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Tarantino S, Proietti Checchi M, Papetti L, Monte G, Ferilli MAN, Valeriani M. Neuropsychological performances, quality of life, and psychological issues in pediatric onset multiple sclerosis: a narrative review. Neurol Sci 2024; 45:1913-1930. [PMID: 38157101 PMCID: PMC11021227 DOI: 10.1007/s10072-023-07281-y] [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: 08/03/2023] [Accepted: 12/18/2023] [Indexed: 01/03/2024]
Abstract
Multiple sclerosis (MS) is primarily a disease diagnosed in young and middle-aged adults. Although MS is a rare condition in pediatric age, an increasing rate of patients is diagnosed under the age of 18. The disabling nature of the disease cannot be reduced only to physical symptoms. Several additional symptoms such as cognitive impairment, fatigue, and psychological symptoms are common features of pediatric MS. The reviewed literature suggests that, despite the lower physical disability, children and adolescents diagnosed with MS are vulnerable to cognitive impairment even in the early stage of the disease. The neuropsychological profile of pediatric MS may resemble that of adult MS, including an impairment in attention/information processing speed, learning, verbal, and visuospatial memory. However, cognitive difficulties in children and adolescents are more likely to involve also general intelligence and linguistic abilities, presumably due to patients' younger age and cognitive growth stage. Cognitive difficulties, beyond physical disability and relapses, may have a considerable impact on learning and school achievement. Depression and fatigue are other highly prevalent disturbances in pediatric MS and may contribute to patients' low functional outcomes. Overall, these manifestations may cause considerable functional impairment on daily activities and quality of life that may require individualized rehabilitative treatment and extensive psychosocial care. Additional neuropsychological research evaluating larger samples, using more homogenous methods, and exploring the role of MS treatment on cognitive and psychological development is required.
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Affiliation(s)
- Samuela Tarantino
- Developmental Neurology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
| | | | - Laura Papetti
- Developmental Neurology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Gabriele Monte
- Developmental Neurology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | | | - Massimiliano Valeriani
- Developmental Neurology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
- Systems Medicine Department, University of Tor Vergata, Rome, Italy
- Center for Sensory-Motor Interaction, Aalborg University, Aalborg, Denmark
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Gury P, Moulin M, Laroye R, Montazel M, Trachino M, Narme P, Ehrlé N. Explicit and implicit abilities in humor processing in patients with relapsing-remitting multiple sclerosis. Soc Neurosci 2024; 19:1-13. [PMID: 38424715 DOI: 10.1080/17470919.2024.2315817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Accepted: 11/28/2023] [Indexed: 03/02/2024]
Abstract
Sociocognitive impairment is well known in the relapsing-remitting form of multiple sclerosis (RR-MS). The purpose of the present study was to assess explicit and implicit humor abilities in this population. Based on clinical observation and contrary to the current cognitive model, we hypothesized that implicit performances (happy facial expressions) would be better than explicit ones (humor judgment assessed by explicit humor comprehension, subjective feeling of amusement as a conscious appreciation of funniness, and verbal justifications of funniness). Twenty-five RR-MS patients and twenty-five healthy participants completed the tasks. Their face was filmed during humor ratings. Patients' results suggest that 32% of them showed an impairment in explicit humor comprehension, with normal facial expressions. Both groups found great difficulty in justifying the cause of their amusement. All these results may suggest the existence of a supplementary implicit pathway in humor processing. The preservation of this implicit pathway may be advantageous for future remediation. Contrary to the current model, we found that the subjective feeling of amusement was preserved when comprehension was impaired. Further studies will be needed to clarify this component, and adjust the theoretical modeling.
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Affiliation(s)
- Pauline Gury
- Neurology department, Maison-Blanche hospital, Reims, France
- Laboratoire Mémoire Cerveau et Cognition (UR 7536), University Paris Cité, Boulogne-Billancourt, France
| | | | | | - Marine Montazel
- Neurology department, Maison-Blanche hospital, Reims, France
| | - Marine Trachino
- Neurology department, Maison-Blanche hospital, Reims, France
| | - Pauline Narme
- Laboratoire Mémoire Cerveau et Cognition (UR 7536), University Paris Cité, Boulogne-Billancourt, France
| | - Nathalie Ehrlé
- Laboratoire Mémoire Cerveau et Cognition (UR 7536), University Paris Cité, Boulogne-Billancourt, France
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3
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Sajad M, Zahoor I, Rashid F, Cerghet M, Rattan R, Giri S. Pyruvate Dehydrogenase-Dependent Metabolic Programming Affects the Oligodendrocyte Maturation and Remyelination. Mol Neurobiol 2024; 61:397-410. [PMID: 37620688 DOI: 10.1007/s12035-023-03546-x] [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: 01/30/2023] [Accepted: 07/21/2023] [Indexed: 08/26/2023]
Abstract
The metabolic needs of the premature/premyelinating oligodendrocytes (pre-OLs) and mature oligodendrocytes (OLs) are distinct. The metabolic control of oligodendrocyte maturation from the pre-OLs to the OLs is not fully understood. Here, we show that the terminal maturation and higher mitochondrial respiration in the OLs is an integrated process controlled through pyruvate dehydrogenase complex (Pdh). Combined bioenergetics and metabolic studies show that OLs show elevated mitochondrial respiration than the pre-OLs. Our signaling studies show that the increased mitochondrial respiration activity in the OLs is mediated by the activation of Pdh due to inhibition of the pyruvate dehydrogenase kinase-1 (Pdhk1) that phosphorylates and inhibits Pdh activity. Accordingly, when Pdhk1 is directly expressed in the pre-OLs, they fail to mature into the OLs. While Pdh converts pyruvate into the acetyl-CoA by its oxidative decarboxylation, our study shows that Pdh-dependent acetyl-CoA generation from pyruvate contributes to the acetylation of the bHLH family transcription factor, oligodendrocyte transcription factor 1 (Olig1) which is known to be involved in the OL maturation. Pdh inhibition via direct expression of Pdhk1 in the pre-OLs blocks the Olig1-acetylation and OL maturation. Using the cuprizone model of demyelination, we show that Pdh is deactivated during the demyelination phase, which is however reversed in the remyelination phase upon cuprizone withdrawal. In addition, Pdh activity status correlates with the Olig1-acetylation status in the cuprizone model. Hence, the Pdh metabolic node activation allows a robust mitochondrial respiration and activation of a molecular program necessary for the terminal maturation of oligodendrocytes. Our findings open a new dialogue in the developmental biology that links cellular development and metabolism. These findings have far-reaching implications in the development of therapies for a variety of demyelinating disorders including multiple sclerosis.
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Affiliation(s)
- M Sajad
- Department of Neurology, Henry Ford Health, Detroit, MI, 48202, USA.
| | - Insha Zahoor
- Department of Neurology, Henry Ford Health, Detroit, MI, 48202, USA
| | - Faraz Rashid
- Department of Neurology, Henry Ford Health, Detroit, MI, 48202, USA
| | - Mirela Cerghet
- Department of Neurology, Henry Ford Health, Detroit, MI, 48202, USA
| | - Ramandeep Rattan
- Gynecologic Oncology and Developmental Therapeutics Research Program, Henry Ford Health Hospital, Detroit, MI, 48202, USA
| | - Shailendra Giri
- Department of Neurology, Henry Ford Health, Detroit, MI, 48202, USA.
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Doskas TK, Christidi F, Spiliopoulos KC, Tsiptsios D, Vavougios GD, Tsiakiri A, Vorvolakos T, Kokkotis C, Iliopoulos I, Aggelousis N, Vadikolias K. Social Cognition Impairments in Association to Clinical, Cognitive, Mood, and Fatigue Features in Multiple Sclerosis: A Study Protocol. Neurol Int 2023; 15:1106-1116. [PMID: 37755359 PMCID: PMC10536405 DOI: 10.3390/neurolint15030068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 08/29/2023] [Accepted: 08/30/2023] [Indexed: 09/28/2023] Open
Abstract
Multiple sclerosis (MS) is a chronic immune-mediated disease of the central nervous system (CNS), characterized by the diffuse grey and white matter damage. Cognitive impairment (CI) is a frequent clinical feature in patients with MS (PwMS) that can be prevalent even in early disease stages, affecting the physical activity and active social participation of PwMS. Limited information is available regarding the influence of MS in social cognition (SC), which may occur independently from the overall neurocognitive dysfunction. In addition, the available information regarding the factors that influence SC in PwMS is limited, e.g., factors such as a patient's physical disability, different cognitive phenotypes, mood status, fatigue. Considering that SC is an important domain of CI in MS and may contribute to subjects' social participation and quality of life, we herein conceptualize and present the methodological design of a cross-sectional study in 100 PwMS of different disease subtypes. The study aims (a) to characterize SC impairment in PwMS in the Greek population and (b) to unveil the relationship between clinical symptoms, phenotypes of CI, mood status and fatigue in PwMS and the potential underlying impairment on tasks of SC.
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Affiliation(s)
- Triantafyllos K. Doskas
- Neurology Department, Athens Naval Hospital, 11521 Athens, Greece; (T.K.D.); (K.C.S.)
- Neurology Department, Democritus University of Thrace, 68100 Alexandroupolis, Greece; (F.C.); (A.T.); (I.I.); (K.V.)
| | - Foteini Christidi
- Neurology Department, Democritus University of Thrace, 68100 Alexandroupolis, Greece; (F.C.); (A.T.); (I.I.); (K.V.)
| | - Kanellos C. Spiliopoulos
- Neurology Department, Athens Naval Hospital, 11521 Athens, Greece; (T.K.D.); (K.C.S.)
