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Ferreira JA, Pinto N, Maricoto T, Pato MV. Relationship between event-related potentials and cognitive dysfunction in multiple sclerosis: A systematic review. Clin Neurophysiol 2024; 163:174-184. [PMID: 38759513 DOI: 10.1016/j.clinph.2024.04.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 04/15/2024] [Accepted: 04/30/2024] [Indexed: 05/19/2024]
Abstract
OBJECTIVE This systematic review aimed to evaluate if event-related potentials (ERPs) can be a relevant tool for cognitive dysfunction diagnosis in Multiple Sclerosis (MS). METHODS Four databases were consulted (PubMed, Embase, Scielo, and Web of Science). The included studies should include adults with clear MS diagnoses, independently of having cognitive complaints, and all should have been submitted to ERPs (P300, N400 or mismatch negativity (MMN)). The main outcomes evaluated were ERPs' amplitude and/or latency. RESULTS 425 studies were obtained initially from all databases, with 26 studies fulfilling the eligibility criteria. P300 was the most used ERP (25 studies), showing a reduced amplitude or an increased latency in 84% of those. N400 was evaluated in one study, showing also abnormal results. MMN was addressed in two studies with inconsistent findings. Some studies further suggest that ERPs may show earlier abnormal results compared with neuropsychological tests. CONCLUSIONS Most MS patient groups revealed ERP abnormalities, suggesting that these neurophysiological tests may be a relevant and appropriate diagnostic aid method for cognitive impairment in MS. SIGNIFICANCE The use of ERPs in MS patients seems able to demonstrate cognitive impairment and its use should be considered as part of the regular patient evaluation.
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Affiliation(s)
- Joana Almeida Ferreira
- Faculty of Health Sciences, University of Beira Interior, Covilhã, Portugal; Neurology Department, Hospital Garcia de Orta, Almada, Portugal
| | - Nuno Pinto
- Faculty of Health Sciences, University of Beira Interior, Covilhã, Portugal; CICS-UBI - Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal; GRUBI - University of Beira Interior Systematic Reviews Group, Covilhã, Portugal.
| | - Tiago Maricoto
- Faculty of Health Sciences, University of Beira Interior, Covilhã, Portugal; CICS-UBI - Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal; GRUBI - University of Beira Interior Systematic Reviews Group, Covilhã, Portugal; Beira Ria Health Center, Aveiro Health Centre, Ílhavo, Portugal
| | - Maria Vaz Pato
- Faculty of Health Sciences, University of Beira Interior, Covilhã, Portugal; CICS-UBI - Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal; GRUBI - University of Beira Interior Systematic Reviews Group, Covilhã, Portugal
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Paolicelli D, Manni A, Iaffaldano A, Tancredi G, Ricci K, Gentile E, Viterbo RG, Quitadamo SG, de Tommaso M, Trojano M. Magnetoencephalography and High-Density Electroencephalography Study of Acoustic Event Related Potentials in Early Stage of Multiple Sclerosis: A Pilot Study on Cognitive Impairment and Fatigue. Brain Sci 2021; 11:481. [PMID: 33918861 PMCID: PMC8069556 DOI: 10.3390/brainsci11040481] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 04/06/2021] [Accepted: 04/07/2021] [Indexed: 11/16/2022] Open
Abstract
Cognitive impairment (CI) is a common and disabling symptom of Multiple Sclerosis (MS) with a negative impact on daily living. In this pilot study, we applied magnetoencephalography (MEG) and high density (hd) electroencephalography (EEG) study to evaluate acoustic P300 features in a cohort of early MS. Sixteen MS patients (pwMS) and 19 healthy controls (HCs) matched for age and gender underwent an MEG-/(hd)-EEG-co-recording, using 306-channel Vectorview and 64 scalp electrodes. CI was assessed using Rao's Brief Repeatable Battery (BRB). Moreover, we performed psychometric tests to assess depression and fatigue. In pwMS, we observed a slight latency prolongation of P300 peak compared to HCs, while P300 amplitude and scalp distribution were similar in the two groups. pwMS did not show an amplitude reduction and different scalp distribution of Event-Related Potentials (ERPs) and Event Related Fields (ERFs) related to an acoustic oddball paradigm. We found an inverse correlation between P300 amplitude and fatigue (r Spearman = -0.4; p = 0.019). In pwMS, phenomena of cortical adaptation to early dysfunction could preserve the cognitive performance of the P300 acoustic task, while the development of fatigue could prospectively lead to amplitude decline of P300, suggesting its possible role as a biomarker.
