1
|
Polidori A, Malagoli M, Giacalone R, Brichetto G, Monti Bragadin M, Prada V. 30-Second Chair Stand and 5-Times Sit-to-Stand Tests Are Interesting Tools for Assessing Disability and Ability to Ambulate among Patients with Multiple Sclerosis. Life (Basel) 2024; 14:703. [PMID: 38929686 PMCID: PMC11205157 DOI: 10.3390/life14060703] [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: 03/29/2024] [Revised: 05/08/2024] [Accepted: 05/27/2024] [Indexed: 06/28/2024] Open
Abstract
Multiple Sclerosis (MS) is a demyelinating and chronic disease with variable neurological symptoms. There are different scales that score the level of disability, but only few papers have taken into consideration the 5-times sit-to-stand (5STS) test and the 30 s chair stand test (30CST), which are valid and easily obtainable indicators of other neurological diseases. The aim of our research is to verify the validity, reproducibility, and responsiveness of these tests. Patients afflicted with MS were enrolled in the AISM outpatient facility. The inclusion criterion was an EDSS score less than 6.5. We performed the 5STS, 30CST, and timed 25-foot walk (T25-FW) tests and recorded EDSS scores in the first evaluation. Then, we recorded the performance after 5 days (conducted by a second blind operator to ensure test-retest reproducibility), and the last evaluation was made after 12 sessions of physiotherapy. We recruited 38 patients diagnosed with MS. The results show significant data regarding validity, reproducibility, and responsiveness for both scales. The data argue in favor of adding these tests to the relevant clinical assessments. These two tests are simple, reliable, and easy to administer, and the data confirm that they can be included in the evaluation of patients with MS.
Collapse
Affiliation(s)
- Andrea Polidori
- Scientific Research Area, Fondazione Italiana Sclerosi Multipla (FISM), 16149 Genova, Italy (R.G.); (G.B.); (M.M.B.)
- Servizio Riabilitazione Liguria, Associazione Italiana Sclerosi Multipla (AISM), 16149 Genova, Italy;
| | - Mattia Malagoli
- Servizio Riabilitazione Liguria, Associazione Italiana Sclerosi Multipla (AISM), 16149 Genova, Italy;
| | - Rosario Giacalone
- Scientific Research Area, Fondazione Italiana Sclerosi Multipla (FISM), 16149 Genova, Italy (R.G.); (G.B.); (M.M.B.)
| | - Giampaolo Brichetto
- Scientific Research Area, Fondazione Italiana Sclerosi Multipla (FISM), 16149 Genova, Italy (R.G.); (G.B.); (M.M.B.)
| | - Margherita Monti Bragadin
- Scientific Research Area, Fondazione Italiana Sclerosi Multipla (FISM), 16149 Genova, Italy (R.G.); (G.B.); (M.M.B.)
- Servizio Riabilitazione Liguria, Associazione Italiana Sclerosi Multipla (AISM), 16149 Genova, Italy;
| | - Valeria Prada
- Scientific Research Area, Fondazione Italiana Sclerosi Multipla (FISM), 16149 Genova, Italy (R.G.); (G.B.); (M.M.B.)
- Servizio Riabilitazione Liguria, Associazione Italiana Sclerosi Multipla (AISM), 16149 Genova, Italy;
| |
Collapse
|
2
|
Gerardo F, Bárbara E, Cecilia G, Aldana M, Natalia C, Lucia B, Silva B, Leila C, Cecilia P, Orlando G, Magdalena C, Luciana L, Gabriel P, Ricardo A. Abnormal eye movements increase as motor disabilities and cognitive impairments become more evident in Multiple Sclerosis: A novel eye-tracking study. Mult Scler J Exp Transl Clin 2024; 10:20552173241255008. [PMID: 38817553 PMCID: PMC11138185 DOI: 10.1177/20552173241255008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 04/29/2024] [Indexed: 06/01/2024] Open
Abstract
Background Eye movements can reflect brain alterations and inform on the presence of motor disabilities and cognitive impairments in people with multiple sclerosis (pwMS). Objective The aim of the study was to determine the correlation between motor and cognitive measurements and eye movement parameters when performing the n-back task (NBKT). Methods This was a cross-sectional study carried out at Ramos Mejía Hospital, a center specialized in demyelinating diseases in Buenos Aires, Argentina. The study population consisted of 66 patients with relapsing-remitting multiple sclerosis (RRMS) and 5 patients with secondary progressive multiple sclerosis (SPMS). pwMS performed the n-back test while using a device head mounted display (HMD) with eyetracking capabilities in order to capture eye movement. Clinical motor and cognitive measures were assessed with Expanded Disability Status Scale (EDSS), Nine Hole Peg Test (NHPT), Timed 25-Foot Walk (T25FW), and Symbol Digit Modalities Test (SDMT). Results pwMS showed strong and statistically significant correlations between gaze duration; number of fixations, saccade amplitude and motor disabilities and cognitive impairments as measured by EDSS, NHPT, T25FW, and SDMT. Conclusion This study found significant correlations between eye movement behavior and motor and cognitive disability in pwMS. These findings suggest that eye movements have the potential to be used as a surrogate biomarker in MS progression.
Collapse
Affiliation(s)
| | - Eizaguirre Bárbara
- Multiple Sclerosis University Center CUEM, Ramos Mejia Hospital, Buenos Aires, Argentina
| | | | | | | | | | | | | | | | | | | | - Lazaro Luciana
- Centro Universitario de Esclerosis Múltiple y enfermedades desmielinizantes (CUEM), Hospital Ramos Mejía, Buenos Aires, Argentina
| | - Pardo Gabriel
- Oklahoma Medical Research Foundation, Oklahoma City, OK, USA
| | - Alonso Ricardo
- Multiple Sclerosis University Center CUEM, Ramos Mejia Hospital, Buenos Aires, Argentina
| |
Collapse
|
3
|
Boschetti A, Maida E, Dini M, Tacchini M, Gamberini G, Comi G, Leocani L. A Review on the Feasibility and Efficacy of Home-Based Cognitive Remediation in People with Multiple Sclerosis. J Clin Med 2024; 13:1916. [PMID: 38610681 PMCID: PMC11012426 DOI: 10.3390/jcm13071916] [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: 02/21/2024] [Revised: 03/15/2024] [Accepted: 03/20/2024] [Indexed: 04/14/2024] Open
Abstract
Cognitive impairment affects 34-65% of People with Multiple Sclerosis (PwMS), significantly impacting their quality of life. Clinicians routinely address cognitive deficits with in-clinic neuro-behavioural interventions, but accessibility issues exist. Given these challenges, coupled with the lifelong need for continuous assistance in PwMS, researchers have underscored the advantageous role of telerehabilitation in addressing these requirements. Nonetheless, the feasibility and efficacy of home-based cognitive remediation remain to be firmly established. In this narrative review, we aimed to investigate the feasibility and efficacy of digital telerehabilitation for cognition in PwMS. Thirteen relevant studies were identified and carefully assessed. Regarding the feasibility of cognitive telerehabilitation, evidence shows adherence rates are generally good, although, surprisingly, not all studies reported measures of compliance with the cognitive training explored. Considering the efficacy of rehabilitative techniques on cognitive performance in PwMS, findings are generally inconsistent, with only one study reporting uniformly positive results. A range of methodological limitations are reported as potential factors contributing to the variable results. Future research must address these challenges, as more rigorous studies are required to draw definitive conclusions regarding the efficacy of home-based cognitive remediation in PwMS. Researchers must prioritise identifying optimal intervention approaches and exploring the long-term effects of telerehabilitation.
Collapse
Affiliation(s)
- Angela Boschetti
- Experimental Neurophysiology Unit, Institute of Experimental Neurology—INSPE, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy; (A.B.); (M.T.)
- San Raffaele Vita-Salute University, 20132 Milan, Italy
| | - Elisabetta Maida
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Michelangelo Dini
- Experimental Neurophysiology Unit, Institute of Experimental Neurology—INSPE, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy; (A.B.); (M.T.)
- San Raffaele Vita-Salute University, 20132 Milan, Italy
| | - Marta Tacchini
- Experimental Neurophysiology Unit, Institute of Experimental Neurology—INSPE, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy; (A.B.); (M.T.)
- San Raffaele Vita-Salute University, 20132 Milan, Italy
| | - Giulia Gamberini
- Department of Neurorehabilitation Sciences, Casa di Cura Igea, 20144 Milan, Italy
| | - Giancarlo Comi
- Department of Neurorehabilitation Sciences, Casa di Cura Igea, 20144 Milan, Italy
| | - Letizia Leocani
- Experimental Neurophysiology Unit, Institute of Experimental Neurology—INSPE, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy; (A.B.); (M.T.)
