department of Neurology (A.H., M.S., M.O., H.T.), University Hospital Ulm, Germany; Department of Neurology (C.E., D.P.), Research Unit for Neuronal Plasticity and Repair, Medical University of Graz, Austria; Division of Neuroradiology, Vascular and Interventional Radiology (C.E.), Department of Radiology, Medical University of Graz, Austria; Department of Diagnostic and Interventional Radiology (G.A., B.T.), Medical Faculty, University Düsseldorf, Germany; and Department of Neurology (H.T.), Dietenbronn, Germany.
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Grossi P, Portaccio E, Bellomi F, Bianchi V, Cilia S, Falautano M, Goretti B, Pietrolongo E, Viterbo RG, Messmer Uccelli M. The minimal neuropsychological assessment of MS patients (MACFIMS): normative data of the Italian population. Neurol Sci 2020; 41:1489-1496. [PMID: 31953702 DOI: 10.1007/s10072-020-04251-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 01/09/2020] [Indexed: 10/25/2022]
Abstract
Cognitive impairment is common in multiple sclerosis (MS), and research has emphasized the crucial role of cognitive assessment in disease monitoring. The minimal neuropsychological assessment of MS (MACFIMS) represents one of the neuropsychological batteries most widely used throughout the world. To date, a complete validation, as well as normative values of an alternative form, is lacking in the Italian population, limiting the use of this tool in longitudinal assessment. A total of 200 healthy subjects (127 females and 73 males) were recruited from the community in 8 Italian cities and were evaluated with the MACFIMS at baseline and reassessed with an alternate form of the same battery after 12 months. Regression-based norms that account for demographic influences on test performance were calculated at each time point (baseline and follow-up). The study provides, for the first time, normative values of two forms of the MACFIMS battery for the Italian population. Data application allows clinicians to monitor the performance of cognitive functions over time and to better understand the efficacy of both pharmacological and non-pharmacological interventions in clinical practice and research.
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Affiliation(s)
| | - Emilio Portaccio
- SOC Neurologia, Ospedale San Giovanni di Dio, AUSL Toscana Centro, Florence, Italy
| | - Fabio Bellomi
- Neuropsychology Unit, ASST, Spedali Civili di Brescia, Brescia, Italy
| | | | | | | | - Benedetta Goretti
- Department NEUROFARBA, Section Neurosciences, University of Florence, Florence, Italy
| | - Erika Pietrolongo
- Department of Neurosciences, Imaging and Clinical Sciences, University G. D'Annunzio, Chieti, Italy
| | - Rosa Gemma Viterbo
- MS Centre, Department of Basic Medical Sciences, Neurosciences and Sense Organs, University of Bari, Bari, Italy
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Akatani R, Chihara N, Tachibana H, Koto S, Kowa H, Kanda F, Matsumoto R, Toda T. Validation of the Guy's Neurological Disability Scale as a screening tool for cognitive impairment in multiple sclerosis. Mult Scler Relat Disord 2019; 35:272-275. [DOI: 10.1016/j.msard.2019.08.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2019] [Revised: 06/23/2019] [Accepted: 08/11/2019] [Indexed: 10/26/2022]
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15
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Lampit A, Heine J, Finke C, Barnett MH, Valenzuela M, Wolf A, Leung IHK, Hill NTM. Computerized Cognitive Training in Multiple Sclerosis: A Systematic Review and Meta-analysis. Neurorehabil Neural Repair 2019; 33:695-706. [PMID: 31328637 DOI: 10.1177/1545968319860490] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/07/2023]
Abstract
Background. Cognitive impairments are common in people with multiple sclerosis (MS). Systematic reviews reported promising evidence for various cognitive interventions in this population. Computerized cognitive training (CCT) has strong evidence for safety and efficacy in several populations, but its effects in MS have yet to be specified. Objective. We aimed to synthesize the evidence from randomized controlled trials (RCTs) investigating the effects of CCT on cognitive, psychosocial, and functional outcomes in adults with MS. Method. We searched MEDLINE, EMBASE, PsycINFO, CINAHL, and CENTRAL from inception to March 2019. We calculated standardized mean difference (Hedges' g) of change from baseline in untrained measures of cognition, individual domains, psychosocial functioning, and daily function between CCT and control groups using a random-effects model. Results. A total of 20 RCTs encompassing 982 participants (78% with relapsing-remitting MS) were included. The overall cognitive effect size was moderate (g = 0.30; 95% CI = 0.18-0.43), with no evidence of small-study effect or between-study heterogeneity (prediction interval = 0.17-0.44). Small to moderate effect sizes were found for attention/processing speed, executive functions, and verbal and visuospatial memory. Evidence for working memory, fatigue, and psychosocial and daily functioning were inconclusive. Cognitive effects waned without further training. Conclusions. CCT is efficacious for overall and key cognitive domains in adults with MS, but efficacy on other outcomes and in progressive subtypes remains unclear. Long-term and well-powered trials with diverse cohorts are needed to optimize and maintain the efficacy of CCT, investigate transfer to daily living, and determine who can benefit and whether CCT is a cost-effective strategy to attenuate cognitive decline in MS.