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Affiliation(s)
- Damiano Paolicelli
- Department of Basic Medical Sciences, Neurosciences, and Sense Organs, University of Bari “Aldo Moro”, 70121 Bari, Italy; (A.M.); (A.I.); (G.T.); (K.R.); (R.G.V.); (S.G.Q.); (M.d.T.); (M.T.)
| | - Alessia Manni
- Department of Basic Medical Sciences, Neurosciences, and Sense Organs, University of Bari “Aldo Moro”, 70121 Bari, Italy; (A.M.); (A.I.); (G.T.); (K.R.); (R.G.V.); (S.G.Q.); (M.d.T.); (M.T.)
| | - Antonio Iaffaldano
- Department of Basic Medical Sciences, Neurosciences, and Sense Organs, University of Bari “Aldo Moro”, 70121 Bari, Italy; (A.M.); (A.I.); (G.T.); (K.R.); (R.G.V.); (S.G.Q.); (M.d.T.); (M.T.)
| | - Giusy Tancredi
- Department of Basic Medical Sciences, Neurosciences, and Sense Organs, University of Bari “Aldo Moro”, 70121 Bari, Italy; (A.M.); (A.I.); (G.T.); (K.R.); (R.G.V.); (S.G.Q.); (M.d.T.); (M.T.)
| | - Katia Ricci
- Department of Basic Medical Sciences, Neurosciences, and Sense Organs, University of Bari “Aldo Moro”, 70121 Bari, Italy; (A.M.); (A.I.); (G.T.); (K.R.); (R.G.V.); (S.G.Q.); (M.d.T.); (M.T.)
| | - Eleonora Gentile
- Basic Health District, Family Counseling Center, ASP (Local Health Company), 85038 Senise, Italy;
| | - Rosa Gemma Viterbo
- Department of Basic Medical Sciences, Neurosciences, and Sense Organs, University of Bari “Aldo Moro”, 70121 Bari, Italy; (A.M.); (A.I.); (G.T.); (K.R.); (R.G.V.); (S.G.Q.); (M.d.T.); (M.T.)
| | - Silvia Giovanna Quitadamo
- Department of Basic Medical Sciences, Neurosciences, and Sense Organs, University of Bari “Aldo Moro”, 70121 Bari, Italy; (A.M.); (A.I.); (G.T.); (K.R.); (R.G.V.); (S.G.Q.); (M.d.T.); (M.T.)
| | - Marina de Tommaso
- Department of Basic Medical Sciences, Neurosciences, and Sense Organs, University of Bari “Aldo Moro”, 70121 Bari, Italy; (A.M.); (A.I.); (G.T.); (K.R.); (R.G.V.); (S.G.Q.); (M.d.T.); (M.T.)
| | - Maria Trojano
- Department of Basic Medical Sciences, Neurosciences, and Sense Organs, University of Bari “Aldo Moro”, 70121 Bari, Italy; (A.M.); (A.I.); (G.T.); (K.R.); (R.G.V.); (S.G.Q.); (M.d.T.); (M.T.)
