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Vlieger R, Austin D, Apthorp D, Daskalaki E, Lensky A, Walton-Sonda D, Suominen H, Lueck CJ. The use of event-related potentials in the investigation of cognitive performance in people with Multiple Sclerosis: Systematic review. Brain Res 2024; 1832:148827. [PMID: 38403040 DOI: 10.1016/j.brainres.2024.148827] [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: 09/29/2023] [Revised: 02/20/2024] [Accepted: 02/22/2024] [Indexed: 02/27/2024]
Abstract
A biomarker of cognition in Multiple Sclerosis (MS) that is independent from the response of people with MS (PwMS) to test questions would provide a more holistic assessment of cognitive decline. One suggested method involves event-related potentials (ERPs). This systematic review tried to answer five questions about the use of ERPs in distinguishing PwMS from controls: which stimulus modality, which experimental paradigm, which electrodes, and which ERP components are most discriminatory, and whether amplitude or latency is a better measure. Our results show larger pooled effect sizes for visual stimuli than auditory stimuli, and larger pooled effect sizes for latency measurements than amplitude measurements. We observed great heterogeneity in methods and suggest that future research would benefit from more uniformity in methods and that results should be reported for the individual subtypes of PwMS. With more standardised methods, ERPs have the potential to be developed into a clinical tool in MS.
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Affiliation(s)
- Robin Vlieger
- School of Medicine and Psychology, College of Health and Medicine, Australian National University, Canberra, ACT, Australia.
| | - Duncan Austin
- Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Deborah Apthorp
- School of Psychology, Faculty of Medicine and Health, University of New England, Armidale, NSW, Australia; School of Computing, College of Engineering, Computing & Cybernetics, Australian National University, Canberra, ACT, Australia
| | - Elena Daskalaki
- School of Computing, College of Engineering, Computing & Cybernetics, Australian National University, Canberra, ACT, Australia
| | - Artem Lensky
- School of Engineering and Technology, University of New South Wales, Canberra, ACT, Australia; School of Biomedical Engineering, Faculty of Engineering, University of Sydney, Sydney, NSW, Australia
| | - Dianne Walton-Sonda
- The ACT Health Library and Multimedia Service, The Canberra Hospital, Canberra, ACT, Australia
| | - Hanna Suominen
- School of Medicine and Psychology, College of Health and Medicine, Australian National University, Canberra, ACT, Australia; School of Computing, College of Engineering, Computing & Cybernetics, Australian National University, Canberra, ACT, Australia; Department of Computing, University of Turku, Turku, Finland
| | - Christian J Lueck
- School of Medicine and Psychology, College of Health and Medicine, Australian National University, Canberra, ACT, Australia
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Holm SP, Wolfer AM, Pointeau GH, Lipsmeier F, Lindemann M. Practice effects in performance outcome measures in patients living with neurologic disorders – A systematic review. Heliyon 2022; 8:e10259. [PMID: 36082322 PMCID: PMC9445299 DOI: 10.1016/j.heliyon.2022.e10259] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 03/05/2021] [Accepted: 08/05/2022] [Indexed: 10/26/2022] Open
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Sormani MP, De Stefano N, Giovannoni G, Langdon D, Piani-Meier D, Haering DA, Kappos L, Tomic D. Learning ability correlates with brain atrophy and disability progression in RRMS. J Neurol Neurosurg Psychiatry 2019; 90:38-43. [PMID: 30322898 PMCID: PMC6327865 DOI: 10.1136/jnnp-2018-319129] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 09/10/2018] [Accepted: 09/17/2018] [Indexed: 01/21/2023]
Abstract
OBJECTIVE To assess the prognostic value of practice effect on Paced Auditory Serial Addition Test (PASAT) in multiple sclerosis. METHODS We compared screening (day -14) and baseline (day 0) PASAT scores of 1009 patients from the FTY720 Research Evaluating Effects of Daily Oral therapy in Multiple Sclerosis (FREEDOMS) trial. We grouped patients into high and low learners if their PASAT score change was above or below the median change in their screening PASAT quartile group. We used Wilcoxon test to compare baseline disease characteristics between high and low learners, and multiple regression models to assess the respective impact of learning ability, baseline normalised brain volume and treatment on brain volume loss and 6-month confirmed disability progression over 2 years. RESULTS The mean PASAT score at screening was 45.38, increasing on average by 3.18 from day -14 to day 0. High learners were younger (p=0.003), had lower Expanded Disability Status Scale score (p=0.031), higher brain volume (p<0.001) and lower T2 lesion volume (p=0.009) at baseline. Learning status was not significantly associated with disability progression (HR=0.953, p=0.779), when adjusting for baseline normalised brain volume, screening PASAT score and treatment arm. However, the effect of fingolimod on disability progression was more pronounced in high learners (HR=0.396, p<0.001) than in low learners (HR=0.798, p=0.351; p for interaction=0.05). Brain volume loss at month 24 tended to be higher in low learners (0.17%, p=0.058), after adjusting for the same covariates. CONCLUSIONS Short-term practice effects on PASAT are related to brain volume, disease severity and age and have clinically meaningful prognostic implications. High learners benefited more from fingolimod treatment.