- Neurology Department, University of Patras, 26504 Patras, Greece
| | - Dimitrios Tsiptsios
- Neurology Department, Democritus University of Thrace, 68100 Alexandroupolis, Greece; (F.C.); (A.T.); (I.I.); (K.V.)
| | | | - Anna Tsiakiri
- Neurology Department, Democritus University of Thrace, 68100 Alexandroupolis, Greece; (F.C.); (A.T.); (I.I.); (K.V.)
| | - Theofanis Vorvolakos
- Psychiatry Department, Democritus University of Thrace, 68100 Alexandroupolis, Greece;
| | - Christos Kokkotis
- Department of Physical Education and Sport Science, Democritus University of Thrace, 69100 Komotini, Greece; (C.K.); (N.A.)
| | - Ioannis Iliopoulos
- Neurology Department, Democritus University of Thrace, 68100 Alexandroupolis, Greece; (F.C.); (A.T.); (I.I.); (K.V.)
| | - Nikolaos Aggelousis
- Department of Physical Education and Sport Science, Democritus University of Thrace, 69100 Komotini, Greece; (C.K.); (N.A.)
| | - Konstantinos Vadikolias
- Neurology Department, Democritus University of Thrace, 68100 Alexandroupolis, Greece; (F.C.); (A.T.); (I.I.); (K.V.)
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Turkstra LS, Hosseini-Moghaddam S, Wohltjen S, Nurre SV, Mutlu B, Duff MC. Facial affect recognition in context in adults with and without TBI. Front Psychol 2023; 14:1111686. [PMID: 37645059 PMCID: PMC10461638 DOI: 10.3389/fpsyg.2023.1111686] [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: 11/29/2022] [Accepted: 07/31/2023] [Indexed: 08/31/2023] Open
Abstract
Introduction Several studies have reported impaired emotion recognition in adults with traumatic brain injury (TBI), but studies have two major design features that limit application of results to real-world contexts: (1) participants choose from among lists of basic emotions, rather than generating emotion labels, and (2) images are typically presented in isolation rather than in context. To address these limitations, we created an open-labeling task with faces shown alone or in real-life scenes, to more closely approximate how adults with TBI label facial emotions beyond the lab. Methods Participants were 55 adults (29 female) with moderate to severe TBI and 55 uninjured comparison peers, individually matched for race, sex, and age. Participants viewed 60 photographs of faces, either alone or in the pictured person's real-life context, and were asked what that person was feeling. We calculated the percent of responses that were standard forced-choice-task options, and also used sentiment intensity analysis to compare verbal responses between the two groups. We tracked eye movements for a subset of participants, to explore whether gaze duration or number of fixations helped explain any group differences in labels. Results Over 50% of responses in both groups were words other than basic emotions on standard affect tasks, highlighting the importance of eliciting open-ended responses. Valence of labels by participants with TBI was attenuated relative to valence of Comparison group labels, i.e., TBI group responses were less positive to positive images and the same was true for negative images, although the TBI group responses had higher lexical diversity. There were no significant differences in gaze duration or number of fixations between groups. Discussion Results revealed qualitative differences in affect labels between adults with and without TBI that would not have emerged on standard forced-choice tasks. Verbal differences did not appear to be attributable to differences in gaze patterns, leaving open the question of mechanisms of atypical affect processing in adults with TBI.
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Affiliation(s)
- Lyn S. Turkstra
- Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | | | - Sophie Wohltjen
- Department of Computer Sciences, University of Wisconsin-Madison, Madison, WI, United States
| | - Sara V. Nurre
- American Speech-Language-Hearing Association, Rockville, MD, United States
| | - Bilge Mutlu
- Department of Computer Sciences, University of Wisconsin-Madison, Madison, WI, United States
| | - Melissa C. Duff
- Department of Hearing and Speech Sciences, Vanderbilt University, Nashville, TN, United States
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Suárez Bagnasco M, Paz EFV, Jerez J, Gonzalez A. Association between intelligence quotient scores and body mass index in pediatric multiple sclerosis. APPLIED NEUROPSYCHOLOGY. CHILD 2023; 12:227-234. [PMID: 35705260 DOI: 10.1080/21622965.2022.2082874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The aim of this study is to examine the relationship between body mass index (BMI) and intelligence quotient scores (IQ). The sample included 11 patients with pediatric multiple sclerosis between 8 and 17 years, mean age 14.45 years (SD = 2.69). The BMI was calculated as weight in kilograms divided by the square of height in meters. The Wechsler Intelligence Scale for Children V and the Abbreviated Weschler Intelligence Scale were used to measure total IQ. Average sample BMI and IQ were 24.61 (SD = 5.53) (range: 19-39.4) and 86.63 (SD = 14.79) (range: 66-111), respectively. Results of the Pearson correlation indicated that there was a significant negative association between BMI and IQ, (r = -0.608, p = 0.042). R-squared was 0.370. We discuss if lower IQ lead to BMI gains or whether overweight/obesity lead to intellectual functioning changes. Implication for practice and future research are presented.
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Affiliation(s)
- Mariana Suárez Bagnasco
- Department of Child Neurology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
- Catholic University of Uruguay, Montevideo, Uruguay
| | | | - Javier Jerez
- Department of Child Neurology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Alejandra Gonzalez
- Department of Child Neurology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
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Şandor S, İşcen P. Faux-Pas Recognition Test: A Turkish adaptation study and a proposal of a standardized short version. APPLIED NEUROPSYCHOLOGY. ADULT 2023; 30:34-42. [PMID: 33847200 DOI: 10.1080/23279095.2021.1909030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Faux Pas Recognition Test (FPRT) is one of the most commonly used tools to assess the theory of mind (ToM) and a valid and reliable screening of this social cognitive function in both clinical and research settings is essential. We aimed to evaluate the psychometric properties of the FPRT on a healthy Turkish sample and to develop a shorter form with adequate psychometric properties to provide an easier application for the tester by shortening the test's duration of administration. Four hundred sixteen healthy individuals completed the Turkish version of the FPRT. Addenbrooke's Cognitive Evaluation-Revised form (ACE-R) was given to the participants who were over 60 years of age in order to eliminate the adverse effects of a potential cognitive decline on FPRT performance. Effects of psychological symptoms on FPRT performance were controlled with Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI). Both the original and short versions of the test showed good psychometric properties: for the original version internal consistency reliability was 0.94 for faux-pas (FP) stories and 0.92 for control stories; for the short version it was 0.92 for FP stories and was 0.93 for control stories. For the original version of the FPRT; inter-rater reliability was 0.88 for FP stories and was 0.96 for control stories. Split-half reliability was 0.78 for FP stories and was 0.85 for control stories. Gender and age comparisons were carried out. Results revealed that women had significantly higher total scores than men in three measures of FPRT.
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Affiliation(s)
- Serra Şandor
- Department of Psychology, Istanbul Kültür University, Istanbul, Turkey
| | - Pınar İşcen
- Faculty of Medicine, Department of Neurology, Behavioral Neurology and Movement Disorders Unit, Neuropsychology Laboratory, Istanbul University, Istanbul, Turkey
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De Somma E, O'Mahony J, Brown RA, Brooks BL, Yeh EA, Cardenas de La Parra A, Arnold D, Collins DL, Maranzano J, Narayanan S, Marrie RA, Bar-Or A, Banwell B, Till C. Disrupted cognitive development following pediatric acquired demyelinating syndromes: a longitudinal study. Child Neuropsychol 2021; 28:649-670. [PMID: 34872458 DOI: 10.1080/09297049.2021.2002289] [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: 01/18/2023]
Abstract
Long-term cognitive deficits have been observed in some children who experience an acquired demyelinating syndrome (ADS). We examined changes in cognitive functioning over the first two years following incident ADS andtested whether normalized brain and thalamic volume accounted for decline over time. Twenty-five youth (mean age 12.8 years) with ADS, 9 of whom were diagnosed with multiple sclerosis (MS) and 16 of whom experienced monophasic ADS (monoADS), underwent two neuropsychological evaluationsand MRI scans at approximately6- and 24-months post ADS-onset. We examined changes in cognitive outcomes over time and between patient groups. Generalized linear mixed-effect regression models were used to examine the association of normalized brain and thalamic volumesbetween the two timepointswith cognitive z-scores. Cognitive performance was within the age-expected range for both groups and remained stable over time on 15 measures. In the combined sample of monoADS and MS patients, declines (p < .05) were noted on the Symbol Digit Modalities Test (SDMT), the Auditory Working Memory (AWM), and the WJ-III Visual Matching (VisMat)tests, but did not survive FDR correction. Clinically significant declines, as measured by the Reliable Change Index, were observed on the SDMT,AWM, and VisMattests by 19, 42, and 32%, respectively. Lower normalized brain volume at 6-months predicted a negative change in SDMT (B = 0.45, 95%CI: 0.07,0.83) and AWM (B = 0.30, 95%CI: 0.13, 0.47). Chronicity of demyelination is not required for cognitive decline nor for reduced brain volume, suggesting that even a single demyelinating event may negatively impact cognitive potential in children.