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Affiliation(s)
- Amit Lampit
- 1 University of Melbourne, Parkville, Victoria, Australia
- 2 Charité-Universitätsmedizin Berlin, Germany
- 3 Humboldt-Universität zu Berlin, Germany
- 4 The University of Sydney, Camperdown, New South Wales, Australia
| | | | - Carsten Finke
- 2 Charité-Universitätsmedizin Berlin, Germany
- 3 Humboldt-Universität zu Berlin, Germany
| | | | | | - Anna Wolf
- 1 University of Melbourne, Parkville, Victoria, Australia
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16
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Raimo S, Trojano L, Gaita M, Spitaleri D, Santangelo G. High openness and high extroversion are linked with better time-based prospective memory in multiple sclerosis. J Neurol 2019; 266:2665-2671. [PMID: 31312957 DOI: 10.1007/s00415-019-09460-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 07/04/2019] [Accepted: 07/08/2019] [Indexed: 02/01/2023]
Abstract
BACKGROUND Prospective memory (PM) deficits are often reported in multiple sclerosis (MS), but their relationship with neuropsychological characteristics and personality traits remains to be explored. OBJECTIVE To systematically investigate both time-based and event-based PM abilities in a sample of MS without clinically relevant disability or global cognitive decline and to explore cognitive, neuropsychiatric characteristics and personality traits associated with PM deficits. METHODS Thirty-three patients with MS and 33 healthy individuals were enrolled in the study. All participants underwent a standardized measure of PM to evaluate both time-based and event-based PM. Moreover, patients with MS completed the Brief Repeatable Battery to assess cognitive functioning, the Beck Depression Inventory-II and the Dimensional Apathy Scale to assess neuropsychiatric characteristics, and the NEO Personality Inventory-3 to assess personality traits. RESULTS Individuals with MS demonstrated impaired time-based PM compared to healthy individuals. The regression analysis showed that poor performance in time-based PM was significantly related to lower extroversion and openness traits, whereas poor performance in event-based PM was significantly related to lower visuospatial memory abilities. CONCLUSIONS Low levels of openness and extroversion traits are associated with a greater risk of developing time-based PM deficit. Therefore, personality assessment and behavioural interventions should be encouraged in MS clinical practice.
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Affiliation(s)
- Simona Raimo
- Department of Medical and Surgical Sciences, University "Magna Graecia" of Catanzaro, Catanzaro, Italy.,Department of Psychology, University of Campania "Luigi Vanvitelli", Viale Ellittico, 31, 81100, Caserta, Italy.,IRCCS Fondazione Santa Lucia, Rome, Italy
| | - Luigi Trojano
- Department of Psychology, University of Campania "Luigi Vanvitelli", Viale Ellittico, 31, 81100, Caserta, Italy
| | - Mariachiara Gaita
- Department of Psychology, University of Campania "Luigi Vanvitelli", Viale Ellittico, 31, 81100, Caserta, Italy
| | - Daniele Spitaleri
- Neurology Unit "San Giuseppe Moscati", Hospital Avellino, Avellino, Italy
| | - Gabriella Santangelo
- Department of Psychology, University of Campania "Luigi Vanvitelli", Viale Ellittico, 31, 81100, Caserta, Italy.