- San Raffaele Vita-Salute University, 20132 Milan, Italy
- Department of Neurorehabilitation Sciences, Casa di Cura Igea, 20144 Milan, Italy
| |
Collapse
|
4
|
Ozcan E, Akduman RC, Eyupoglu S, Bingol A, Balci Ekmekci O, Hatipoglu E. 5 -Alpha-dihydroxyprogesterone may contribute to perceptual processing and attention of the cases with relapsing remitting multiple sclerosis. Neurol Res 2024; 46:132-138. [PMID: 37733038 DOI: 10.1080/01616412.2023.2258040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 09/04/2023] [Indexed: 09/22/2023]
Abstract
Neurosteroids (NSs) are endogenous steroid hormones, which are synthesised and metabolised within the central nervous system (CNS). NSs aid myelination and glial differentiation and modulate cognitive functions. Herein, we aim to investigate the relationship between NS levels, 5-alpha-dihydroxyprogesterone (5-α-DHP) and allopregnanolone (ALPG), and their relationship with cognitive changes in relapsing remitting MS patients.A total of 43 cases with well controlled, relapsing remitting MS composed the study group. The control group included 21 age and gender matched healthy controls (HC). MS patients were assessed by calculating Expanded Disability Status Scale (EDSS) scores, and the Brief Repeatable Battery of Neuropsychological Tests (BRBNT) was performed in both MS group and HC. Levels of 5-α-DHP and ALPG levels were also evaluated for each participant.The median level of 5-α-DHP was 48 [IQR: 39.2-144.2] pg/mcgL in the MS group and 68.4 [IQR: 57.1-365.9] pg/mcgL in HC (p = 0.02). The median ALPG level was found to be 56.5 [IQR: 37.7-75.4] pg/mcgL in the MS group and 43.9 [IQR: 29.4-70.2] pg/mcgL in HC (p = 0.1). In both groups 5-α-DHP levels were positively correlated with Symbol Digit Modalities Test (SDMT) scores (HC: p = 0.01, r = 0.3 and MS: p = 0.03, r = 0.3). In the MS group, higher EDSS scores were associated with lower scores on Spatial Recall Test (SPART)-Delayed (p = 0.009, r= -0.4) and SDMT (p = 0.01, r= -0.4). The disease duration was negatively correlated with the scores on SPART-Immediate, SPART-Delayed and SDMT (p = 0.02, r= -0.4; p = 0.005, r= -0.4 and p = 0.05, r= -0.3).5-α-DHP may be lower even in well-controlled cases. 5-α-DHP may contribute to better perceptual processing and attention in cases with MS.
Collapse
Affiliation(s)
- Emin Ozcan
- Department of Neurology, Yeditepe University Hospital, Istanbul, Turkey
| | | | - Sevim Eyupoglu
- Department of Psychology, Davranis Degisim Akademisi, Istanbul, Turkey
| | - Ayhan Bingol
- Department of Psychology, Davranis Degisim Akademisi, Istanbul, Turkey
| | - Ozlem Balci Ekmekci
- Department of Biochemistry, Istanbul University, Cerrahpasa Medical Faculty, Istanbul, Turkey
| | - Esra Hatipoglu
- Division of Endocrinology, Department of Internal Medicine, University of Health Sciences, Basaksehir Cam and Sakura City Hospital, Istanbul, Turkey
| |
Collapse
|
5
|
Nielsen NM, Frisch M, Gørtz S, Stenager E, Skogstrand K, Hougaard DM, Ascherio A, Rostgaard K, Hjalgrim H. Smoking during pregnancy and risk of multiple sclerosis in offspring and mother: A Danish nationwide register-based cohort study. Mult Scler 2024; 30:200-208. [PMID: 37981600 DOI: 10.1177/13524585231208310] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2023]
Abstract
BACKGROUND The association between intra-uterine exposure to maternal smoking and risk of multiple sclerosis (MS) has been little studied and with conflicting results. OBJECTIVE To examine the risk of MS in offspring exposed intra-uterine to maternal smoking. In addition, to re-examine prior observations of an elevated risk of MS among smokers, assuming that self-reported smoking during pregnancy reflects the woman's general smoking habits. METHODS The study cohort included all Danish women, pregnant in the period 1991-2018, (n = 789,299) and singletons from these pregnancies (n = 879,135). Nationwide information on maternal smoking during pregnancy and MS cases in the study cohort were obtained from the Medical Birth Register and the National Patient Register. Cox regression analysis was used to estimate hazard ratios (HRs) for the association between smoking and MS risk. RESULTS Women who smoked during pregnancy had a 42% increased risk of developing MS compared with non-smoking women (HR = 1.42 (1.32-1.52), n = 1,296). The risk of MS among singletons of women who smoked during pregnancy was 38% higher than that among singletons born to non-smoking women (HR = 1.38 (1.08-1.76), n = 110). CONCLUSION Our observations add further to the evidence implicating smoking in the development of MS and suggest that intra-uterine exposure to tobacco smoke may increase MS risk.
Collapse
Affiliation(s)
- Nete Munk Nielsen
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
- Focused Research Unit in Neurology, Department of Neurology, Hospital of Southern Jutland, University of Southern Denmark, Aabenraa, Denmark
| | - Morten Frisch
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
| | - Sanne Gørtz
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
| | - Egon Stenager
- Focused Research Unit in Neurology, Department of Neurology, Hospital of Southern Jutland, University of Southern Denmark, Aabenraa, Denmark
- Multiple Sclerosis Clinic of Southern Jutland (Aabenraa, Kolding, Esbjerg), Department of Neurology, Hospital of Southern Jutland, University of Southern Denmark, Denmark
| | - Kristin Skogstrand
- Danish Center for Neonatal Screening, Department for Congenital Disorders, Statens Serum Institut, Copenhagen, Denmark
| | - David M Hougaard
- Danish Center for Neonatal Screening, Department for Congenital Disorders, Statens Serum Institut, Copenhagen, Denmark
- iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Copenhagen, Denmark
| | - Alberto Ascherio
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Klaus Rostgaard
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
- Danish Cancer Society Research Center, Danish Cancer Society, Copenhagen, Denmark
| | - Henrik Hjalgrim
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
- Danish Cancer Society Research Center, Danish Cancer Society, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Department of Haematology, Rigshospitalet, Copenhagen, Denmark
| |
Collapse
|
6
|
Williams T, John N, Doshi A, Chataway J. Adult inflammatory leukoencephalopathies. HANDBOOK OF CLINICAL NEUROLOGY 2024; 204:399-430. [PMID: 39322392 DOI: 10.1016/b978-0-323-99209-1.00003-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/27/2024]
Abstract
Inflammatory white matter disorders may commonly mimic genetic leukoencephalopathies. These include atypical presentations of common conditions, such as multiple sclerosis, together with rare inflammatory disorders. A structured approach to such cases is essential, together with judicious use of the many available diagnostic biomarkers. The potential for such conditions to respond to immunotherapy emphasizes the importance of an accurate and prompt diagnosis in improving patient outcomes.
Collapse
Affiliation(s)
- Thomas Williams
- Queen Square Multiple Sclerosis Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, United Kingdom.
| | - Nevin John
- Queen Square Multiple Sclerosis Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, United Kingdom; Department of Medicine, School of Clinical Sciences, Monash University, Clayton, VIC, Australia
| | - Anisha Doshi
- Queen Square Multiple Sclerosis Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, United Kingdom
| | - Jeremy Chataway
- Queen Square Multiple Sclerosis Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, United Kingdom; National Institute for Health Research (NIHR), University College London Hospitals (UCLH) Biomedical Research Centre (BRC), London, United Kingdom
| |
Collapse
|
7
|
Wang M, Liu C, Zou M, Niu Z, Zhu J, Jin T. Recent progress in epidemiology, clinical features, and therapy of multiple sclerosis in China. Ther Adv Neurol Disord 2023; 16:17562864231193816. [PMID: 37719665 PMCID: PMC10504852 DOI: 10.1177/17562864231193816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Accepted: 07/24/2023] [Indexed: 09/19/2023] Open
Abstract
Multiple sclerosis (MS) is a demyelinating disease of the central nervous system characterized by inflammation, demyelination, and neurodegeneration. It mainly affects young adults, imposing a heavy burden on families and society. The epidemiology, clinical features, and management of MS are distinct among different countries. Although MS is a rare disease in China, there are 1.4 billion people in China, so the total number of MS patients is not small. Because of the lack of specific diagnostic biomarkers for MS, there is a high misdiagnosis rate in China, as in other regions. Due to different genetic backgrounds, the clinical manifestations of MS in Chinese are different from those in the West. Herein, this review aims to summarize the disease comprehensively, including clinical profile and the status of disease-modifying therapies in China based on published population-based observation and cohort studies, and also to compare with data from other countries and regions, thus providing help to develop diagnostic guideline and the novel therapeutic drugs. Meanwhile, we also discuss the problems and challenges we face, specifically for the diagnosis and treatment of MS in the middle- and low-income countries.