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Affiliation(s)
| | - Julia O'Mahony
- Neurosciences and Mental Health, Hospital for Sick Children, Canada Hospital for Sick Children, Toronto, Canada
| | | | - Brian L Brooks
- Neurosciences Program, Alberta Children's Hospital, Calgary, Canada.,Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Canada.,Departments of Pediatrics, Clinical Neurosciences, and Psychology, University of Calgary, Calgary, Canada
| | - E Ann Yeh
- Neurosciences and Mental Health, Hospital for Sick Children, Canada Hospital for Sick Children, Toronto, Canada.,Department of Neurology, Hospital for Sick Children, Toronto, Canada
| | | | - Douglas Arnold
- McConnell Brain Imaging Centre, McGill University, Montreal, Canada
| | - D Louis Collins
- McConnell Brain Imaging Centre, McGill University, Montreal, Canada
| | | | - Sridar Narayanan
- McConnell Brain Imaging Centre, McGill University, Montreal, Canada
| | - Ruth Ann Marrie
- Departments of Internal Medicine and Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Amit Bar-Or
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Brenda Banwell
- Children's Hospital of Philadelphia, Departments of Neurology and Pediatrics Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Christine Till
- Department of Psychology, York University, Toronto, Canada.,Neurosciences and Mental Health, Hospital for Sick Children, Canada Hospital for Sick Children, Toronto, Canada
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9
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Theory of mind and its neuroanatomical correlates in people with multiple sclerosis. Mult Scler Relat Disord 2021; 55:103156. [PMID: 34332459 DOI: 10.1016/j.msard.2021.103156] [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: 05/31/2021] [Revised: 07/09/2021] [Accepted: 07/17/2021] [Indexed: 11/22/2022]
Abstract
Background Theory of mind (ToM) is one of the several different concepts in social cognition and is defined as the ability to access the mental states of others or to adopt the point of view of others. Although studies have shown that ToM is impaired in people with multiple sclerosis (MS), the results based on individual ToM tasks are conflicting; some studies have shown deficits only in the 'Reading the Mind in the Eyes' Test (RMET), while others have reported poor performance in the Faux Pas Test (FPT) as well as RMET. Furthermore, little is known about the relationship between ToM performance and neuroanatomical characteristics in MS. This study investigated ToM impairment and its relationship to regional brain volume or cortical thickness in people with MS. Methods This cross-sectional study included 20 participants with relapse-onset MS and 27 age- and sex-matched volunteers as healthy controls (HC). All the participants underwent neuropsychological (NP) tests as well as ToM tasks, including RMET and FPT. Participants with MS underwent brain MRI within 6 months before and after undergoing the NP and ToM tests. Regional volume of subcortical structures or cortical thickness were analysed based on 3D T1-weighted images using FreeSurfer software. Results Both RMET and FPT scores were significantly lower in participants with MS than in HC (p = 0.0049, p = 0.0071, respectively). Imaging analyses showed that FPT scores, but not RMET scores, were positively correlated with the right thalamus (R2 = 0.26, p = 0.012) and left pallidum (R2 = 0.39, p = 0.0021) volumes after adjusting for age. Furthermore, surface-based morphometry revealed significant correlation between age-adjusted cortical thickness of ten cortical areas, including the fusiform gyrus, orbitofrontal cortex, temporal-parietal junction, and superior temporal gyrus, and FPT scores. Conclusions These study findings showed that both RMET and FPT performances are impaired in participants with MS. Furthermore, FPT deficits, but not RMET deficits, were significantly associated with the volume of two subcortical structures as well as the thickness of ten cortical areas, suggesting that FPT is an appropriate task to access ToM performance in MS.
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Fabri TL, Datta R, O'Mahony J, Barlow-Krelina E, De Somma E, Longoni G, Gur RE, Gur RC, Bacchus M, Ann Yeh E, Banwell BL, Till C. Memory, processing of emotional stimuli, and volume of limbic structures in pediatric-onset multiple sclerosis. Neuroimage Clin 2021; 31:102753. [PMID: 34273791 PMCID: PMC8319518 DOI: 10.1016/j.nicl.2021.102753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 06/22/2021] [Accepted: 06/29/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The limbic system is involved in memory and in processing of emotional stimuli. We measured volume of the hippocampus, amygdala, and thalamus, and assessed their relative contribution to episodic memory and emotion identification in POMS. METHOD Sixty-five POMS participants (Mage = 18.3 ± 3.9 years; 48 female (73.8%)), average disease duration = 3.8 ± 3.8 years) and 76 age- and sex-matched controls (Mage = 18.1 ± 4.6 years; 49 female (64.5%)) completed the Penn Computerized Neurocognitive Battery (PCNB); 59 of 65 POMS participants and 69 out of 76 controls underwent 3 T MRI scanning. We derived age-adjusted Z-scores on accuracy and response time (RT) measures of episodic memory and emotion identification of the PCNB. Magnetic resonance imaging (MRI) volumetrics were normalized using the scaling factor computed by SIENAx. On PCNB tests that differed between groups, we used multiple linear regression to assess relationships between regional brain volumes and either episodic memory or emotion identification outcomes controlling for age, sex, accuracy/RT, and parental education. RESULTS POMS participants were slower and less accurate than controls on the episodic memory domain but did not differ from controls on emotion outcomes. At the subtest level, POMS participants showed reduced accuracy on Word Memory (p = .002) and slower performance on Face Memory (p = .04) subtests. POMS participants had smaller total and regional brain volumes of the hippocampus, amygdala, and thalamus (p values ≤ 0.01). Collapsing across groups, both hippocampal and thalamic volume were significant predictors of Word Memory accuracy; hippocampal volume (B = 0.24, SE = 0.10, p = .02) was more strongly associated with Word Memory performance than thalamic volume (B = 0.16, SE = 0.05, p = .003), though the estimate with was less precise. CONCLUSIONS POMS participants showed reduced episodic memory performance compared to controls. Aspects of episodic memory performance were associated with hippocampal and thalamic volume. Emotion identification was intact, despite volume loss in the amygdala.
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Affiliation(s)
| | - Ritobrato Datta
- Division of Neurology, Children's Hospital of Philadelphia, United States
| | - Julia O'Mahony
- Departments of Internal Medicine, University of Manitoba, Winnipeg, MB, Canada
| | | | | | - Giulia Longoni
- Department of Paediatrics, Division of Neurology, The Hospital for Sick Children, University of Toronto, Canada
| | - Raquel E Gur
- Penn-CHOP Lifespan Brain Institute, Departments of Psychiatry, Neurology, and Radiology, University of Pennsylvania School of Medicine, United States
| | - Ruben C Gur
- Penn-CHOP Lifespan Brain Institute, Departments of Psychiatry, Neurology, and Radiology, University of Pennsylvania School of Medicine, United States
| | - Micky Bacchus
- Division of Neurology, Children's Hospital of Philadelphia, United States
| | - E Ann Yeh
- Department of Paediatrics, Division of Neurology, The Hospital for Sick Children, University of Toronto, Canada
| | - Brenda L Banwell
- Division of Neurology, Children's Hospital of Philadelphia, United States; Perelman School of Medicine, University of Pennsylvania, United States
| | - Christine Till
- Department of Psychology, York University, Canada; Department of Paediatrics, Division of Neurology, The Hospital for Sick Children, University of Toronto, Canada.
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11
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Massano C, Lima M, Monteiro I, Machado R, Correia I, Nunes CC, Macário C, Sousa L, Santana I, Batista S. Outcomes on Social and Classic Cognition in adults with Pediatric-onset Multiple Sclerosis. Mult Scler Relat Disord 2021; 53:103071. [PMID: 34161899 DOI: 10.1016/j.msard.2021.103071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 05/10/2021] [Accepted: 05/31/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Cognitive impairment affecting classic and social domains has been consistently reported in patients with Multiple Sclerosis (MS). However, little is known about the cognitive outcomes, particularly on social cognition, in adults with pediatric-onset multiple sclerosis (POMS). OBJECTIVES To compare the performance in classic and social cognitive domains between adults with POMS and adult-onset MS (AOMS). METHODS A group of 30 patients with POMS (age onset <18 years) was compared with age-matched (AOAMS, n=30) and disease duration-matched (AODMS, n= 30) patients who developed MS after the age of 18 years. Cognitive performance was assessed using the Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) and Theory of Mind (ToM) tests. RESULTS Cognitive impairment was more prevalent in POMS patients (40% vs. 16.7%, p=0.045), independently of age or disease duration, affecting more severely information-processing speed and visual memory domains. No statistically significant differences were found in ToM performance between patients with POMS and AOMS. When analyzing ToM performance according to age of disease onset (≤15 years; 15-20 years; ≥20 years), patients with disease onset ≤15 years old had significantly lower scores on ToM tests when compared to the other groups. CONCLUSION Patients with POMS were more prone to develop impairment on classic cognitive domains than on ToM ability, when compared with AOMS patients. The interference of POMS with critical neurodevelopmental periods, specific for each cognitive domain, may explain different outcomes at adulthood on social and classic cognition.
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Affiliation(s)
| | - Marisa Lima
- Department of Neurology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Isabel Monteiro
- Department of Neurology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Rita Machado
- Department of Neurology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Inês Correia
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal; Department of Neurology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Carla Cecília Nunes
- Department of Neurology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Carmo Macário
- Department of Neurology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Lívia Sousa
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal; Department of Neurology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Isabel Santana
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal; Department of Neurology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Sónia Batista
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal; Department of Neurology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
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12
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Lin X, Zhang X, Liu Q, Zhao P, Zhong J, Pan P, Wang G, Yi Z. Social cognition in multiple sclerosis and its subtypes: A meta-analysis. Mult Scler Relat Disord 2021; 52:102973. [PMID: 33962135 DOI: 10.1016/j.msard.2021.102973] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 04/12/2021] [Accepted: 04/17/2021] [Indexed: 01/11/2023]
Abstract
BACKGROUND Multiple sclerosis (MS) is an immune-mediated demyelinating disease that disrupts several social cognitive abilities, including the theory of mind (ToM) and facial emotion recognition (FER). It is unclear how specific ToM subcomponents, including cognitive and affective ToM, are affected in patients with MS and the social cognitive abilities in MS subtypes. METHODS A search of PubMed, Web of Science, and Embase databases was conducted until June 2020. Effect sizes were calculated using Hedges g with a random-effects model. RESULTS A total of 45 studies were included. Relative to health controls (HCs), patients with MS and its subtypes (including relapsing-remitting MS [RRMS] and progressive MS) exhibited impairments in ToM (g = -0.77, g = -0.70, g = -0.75, respectively), cognitive ToM (g = -0.72, g = -0.83, g = -0.73, respectively), affective ToM (g = -0.84, g = -0.63, g = -0. 50, respectively), and FER (g = -0.62, g = -0.53, g = -1.07, respectively). In addition, there was no difference between progressive primary MS and secondary progressive MS in overall ToM, cognitive ToM, affective ToM, and FER. Compared to patients with RRMS, patients with progressive MS showed no difference in overall ToM, cognitive ToM, and affective ToM but had more serious defects in FER (g = -0.57). CONCLUSIONS These quantitative results indicate that patients with MS and its subtypes have a differential impairment of the core aspects of social cognitive processing (including ToM and FER), which may help develop the structured social cognitive interventions in MS.