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17
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Migliore S, Curcio G, Porcaro C, Cottone C, Simonelli I, D'aurizio G, Landi D, Palmieri M, Ghazaryan A, Squitieri F, Filippi M, Vernieri F. Emotional processing in RRMS patients: Dissociation between behavioural and neurophysiological response. Mult Scler Relat Disord 2019; 27:344-349. [DOI: 10.1016/j.msard.2018.11.019] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 11/13/2018] [Accepted: 11/17/2018] [Indexed: 10/27/2022]
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18
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Pender MP, Csurhes PA, Smith C, Douglas NL, Neller MA, Matthews KK, Beagley L, Rehan S, Crooks P, Hopkins TJ, Blum S, Green KA, Ioannides ZA, Swayne A, Aftab BT, Hooper KD, Burrows SR, Thompson KM, Coulthard A, Khanna R. Epstein-Barr virus-specific T cell therapy for progressive multiple sclerosis. JCI Insight 2018; 3:124714. [PMID: 30429369 DOI: 10.1172/jci.insight.124714] [Citation(s) in RCA: 93] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Accepted: 10/16/2018] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Increasing evidence indicates a role for EBV in the pathogenesis of multiple sclerosis (MS). EBV-infected autoreactive B cells might accumulate in the CNS because of defective cytotoxic CD8+ T cell immunity. We sought to determine the feasibility and safety of treating progressive MS patients with autologous EBV-specific T cell therapy. METHODS An open-label phase I trial was designed to treat 5 patients with secondary progressive MS and 5 patients with primary progressive MS with 4 escalating doses of in vitro-expanded autologous EBV-specific T cells targeting EBV nuclear antigen 1, latent membrane protein 1 (LMP1), and LMP2A. Following adoptive immunotherapy, we monitored the patients for safety and clinical responses. RESULTS Of the 13 recruited participants, 10 received the full course of T cell therapy. There were no serious adverse events. Seven patients showed improvement, with 6 experiencing both symptomatic and objective neurological improvement, together with a reduction in fatigue, improved quality of life, and, in 3 patients, reduced intrathecal IgG production. All 6 patients receiving T cells with strong EBV reactivity showed clinical improvement, whereas only 1 of the 4 patients receiving T cells with weak EBV reactivity showed improvement (P = 0.033, Fisher's exact test). CONCLUSION EBV-specific adoptive T cell therapy was well tolerated. Clinical improvement following treatment was associated with the potency of EBV-specific reactivity of the administered T cells. Further clinical trials are warranted to determine the efficacy of EBV-specific T cell therapy in MS. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry, ACTRN12615000422527. FUNDING MS Queensland, MS Research Australia, Perpetual Trustee Company Ltd., and donations from private individuals who wish to remain anonymous.
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Affiliation(s)
- Michael P Pender
- Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia.,Department of Neurology, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.,QIMR Berghofer Centre for Immunotherapy and Vaccine Development, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Peter A Csurhes
- Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia.,The University of Queensland Centre for Clinical Research, Brisbane, Queensland, Australia
| | - Corey Smith
- QIMR Berghofer Centre for Immunotherapy and Vaccine Development, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Nanette L Douglas
- Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia.,Department of Neurology, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Michelle A Neller
- QIMR Berghofer Centre for Immunotherapy and Vaccine Development, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Katherine K Matthews
- QIMR Berghofer Centre for Immunotherapy and Vaccine Development, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Leone Beagley
- QIMR Berghofer Centre for Immunotherapy and Vaccine Development, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Sweera Rehan
- QIMR Berghofer Centre for Immunotherapy and Vaccine Development, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Pauline Crooks
- QIMR Berghofer Centre for Immunotherapy and Vaccine Development, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Tracey J Hopkins
- Internal Medicine Day Treatment Unit, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Stefan Blum
- Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia.,Department of Neurology, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Kerryn A Green
- Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia.,Department of Neurology, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Zara A Ioannides
- Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia.,Department of Neurology, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Andrew Swayne
- Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia.,Department of Neurology, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Blake T Aftab
- Preclinical Science and Translational Medicine, Atara Biotherapeutics, South San Francisco, California, USA
| | - Kaye D Hooper
- Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia.,Department of Neurology, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Scott R Burrows
- Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia.,QIMR Berghofer Centre for Immunotherapy and Vaccine Development, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Kate M Thompson