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Waliszewska-Prosół M, Bladowska J, Budrewicz S, Sąsiadek M, Dziadkowiak E, Ejma M. The evaluation of Hashimoto's thyroiditis with event-related potentials and magnetic resonance spectroscopy and its relation to cognitive function. Sci Rep 2021; 11:2480. [PMID: 33510336 PMCID: PMC7843607 DOI: 10.1038/s41598-021-82281-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 01/19/2021] [Indexed: 11/09/2022] Open
Abstract
Thyroid dysfunction is very often accompanied by cognitive and affective disorders. The frequency of these disorders in patients with compensated Hashimoto's thyroiditis (HT) is unknown. The aim of the present study was to evaluate brain dysfunction in euthyroid HT patients by means of event-related potentials (ERP) and magnetic resonance spectroscopy (MRS) and to correlate it with cognitive function. 68 patients with HT (59 female, 9 male) and 45 healthy controls were included in the study. All the patients underwent ERP including an analysis of N200 and P300 response parameters. MRS voxels were located in the posterior cingulate gyrus (PCG) and the left parietal white matter (PWM). The NAA/Cr, mI/Cr, and Cho/Cr ratios were analysed. The ERP parameters, MRS metabolite ratios and hormonal concentrations (TSH, fT3, fT4) as well as TGAb and TPOAb titer were also correlated. There was a significant prolongation of the latencies of N200 and P300 potentials and a significant decrease of P300 amplitude in HT patients than in the control group. There was a significant positive correlation between the mI/Cr ratio in the PCG area and P300 latencies. NAA/Cr ratio in the PCG region showed significant negative correlations with all N200 latencies. The results may suggest brain dysfunction in neurologically asymptomatic HT patients. ERPs undergo significant changes in patients with HT and may, in combination with MRS, constitute an important element in the recognition and monitoring of cognitive functions in this group of patients.
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Affiliation(s)
| | - Joanna Bladowska
- Department of General Radiology, Interventional Radiology and Neuroradiology, Wroclaw Medical University, Wroclaw, Poland
| | | | - Marek Sąsiadek
- Department of General Radiology, Interventional Radiology and Neuroradiology, Wroclaw Medical University, Wroclaw, Poland
| | - Edyta Dziadkowiak
- Department of Neurology, Wroclaw Medical University, Wroclaw, Poland
| | - Maria Ejma
- Department of Neurology, Wroclaw Medical University, Wroclaw, Poland
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Lorefice L, Fenu G, Mammoliti R, Carta E, Sechi V, Frau J, Coghe G, Canalis L, Barracciu MA, Marrosu G, Marrosu MG, Cocco E. Event-related potentials and deep grey matter atrophy in multiple sclerosis: Exploring the possible associations with cognition. Mult Scler Relat Disord 2021; 49:102785. [PMID: 33508572 DOI: 10.1016/j.msard.2021.102785] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 01/08/2021] [Accepted: 01/18/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Event-related potentials (ERPs) have been proposed as a neurophysiological biomarker to capture cognitive dysfunction in multiple sclerosis (MS). Few studies have evaluated the relationships between ERPs and brain atrophy as known marker of structural brain damage related to cognitive impairment (CI). OBJECTIVES To explore the relationships of brain atrophy, including of the cortex and deep grey matter, with ERP abnormalities and cognitive function, as defined using the Brief Repeatable Battery of Neuropsychological Tests (BRBN). RESULTS Seventy-eight patients with relapsing-remitting MS were enroled, of which 38 (48.7%) had CI. Independent t-test comparisons of the ERP parameters found a significant difference in P300 wave latency, with a latency of 343.7 ± 32.6 ms in the CI group vs. 320.3 ± 16.5 ms in the cognitively preserved (CP) group (p = 0.001). Significant differences in the MRI measurements, including the cortex (p = 0.02) and deep grey matter structures [thalamus (p = 0.001), amygdala (p = 0.030), and nucleus accumbens (p = 0.004)) were observed, with lower measurements in the CI group. Regression models were also performed to explore the impact of brain volumes on ERP parameters. This showed a relationship between P300 latency and the lower amygdala (p = 0.02) and hippocampus (p = 0.03) volumes, while the amplitude of the P300 was significantly associated with a lower cortex volume (p = 0.01). CONCLUSION Cortex volume emerged as the most significant predictor of the P300 amplitude. The amygdala and hippocampal volumes were found to influence P300 latency, highlighting the role of deep grey matter atrophy in ERPs for the first time. The combination of structural MRI and neurophysiological techniques, sensitive to diverse aspects of MS pathology, could improve the understanding of CI in MS and its neurodegenerative and inflammatory substrate.