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Affiliation(s)
- XiaoGuang Lin
- Department of Neurology, Affiliated Suqian Hospital of Xuzhou Medical University, Suqian, PR China
| | - XueLing Zhang
- Department of Neurology, Affiliated Suqian Hospital of Xuzhou Medical University, Suqian, PR China
| | - QinQin Liu
- Department of Neurology, Affiliated Suqian Hospital of Xuzhou Medical University, Suqian, PR China
| | - PanWen Zhao
- Department of Central Laboratory, Affiliated Yancheng School of Clinical Medicine of Nanjing Medical University, PR China
| | - JianGuo Zhong
- Department of Neurology, Affiliated Yancheng School of Clinical Medicine of Nanjing Medical University, PR China
| | - PingLei Pan
- Department of Neurology and Department of Central Laboratory, Affiliated Yancheng School of Clinical Medicine of Nanjing Medical University, PR China
| | - GenDi Wang
- Department of Neurology, Affiliated Yancheng School of Clinical Medicine of Nanjing Medical University, PR China
| | - ZhongQuan Yi
- Department of Central Laboratory, Affiliated Yancheng School of Clinical Medicine of Nanjing Medical University, PR China.
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13
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Doskas T, Vavougios GD, Karampetsou P, Kormas C, Synadinakis E, Stavrogianni K, Sionidou P, Serdari A, Vorvolakos T, Iliopoulos I, Vadikolias Κ. Neurocognitive impairment and social cognition in multiple sclerosis. Int J Neurosci 2021; 132:1229-1244. [PMID: 33527857 DOI: 10.1080/00207454.2021.1879066] [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: 10/22/2022]
Abstract
PURPOSE/AIM OF THE STUDY The impairment of neurocognitive functions occurs in all subtypes of multiple sclerosis, even from the earliest stages of the disease. Commonly reported manifestations of cognitive impairment include deficits in attention, conceptual reasoning, processing efficiency, information processing speed, memory (episodic and working), verbal fluency (language), and executive functions. Multiple sclerosis patients also suffer from social cognition impairment, which affects their social functioning. The objective of the current paper is to assess the effect of neurocognitive impairment and its potential correlation with social cognition performance and impairment in multiple sclerosis patients. MATERIALS AND METHODS An overview of the available-to-date literature on neurocognitive impairment and social cognition performance in multiple sclerosis patients by disease subtype was performed. RESULTS It is not clear if social cognition impairment occurs independently or secondarily to neurocognitive impairment. There are associations of variable strengths between neurocognitive and social cognition deficits and their neural basis is increasingly investigated. CONCLUSIONS The prompt detection of neurocognitive predictors of social cognition impairment that may be applicable to all multiple sclerosis subtypes and intervention are crucial to prevent further neural and social cognition decline in multiple sclerosis patients.
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Affiliation(s)
- Triantafyllos Doskas
- Department of Neurology, Athens Naval Hospital, Athens, Greece.,Department of Neurology, University Hospital of Alexandroupolis, Alexandroupolis, Greece
| | | | | | | | | | | | | | - Aspasia Serdari
- Department of Psychiatry, University Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - Theofanis Vorvolakos
- Department of Psychiatry, University Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - Ioannis Iliopoulos
- Department of Neurology, University Hospital of Alexandroupolis, Alexandroupolis, Greece
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14
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Lin X, Zhang X, Liu Q, Zhao P, Zhong J, Pan P, Wang G, Yi Z. Empathy and Theory of Mind in Multiple Sclerosis: A Meta-Analysis. Front Psychiatry 2021; 12:628110. [PMID: 33897490 PMCID: PMC8062809 DOI: 10.3389/fpsyt.2021.628110] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 03/18/2021] [Indexed: 12/25/2022] Open
Abstract
Multiple sclerosis (MS) is an immune-mediated demyelinating disease of the central nervous system. Studies have shown that MS disrupts several social cognitive abilities [including empathy and theory of mind (ToM)]. Overall ToM deficits in MS are well documented, but how the specific ToM subcomponents and empathic capacity are affected remains unclear. For this meta-analysis, we searched PubMed, Web of Science, and Embase from inception to July 2020. Effect sizes were calculated using Hedges g with a random-effects model. Thirty-three studies were included. Relative to healthy controls (HCs), patients with MS were moderately impaired in overall empathy (g = -0.67), overall ToM (g = -74), cognitive ToM (g = -0.72), and the overlapping domains of cognitive empathy/affective ToM (g = -0.79); no group differences were identified for affective empathy (g = -0.19). Compared with HCs, patients with relapsing-remitting MS (RRMS) and progressive MS were impaired in overall empathy, overall ToM, cognitive ToM, and cognitive empathy/affective ToM, without significant RRMS-progressive MS differences in impairment degree. We conducted the first meta-analytic review investigating the empathy and ToM functioning patterns in patients with MS and examined the overlapping and distinct subcomponents of these constructs. The findings suggest differential impairment of the core aspects of social cognitive processing in patients with MS, which may importantly inform the development of structured social cognitive MS interventions.
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Affiliation(s)
- XiaoGuang Lin
- Department of Neurology, Affiliated Suqian Hospital of Xuzhou Medical University, Suqian, China
| | - XueLing Zhang
- Department of Neurology, Affiliated Suqian Hospital of Xuzhou Medical University, Suqian, China
| | - QinQin Liu
- Department of Neurology, Affiliated Suqian Hospital of Xuzhou Medical University, Suqian, China
| | - PanWen Zhao
- Department of Central Laboratory, Affiliated Yancheng School of Clinical Medicine of Nanjing Medical University, Yancheng, China
| | - JianGuo Zhong
- Department of Neurology, Affiliated Yancheng School of Clinical Medicine of Nanjing Medical University, Yancheng, China
| | - PingLei Pan
- Department of Neurology and Department of Central Laboratory, Affiliated Yancheng School of Clinical Medicine of Nanjing Medical University, Yancheng, China
| | - GenDi Wang
- Department of Neurology, Affiliated Yancheng School of Clinical Medicine of Nanjing Medical University, Yancheng, China
| | - ZhongQuan Yi
- Department of Central Laboratory, Affiliated Yancheng School of Clinical Medicine of Nanjing Medical University, Yancheng, China
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15
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Lin WS, Lin SJ, Hsu TR. Cognitive Assessment and Rehabilitation for Pediatric-Onset Multiple Sclerosis: A Scoping Review. CHILDREN-BASEL 2020; 7:children7100183. [PMID: 33076220 PMCID: PMC7602453 DOI: 10.3390/children7100183] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 10/08/2020] [Accepted: 10/10/2020] [Indexed: 02/07/2023]
Abstract
Cognitive impairment is increasingly recognized as an important clinical issue in pediatric multiple sclerosis (MS). However, variations regarding its assessment and remediation are noted in clinical arena. This scoping review aims to collate available evidence concerning cognitive assessment tool and cognitive rehabilitation for pediatric MS. We performed a systematic search of electronic databases (MEDLINE, PubMed, CINAHL Plus, and Web of Science) from inception to February 2020. Reference lists of included articles and trial registers were also searched. We included original studies published in English that addressed cognitive assessment tools or cognitive rehabilitation for pediatric-onset MS. Fourteen studies fulfilled our inclusion criteria. Among them, 11 studies evaluated the psychometric aspects of various cognitive assessment tools in the context of pediatric MS, and different neuro-cognitive domains were emphasized across studies. There were only three pilot studies reporting cognitive rehabilitation for pediatric-onset MS, all of which used home-based computerized programs targeting working memory and attention, respectively. Overall, more systematic research on cognitive assessment tools and rehabilitation for pediatric MS is needed to inform evidence-based practice. Computer-assisted cognitive assessment and rehabilitation appear feasible and deserve further studies.
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Affiliation(s)
- Wei-Sheng Lin
- Department of Pediatrics, Taipei Veterans General Hospital, Taipei 11217, Taiwan;
- Correspondence:
| | - Shan-Ju Lin
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital Yunlin Branch, Yunlin 640, Taiwan;
| | - Ting-Rong Hsu
- Department of Pediatrics, Taipei Veterans General Hospital, Taipei 11217, Taiwan;
- Institute of Clinical Medicine, National Yang-Ming University, Taipei 112, Taiwan
- Faculty of Medicine, National Yang-Ming University, Taipei 112, Taiwan
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16
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Ehrlé N, Hody A, Lecrique M, Gury P, Bakchine S. Social norms in patients with relapsing-remitting multiple sclerosis: Impairment of the moral/conventional distinction? Soc Neurosci 2020; 15:630-640. [PMID: 33026971 DOI: 10.1080/17470919.2020.1834449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
In multiple sclerosis, conflicting results have been reported between social impairment and relatively preserved moral judgments, mainly tested with moral dilemmas. Some results even yet suggest signs of "ultra-morality" in these patients. The objective of the present study was to test this hypothesis with the moral/conventional distinction task, investigating the knowledge of social norms and the judgment of moral versus conventional transgressions. In the first condition, the permissibility of social situations was estimated. If the participant judged the situation as wrong, he had to estimate the seriousness of the transgression, to give verbal justifications and to re-estimate the permissibility when the law authorizes the act (generalization condition) and when a social authority recommends the act (dependency condition). Forty-six multiple sclerosis patients matched to healthy controls completed this task. Contrary to our hypotheses, patients showed less permissibility for moral transgressions or a higher seriousness but, unexpectedly, for conventional transgressions. Most importantly, abnormal justifications were observed (strictly moral arguments for conventional transgressions and vice versa). This suggests a lack of distinction between conventional and moral judgment in multiple sclerosis. This confusion may explain the "ultra-morality" sometimes reported, if patients base their judgment mainly on social knowledge and not on emotional processing.