Collapse
Affiliation(s)
- Meng Wang
- Neuroscience Center, Department of Neurology, The First Hospital of Jilin University, Changchun, China
| | - Caiyun Liu
- Neuroscience Center, Department of Neurology, The First Hospital of Jilin University, Changchun, China
| | - Meijuan Zou
- Neuroscience Center, Department of Neurology, The First Hospital of Jilin University, Changchun, China
| | - Zixuan Niu
- Neuroscience Center, Department of Neurology, The First Hospital of Jilin University, Changchun, China
| | - Jie Zhu
- Neuroscience Center, Department of Neurology, The First Hospital of Jilin University, No. 1, Xinmin Street, Changchun 130021, China
- Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Karolinska University Hospital, Solna, Stockholm 171 64, Sweden
| | - Tao Jin
- Neuroscience Center, Department of Neurology, The First Hospital of Jilin University, No. 1, Xinmin Street, Changchun 130021, China
| |
Collapse
|
8
|
Costabile T, Signoriello E, Lauro F, Altieri M, Ziello AR, D'Ambrosio A, Bisecco A, Maniscalco G, Bonavita S, Gallo A, Brescia Morra V, Lus G, Saccà F, Russo CV. Validation of an iPad version of the Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS). Mult Scler Relat Disord 2023; 74:104723. [PMID: 37086633 DOI: 10.1016/j.msard.2023.104723] [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: 01/20/2023] [Revised: 04/02/2023] [Accepted: 04/16/2023] [Indexed: 04/24/2023]
Abstract
BACKGROUND The Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) is the most widely used screening tool for cognitive impairment in Multiple Sclerosis (MS). However, the administration and scoring procedures of the paper version are time consuming and prone to errors. Aim of our study was to develop a tablet version of BICAMS (iBICAMS), and to assess its reliability compared to the paper version. METHODS We administered both BICAMS and iBICAMS to 139 MS patients in two different sessions. We compared scores on both versions using a paired t-test. We used a repeated measures ANOVA to test the impact of rater, order of administration and test-retest time on test-retest performances. We used the Intraclass Correlation Coefficient (ICC) to assess the reliability between BICAMS and iBICAMS. RESULTS All three sub-tests of the BICAMS (SDMT, CVLT-II and BVMT-R) were different between the paper and the tablet versions. Order of administration influenced test-retest performances at the SDMT (p<0.001), CVLT- II (p<0.001) and BVMT-R (p<0.001). Intraclass coefficient correlation (ICC) revealed a high level of agreement between the paper BICAMS and the iPad version for all three tests: SDMT (0.92), CVLT-II (0.83) and BVMT-R (0.82). CONCLUSIONS We found a high reliability between BICAMS and iBICAMS. Considering the inherent advantages of automated scoring, digital storage of data, standardized timing, the iBICAMS could become a standard in clinical practice.
Collapse
Affiliation(s)
- Teresa Costabile
- Multiple Sclerosis Center, II Division of Neurology, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Elisabetta Signoriello
- Multiple Sclerosis Center, II Division of Neurology, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Francesca Lauro
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II, Naples, Italy
| | - Manuela Altieri
- Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta, Italy
| | | | - Alessandro D'Ambrosio
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Alvino Bisecco
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | | | - Simona Bonavita
- Multiple Sclerosis Center, II Division of Neurology, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Antonio Gallo
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Vincenzo Brescia Morra
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II, Naples, Italy
| | - Giacomo Lus
- Multiple Sclerosis Center, II Division of Neurology, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Francesco Saccà
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II, Naples, Italy.
| | - Cinzia Valeria Russo
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II, Naples, Italy
| |
Collapse
|
9
|
Barateiro A, Barros C, Pinto MV, Ribeiro AR, Alberro A, Fernandes A. Women in the field of multiple sclerosis: How they contributed to paradigm shifts. Front Mol Neurosci 2023; 16:1087745. [PMID: 36818652 PMCID: PMC9937661 DOI: 10.3389/fnmol.2023.1087745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 01/13/2023] [Indexed: 02/05/2023] Open
Abstract
History is full of women who made enormous contributions to science. While there is little to no imbalance at the early career stage, a decreasing proportion of women is found as seniority increases. In the multiple sclerosis (MS) field, 44% of first authors and only 35% of senior authors were female. So, in this review, we highlight ground-breaking research done by women in the field of MS, focusing mostly on their work as principal investigators. MS is an autoimmune disorder of the central nervous system (CNS), with evident paradigm shifts in the understating of its pathophysiology. It is known that the immune system becomes overactivated and attacks myelin sheath surrounding axons. The resulting demyelination disrupts the communication signals to and from the CNS, which causes unpredictable symptoms, depending on the neurons that are affected. Classically, MS was reported to cause mostly physical and motor disabilities. However, it is now recognized that cognitive impairment affects more than 50% of the MS patients. Another shifting paradigm was the involvement of gray matter in MS pathology, formerly considered to be a white matter disease. Additionally, the identification of different T cell immune subsets and the mechanisms underlying the involvement of B cells and peripheral macrophages provided a better understanding of the immunopathophysiological processes present in MS. Relevantly, the gut-brain axis, recognized as a bi-directional communication system between the CNS and the gut, was found to be crucial in MS. Indeed, gut microbiota influences not only different susceptibilities to MS pathology, but it can also be modulated in order to positively act in MS course. Also, after the identification of the first microRNA in 1993, the role of microRNAs has been investigated in MS, either as potential biomarkers or therapeutic agents. Finally, concerning MS therapeutical approaches, remyelination-based studies have arisen on the spotlight aiming to repair myelin loss/neuronal connectivity. Altogether, here we emphasize the new insights of remarkable women that have voiced the impact of cognitive impairment, white and gray matter pathology, immune response, and that of the CNS-peripheral interplay on MS diagnosis, progression, and/or therapy efficacy, leading to huge breakthroughs in the MS field.
Collapse
Affiliation(s)
- Andreia Barateiro
- Central Nervous System, Blood and Peripheral Inflammation Lab, Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, Universidade de Lisboa, Lisbon, Portugal,Department of Pharmaceutical Sciences and Medicines, Faculty of Pharmacy, Universidade de Lisboa, Lisbon, Portugal,Andreia Barateiro,
| | - Catarina Barros
- Central Nervous System, Blood and Peripheral Inflammation Lab, Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, Universidade de Lisboa, Lisbon, Portugal
| | - Maria V. Pinto
- Central Nervous System, Blood and Peripheral Inflammation Lab, Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, Universidade de Lisboa, Lisbon, Portugal
| | - Ana Rita Ribeiro
- Central Nervous System, Blood and Peripheral Inflammation Lab, Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, Universidade de Lisboa, Lisbon, Portugal
| | - Ainhoa Alberro
- Central Nervous System, Blood and Peripheral Inflammation Lab, Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, Universidade de Lisboa, Lisbon, Portugal,Multiple Sclerosis Group, Biodonostia Health Research Institute, Donostia-San Sebastian, Spain
| | - Adelaide Fernandes
- Central Nervous System, Blood and Peripheral Inflammation Lab, Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, Universidade de Lisboa, Lisbon, Portugal,Department of Pharmaceutical Sciences and Medicines, Faculty of Pharmacy, Universidade de Lisboa, Lisbon, Portugal,*Correspondence: Adelaide Fernandes,
| |
Collapse
|
10
|
Iva P, Martin R, Fielding J, Clough M, White O, Godic B, van der Walt A, Rajan R. Discriminating spatialised speech in complex environments in multiple sclerosis. Cortex 2023; 159:217-232. [PMID: 36640621 DOI: 10.1016/j.cortex.2022.11.014] [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: 01/04/2022] [Revised: 06/13/2022] [Accepted: 11/09/2022] [Indexed: 12/25/2022]
Abstract
People with multiple sclerosis (pwMS) frequently present with deficits in binaural processing used for sound localization. This study examined spatial release from speech-on-speech masking in pwMS, which involves binaural processing and additional higher level mechanisms underlying streaming, such as spatial attention. 26 pwMS with mild severity (Expanded Disability Status Scale score <3) and 20 age-matched controls listened via headphones to pre-recorded sentences from a standard list presented simultaneously with eight-talker babble. Virtual acoustic techniques were used to simulate sentences originating from 0°, 20°, or 50° on the interaural horizontal plane around the listener whilst babble was presented continuously at 0° azimuth, and participants verbally repeated the target sentence. In a separate task, two simultaneous sentences both containing a colour and number were presented, and participants were required to report the target colour and number. Both competing sentences could originate from 0°, 20°, or 50° on the azimuthal plane. Participants also completed a series of neuropsychological assessments, an auditory questionnaire, and a three-alternative forced-choice task that involved the detection of interaural time differences (ITDs) in noise bursts. Spatial release from masking was observed in both pwMS and controls, as response accuracy in the two speech discrimination tasks improved in the spatially separated conditions (20° and 50°) compared with the co-localised condition. However, pwMS demonstrated significantly less spatial release (18%) than controls (28%) when discriminating colour/number coordinates. At 50° separation, pwMS discriminated significantly fewer coordinates (77%) than controls (89%). In contrast, pwMS had similar performances to controls when sentences were presented in babble, and for the basic ITD discrimination task. Significant correlations between speech discrimination performance and standardized neuropsychological scores were observed across all spatial conditions. Our findings suggest that spatial hearing is likely to be implicated in pwMS, thereby affecting the perception of competing speech originating from various locations.