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Affiliation(s)
- Maria Pia Sormani
- Biostatistics Unit, Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Nicola De Stefano
- Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
| | - Gavin Giovannoni
- Barts and The London School of Medicine and Dentistry, Blizard Institute, Queen Mary University of London, London, UK
| | - Dawn Langdon
- Department of Psychology, Royal Holloway, University of London, Egham, UK
| | | | | | - Ludwig Kappos
- Neurological Clinic and Polyclinic, Departments of Medicine, Clinical Research, Biomedicine and Biomedical Engineering, University Hospital Basel, University of Basel, Basel, Switzerland
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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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Ozakbas S, Cinar BP, Gurkan MA, Ozturk O, Oz D, Kursun BB. Paced auditory serial addition test: National normative data. Clin Neurol Neurosurg 2016; 140:97-9. [DOI: 10.1016/j.clineuro.2015.11.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Revised: 11/20/2015] [Accepted: 11/21/2015] [Indexed: 11/30/2022]
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Huolman S, Hämäläinen P, Vorobyev V, Ruutiainen J, Parkkola R, Laine T, Hämäläinen H. The effects of rivastigmine on processing speed and brain activation in patients with multiple sclerosis and subjective cognitive fatigue. Mult Scler 2011; 17:1351-61. [DOI: 10.1177/1352458511412061] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Cognitive decline and fatigue are typical in multiple sclerosis (MS). However, there is no official medication for either of these symptoms. Objective: The purpose of this study was to estimate the effects of a single dose of rivastigmine on processing speed and associated brain activity in patients with MS and subjective cognitive fatigue. Methods: Fifteen patients with MS and subjective cognitive fatigue and 13 healthy controls (HCs) matched for age, gender and education performed a neuropsychological assessment and functional (f)MRI. A modified version of the Paced Visual Serial Addition Test (mPVSAT) was used as the behavioural task during fMRIs. After the first scanning session, both groups were randomly divided into two subgroups receiving either rivastigmine or placebo. A single dose of rivastigmine or placebo was administrated double-blindly and 2.5 hours later the scanning was repeated. Results: At baseline, the patients with MS showed slower processing speed in mPVSAT compared with the HCs. They also demonstrated stronger bilateral frontal activation after sustained cognitive effort than the HCs. Performance improvement and a further activation increase in the left anterior frontal cortex and additional activation in the right cerebellum were observed in patients who received rivastigmine but not in patients on placebo, or in HCs with placebo or rivastigmine. Conclusion: These preliminary findings suggest that rivastigmine may improve cognitive processing speed by enhancing compensatory brain activation in patients with MS.