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Affiliation(s)
- Nathalie Ehrlé
- Hôpital Maison-Blanche, Service de neurologie , Reims cedex, France.,Laboratoire Mémoire, Cerveau & Cognition (MC²Lab URP 7536) , Boulogne-Billancourt, France
| | | | - Maud Lecrique
- Hôpital Maison-Blanche, Service de neurologie , Reims cedex, France
| | - Pauline Gury
- Hôpital Maison-Blanche, Service de neurologie , Reims cedex, France
| | - Serge Bakchine
- Hôpital Maison-Blanche, Service de neurologie , Reims cedex, France
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17
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Lin X, Zhang X, Liu Q, Zhao P, Zhong J, Pan P, Wang G, Yi Z. Social cognition in multiple sclerosis and its subtypes: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2020; 99:e21750. [PMID: 32872066 PMCID: PMC7437743 DOI: 10.1097/md.0000000000021750] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Multiple sclerosis (MS) is an inflammatory and degenerative neurological disorder of the central nervous system. Cognitive impairment is frequent in MS patients, which not only includes deficits in abilities assessed by traditional neuropsychological batteries, but also often features impairments in social cognition (including theory of mind and facial emotion recognition). Recently, numerous studies have assessed social cognition performance in MS. However, there have been inconsistent findings. Besides, it is not clear how social cognitive abilities are affected in MS subtypes. The aim of this study is to conduct a meta-analysis to characterize social cognition performance in MS and its subtypes (clinically isolated syndrome, relapsing-remitting MS, progressive primary MS, and secondary progressive MS). METHODS Literature sources will be divided into 2 sections: electronic sources and manual sources. A systematic literature search will be performed for eligible studies published up to June 10, 2020 in 3 international databases (Embase, PubMed, and Web of Science). In addition, manual sources will be searched, such as the references of all included studies. Two researchers will independently conduct the work such as article retrieval, screening, quality evaluation, data collection. Meta-analysis will be conducted using Stata 15.0 software. RESULTS The results of this study will be published in a peer-reviewed journal. CONCLUSIONS This meta-analysis will provide a high-quality synthesis from existing evidence for social cognition performance in MS and its subtypes. PROSPERO REGISTRATION NUMBER INPLASY202070028.
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Affiliation(s)
- XiaoGuang Lin
- Department of Neurology, Affiliated Suqian Hospital of Xuzhou Medical University, Suqian
| | - XueLing Zhang
- Department of Neurology, Affiliated Suqian Hospital of Xuzhou Medical University, Suqian
| | - QinQin Liu
- Department of Neurology, Affiliated Suqian Hospital of Xuzhou Medical University, Suqian
| | | | - JianGuo Zhong
- Department of Neurology, Affiliated Yancheng School of Clinical Medicine, Nanjing Medical University, Yancheng, Jiangsu Province, PR China
| | - PingLei Pan
- Department of Central Laboratory
- Department of Neurology, Affiliated Yancheng School of Clinical Medicine, Nanjing Medical University, Yancheng, Jiangsu Province, PR China
| | - GenDi Wang
- Department of Neurology, Affiliated Yancheng School of Clinical Medicine, Nanjing Medical University, Yancheng, Jiangsu Province, PR China
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18
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Bogdanova MD, Mikadze YV, Bembeeva RT, Volkova EY. [Methodological issues of cognitive impairment studies in pediatric multiple sclerosis patients]. Zh Nevrol Psikhiatr Im S S Korsakova 2020; 119:105-111. [PMID: 31626226 DOI: 10.17116/jnevro2019119091105] [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] [Indexed: 11/17/2022]
Abstract
The article provides a review of the characteristics of cognitive impairment in multiple sclerosis (MS) and methods for its assessment in children. The features of the most frequently used neuropsychological batteries, with consideration of specifics of cognitive impairment in MS, and data on assessment of a state of cognitive functions obtained using neuropsychological tests are presented. The authors also discuss the issue of a long-term impact of the disease on a state of cognitive functions. Clinical factors, which can lead to cognitive impairment (type of multiple sclerosis, age at manifestation, number of relapses), are described.
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Affiliation(s)
- M D Bogdanova
- Lomonosov Moscow State University, Moscow, Russia; Sechenov First Moscow State Medical University, Moscow, Russia
| | - Yu V Mikadze
- Lomonosov Moscow State University, Moscow, Russia; Pirogov Russian National Research Medical University, Moscow, Russia
| | - R Ts Bembeeva
- Pirogov Russian National Research Medical University, Moscow, Russia
| | - E Yu Volkova
- Russian Pediatric Clinical Hospital, Pirogov Russian National Research Medical University, Moscow, Russia
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19
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No evidence of disease activity including cognition (NEDA-3 plus) in naïve pediatric multiple sclerosis patients treated with natalizumab. J Neurol 2019; 267:100-105. [PMID: 31562558 DOI: 10.1007/s00415-019-09554-z] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 09/18/2019] [Accepted: 09/21/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Pediatric-onset multiple sclerosis (POMS) is characterized by high inflammatory activity, aggressive course and early development of physical and cognitive disability. A highly effective early treatment must be considered in POMS. OBJECTIVE To evaluate safety and efficacy of natalizumab (NTZ) in naïve POMS. METHODS 20 naïve POMS (13F, 7 M; mean age: 13.8 ± 2.7 years) were treated with NTZ for at least 24 months (mean number of infusions: 42 ± 20). No evidence of disease activity (NEDA)-3 plus status, i.e., no relapse, no disease progression (EDSS score), no radiological activity and no cognitive decline, was evaluated. RESULTS After 2 years of NTZ treatment, a significant reduction in the mean EDSS score (p < 0.0001) was observed in the whole cohort. During the follow-up, evidence of disease activity on MRI was observed in two patients (10%) and a mild decline in cognition was observed in other two. No patient had clinical relapse. At the time of last visit NEDA-3 plus status was maintained in 16 (80%) patients. No major adverse event was observed. CONCLUSION Early treatment of aggressive POMS with NTZ proved to be highly effective in achieving and maintaining the NEDA-3 plus status. Our data support the use of NTZ as first treatment choice in POMS.
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20
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Eddy CM. What Do You Have in Mind? Measures to Assess Mental State Reasoning in Neuropsychiatric Populations. Front Psychiatry 2019; 10:425. [PMID: 31354534 PMCID: PMC6636467 DOI: 10.3389/fpsyt.2019.00425] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Accepted: 05/29/2019] [Indexed: 12/12/2022] Open
Abstract
Social interaction is closely associated with both functional capacity and well-being. Previous research has not only revealed evidence of social dysfunction in individuals with a wide range of psychiatric and neurological disorders but also generated an abundance of potential measures for assessing social cognition. This review explores the most popular measures used within neuropsychiatric populations to investigate the ability to recognize or reason about the mental states of others. Measures are also critically analyzed in terms of strengths and limitations to aid task selection in future clinical studies. The most frequently applied assessment tools use verbal, visual or audiovisual forms of presentation and assess recognition of mental states from facial features, self-rated empathy, the understanding of other's cognitive mental states such as beliefs and intentions, or the ability to combine knowledge of other's thoughts and emotions in order to understand subtle communications or socially inappropriate behavior. Key weaknesses of previous research include limited investigation of relationships with clinical symptoms, and underutilization of measures of everyday social functioning that offer a useful counterpart to traditional "lab" tasks. Future studies should aim to carefully select measures not only based on the range of skills to be assessed but also taking into account potential difficulties with interpretation and the need to gain insight into the application of social cognitive skills as well as ability per se. Some of the best measures include those with well-matched control trials (e.g., Yoni Task) or those that restrict the influence of verbal deficits (e.g., intentions comic strip task), elicit spontaneous mentalizing (e.g., Animations Task), and possess greater ecological validity (e.g., Movie for the Assessment of Social Cognition). Social cognitive research within psychiatric populations will be further enhanced through the development of more closely matched control tasks, and the exploration of relationships between task performance, medication, strategy use, and broader emotional and motor functions.
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Affiliation(s)
- Clare M. Eddy
- Research and Innovation, BSMHFT National Centre for Mental Health, Birmingham, United Kingdom
- Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
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22
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Cognitive Functioning in Patients with Pediatric-Onset Multiple Sclerosis, an Updated Review and Future Focus. CHILDREN-BASEL 2019; 6:children6020021. [PMID: 30720736 PMCID: PMC6406784 DOI: 10.3390/children6020021] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Revised: 01/28/2019] [Accepted: 01/31/2019] [Indexed: 12/11/2022]
Abstract
Pediatric-onset multiple sclerosis (POMS) is relatively rare, but as technology and neuroimaging advance, an increasing number of cases are identified, and our understanding of how multiple sclerosis (MS) impacts the developing brain improves. There are consistent findings in the literature highlighting the impact of MS and other demyelinating diseases on cognitive functioning and cognitive development. We also have a better understanding of how POMS impacts psychosocial functioning and functional outcomes in daily living. This paper hopes to review findings associated with cognitive and psychosocial functioning in patients with POMS, as well as explore more recent advances in the field and how they relate to cognitive and psychosocial outcomes. We also discuss the ongoing need for future studies with a focus on better understanding deficits and disease correlates, but also preventative measures and potential rehabilitation.