Collapse
Affiliation(s)
- Pippa Iva
- Department of Physiology, Biomedicine Discovery Institute, Monash University, Melbourne, VIC, Australia.
| | - Russell Martin
- Department of Physiology, Biomedicine Discovery Institute, Monash University, Melbourne, VIC, Australia
| | - Joanne Fielding
- Department of Neurosciences, Central Clinical School, Alfred Hospital, Monash University, Melbourne, VIC, Australia
| | - Meaghan Clough
- Department of Neurosciences, Central Clinical School, Alfred Hospital, Monash University, Melbourne, VIC, Australia
| | - Owen White
- Department of Neurosciences, Central Clinical School, Alfred Hospital, Monash University, Melbourne, VIC, Australia
| | - Branislava Godic
- Department of Physiology, Biomedicine Discovery Institute, Monash University, Melbourne, VIC, Australia
| | - Anneke van der Walt
- Department of Neurosciences, Central Clinical School, Alfred Hospital, Monash University, Melbourne, VIC, Australia
| | - Ramesh Rajan
- Department of Physiology, Biomedicine Discovery Institute, Monash University, Melbourne, VIC, Australia
| |
Collapse
|
11
|
Howlett-Prieto Q, Oommen C, Carrithers MD, Wunsch DC, Hier DB. Subtypes of relapsing-remitting multiple sclerosis identified by network analysis. Front Digit Health 2023; 4:1063264. [PMID: 36714613 PMCID: PMC9874946 DOI: 10.3389/fdgth.2022.1063264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 12/22/2022] [Indexed: 01/12/2023] Open
Abstract
We used network analysis to identify subtypes of relapsing-remitting multiple sclerosis subjects based on their cumulative signs and symptoms. The electronic medical records of 113 subjects with relapsing-remitting multiple sclerosis were reviewed, signs and symptoms were mapped to classes in a neuro-ontology, and classes were collapsed into sixteen superclasses by subsumption. After normalization and vectorization of the data, bipartite (subject-feature) and unipartite (subject-subject) network graphs were created using NetworkX and visualized in Gephi. Degree and weighted degree were calculated for each node. Graphs were partitioned into communities using the modularity score. Feature maps visualized differences in features by community. Network analysis of the unipartite graph yielded a higher modularity score (0.49) than the bipartite graph (0.25). The bipartite network was partitioned into five communities which were named fatigue, behavioral, hypertonia/weakness, abnormal gait/sphincter, and sensory, based on feature characteristics. The unipartite network was partitioned into five communities which were named fatigue, pain, cognitive, sensory, and gait/weakness/hypertonia based on features. Although we did not identify pure subtypes (e.g., pure motor, pure sensory, etc.) in this cohort of multiple sclerosis subjects, we demonstrated that network analysis could partition these subjects into different subtype communities. Larger datasets and additional partitioning algorithms are needed to confirm these findings and elucidate their significance. This study contributes to the literature investigating subtypes of multiple sclerosis by combining feature reduction by subsumption with network analysis.
Collapse
Affiliation(s)
- Quentin Howlett-Prieto
- Department of Neurology and Rehabilitation, University of Illinois at Chicago, Chicago, IL, United States
| | - Chelsea Oommen
- Department of Neurology and Rehabilitation, University of Illinois at Chicago, Chicago, IL, United States
| | - Michael D. Carrithers
- Department of Neurology and Rehabilitation, University of Illinois at Chicago, Chicago, IL, United States
| | - Donald C. Wunsch
- Department of Electrical and Computer Engineering, Missouri University of Science and Technology, Rolla, MO, United States
| | - Daniel B. Hier
- Department of Neurology and Rehabilitation, University of Illinois at Chicago, Chicago, IL, United States,Department of Electrical and Computer Engineering, Missouri University of Science and Technology, Rolla, MO, United States,Correspondence: Daniel B. Hier
| |
Collapse
|
12
|
Weerasinghe-Mudiyanselage PDE, Ang MJ, Kang S, Kim JS, Moon C. Structural Plasticity of the Hippocampus in Neurodegenerative Diseases. Int J Mol Sci 2022; 23:3349. [PMID: 35328770 PMCID: PMC8955928 DOI: 10.3390/ijms23063349] [Citation(s) in RCA: 38] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 03/17/2022] [Accepted: 03/18/2022] [Indexed: 12/10/2022] Open
Abstract
Neuroplasticity is the capacity of neural networks in the brain to alter through development and rearrangement. It can be classified as structural and functional plasticity. The hippocampus is more susceptible to neuroplasticity as compared to other brain regions. Structural modifications in the hippocampus underpin several neurodegenerative diseases that exhibit cognitive and emotional dysregulation. This article reviews the findings of several preclinical and clinical studies about the role of structural plasticity in the hippocampus in neurodegenerative diseases, including Alzheimer's disease, Parkinson's disease, Huntington's disease, and multiple sclerosis. In this study, literature was surveyed using Google Scholar, PubMed, Web of Science, and Scopus, to review the mechanisms that underlie the alterations in the structural plasticity of the hippocampus in neurodegenerative diseases. This review summarizes the role of structural plasticity in the hippocampus for the etiopathogenesis of neurodegenerative diseases and identifies the current focus and gaps in knowledge about hippocampal dysfunctions. Ultimately, this information will be useful to propel future mechanistic and therapeutic research in neurodegenerative diseases.
Collapse
Affiliation(s)
- Poornima D. E. Weerasinghe-Mudiyanselage
- Department of Veterinary Anatomy and Animal Behavior, College of Veterinary Medicine and BK21 FOUR Program, Chonnam National University, Gwangju 61186, Korea; (P.D.E.W.-M.); (M.J.A.); (S.K.); (J.-S.K.)
| | - Mary Jasmin Ang
- Department of Veterinary Anatomy and Animal Behavior, College of Veterinary Medicine and BK21 FOUR Program, Chonnam National University, Gwangju 61186, Korea; (P.D.E.W.-M.); (M.J.A.); (S.K.); (J.-S.K.)
- College of Veterinary Medicine, University of the Philippines Los Baños, Los Baños 4031, Philippines
| | - Sohi Kang
- Department of Veterinary Anatomy and Animal Behavior, College of Veterinary Medicine and BK21 FOUR Program, Chonnam National University, Gwangju 61186, Korea; (P.D.E.W.-M.); (M.J.A.); (S.K.); (J.-S.K.)
| | - Joong-Sun Kim
- Department of Veterinary Anatomy and Animal Behavior, College of Veterinary Medicine and BK21 FOUR Program, Chonnam National University, Gwangju 61186, Korea; (P.D.E.W.-M.); (M.J.A.); (S.K.); (J.-S.K.)
| | - Changjong Moon
- Department of Veterinary Anatomy and Animal Behavior, College of Veterinary Medicine and BK21 FOUR Program, Chonnam National University, Gwangju 61186, Korea; (P.D.E.W.-M.); (M.J.A.); (S.K.); (J.-S.K.)
| |
Collapse
|
13
|
The Brief International Cognitive Assessment in Multiple Sclerosis (BICAMS): Validation in Arabic and Lebanese Normative Values. J Int Neuropsychol Soc 2022; 28:94-103. [PMID: 33563350 DOI: 10.1017/s1355617721000102] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Multiple sclerosis (MS) is often associated with cognitive deficits. Accurate evaluation of the MS patients' cognitive performance is essential for diagnosis and treatment recommendation. The Brief International Cognitive Assessment in Multiple Sclerosis (BICAMS), widely used cognitive testing battery, examines processing speed, verbal and visuospatial learning, and memory. Our study aims to examine the psychometric properties of an Arabic version of the BICAMS and to provide normative values in a Lebanese sample. METHOD The BICAMS, comprised of the Symbol Digit Modalities Test (SDMT), Brief Visuospatial Memory Test-Revised (BVMT-R), and a newly developed verbal learning/memory test, the Verbal Memory Arabic Test (VMAT), were administered on healthy subjects and MS patients. The sample consisted of 180 healthy individuals, of whom 63 were retested after 2-3 weeks. Forty-three MS patients matched with 43 healthy subjects based on age, sex, and years of education were assessed. A sample of 10 MS patients was also examined on two occasions. Test-retest reliability and criterion-related validity were examined, and regression-based norms were derived. RESULTS The test-retest correlations showed good evidence of reliability with coefficients ranging between 0.64 and 0.73 in the healthy sample, and between 0.43 and 0.92 in the MS sample. The BICAMS was able to discriminate between MS patients and matched healthy participants on the SDMT and BVMT-R. Normative data were comparable to other studies. CONCLUSIONS This new Arabic version of the BICAMS shows initial good psychometric properties. While good evidence of VMAT's reliability was shown in the healthy participants, less test-retest reliability in this tool was seen in the MS group, and partial criterion-related validity was evident. This renders further examination of the VMAT. We provide regression-based norms for a Lebanese sample and encourage the use of this battery in both research and clinical settings.
Collapse
|
14
|
Validation of the Spanish-language version of the Montreal Cognitive Assessment as a screening test for cognitive impairment in multiple sclerosis. NEUROLOGÍA (ENGLISH EDITION) 2021; 37:726-734. [PMID: 34836843 DOI: 10.1016/j.nrleng.2019.11.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 11/04/2019] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND The neuropsychological batteries traditionally used for the assessment of cognitive impairment (CI) in patients with multiple sclerosis are complex tests requiring a long time to administer. Simpler tests are needed to detect cognitive impairment in daily clinical practice. OBJECTIVE We aimed to evaluate the diagnostic validity and reliability of the Montreal Cognitive Assessment (MoCA) test as a screening tool for CI in patients with multiple sclerosis, as compared against the Brief Neuropsychological Battery. MATERIAL AND METHODS We recruited 52 patients with multiple sclerosis (61.5% women; mean age [standard deviation]: 41.7 [11.5] years). We analysed the reliability (internal consistency, interobserver reliability, and test-retest reliability), construct validity (factor analysis, Pearson correlation coefficient, and coefficient of determination), and criterion validity (ROC curve, sensitivity, specificity, total agreement, positive and negative predictive values, positive and negative likelihood ratios, and Fagan nomogram) of the MoCA test in this population. RESULTS The prevalence of CI was 21.2% according to findings from the Brief Neuropsychological Battery, and 25% according to the MoCA test. The MoCA test showed good internal consistency (Cronbach alpha, 0.822) and interobserver and test-retest reliability (intraclass correlation coefficient 0.80 and 0.96, respectively). The correlation coefficient between total Brief Neuropsychological Battery and MoCA test scores was 0.82. The optimal cut-off point on the ROC curve was 25-26, yielding 91% sensitivity and 93% specificity. CONCLUSION The MoCA test is a valid and reliable tool for screening for CI in patients with multiple sclerosis.