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Affiliation(s)
- S Huolman
- Rehabilitation Clinic, Turku University Hospital, Turku, Finland
- Masku Neurological Rehabilitation Centre, Masku, Finland
- Centre for Cognitive Neuroscience and Department of Psychology, University of Turku, Turku, Finland
| | - P Hämäläinen
- Masku Neurological Rehabilitation Centre, Masku, Finland
| | - V Vorobyev
- Centre for Cognitive Neuroscience and Department of Psychology, University of Turku, Turku, Finland
| | - J Ruutiainen
- Masku Neurological Rehabilitation Centre, Masku, Finland
| | | | - T Laine
- Centre for Cognitive Neuroscience and Department of Psychology, University of Turku, Turku, Finland
| | - H Hämäläinen
- Centre for Cognitive Neuroscience and Department of Psychology, University of Turku, Turku, Finland
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Morrow SA, Drake A, Zivadinov R, Munschauer F, Weinstock-Guttman B, Benedict RHB. Predicting loss of employment over three years in multiple sclerosis: clinically meaningful cognitive decline. Clin Neuropsychol 2010; 24:1131-45. [PMID: 20830649 DOI: 10.1080/13854046.2010.511272] [Citation(s) in RCA: 181] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Cognitive dysfunction is common in multiple sclerosis (MS), yet the magnitude of change on objective neuropsychological (NP) tests that is clinically meaningful is unclear. We endeavored to determine NP markers of the transition from employment to work disability in MS, as indicated by degree of decline on individual tests. Participants were 97 employed MS patients followed over 41.3 ± 17.6 months with a NP battery covering six domains of cognitive function. Deterioration at follow-up was designated as documented and paid disability benefits (conservative definition) or a reduction in hours/work responsibilities (liberal definition). Using the conservative definition, 28.9% reported deteriorated employment status and for the liberal definition, 45.4%. The Symbol Digit Modalities Test (SDMT) and California Verbal Learning Test, Total Learning (CVLT2-TL) measures distinguished employed and disabled patients at follow-up. Controlling for demographic and MS characteristics, the odds ratio of a deterioration based on a change of 2.0 on the CVLT2-TL was 3.7 (95% CI 1.2-11.4 and SDMT by 4.0 was 4.2 (95% CI 1.2-14.8), accounting for 86.7% of the area under the ROC curve. We conclude that decline on NP testing over time is predictive of deterioration in vocational status, establishing a magnitude of decline on NP tests that is clinically meaningful.
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Affiliation(s)
- Sarah A Morrow
- The Jacobs Neurological Institute, State University of New York at Buffalo, NY 14203, USA
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Morrow SA, Weinstock-Guttman B, Munschauer FE, Hojnacki D, Benedict RHB. Subjective fatigue is not associated with cognitive impairment in multiple sclerosis: cross-sectional and longitudinal analysis. Mult Scler 2009; 15:998-1005. [DOI: 10.1177/1352458509106213] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background Studies in multiple sclerosis (MS) report conflicting conclusions regarding fatigue and cognition, which may partly be due to the use of small sample sizes and frequent reliance on a cross-sectional approach. Objective The ability to distinguish between these two disabling symptoms is necessary in order to properly assess and treat MS patients. Methods In a retrospective analysis, we assessed the correlation between fatigue and neuropsychological (NP) testing using a cross-sectional ( n = 465) and longitudinal approach ( n = 69). Cognition was measured using a comprehensive battery called the Minimal Assessment of Cognitive Function in MS (MACFIMS), and fatigue was measured with the Fatigue Severity Scale (FSS). FSS scores were categorized as normal (≤4.0), borderline fatigue (4 < FSS < 5.0), and fatigued (≥5.0). Repeat assessments ( n = 69) were categorized as improved or worsened by a change in FSS of either 0.5 or 1.0. Results MS patients had significantly higher FSS scores than normal controls ( P < 0.001). No correlation was found between FSS and NP scores in either cross-sectional or longitudinal analyses. Fatigue was moderately correlated with depression, assessed using the Beck Depression Inventory Fast Screen (BDIFS) ( r = 0.44, P < 0.001). Longitudinally, there was a medium correlation between change in FSS and BDIFS ( r = 0.34, P = 0.001), but no significant differences on NP scores using either definition of change. Conclusion We conclude that self-reported fatigue, while correlated with self-reported depression, is not significantly related to cognitive capacity in MS.
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Affiliation(s)
- SA Morrow
- School of Medicine, The Jacobs Neurological Institute, State University of New York at Buffalo, Buffalo, New York, USA
| | - B Weinstock-Guttman
- School of Medicine, The Jacobs Neurological Institute, State University of New York at Buffalo, Buffalo, New York, USA
| | - FE Munschauer
- School of Medicine, The Jacobs Neurological Institute, State University of New York at Buffalo, Buffalo, New York, USA
| | - D Hojnacki
- School of Medicine, The Jacobs Neurological Institute, State University of New York at Buffalo, Buffalo, New York, USA
| | - RHB Benedict
- School of Medicine, The Jacobs Neurological Institute, State University of New York at Buffalo, Buffalo, New York, USA
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