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23
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Green R, Adler A, Banwell BL, Fabri TL, Yeh EA, Collins DL, Sled JG, Narayanan S, Till C. Involvement of the Amygdala in Memory and Psychosocial Functioning in Pediatric-Onset Multiple Sclerosis. Dev Neuropsychol 2018; 43:524-534. [PMID: 29911891 DOI: 10.1080/87565641.2018.1485679] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Youth with multiple sclerosis (MS) often experience cognitive impairment and psychosocial disturbances. We describe the relationship between memory function, psychosocial skills, and brain volume in 32 patients with pediatric-onset MS and 30 controls. Amygdala volume was significantly lower in patients compared with controls. In general, poorer memory was associated with reduced functional communication skills and reduced amygdala volume. Greater amygdala volume in patients correlated with parent-reported functional communication and social skills. Adjusting for whole-brain volume, right amygdala volume was positively associated with visual memory; left amygdala volume was a stronger predictor of parent-reported social skills.
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Affiliation(s)
- Rivka Green
- a Department of Psychology , York University , Toronto , Canada
| | - Ayala Adler
- a Department of Psychology , York University , Toronto , Canada
| | - Brenda L Banwell
- b Children's Hospital of Philadelphia, Perelman School of Medicine , University of Pennsylvania , Philadelphia , PA , USA.,c Neurosciences and Mental Health Program , The Hospital for Sick Children , Toronto , Canada
| | - Tracy L Fabri
- a Department of Psychology , York University , Toronto , Canada
| | - E Ann Yeh
- c Neurosciences and Mental Health Program , The Hospital for Sick Children , Toronto , Canada.,d Division of Neurology, Department of Paediatrics , University of Toronto , Toronto , Ontario , Canada
| | - D Louis Collins
- e McConnell Brain Imaging Centre, Montreal Neurological Institute , McGill University , Montreal , Canada
| | - John G Sled
- f Translational Medicine Program , The Hospital for Sick Children , Toronto , Canada
| | - Sridar Narayanan
- e McConnell Brain Imaging Centre, Montreal Neurological Institute , McGill University , Montreal , Canada
| | - Christine Till
- a Department of Psychology , York University , Toronto , Canada.,d Division of Neurology, Department of Paediatrics , University of Toronto , Toronto , Ontario , Canada
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Ciampi E, Uribe-San-Martin R, Vásquez M, Ruiz-Tagle A, Labbe T, Cruz JP, Lillo P, Slachevsky A, Reyes D, Reyes A, Cárcamo-Rodríguez C. Relationship between Social Cognition and traditional cognitive impairment in Progressive Multiple Sclerosis and possible implicated neuroanatomical regions. Mult Scler Relat Disord 2018; 20:122-128. [PMID: 29414284 DOI: 10.1016/j.msard.2018.01.013] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Revised: 11/16/2017] [Accepted: 01/16/2018] [Indexed: 01/12/2023]
Abstract
BACKGROUND Cognitive impairment is a relevant contributor of the medical and social burden in Progressive MS. Social Cognition, the neurocognitive processes underlying social interaction, has been explored mainly in European and North American cohorts, influencing social aspects of quality of life (QOL) of early MS patients and families. Few studies have studied Social Cognition in Progressive MS and the literature on its neuroanatomical bases or brain atrophy measurements is still scarce. OBJECTIVES To explore the relationship between Social Cognition performance and its correlations with traditional cognitive domains, brain atrophy and QOL in primary and secondary Progressive MS patients. METHODS Cross-sectional analysis including: mini-Social-Cognition-and-Emotional-Assessment (mini-SEA), neuropsychological battery, disability, depression, fatigue, QOL, and brain volume. RESULTS Forty-three MS patients, 23 primary and 20 secondary Progressive, 65% women, mean age and disease duration of 57.2 and 15.7 years, respectively, with high levels of disability (median EDSS 6.0) and a widespread impairment in traditional domains (mostly episodic verbal/visual and working memories) were assessed. The Mini-SEA score was correlated with executive functions (cognitive shifts Rho:0.55; p = 0.001) analyzing the whole group, and with visual episodic memory (Rho:0.58, p = 0.009) in the primary Progressive MS group. Mini-SEA score was also correlated with total normalized grey matter volume (Rho:0.48; p = 0.004). Particularly, atrophy within bilateral cortical regions of orbitofrontal, insula and cerebellum, and right regions of fusiform gyrus and precuneus were significantly associated with higher Social Cognition impairment. In this cohort, QOL was not correlated with Social Cognition, but with EDSS, fatigue and depression. CONCLUSIONS In Progressive MS, Social Cognition is directly correlated with traditional cognitive domains such as executive function and episodic memory. It is also associated with global grey matter atrophy and regional atrophy within associative visual and executive cortical areas, but no correlations with QOL were found in this cohort. These findings may contribute to the understanding of the pathological bases behind Social Cognition in Progressive MS.
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Affiliation(s)
- E Ciampi
- Neurology Department, Pontifical Catholic University of Chile, Santiago, Chile; Neurology, Hospital Sotero del Rio, Santiago, Chile.
| | - R Uribe-San-Martin
- Neurology Department, Pontifical Catholic University of Chile, Santiago, Chile; Neurology, Hospital Sotero del Rio, Santiago, Chile
| | - M Vásquez
- Neurology Department, Pontifical Catholic University of Chile, Santiago, Chile
| | - A Ruiz-Tagle
- Centre for Advanced Research in Education, University of Chile, Santiago, Chile
| | - T Labbe
- Pontifical Catholic University of Chile, Santiago, Chile
| | - J P Cruz
- Radiology Department, Pontifical Catholic University of Chile, Santiago, Chile
| | - P Lillo
- Neurology Department South, Faculty of Medicine, University of Chile, Geroscience Center for Brain Health and Metabolism, Santiago, Chile
| | - A Slachevsky
- Centre for Advanced Research in Education, University of Chile, Santiago, Chile; Gerosciences Center for Brain Health and Metabolism, Santiago, Chile; Physiopathology Department, ICBM and East Neuroscience Department Faculty of Medicine University of Chile, Santiago, Chile; Cognitive Neurology and Dementia, Neurology Department, Salvador Hospital, Santiago, Chile; Neurology Service, Medicine Department, Alemana Clinic and Universidad del Desarrollo, Santiago, Chile
| | - D Reyes
- Faculty of Medicine, Pontifical Catholic University of Chile, Santiago, Chile
| | - A Reyes
- Neurology Department, Pontifical Catholic University of Chile, Santiago, Chile
| | - C Cárcamo-Rodríguez
- Neurology Department, Pontifical Catholic University of Chile, Santiago, Chile
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Pediatric Multiple Sclerosis and Cognition: A Review of Clinical, Neuropsychologic, and Neuroradiologic Features. Behav Neurol 2017; 2017:1463570. [PMID: 29434433 PMCID: PMC5757108 DOI: 10.1155/2017/1463570] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 11/10/2017] [Accepted: 12/04/2017] [Indexed: 11/17/2022] Open
Abstract
Multiple sclerosis (MS) is an inflammatory demyelinating and neurodegenerative disease. Although cognitive impairment has been well established in adult patients with MS, its occurrence in patients with pediatric-onset MS has recently been reported. In this review, I discuss the main features of cognitive impairment in pediatric MS as determined by long-term follow-up studies, neuropsychiatric test batteries, and the results of neuroradiological imaging studies that investigated the pathogenesis of pediatric MS. The most commonly affected cognitive domains in adults are attention, processing speed, and visuomotor skills; language and intelligence are also affected in pediatric MS. A young age at disease onset is the strongest risk factor for these impairments, which may be due to the effect of inflammatory demyelination and neurodegeneration on the developing central nervous system and neural networks in children. Cognitive impairment has long-term effects on patients' academic life and the quality of their social life. Therefore, all patients with pediatric MS should be screened and monitored for cognitive impairment. This review also highlights the need for neuropsychological test batteries that assess different cognitive domains in children and adolescents with multiple sclerosis and for cognitive rehabilitation programs to improve the quality of their academic and social life.
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Labbé T, Ciampi E, Carcamo Rodríguez C. Social cognition: Concepts, neural basis and its role in multiple sclerosis. ACTA ACUST UNITED AC 2017. [DOI: 10.1111/ncn3.12164] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Tomás Labbé
- Interdisciplinary Center of Neuroscience School of Medicine Pontifical Catholic University of ChileSantiago Chile
| | - Ethel Ciampi
- Neurology Department School of Medicine Pontifical Catholic University of Chile Santiago Chile
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McGinley M, Rossman IT. Bringing the HEET: The Argument for High-Efficacy Early Treatment for Pediatric-Onset Multiple Sclerosis. Neurotherapeutics 2017; 14:985-998. [PMID: 28895071 PMCID: PMC5722772 DOI: 10.1007/s13311-017-0568-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Pediatric-onset multiple sclerosis (POMS) is rarer than adult-onset disease, and represents a different diagnostic and treatment challenge to clinicians. We review POMS clinical and radiographic presentations, and explore important differences between POMS and adult-onset MS natural histories and long-term outcomes. Despite having more active disease, current treatment guidelines for patients with POMS endorse the off-label use of lower-efficacy disease-modifying therapies (DMTs) as first line. We review the available MS DMTs, their evidence for use in POMS, and the contrasting treatment strategies of high-efficacy early treatment and escalation therapy. We introduce a new treatment approach, the "high-efficacy early treatment", or HEET strategy, based on using directly observed, high-efficacy intravenously infused DMTs as first-line therapies. Like other proposed POMS treatment strategies, HEET will need to be prospectively studied, and all treatment decisions should be determined by an experienced neurologist, the patient, and his/her parents.