- Department of Psychology, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.,Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Alan Coulthard
- Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia.,Department of Medical Imaging, Royal Brisbane and Women's Hospital, Brisbane,Queensland, Australia
| | - Rajiv Khanna
- Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia.,QIMR Berghofer Centre for Immunotherapy and Vaccine Development, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
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19
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Cognitive assessment in multiple sclerosis—an Italian consensus. Neurol Sci 2018; 39:1317-1324. [DOI: 10.1007/s10072-018-3427-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Accepted: 04/21/2018] [Indexed: 11/25/2022]
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20
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Argento O, Incerti CC, Quartuccio ME, Magistrale G, Francia A, Caltagirone C, Pisani V, Nocentini U. The Italian validation of the minimal assessment of cognitive function in multiple sclerosis (MACFIMS) and the application of the Cognitive Impairment Index scoring procedure in MS patients. Neurol Sci 2018; 39:1237-1244. [DOI: 10.1007/s10072-018-3417-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Accepted: 04/20/2018] [Indexed: 11/29/2022]
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21
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Grzegorski T, Losy J. Cognitive impairment in multiple sclerosis - a review of current knowledge and recent research. Rev Neurosci 2018; 28:845-860. [PMID: 28787275 DOI: 10.1515/revneuro-2017-0011] [Citation(s) in RCA: 89] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Accepted: 05/19/2017] [Indexed: 11/15/2022]
Abstract
Multiple sclerosis (MS) is a chronic, progressive disease of the central nervous system that is characterised by inflammatory damage to the myelin sheath. Though often neglected, cognitive impairment is a common feature of MS that affects 43-70% of patients. It has a sophisticated neuroanatomic and pathophysiologic background and disturbs such vital cognitive domains as speed of information processing, memory, attention, executive functions and visual perceptual functions. In recent years there has been growing interest in neuroimaging findings with regard to cognitive impairment in MS. The possible options of managing cognitive dysfunction in MS are pharmacologic interventions, cognitive rehabilitation and exercise training; however, not enough evidence has been presented in this field. The aim of our article is to provide current knowledge on cognitive impairment in MS based on the most recent scientific results and conclusions with regard to affected cognitive domains, neuropsychological assessment, underlying mechanisms of this disturbance, neuroimaging findings and therapeutic options.
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22
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Matias-Guiu JA, Cortés-Martínez A, Valles-Salgado M, Oreja-Guevara C, Pytel V, Montero P, Moreno-Ramos T, Matias-Guiu J. Functional Components of Cognitive Impairment in Multiple Sclerosis: A Cross-Sectional Investigation. Front Neurol 2017; 8:643. [PMID: 29234305 PMCID: PMC5712315 DOI: 10.3389/fneur.2017.00643] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Accepted: 11/16/2017] [Indexed: 12/14/2022] Open
Abstract
Background Cognitive impairment is frequent and disabling in multiple sclerosis (MS). Changes in information processing speed constitute the most important cognitive deficit in MS. However, given the clinical and topographical variability of the disease, cognitive impairment may vary greatly and appear in other forms in addition to slower information processing speed. Our aim was to determine the frequency of cognitive impairment, the principal cognitive domains, and components involved in MS and to identify factors associated with presence of cognitive impairment in these patients in a large series of patients. Methods Cross-sectional study of 311 patients with MS [236 with relapsing-remitting MS (RRMS), 52 with secondary progressive MS (SPMS), and 23 with primary progressive MS (PPMS)]. Patients' cognitive function was assessed with a comprehensive neuropsychological assessment protocol. Patients displaying deficits in 2 or more cognitive domains were considered to have cognitive impairment associated with MS. We conducted a principal component analysis to detect different cognitive patterns by identifying clusters of tests highly correlated to one another. Results Cognitive impairment was detected in 41.5% of the sample, and it was more frequent in patients with SPMS and PPMS (P = 0.002). Expanded Disability Status Scale scores and education were independent predictors of cognitive impairment. Principal component analysis identified seven clusters: attention and basic executive function (including information processing speed), planning and high-level executive function, verbal memory and language, executive and visuospatial performance time, fatigue-depression, visuospatial function, and basic attention and verbal/visual working memory. Mean scoring of components 2 (high-order executive functioning) and 3 (verbal memory-language) was higher in patients with RRMS than in those with PPMS (component 2) and SPMS (component 3). Conclusion MS is linked to multiple cognitive profiles and disturbances in different domains. This suggests that cognitive alterations in MS are heterogeneous and affect other domains in addition to information processing speed.