Collapse
|
15
|
Characterizing gaze and postural stability deficits in people with multiple sclerosis. Mult Scler Relat Disord 2021; 55:103205. [PMID: 34438218 DOI: 10.1016/j.msard.2021.103205] [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: 03/24/2021] [Revised: 07/28/2021] [Accepted: 08/06/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND People with Multiple Sclerosis (PwMS) experience a wide range of symptoms that can alter function and limit activity and community participation. Symptoms including sensory changes, weakness, fatigue and others have been well documented. However, symptoms related to changes in vestibular related function, including gaze and postural stability have not been fully explored. While some recent studies have begun to provide insight into these deficits in PwMS and have explored the use of rehabilitation paradigms for their management, much remains unknown about the full extent of these deficits. Therefore, this study aimed to characterize the presence of gaze and postural stability deficits in measures across the World Health Organization International Classification of Functioning, Disability, and Health (WHO ICF) and to examine how deficits in domains of body structure and function and activity contribute to participation level limitations. METHODS Baseline data from 41 PwMS (mean(SD) age = 53.9(11.2), 78% female) enrolled as part of a randomized clinical trial were used in this analysis. Measures of gaze and postural stability from the ICF domains of body structure and function (Vestibular ocular reflex [VOR] gain and postural sway area), activity (computerized dynamic visual acuity [cDVA] and MiniBEST test), and participation (Dizziness handicap inventory [DHI] and Activities Balance Confidence [ABC] scale) along with demographic data were used to characterize the sample. To explore relationships between ICF domains for gaze and postural stability, univariate correlations were performed between measures from each domain using Pearson's correlations. Separate multivariate regression models examined how measures from the body structure and function and activity domains contributed to the variance in the participation level outcomes. Variance explained by the models was quantified using R-squared statistic and contribution of the independent variables were quantified using the beta coefficient (p < 0.05). RESULTS Correlation analysis demonstrated significant relationships in the postural stability measures across domains. Specifically, between postural sway area on a firm surface and MiniBEST test score (r = -.48;p < 0.01) and MiniBEST test score and ABC score (r = 0.5;p < 0.01). Significant correlations were also found between the gaze stability measures of horizontal and vertical VOR gain (r = .68;p < 0.001), horizontal VOR gain and dynamic visual acuity (r = .38;p = 0.02), and vertical VOR gain and dynamic visual acuity (r = .54;p < 0.001). Regression models assessing postural stability, found that only the MiniBEST score significantly contributed to the variance in ABC score (p = 0.01) and the full model explained 34% of the variance in ABC score. Regression modeling of gaze stability outcomes did not produce any variable that significantly contributed to the variance in DHI score and the full model explained 18% of the variance in DHI score. CONCLUSIONS PwMS in this sample demonstrated deficits in gaze and postural stability across the domains of the WHO ICF compared to past samples of PwMS and healthy cohorts. Correlation between measures in the different domains were present, but no strong relationship between measures of body structure and function, activity and participation level outcomes were observed. This lack of relationship across the domains is likely contributed to the relatively small sample size, the high level of variability observed in the outcomes, and the diverse presentation often seen in PwMS.
Collapse
|
16
|
Kalinowska-Lyszczarz A, Tillema JM, Tobin WO, Guo Y, Fitz-Gibbon PD, Weigand SD, Giraldo-Chica M, Port JD, Lucchinetti CF. Long-term clinical, MRI, and cognitive follow-up in a large cohort of pathologically confirmed, predominantly tumefactive multiple sclerosis. Mult Scler 2021; 28:441-452. [PMID: 34212755 DOI: 10.1177/13524585211024162] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Limited studies have described long-term outcomes in pathology confirmed multiple sclerosis (MS). OBJECTIVES To describe long-term clinical-radiographic-cognitive outcomes in a prospectively followed cohort of patients with pathologically confirmed CNS demyelinating disease, consistent with MS. METHODS Subjects underwent clinical assessment, standardized 3T-MRI brain, and cognitive battery. RESULTS Seventy-five patients were included. Biopsied lesion size was ⩾ 2 cm in 62/75. At follow-up, median duration since biopsy was 11 years. Median EDSS was 3 and lesion burden was large (median 10 cm3). At follow-up, 57/75 met MS criteria, 17/75 had clinically isolated syndrome, and 1 radiographic changes only. Disability scores were comparable to a prevalence cohort in Olmsted County (p < 0.001, n = 218). Cognitive outcomes below age-normed standards included psychomotor, attention, working memory, and executive function domains. Total lesion volume and index lesion-related severity correlated with EDSS and cognitive performance. Volumetric cortical/subcortical GM correlated less than lesion metrics to cognitive outcomes. CONCLUSION Despite early aggressive course in pathologically confirmed MS, its long-term course was comparable to typical MS in our study. Cognitive impairment in this group seemed to correlate strongest to index lesion severity and total lesion volume. It remains to be established how the aggressive nature of the lesion, biopsy, and treatment affect clinical/cognitive outcomes.
Collapse
Affiliation(s)
- Alicja Kalinowska-Lyszczarz
- Department of Neurology, Mayo Clinic, Rochester, MN, USA/Department of Neurology, Poznań University of Medical Sciences, Poznań, Poland
| | | | - W Oliver Tobin
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Yong Guo
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | | | - Stephen D Weigand
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | | | - John D Port
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | | |
Collapse
|
17
|
Dogru-Huzmeli E, Duman T. There is an impairment in time perception of patients with multiple sclerosis. Somatosens Mot Res 2021; 38:140-145. [PMID: 33719839 DOI: 10.1080/08990220.2021.1879777] [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: 10/21/2022]
Abstract
OBJECTIVE The objective of this study is to examine time perception impairment in multiple sclerosis (MS) patients. METHOD The study was performed with 60 MS patients and 60 age-matched healthy people. Estimation and Production Tests were carried out with a standard personal laptop computer and participants were aware to count the seconds by the 'start' command and to stop by the 'stop' command. The outcome measure was the ratio between the estimated duration and the target (7 s, 32 s, or 58 s) one for the Estimation Test and the Produced duration and the target (7 s, 32 s, or 58 s) one for the Production Test; and each time duration was repeated three times both for Production and Estimation Tests. RESULTS We found a significant difference in the Estimation Test (7 s, 32 s, 58 s), and the Production Test (7 s, 32 s, 58 s) between the MS group and healthy control group (p < .05). It was observed that patients with MS had a higher deviation from the target time compared to the control group. It was found that this difference was statistically significant (p < .05). There was a high and negative correlation between the Estimation and Production Tests in MS patients. CONCLUSION In conclusion, our data suggests that time estimation and production are disturbed in MS patients, and cognitive rehabilitation is required for most of them.
Collapse
Affiliation(s)
- Esra Dogru-Huzmeli
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Hatay Mustafa Kemal University, Hatay, Turkey
| | - Taskin Duman
- Department of Neurology, Faculty of Medicine, Hatay Mustafa Kemal University, Hatay, Turkey
| |
Collapse
|
18
|
[Clinical practicability of the cognitive screening battery BICAMS in patients with multiple sclerosis: results of the feasibility study in Germany]. DER NERVENARZT 2021; 92:1031-1041. [PMID: 33598773 PMCID: PMC8484165 DOI: 10.1007/s00115-021-01073-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 01/04/2021] [Indexed: 11/02/2022]
Abstract
BACKGROUND Patients with multiple sclerosis (MS) suffer from cognitive impairment in 40-70% of the cases. There is evidence that the cognitive status is predictive for working ability and early retirement. Regular assessment of cognitive functionality is therefore urgently needed. PURPOSE The German validation of the Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) battery was evaluated in a multicentric way with respect to its feasibility in private neurological centers across Germany. METHODS Physician assistants were trained with respect to application and scoring of BICAMS. All scored test materials were evaluated by independent neuropsychological experts. RESULTS A total of 1606 BICAMS datasets were collected from 65 neurological centers. Of these 1573 datasets were analyzed of which 49.7% were correctly applied and scored while mistakes in application, scoring and transformation were found in 50.3%. Interrater reliability for each subtest was found to be ICC [Formula: see text] 0.953 when datasets containing mistakes were excluded. DISCUSSION In general, BICAMS is highly recommended to be applied in standard clinical care; however, it should be emphasized that although the interrater reliability in the final sample was high, serious mistakes were found in 50.3% of cases. From these findings we conclude that nonpsychological staff have to be even more intensively trained and supervised by experts in the application and scoring of BICAMS.