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Affiliation(s)
- Marisa McGinley
- Mellen Center for Multiple Sclerosis Treatment and Research, Cleveland Clinic, 9500 Euclid Avenue U10, Cleveland, OH, 44195, USA
| | - Ian T Rossman
- NeuroDevelopmental Science Center, Akron Children's Hospital, One Perkins Square, Akron, OH, 44308, USA.
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Ghezzi A, Bianchi A, Baroncini D, Bertolotto A, Malucchi S, Bresciamorra V, Lanzillo R, Milani N, Martinelli V, Patti F, Chisari C, Rottoli M, Simone M, Paolicelli D, Visconti A. A multicenter, observational, prospective study of self- and parent-reported quality of life in adolescent multiple sclerosis patients self-administering interferon-β1a using RebiSmart™-the FUTURE study. Neurol Sci 2017; 38:1999-2005. [PMID: 28831635 DOI: 10.1007/s10072-017-3091-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Accepted: 08/07/2017] [Indexed: 11/28/2022]
Abstract
Besides the impact of disease per se, the use of immunomodulatory therapies in adolescents with relapsing-remitting multiple sclerosis (RRMS) may have an effect on quality of life (QL). The FUTURE (Quality of liFe in adolescent sUbjecTs affected by mUltiple sclerosis treated with immunomodulatoRy agEnt using self-injecting device) study was designed to evaluate the changes in QL of Italian adolescents with RRMS receiving treatment with IFN-β1a (Rebif; 22 μg), administered subcutaneously three times weekly using the RebiSmart™ electronic autoinjection device over a 52-week period. Fifty adolescents with RRMS were enrolled and 40 completed the study. Changes from baseline to end of treatment (EoT) in adolescent self-reported and parent-reported QL were assessed using the Pediatric Quality of Life Inventory Multidimensional Fatigue Scale (PedsQL), which has been validated for use in pediatric MS and for which an Italian version is available. The adolescent self-reported total PedsQL4.0 score and all of its subscales tended to increase from baseline to EoT, the only exception being "Emotional functioning." In parent-reported measures, the total PedsQL4.0 score increased significantly from baseline to EoT (+ 5.27 points, p = 0.041). Significant increases were also evident for parent-reported "Psychosocial health summary score" (+ 5.90 points; p = 0.015) and "School functioning" (+ 7.84 points; p = 0.029). Our results indicate that adolescents with RRMS using the electronic injection device RebiSmart™ for self-administration of Rebif® can experience long-term improvements in QL.
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Affiliation(s)
- A Ghezzi
- Azienda Ospedaliera S. Antonio Abate, Gallarate, Italy.
| | - A Bianchi
- Azienda Ospedaliera S. Antonio Abate, Gallarate, Italy
| | - D Baroncini
- Azienda Ospedaliera S. Antonio Abate, Gallarate, Italy
| | - A Bertolotto
- AOU S. Luigi Gonzaga Neurologia 2 CRESM, Orbassano, Italy
| | - S Malucchi
- AOU S. Luigi Gonzaga Neurologia 2 CRESM, Orbassano, Italy
| | - V Bresciamorra
- Azienda Ospedaliero Universitaria Policlinico Federico II, Naples, Italy
| | - R Lanzillo
- Azienda Ospedaliero Universitaria Policlinico Federico II, Naples, Italy
| | - N Milani
- Istituto Neurologico Carlo Besta, Milan, Italy
| | | | - F Patti
- Department of Medical and Surgical Sciences, and Advanced Technologies, Neuroscience Section, Multiple Sclerosis Center, University of Catania, Catania, Italy
| | - C Chisari
- Department of Medical and Surgical Sciences, and Advanced Technologies, Neuroscience Section, Multiple Sclerosis Center, University of Catania, Catania, Italy
| | - M Rottoli
- Neurologia USS Malattie Autoimmuni - Centro Sclerosi Multipla ASST Papa Giovanni XXIII, Bergamo, Italy
| | - M Simone
- Dip di Scienze mediche di Base, Neuroscienze ed Organi di Senso Università di Bari, Bari, Italy
| | - D Paolicelli
- Dip di Scienze mediche di Base, Neuroscienze ed Organi di Senso Università di Bari, Bari, Italy
| | - A Visconti
- Medical Affair Department Merck Serono, Rome, Italy
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Tan A, Hague C, Greenberg BM, Harder L. Neuropsychological outcomes of pediatric demyelinating diseases: a review. Child Neuropsychol 2017. [DOI: 10.1080/09297049.2017.1339785] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Affiliation(s)
- Alexander Tan
- Children’s Medical Center Dallas, Dallas, TX, USA
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Cole Hague
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Benjamin M. Greenberg
- Children’s Medical Center Dallas, Dallas, TX, USA
- Department of Neurology and Neurotherapeutics and Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Lana Harder
- Children’s Medical Center Dallas, Dallas, TX, USA
- Department of Psychiatry and Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, TX, USA
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30
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Ghezzi A, Baroncini D, Zaffaroni M, Comi G. Pediatric versus adult MS: similar or different? ACTA ACUST UNITED AC 2017. [DOI: 10.1186/s40893-017-0022-6] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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Abstract
BACKGROUND AND OBJECTIVES Multiple sclerosis (MS) is a chronic progressive inflammatory disease of the central nervous system, representing the primary cause of non-traumatic disability in young adults. Cognitive dysfunction can affect patients at any time during the disease process and might alter the six core functional domains. Social cognition is a multi-component construct that includes the theory of mind, empathy and social perception of emotions from facial, bodily and vocal cues. Deficits in this cognitive faculty might have a drastic impact on interpersonal relationships and quality of life (QoL). Although exhaustive data exist for non-social cognitive functions in MS, only a little attention has been paid for social cognition. The objectives of the present work are to reappraise the definition and anatomy of social cognition and evaluate the integrity of this domain across MS studies. We will put special emphasis on neuropsychological and neuroimaging studies concerning social cognitive performance in MS. METHODS Studies were selected in conformity with PRISMA guidelines. We looked for computerized databases (PubMed, Medline, and Scopus) that index peer-reviewed journals to identify published reports in English and French languages that mention social cognition and multiple sclerosis, regardless of publication year. We combined keywords as follows: (facial emotion or facial expression or emotional facial expressions or theory of mind or social cognition or empathy or affective prosody) AND multiple sclerosis AND (MRI or functional MRI or positron emission tomography or functional imaging or structural imaging). We also scanned references from articles aiming to get additional relevant studies. RESULTS In total, 26 studies matched the abovementioned criteria (26 neuropsychological studies including five neuroimaging studies). Available data support the presence of social cognitive deficits even at early stages of MS. The increase in disease burden along with the "multiple disconnection syndrome" resulting from gray and white matters pathology might exceed the "threshold for cerebral tolerance" and can manifest as deficits in social cognition. Admitting the impact of the latter on patients' social functioning, a thorough screening for such deficits is crucial to improving patients' QoL. (JINS, 2017, 23, 266-286).
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32
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Social cognition according to cognitive impairment in different clinical phenotypes of multiple sclerosis. J Neurol 2017; 264:740-748. [DOI: 10.1007/s00415-017-8417-z] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Revised: 02/04/2017] [Accepted: 02/09/2017] [Indexed: 12/28/2022]
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Abstract
Recognition of facial affect has been studied extensively in adults with and without traumatic brain injury (TBI), mostly by asking examinees to match basic emotion words to isolated faces. This method may not capture affect labelling in everyday life when faces are in context and choices are open-ended. To examine effects of context and response format, we asked 148 undergraduate students to label emotions shown on faces either in isolation or in natural visual scenes. Responses were categorised as representing basic emotions, social emotions, cognitive state terms, or appraisals. We used students' responses to create a scoring system that was applied prospectively to five men with TBI. In both groups, over 50% of responses were neither basic emotion words nor synonyms, and there was no significant difference in response types between faces alone vs. in scenes. Adults with TBI used labels not seen in students' responses, talked more overall, and often gave multiple labels for one photo. Results suggest benefits of moving beyond forced-choice tests of faces in isolation to fully characterise affect recognition in adults with and without TBI.
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Cotter J, Firth J, Enzinger C, Kontopantelis E, Yung AR, Elliott R, Drake RJ. Social cognition in multiple sclerosis: A systematic review and meta-analysis. Neurology 2016; 87:1727-1736. [PMID: 27655736 DOI: 10.1212/wnl.0000000000003236] [Citation(s) in RCA: 100] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Accepted: 07/05/2016] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVE To quantify the magnitude of deficits in theory of mind (ToM) and facial emotion recognition among patients with multiple sclerosis (MS) relative to healthy controls. METHODS An electronic database search of Ovid MEDLINE, PsycINFO, and Embase was conducted from inception to April 1, 2016. Eligible studies were original research articles published in peer-reviewed journals that examined ToM or facial emotion recognition among patients with a diagnosis of MS and a healthy control comparison group. Data were independently extracted by 2 authors. Effect sizes were calculated using Hedges g. RESULTS Twenty-one eligible studies were identified assessing ToM (12 studies) and/or facial emotion recognition (13 studies) among 722 patients with MS and 635 controls. Deficits in both ToM (g = -0.71, 95% confidence interval [CI] -0.88 to -0.55, p < 0.001) and facial emotion recognition (g = -0.64, 95% CI -0.81 to -0.47, p < 0.001) were identified among patients with MS relative to healthy controls. The largest deficits were observed for visual ToM tasks and for the recognition of negative facial emotional expressions. Older age predicted larger emotion recognition deficits. Other cognitive domains were inconsistently associated with social cognitive performance. CONCLUSIONS Social cognitive deficits are an overlooked but potentially important aspect of cognitive impairment in MS with potential prognostic significance for social functioning and quality of life. Further research is required to clarify the longitudinal course of social cognitive dysfunction, its association with MS disease characteristics and neurocognitive impairment, and the MS-specific neurologic damage underlying these deficits.