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Affiliation(s)
- Jordi A Matias-Guiu
- Department of Neurology, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Universidad Complutense de Madrid, Madrid, Spain
| | - Ana Cortés-Martínez
- Department of Neurology, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Universidad Complutense de Madrid, Madrid, Spain
| | - María Valles-Salgado
- Department of Neurology, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Universidad Complutense de Madrid, Madrid, Spain
| | - Celia Oreja-Guevara
- Department of Neurology, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Universidad Complutense de Madrid, Madrid, Spain
| | - Vanesa Pytel
- Department of Neurology, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Universidad Complutense de Madrid, Madrid, Spain
| | - Paloma Montero
- Department of Neurology, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Universidad Complutense de Madrid, Madrid, Spain
| | - Teresa Moreno-Ramos
- Department of Neurology, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Universidad Complutense de Madrid, Madrid, Spain
| | - Jorge Matias-Guiu
- Department of Neurology, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Universidad Complutense de Madrid, Madrid, Spain
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23
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Cognitive Impairment in Relapsing-Remitting Multiple Sclerosis Patients with Very Mild Clinical Disability. Behav Neurol 2017; 2017:7404289. [PMID: 28912625 PMCID: PMC5574272 DOI: 10.1155/2017/7404289] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Revised: 05/24/2017] [Accepted: 06/12/2017] [Indexed: 01/23/2023] Open
Abstract
Cognitive dysfunction affects 40–65% of multiple sclerosis (MS) patients and can occur in the early stages of the disease. This study aimed to explore cognitive functions by means of the Italian version of the minimal assessment of cognitive function in MS (MACFIMS) in relapsing-remitting MS (RRMS) patients with very mild clinical disability to identify the primarily involved cognitive functions. Ninety-two consecutive RRMS patients with Expanded Disability Status Scale (EDSS) scores ≤ 2.5 and forty-two healthy controls (HC) were investigated. Our results show that 51.1% of MS patients have cognitive dysfunction compared to HC. An impairment of verbal and visual memory, working memory, and executive functions was found in the RRMS group. After subgrouping RRMS by EDSS, group 1 (EDSS ≤ 1.5) showed involvement of verbal memory and executive functions; moreover, group 2 (2 ≤ EDSS ≤ 2.5) patients were also impaired in information processing speed and visual memory. Our results show that utilizing a comprehensive neuropsychological assessment, approximately half of MS patients with very mild physical disability exhibit cognitive impairment with a primary involvement of prefrontal cognitive functions. Detecting impairment of executive functions at an early clinical stage of disease could be useful to promptly enroll MS patients in targeted rehabilitation.
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24
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Migliore S, Curcio G, Couyoumdjian A, Ghazaryan A, Landi D, Moffa F, Quintiliani L, Squitieri F, Palmieri MG, Filippi MM, Vernieri F. Executive functioning in relapsing-remitting multiple sclerosis patients without cognitive impairment: A task-switching protocol. Mult Scler 2017; 24:1328-1336. [DOI: 10.1177/1352458517719149] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Cognitive dysfunction affects 40%–65% of multiple sclerosis (MS) patients, most often affecting information processing speed and working memory, mediated by the pre-frontal cortex (PFC). Objective: Our study aimed to investigate PFC functioning through a task-switching protocol in relapsing-remitting multiple sclerosis (RRMS) patients without cognitive impairment. Methods: A total of 24 RRMS patients and 25 controls were enrolled. Two different tasks were performed in rapid and random succession, so that the task was either changed from one trial to the next one (switch trials) or repeated (repetition trials). Switch trials are usually slower than repetitions, causing a so-called switch cost (SC). Results: Patients had worse performance than controls only in the switch trials, as indicated by increased SC and reaction times. Moreover, patients showed a reduced ability to reconfigure the task-set for the execution of a new task and to disengage from the previous one. Conclusion: Our results showed a primary deficit in executive control processes involved in the task-switching performance in RRMS patients without cognitive impairment. This deficit may depend on the functional impairment of the PFC, which is essential to adjust behaviour rapidly and flexibly in response to environmental changes, representing one of the most sophisticated human abilities.
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Affiliation(s)
- Simone Migliore
- Clinical Psychology, Campus Bio-Medico University, Rome, Italy/LIRH Foundation, Rome, Italy
| | - Giuseppe Curcio
- Department of Life, Health and Environmental Sciences, University of L’Aquila, L’Aquila, Italy
| | | | - Anna Ghazaryan
- Department of Neurology, Fatebenefratelli Hospital, Rome, Italy
| | - Doriana Landi
- Department of Neuroscience, Tor Vergata University, Rome, Italy
| | - Filomena Moffa
- Department of Neurology, Fatebenefratelli Hospital, Rome, Italy
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25
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Advances in clinical neurology through the journal "Neurological Sciences" (2015-2016). Neurol Sci 2017; 38:9-18. [PMID: 28093657 DOI: 10.1007/s10072-017-2815-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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