Collapse
|
19
|
Lebkuecher AL, Chiaravalloti ND, Strober LB. The role of language ability in verbal fluency of individuals with multiple sclerosis. Mult Scler Relat Disord 2021; 50:102846. [PMID: 33626431 DOI: 10.1016/j.msard.2021.102846] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 01/15/2021] [Accepted: 02/13/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND While cognitive deficits in memory and processing speed have been well-documented in individuals with multiple sclerosis (MS), language is largely considered to be intact. Verbal fluency deficits observed in MS are often attributed to impaired processing speed and executive functions rather than language ability. The current study evaluates the contribution of various cognitive factors to verbal fluency including language ability, oral-motor speed, processing speed, and executive functions. METHODS We analyzed pre-existing data from seventy-four (74) individuals with MS who completed a battery of neuropsychological tests designed to assess individual ability for various cognitive factors. We conducted linear multiple regression analyses with letter and category verbal fluency as outcome variables and performance on other cognitive domains (e.g., processing speed, executive functioning) as predictors. RESULTS Both vocabulary and processing speed predicted letter fluency while only vocabulary predicted category fluency. These findings suggest that the observed verbal fluency deficits in MS may reflect both impaired language ability and processing speed. CONCLUSION We propose that further research on language ability in MS is needed to determine if comprehensive neuropsychological test batteries for persons with MS should include tests of language ability to fully understand the cognitive profile of any given patient. Given the importance of language ability, it may be necessary to conduct a more thorough assessment of language in individuals with MS who experience a deficit in this domain.
Collapse
Affiliation(s)
- Amy L Lebkuecher
- Department of Psychology, The Pennsylvania State University, 140 Moore Building, University Park, PA 16802, United States.
| | - Nancy D Chiaravalloti
- Cognitive Functioning and Cognitive Rehabilitation Laboratory, Kessler Foundation, 120 Eagle Rock Avenue, East Hanover, NJ 07936, United States; Department of Physical Medicine & Rehabilitation, Rutgers New Jersey Medical School, Medical Science Building, 185 South Orange Avenue, Newark, NJ 07103, United States
| | - Lauren B Strober
- Department of Physical Medicine & Rehabilitation, Rutgers New Jersey Medical School, Medical Science Building, 185 South Orange Avenue, Newark, NJ 07103, United States; Center for Neuropsychology and Neuroscience Research, Kessler Foundation, 120 Eagle Rock Avenue, East Hanover, NJ 07936, United States
| |
Collapse
|
20
|
Lorefice L, Fenu G, Mammoliti R, Carta E, Sechi V, Frau J, Coghe G, Canalis L, Barracciu MA, Marrosu G, Marrosu MG, Cocco E. Event-related potentials and deep grey matter atrophy in multiple sclerosis: Exploring the possible associations with cognition. Mult Scler Relat Disord 2021; 49:102785. [PMID: 33508572 DOI: 10.1016/j.msard.2021.102785] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 01/08/2021] [Accepted: 01/18/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Event-related potentials (ERPs) have been proposed as a neurophysiological biomarker to capture cognitive dysfunction in multiple sclerosis (MS). Few studies have evaluated the relationships between ERPs and brain atrophy as known marker of structural brain damage related to cognitive impairment (CI). OBJECTIVES To explore the relationships of brain atrophy, including of the cortex and deep grey matter, with ERP abnormalities and cognitive function, as defined using the Brief Repeatable Battery of Neuropsychological Tests (BRBN). RESULTS Seventy-eight patients with relapsing-remitting MS were enroled, of which 38 (48.7%) had CI. Independent t-test comparisons of the ERP parameters found a significant difference in P300 wave latency, with a latency of 343.7 ± 32.6 ms in the CI group vs. 320.3 ± 16.5 ms in the cognitively preserved (CP) group (p = 0.001). Significant differences in the MRI measurements, including the cortex (p = 0.02) and deep grey matter structures [thalamus (p = 0.001), amygdala (p = 0.030), and nucleus accumbens (p = 0.004)) were observed, with lower measurements in the CI group. Regression models were also performed to explore the impact of brain volumes on ERP parameters. This showed a relationship between P300 latency and the lower amygdala (p = 0.02) and hippocampus (p = 0.03) volumes, while the amplitude of the P300 was significantly associated with a lower cortex volume (p = 0.01). CONCLUSION Cortex volume emerged as the most significant predictor of the P300 amplitude. The amygdala and hippocampal volumes were found to influence P300 latency, highlighting the role of deep grey matter atrophy in ERPs for the first time. The combination of structural MRI and neurophysiological techniques, sensitive to diverse aspects of MS pathology, could improve the understanding of CI in MS and its neurodegenerative and inflammatory substrate.
Collapse
Affiliation(s)
- L Lorefice
- Multiple Sclerosis Centre, Binaghi Hospital, ATS Sardegna, Cagliari, Italy; Multiple Sclerosis Centre, Binaghi Hospital, Department of Medical Sciences and Public Health, University of Cagliari, Italy.
| | - G Fenu
- Multiple Sclerosis Centre, Binaghi Hospital, Department of Medical Sciences and Public Health, University of Cagliari, Italy
| | - R Mammoliti
- Multiple Sclerosis Centre, Binaghi Hospital, ATS Sardegna, Cagliari, Italy
| | - E Carta
- Multiple Sclerosis Centre, Binaghi Hospital, Department of Medical Sciences and Public Health, University of Cagliari, Italy
| | - V Sechi
- Radiology Unit, Binaghi Hospital, ATS Sardegna, Cagliari, Italy
| | - J Frau
- Multiple Sclerosis Centre, Binaghi Hospital, ATS Sardegna, Cagliari, Italy
| | - G Coghe
- Multiple Sclerosis Centre, Binaghi Hospital, ATS Sardegna, Cagliari, Italy
| | - L Canalis
- Radiology Unit, Binaghi Hospital, ATS Sardegna, Cagliari, Italy
| | - M A Barracciu
- Radiology Unit, Binaghi Hospital, ATS Sardegna, Cagliari, Italy
| | - G Marrosu
- Multiple Sclerosis Centre, Binaghi Hospital, ATS Sardegna, Cagliari, Italy
| | - M G Marrosu
- Multiple Sclerosis Centre, Binaghi Hospital, Department of Medical Sciences and Public Health, University of Cagliari, Italy
| | - E Cocco
- Multiple Sclerosis Centre, Binaghi Hospital, Department of Medical Sciences and Public Health, University of Cagliari, Italy
| |
Collapse
|
21
|
Iva P, Fielding J, Clough M, White O, Godic B, Martin R, Rajan R. Speech Discrimination Tasks: A Sensitive Sensory and Cognitive Measure in Early and Mild Multiple Sclerosis. Front Neurosci 2021; 14:604991. [PMID: 33424540 PMCID: PMC7786116 DOI: 10.3389/fnins.2020.604991] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 11/30/2020] [Indexed: 11/13/2022] Open
Abstract
There is a need for reliable and objective measures of early and mild symptomology in multiple sclerosis (MS), as deficits can be subtle and difficult to quantify objectively in patients without overt physical deficits. We hypothesized that a speech-in-noise (SiN) task would be sensitive to demyelinating effects on precise neural timing and diffuse higher-level networks required for speech intelligibility, and therefore be a useful tool for monitoring sensory and cognitive changes in early MS. The objective of this study was to develop a SiN task for clinical use that sensitively monitors disease activity in early (<5 years) and late (>10 years) stages of MS subjects with mild severity [Expanded Disability Status Scale (EDSS) score < 3]. Pre-recorded Bamford-Kowal-Bench sentences and isolated keywords were presented at five signal-to-noise ratios (SNR) in one of two background noises: speech-weighted noise and eight-talker babble. All speech and noise were presented via headphones to controls (n = 38), early MS (n = 23), and late MS (n = 12) who were required to verbally repeat the target speech. MS subjects also completed extensive neuropsychological testing which included: Paced Auditory Serial Addition Test, Digit Span Test, and California Verbal Learning Test. Despite normal hearing thresholds, subjects with early and late mild MS displayed speech discrimination deficits when sentences and words were presented in babble - but not speech-weighted noise. Significant correlations between SiN performance and standardized neuropsychological assessments indicated that MS subjects with lower functional scores also had poorer speech discrimination. Furthermore, a quick 5-min task with words and keywords presented in multi-talker babble at an SNR of -1 dB was 82% accurate in discriminating mildly impaired MS individuals (median EDSS = 0) from healthy controls. Quantifying functional deficits in mild MS will help clinicians to maximize the opportunities to preserve neurological reserve in patients with appropriate therapeutic management, particularly in the earliest stages. Given that physical assessments are not informative in this fully ambulatory cohort, a quick 5-min task with words and keywords presented in multi-talker babble at a single SNR could serve as a complementary test for clinical use due to its ease of use and speed.