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Affiliation(s)
- Jack Cotter
- From the Institute of Brain, Behaviour and Mental Health (J.C., J.F., A.R.Y., R.E., R.J.D.) and Farr Institute for Health Informatics Research (E.K.), University of Manchester, UK; and Research Unit for Neuronal Repair and Plasticity (C.E.), Department of Neurology, Medical University of Graz, Austria.
| | - Joseph Firth
- From the Institute of Brain, Behaviour and Mental Health (J.C., J.F., A.R.Y., R.E., R.J.D.) and Farr Institute for Health Informatics Research (E.K.), University of Manchester, UK; and Research Unit for Neuronal Repair and Plasticity (C.E.), Department of Neurology, Medical University of Graz, Austria
| | - Christian Enzinger
- From the Institute of Brain, Behaviour and Mental Health (J.C., J.F., A.R.Y., R.E., R.J.D.) and Farr Institute for Health Informatics Research (E.K.), University of Manchester, UK; and Research Unit for Neuronal Repair and Plasticity (C.E.), Department of Neurology, Medical University of Graz, Austria
| | - Evangelos Kontopantelis
- From the Institute of Brain, Behaviour and Mental Health (J.C., J.F., A.R.Y., R.E., R.J.D.) and Farr Institute for Health Informatics Research (E.K.), University of Manchester, UK; and Research Unit for Neuronal Repair and Plasticity (C.E.), Department of Neurology, Medical University of Graz, Austria
| | - Alison R Yung
- From the Institute of Brain, Behaviour and Mental Health (J.C., J.F., A.R.Y., R.E., R.J.D.) and Farr Institute for Health Informatics Research (E.K.), University of Manchester, UK; and Research Unit for Neuronal Repair and Plasticity (C.E.), Department of Neurology, Medical University of Graz, Austria
| | - Rebecca Elliott
- From the Institute of Brain, Behaviour and Mental Health (J.C., J.F., A.R.Y., R.E., R.J.D.) and Farr Institute for Health Informatics Research (E.K.), University of Manchester, UK; and Research Unit for Neuronal Repair and Plasticity (C.E.), Department of Neurology, Medical University of Graz, Austria
| | - Richard J Drake
- From the Institute of Brain, Behaviour and Mental Health (J.C., J.F., A.R.Y., R.E., R.J.D.) and Farr Institute for Health Informatics Research (E.K.), University of Manchester, UK; and Research Unit for Neuronal Repair and Plasticity (C.E.), Department of Neurology, Medical University of Graz, Austria
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Bora E, Özakbaş S, Velakoulis D, Walterfang M. Social Cognition in Multiple Sclerosis: a Meta-Analysis. Neuropsychol Rev 2016; 26:160-72. [DOI: 10.1007/s11065-016-9320-6] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2015] [Accepted: 05/12/2016] [Indexed: 12/16/2022]
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Patil I, Young L, Sinay V, Gleichgerrcht E. Elevated moral condemnation of third-party violations in multiple sclerosis patients. Soc Neurosci 2016; 12:308-329. [DOI: 10.1080/17470919.2016.1175380] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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de Bruin NMWJ, Schmitz K, Schiffmann S, Tafferner N, Schmidt M, Jordan H, Häußler A, Tegeder I, Geisslinger G, Parnham MJ. Multiple rodent models and behavioral measures reveal unexpected responses to FTY720 and DMF in experimental autoimmune encephalomyelitis. Behav Brain Res 2015; 300:160-74. [PMID: 26692368 DOI: 10.1016/j.bbr.2015.12.006] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Revised: 11/30/2015] [Accepted: 12/09/2015] [Indexed: 10/22/2022]
Abstract
Experimental autoimmune encephalomyelitis (EAE) is a widely-used rodent model for multiple sclerosis (MS), but a single model can hardly capture all features of MS. We investigated whether behavioral parameters in addition to clinical motor function scores could be used to assess treatment efficacy during score-free intervals in the relapsing-remitting EAE model in SJL/J mice. We studied the effects of the clinical reference compounds FTY720 (fingolimod, 0.5mg/kg/day) and dimethyl fumarate (DMF, 20-30 mg/kg/day) on clinical scores in several rodent EAE models in order to generate efficacy profiles. SJL/J mice with relapsing-remitting EAE were studied using behavioral tests, including rotarod, gait analysis, locomotor activity and grip strength. SJL/J mice were also examined according to Crawley's sociability and preference for social novelty test. Prophylactic treatment with FTY720 prevented clinical scores in three of the four EAE rodent models: Dark Agouti (DA) and Lewis rats and C57BL/6J mice. Neither prophylactic nor late-therapeutic treatment with FTY720 reduced clinical scores or reversed deficits in the rotarod test in SJL/J mice, but we observed effects on motor functions and sociability in the absence of clinical scores. Prophylactic treatment with FTY720 improved the gait of SJL/J mice whereas late-therapeutic treatment improved manifestations of reduced social (re)cognition or preference for social novelty. DMF was tested in three EAE models and did not improve clinical scores at the dose used. These data indicate that improvements in behavioral deficits can occur in absence of clinical scores, which indicate subtle drug effects and may have translational value for human MS.
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Affiliation(s)
- N M W J de Bruin
- Fraunhofer Institute for Molecular Biology and Applied Ecology IME, Project Group Translational Medicine & Pharmacology TMP, Theodor-Stern-Kai 7, 60596 Frankfurt am Main, Germany.
| | - K Schmitz
- Pharmazentrum Frankfurt/ZAFES, Institute of Clinical Pharmacology, Goethe-University Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany
| | - S Schiffmann
- Fraunhofer Institute for Molecular Biology and Applied Ecology IME, Project Group Translational Medicine & Pharmacology TMP, Theodor-Stern-Kai 7, 60596 Frankfurt am Main, Germany
| | - N Tafferner
- Fraunhofer Institute for Molecular Biology and Applied Ecology IME, Project Group Translational Medicine & Pharmacology TMP, Theodor-Stern-Kai 7, 60596 Frankfurt am Main, Germany
| | - M Schmidt
- Fraunhofer Institute for Molecular Biology and Applied Ecology IME, Project Group Translational Medicine & Pharmacology TMP, Theodor-Stern-Kai 7, 60596 Frankfurt am Main, Germany
| | - H Jordan
- Fraunhofer Institute for Molecular Biology and Applied Ecology IME, Project Group Translational Medicine & Pharmacology TMP, Theodor-Stern-Kai 7, 60596 Frankfurt am Main, Germany
| | - A Häußler
- Pharmazentrum Frankfurt/ZAFES, Institute of Clinical Pharmacology, Goethe-University Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany
| | - I Tegeder
- Pharmazentrum Frankfurt/ZAFES, Institute of Clinical Pharmacology, Goethe-University Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany
| | - G Geisslinger
- Fraunhofer Institute for Molecular Biology and Applied Ecology IME, Project Group Translational Medicine & Pharmacology TMP, Theodor-Stern-Kai 7, 60596 Frankfurt am Main, Germany; Pharmazentrum Frankfurt/ZAFES, Institute of Clinical Pharmacology, Goethe-University Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany
| | - M J Parnham
- Fraunhofer Institute for Molecular Biology and Applied Ecology IME, Project Group Translational Medicine & Pharmacology TMP, Theodor-Stern-Kai 7, 60596 Frankfurt am Main, Germany
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Neuropsychological correlates of multiple sclerosis across the lifespan. Mult Scler 2015; 21:1355-64. [DOI: 10.1177/1352458515586088] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Accepted: 04/13/2015] [Indexed: 11/15/2022]
Abstract
Multiple sclerosis can adversely affect cognitive functioning whether the disease has an adult or pediatric onset. The research thus far suggests that pediatric MS shares many features with adult MS but is also unique in several respects. One particular characteristic of pediatric MS is that, while physical disability develops more slowly as compared with adult patients, the impact of cognitive deficits in children may be more substantial as they are in a period of life during which they acquire many skills that are needed to transition into independently functioning adults. Our review takes a lifespan approach to MS, comparing and contrasting the neuropsychology (i.e., cognitive, psychological, and psychosocial factors) of these two populations. Understanding how MS manifests across the lifespan has important implications for tailoring assessment and treatment for individuals with MS as they transition from childhood to adulthood, and later life.
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Gleichgerrcht E, Tomashitis B, Sinay V. The relationship between alexithymia, empathy and moral judgment in patients with multiple sclerosis. Eur J Neurol 2015; 22:1295-303. [DOI: 10.1111/ene.12745] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2014] [Accepted: 03/30/2015] [Indexed: 11/27/2022]
Affiliation(s)
- E. Gleichgerrcht
- Department of Neurology; Medical University of South Carolina; Charleston SC USA
- UDP-INECO Foundation Core on Neuroscience (UIFCoN) Diego Portales University; Santiago Chile
| | - B. Tomashitis
- Department of Neurology; Medical University of South Carolina; Charleston SC USA
| | - V. Sinay
- Institute of Cognitive Neurology (INECO); Buenos Aires Argentina
- Favaloro University; Buenos Aires Argentina
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