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Affiliation(s)
- L Lorefice
- Multiple Sclerosis Centre, Binaghi Hospital, ATS Sardegna, Cagliari, Italy; Multiple Sclerosis Centre, Binaghi Hospital, Department of Medical Sciences and Public Health, University of Cagliari, Italy.
| | - G Fenu
- Multiple Sclerosis Centre, Binaghi Hospital, Department of Medical Sciences and Public Health, University of Cagliari, Italy
| | - R Mammoliti
- Multiple Sclerosis Centre, Binaghi Hospital, ATS Sardegna, Cagliari, Italy
| | - E Carta
- Multiple Sclerosis Centre, Binaghi Hospital, Department of Medical Sciences and Public Health, University of Cagliari, Italy
| | - V Sechi
- Radiology Unit, Binaghi Hospital, ATS Sardegna, Cagliari, Italy
| | - J Frau
- Multiple Sclerosis Centre, Binaghi Hospital, ATS Sardegna, Cagliari, Italy
| | - G Coghe
- Multiple Sclerosis Centre, Binaghi Hospital, ATS Sardegna, Cagliari, Italy
| | - L Canalis
- Radiology Unit, Binaghi Hospital, ATS Sardegna, Cagliari, Italy
| | - M A Barracciu
- Radiology Unit, Binaghi Hospital, ATS Sardegna, Cagliari, Italy
| | - G Marrosu
- Multiple Sclerosis Centre, Binaghi Hospital, ATS Sardegna, Cagliari, Italy
| | - M G Marrosu
- Multiple Sclerosis Centre, Binaghi Hospital, Department of Medical Sciences and Public Health, University of Cagliari, Italy
| | - E Cocco
- Multiple Sclerosis Centre, Binaghi Hospital, Department of Medical Sciences and Public Health, University of Cagliari, Italy
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Cognitive Event-Related Potentials-The P300 Wave Is a Prognostic Factor of Long-Term Disability Progression in Patients With Multiple Sclerosis. J Clin Neurophysiol 2020; 39:390-396. [PMID: 33031128 DOI: 10.1097/wnp.0000000000000788] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
PURPOSE Multiple sclerosis (MS) is a chronic disorder with a variable course. The aim of our study was to find out whether cognitive event-related potentials are prognostic for patient disability at the 15-year follow-up. METHODS In the observed cohort of patients with MS, we examined the event-related potentials at baseline (2003). Functional status (Expanded Disability Status Scale score) was then assessed 15 years later, and the prognostic model was developed using binary logistic regression analysis. The independent variables included demographic (age, sex, and education), clinical (disability in 2003), radiologic (MRI lesion load), and event-related potentials parameters. The prognostic accuracy of the proposed model was evaluated by calculating the area under the receiver-operating characteristics curve. RESULTS The study sample consisted of 85 patients with MS. The mean age was 35.5 (SD, 11.2) years, and the median disability score was 3.0 (1-7) in 2003 and 5.0 (1.5-9.5) in 2018. The significant prognostic factors of poor Expanded Disability Status Scale are higher baseline Expanded Disability Status Scale, longer MS duration, and prolonged P300 latency. The sensitivity and specificity of the cutoff at 5.0 for the disability score were 94% and 89%, respectively, with the area under the receiver-operating characteristics curve 0.94 (95% confidence interval, 0.889-0.984; P < 0.001). CONCLUSIONS The results show that out of event-related potentials, the P300 wave latency is a prognostic of long-term disability progression in patients with MS.
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