Collapse
Affiliation(s)
- Pippa Iva
- Department of Physiology, Biomedicine Discovery Institute, Monash University, Melbourne, VIC, Australia
| | - Joanne Fielding
- Department of Neuroscience, Central Clinical School, Monash University, Alfred Centre, Melbourne, VIC, Australia
| | - Meaghan Clough
- Department of Neuroscience, Central Clinical School, Monash University, Alfred Centre, Melbourne, VIC, Australia
| | - Owen White
- Department of Neuroscience, Central Clinical School, Monash University, Alfred Centre, Melbourne, VIC, Australia
| | - Branislava Godic
- Department of Physiology, Biomedicine Discovery Institute, Monash University, Melbourne, VIC, Australia
| | - Russell Martin
- Department of Physiology, Biomedicine Discovery Institute, Monash University, Melbourne, VIC, Australia
| | - Ramesh Rajan
- Department of Physiology, Biomedicine Discovery Institute, Monash University, Melbourne, VIC, Australia
| |
Collapse
|
22
|
Varma-Doyle AV, Lukiw WJ, Zhao Y, Lovera J, Devier D. A hypothesis-generating scoping review of miRs identified in both multiple sclerosis and dementia, their protein targets, and miR signaling pathways. J Neurol Sci 2020; 420:117202. [PMID: 33183778 DOI: 10.1016/j.jns.2020.117202] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 09/26/2020] [Accepted: 10/19/2020] [Indexed: 12/11/2022]
Abstract
Cognitive impairment (CI) is a frequent complication affecting people with multiple sclerosis (MS). The causes of CI in MS are not fully understood. Besides MRI measures, few other biomarkers exist to help us predict the development of CI and understand its biology. MicroRNAs (miRs) are relatively stable, non-coding RNA molecules about 22 nucleotides in length that can serve as biomarkers and possible therapeutic targets in several autoimmune and neurodegenerative diseases, including the dementias. In this review, we identify dysregulated miRs in MS that overlap with dysregulated miRs in cognitive disorders and dementia and explore how these overlapping miRs play a role in CI in MS. MiR-15, miR-21, miR-128, miR-132, miR-138, miR-142, miR-146a, miR-155, miR-181, miR-572, and let-7 are known to contribute to various forms of dementia and show abnormal expression in MS. These overlapping miRs are involved in pathways related to apoptosis, neuroinflammation, glutamate toxicity, astrocyte activation, microglial burst activity, synaptic dysfunction, and remyelination. The mechanisms of action suggest that these miRs may be related to CI in MS. From our review, we also delineated miRs that could be neuroprotective in MS, namely miR-23a, miR-219, miR-214, and miR-22. Further studies can help clarify if these miRs are responsible for CI in MS, leading to potential therapeutic targets.
Collapse
Affiliation(s)
- Aditi Vian Varma-Doyle
- Louisiana State University Health Sciences Center -New Orleans School of Medicine, Department of Neurology, New Orleans, United States of America
| | - Walter J Lukiw
- Louisiana State University Health Sciences Center -New Orleans School of Medicine, Department of Neurology, New Orleans, United States of America; Louisiana State University Health Sciences Center - New Orleans Neuroscience Center, United States of America; Louisiana State University Health Sciences Center - New Orleans Department of Ophthalmology, United States of America
| | - Yuhai Zhao
- Louisiana State University Health Sciences Center - New Orleans Department of Cell Biology and Anatomy, United States of America; Louisiana State University Health Sciences Center - New Orleans Neuroscience Center, United States of America
| | - Jesus Lovera
- Louisiana State University Health Sciences Center -New Orleans School of Medicine, Department of Neurology, New Orleans, United States of America.
| | - Deidre Devier
- Louisiana State University Health Sciences Center -New Orleans School of Medicine, Department of Neurology, New Orleans, United States of America; Louisiana State University Health Sciences Center - New Orleans Department of Cell Biology and Anatomy, United States of America.
| |
Collapse
|
23
|
Evolving relationship between respiratory functions & impairment in sleep and cognition in patients with multiple sclerosis. Mult Scler Relat Disord 2020; 46:102514. [PMID: 32992131 DOI: 10.1016/j.msard.2020.102514] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Revised: 09/03/2020] [Accepted: 09/05/2020] [Indexed: 11/20/2022]
Abstract
BACKGROUND The most apparent source of disability in patients with multiple sclerosis (MS) is the physical and mental impact. The pathophysiological mechanisms of cognitive dysfunction are multifactorial although hypoventilation secondary to respiratory dysfunction may contribute to cognitive decline. METHODS This study was conducted on 146 MS patients with baseline clinical assessments including the Epworth sleepiness scale (ESS) and physical disability was assessed using the Expanded Disability Status Scale (EDSS). Cognitive testing was performed utilizing the Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) and the Perceived Deficits Questionnaire (PDQ). Respiratory functions were assessed by spirometry and the respiratory muscle functional assessment was done by maximal mouth pressure measurement. RESULTS The respiratory muscle function test had a significant negative correlation with the score of ESS and PDQ scale and a significant positive correlation with the BICAMS scale score (p < 0.001). The ESS and PDQ scores were significantly negatively correlated with forced expiratory volume in the first second (FEV1)/ forced vital capacity (FVC) (p = 0.03, 0.02), FVC supine (p = 0.03, 0.01), FVC upright- FVC supine (ΔFVC) (p < 0.001, <0.001) FEV1 (p < 0.001) and FVC (L) (p < 0.001), respectively. While the BICAMS showed a significant positive correlation with spirometry results except FVC upright. ESS scores were significantly correlated with the BICAMS and PDQ scale score (p < 0.001). CONCLUSION Among MS patients, impaired respiratory functions are significantly associated with sleep disturbance and cognitive impairment. Thus the spirometry and respiratory muscle strength assessment are necessary from the early phase of MS.
Collapse
|
24
|
Motavalli A, Majdi A, Hosseini L, Talebi M, Mahmoudi J, Hosseini SH, Sadigh-Eteghad S. Pharmacotherapy in multiple sclerosis-induced cognitive impairment: A systematic review and meta-analysis. Mult Scler Relat Disord 2020; 46:102478. [PMID: 32896820 DOI: 10.1016/j.msard.2020.102478] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 08/27/2020] [Accepted: 08/29/2020] [Indexed: 11/19/2022]
Abstract
Multiple sclerosis (MS) is an inflammatory demyelinating disease of the central nervous system (CNS) commonly complicated by cognitive impairment. Unfortunately, no medical therapy has been proved to improve cognitive problems in these patients. This meta-analysis investigated the effectiveness of different categories of drugs on the minimal assessment of cognitive function in MS (MACFIMS)-related tasks outcome in MS patients. To this end, a systematic evaluation was conducted using PubMed, Google Scholar, and Scopus databases. Among a total of 128 publications, 31 studies met our inclusion criteria, and 22 included in the meta-analysis. We found that symbol digit modalities test (SDMT), paced auditory serial addition test (PASAT), controlled oral word association test (COWAT), and California verbal learning test (CVLT) were the most frequently reported tasks in included studies. The frequently reported drugs were classified into five main groups of acetylcholine esterase inhibitors, CNS stimulants, fampridine, herbal remedies, and miscellaneous. Overall heterogeneity of the studies was modest. The treatments did not affect cognitive function in any of the tasks (p>0.05). However, in subgroup analysis, we found significant improvement in SDMT task outecomes after treatment by fampridine (0.283 SMD, 95%CI, 0.015 to 0.550, p = 0.039, I2=11.7%). Our meta-analysis highlighted that the currently proposed therapeutic agents had no beneficial effects on the alleviation of MS-induced cognitive impairment.
Collapse
Affiliation(s)
- Ali Motavalli
- Neurosciences Research Center, Tabriz University of Medical Sciences, 5166614756, Tabriz, Iran
| | - Alireza Majdi
- Neurosciences Research Center, Tabriz University of Medical Sciences, 5166614756, Tabriz, Iran
| | - Leila Hosseini
- Neurosciences Research Center, Tabriz University of Medical Sciences, 5166614756, Tabriz, Iran
| | - Mahnaz Talebi
- Neurosciences Research Center, Tabriz University of Medical Sciences, 5166614756, Tabriz, Iran
| | - Javad Mahmoudi
- Neurosciences Research Center, Tabriz University of Medical Sciences, 5166614756, Tabriz, Iran
| | - Seyed Hojjat Hosseini
- Department of Pharmacology, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran; Zanjan Metabolic Diseases Research Center, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Saeed Sadigh-Eteghad
- Neurosciences Research Center, Tabriz University of Medical Sciences, 5166614756, Tabriz, Iran; Department of Persian Medicine, Faculty of Persian Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
| |
Collapse
|
25
|
Gerhardsson L, Hou L, Pettersson K. Work-related exposure to organic solvents and the risk for multiple sclerosis-a systematic review. Int Arch Occup Environ Health 2020; 94:221-229. [PMID: 32880046 PMCID: PMC7872988 DOI: 10.1007/s00420-020-01564-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 08/25/2020] [Indexed: 11/12/2022]
Abstract
Purpose Multiple sclerosis (MS) is a chronic progressive neurological disorder. Several environmental factors have been discussed as possible causing agents, e.g. organic solvents, whose impact on the disease is analysed in this review.
Methods Systematic search strategies were used to identify high-quality studies of workers exposed to organic solvents, published up to September 30, 2019, in databases, such as PubMed, Cochrane library and Scopus. The exposure was in most studies obtained by questionnaires, supplemented with telephone interviews. The diagnosis MS was mainly detemined following a thorough neurological examination. Finally, fourteen case–control studies and two cohort studies met the inclusion criteria and were included in the meta-analysis. Random effects models were used to pool the results of the studies. Results The odds ratios from the 14 case–control studies included in the meta-analysis ranged from 0.12–4.0. Five case–control studies and one cohort study showed a significant association between the development of multiple sclerosis and exposure to organic solvents. The results from the other nine case–control studies and from one of the two cohort studies did not reach statistical significance. The pooled data from the 14 case–control studies gave an OR of 1.44 (95% CI 1.03–1.99), which shows a moderately increased risk of developing MS after exposure to organic solvents. Conclusions The final interpretation of the result is that organic solvents may be slightly associated with an increased risk to develop MS. In addition, other factors, e.g. genetic markers and smoking, may contribute to the development of the disease.
Collapse
Affiliation(s)
- Lars Gerhardsson
- Department of Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Medicinaregatan 16A, Box 414, 405 30, Gothenburg, Sweden.
| | - Linda Hou
- Institute of Neuroscience and Physiology, Rehabilitation Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Feelgood Occupational Health Care AB, Gothenburg City, Sweden
| | - Kjell Pettersson
- Department of Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Medicinaregatan 16A, Box 414, 405 30, Gothenburg, Sweden
| |
Collapse
|
26
|
McNicholas N, Russell A, Nolan G, Tubridy N, Hutchinson M, Garvey JF, McGuigan C. Impact of obstructive sleep apnoea on cognitive function in multiple sclerosis: A longitudinal study. J Sleep Res 2020; 30:e13159. [PMID: 32791570 DOI: 10.1111/jsr.13159] [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: 04/15/2020] [Revised: 06/22/2020] [Accepted: 07/15/2020] [Indexed: 11/28/2022]
Abstract
Cognitive impairment (CI) and fatigue are common in people with multiple sclerosis (MS), with well-known profound effects on quality of life. Sleep disorders, including obstructive sleep apnoea (OSA), are also common in MS patients. The presence of CI has previously been shown to strongly correlate with OSA diagnosed using polysomnography in MS. Treatment of OSA has not previously been investigated as a potential modality to improve cognition in MS patients. Therefore, we sought to investigate the potential effects of OSA treatment on both cognitive function and fatigue in MS patients. Twenty-three participants with MS reporting significant fatigue were enrolled. CI was assessed by the Brief International Cognitive Assessment in MS and the 3-second Paced Auditory Serial Addition Test. All participants underwent overnight polysomnography to assess for possible OSA. Cognitive and fatigue measures were repeated in those subsequently treated for OSA and in a comparative untreated sample. Seven participants (30%) had a diagnosis of OSA based on an apnoea-hypopnea index greater than 5 per hour, with no correlation between the presence of CI and OSA. Verbal learning at follow-up assessment was seen to improve significantly in those treated for OSA, compared with those who were not treated for a sleep disorder. This small study demonstrates the potential for OSA treatment to improve verbal learning in people with MS, larger studies are indicated to further investigate the potential for cognitive and fatigue improvement in people with MS through treatment of comorbid OSA.
Collapse
Affiliation(s)
- Nuala McNicholas
- Department of Neurology, St. Vincent's University Hospital, Dublin, Ireland.,School of Medicine, University College Dublin, Dublin, Ireland
| | - Audrey Russell
- Department of Respiratory and Sleep Medicine, St. Vincent's University Hospital, Dublin, Ireland
| | - Geraldine Nolan
- Department of Respiratory and Sleep Medicine, St. Vincent's University Hospital, Dublin, Ireland
| | - Niall Tubridy
- Department of Neurology, St. Vincent's University Hospital, Dublin, Ireland.,School of Medicine, University College Dublin, Dublin, Ireland
| | - Michael Hutchinson
- Department of Neurology, St. Vincent's University Hospital, Dublin, Ireland.,School of Medicine, University College Dublin, Dublin, Ireland
| | - John Francis Garvey
- School of Medicine, University College Dublin, Dublin, Ireland.,Department of Respiratory and Sleep Medicine, St. Vincent's University Hospital, Dublin, Ireland
| | | |
Collapse
|
27
|
Loring DW, Meador KJ, Goldstein FC. Valid or not: A critique of Graver and Green. APPLIED NEUROPSYCHOLOGY. ADULT 2020; 29:639-642. [PMID: 32735139 DOI: 10.1080/23279095.2020.1798961] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Disagreements in science and medicine are not uncommon, and formal exchanges of disagreements serve a variety of valuable roles. As identified by a Nature Methods editorial entitled "The Power of Disagreement" (2016), disagreements bring attention to best practices so that differences in interpretation do not result from inferior data sets or confirmation bias, "prompting researchers to take a second look at evidence that is not in agreement with their hypothesis, rather than dismiss it as artifacts." Graver and Green published reasons why they disagree with a recent clinical case report and a decades old randomized control trial characterizing the effect of an acute 2 mg dosing of lorazepam on the Word Memory Test. In this article, we formally responded to their commentary to further clarify the reasons for our data interpretations. These two opposing views provide an excellent learning opportunity, particularly for students, demonstrating the importance of careful articulation of the rationale behind certain conclusions from different perspectives. We encourage careful review of the original articles being discussed so the neuropsychologists can read both positions and decide which interpretation of the findings they consider most sound.
Collapse
Affiliation(s)
- David W Loring
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA.,Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
| | - Kimford J Meador
- Department of Neurology & Neurological Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Felicia C Goldstein
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
| |
Collapse
|
28
|
Lorefice L, Carta E, Frau J, Contu F, Casaglia E, Coghe G, Barracciu MA, Cocco E, Fenu G. The impact of deep grey matter volume on cognition in multiple sclerosis. Mult Scler Relat Disord 2020; 45:102351. [PMID: 32731200 DOI: 10.1016/j.msard.2020.102351] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 06/03/2020] [Accepted: 06/30/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND Cognitive dysfunctions are very frequent in people living with multiple sclerosis (MS). Several studies have previously indicated grey matter (GM) atrophy as useful predictor of patients' cognitive impairment. However, considerable uncertainty exists about the possible impact of deep grey matter volumes on cognition. This study aimed to evaluate the relationship of the subcortical (sc) GM volumes with the presence and severity of global and selective cognitive impairment in MS. METHODS A group of MS patients with relapsing remitting course were enrolled. Patients underwent a neuropsychological evaluation by using the Brief Repeatable Battery of Neuropsychological Tests (BRBN) and the Delis-Kaplan Executive Function System Sorting Test (D-KEFST); z scores were estimated and items with z score below 2 standard deviation were considered failed. Thus, brain MRIs images were acquired and measurements of whole brain (WB), white matter (WM), and cortical grey matter (GM) were obtained by SIENAX. After FIRST tool segmentation, volumes of subcortical GM structures were also estimated. RESULTS The sample included 50 MS patients, of which 16/50 (32%) subjects were cognitively impaired. Multiple regression analyses found a significant association of severity of cognitive impairment, defined as number of failed neuropsychological tests, with lower volumes of cortex (p=0.003), thalamus (p=0.009), caudate (p=0.011), putamen (p=0.020), pallidus (p=0.012) and hippocampus (p=0.045), independently from other MS features. In addition, an association between accumbens volume and D-KEFS ST FSC and D-KEFS ST FSD z scores was observed (p<0.03). CONCLUSIONS Our results indicated that volumes of several scGM structures, and in particular of thalamus, contribute to determine cognitive dysfunctions in MS, mainly influencing the executive functioning. Further investigations in larger MS cohorts with cognitive impairment are necessary to better understand the structural brain damage underlying this "invisible disability".
Collapse
Affiliation(s)
- L Lorefice
- Multiple Sclerosis Center, Binaghi Hospital, ATS Sardegna, via Is Guadazzonis 2, 09126, Cagliari, Italy.
| | - E Carta
- Multiple Sclerosis Center, Department of Medical Sciences and Public Health, University of Cagliari, Italy
| | - J Frau
- Multiple Sclerosis Center, Binaghi Hospital, ATS Sardegna, via Is Guadazzonis 2, 09126, Cagliari, Italy
| | - F Contu
- Radiology Unit, Binaghi Hospital, ATS Sardegna, Cagliari, Italy
| | - E Casaglia
- Multiple Sclerosis Center, Department of Medical Sciences and Public Health, University of Cagliari, Italy
| | - G Coghe
- Multiple Sclerosis Center, Binaghi Hospital, ATS Sardegna, via Is Guadazzonis 2, 09126, Cagliari, Italy
| | - M A Barracciu
- Radiology Unit, Binaghi Hospital, ATS Sardegna, Cagliari, Italy
| | - E Cocco
- Multiple Sclerosis Center, Binaghi Hospital, ATS Sardegna, via Is Guadazzonis 2, 09126, Cagliari, Italy; Multiple Sclerosis Center, Department of Medical Sciences and Public Health, University of Cagliari, Italy
| | - G Fenu
- Multiple Sclerosis Center, Binaghi Hospital, ATS Sardegna, via Is Guadazzonis 2, 09126, Cagliari, Italy
| |
Collapse
|
29
|
Darwish H, Farran N, Hannoun S, Tadros N, Yamout B, El Ayoubi NK, Khoury SJ. Serum vitamin D level is associated with speed of processing in multiple sclerosis patients. J Steroid Biochem Mol Biol 2020; 200:105628. [PMID: 32061642 DOI: 10.1016/j.jsbmb.2020.105628] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 01/16/2020] [Accepted: 02/12/2020] [Indexed: 01/01/2023]
Abstract
Multiple Sclerosis (MS) is often associated with low serum 25(OH)D levels, as well as cognitive dysfunctions. The relationship between 25(OH)D and the most commonly affected cognitive domain in MS; processing speed, is poorly explored. The purpose of this study is to: (1) assess the effect of serum 25(OH)D change on processing speed in MS, and (2) explore the relationship between serum 25(OH)D and brain volume changes in MS. A retrospective chart review was conducted, data from 299 patients were extracted (baseline), of whom 163 had follow-up measurements (after at least a 9-month interval). The Symbol Digits Modalities Test (SDMT) was used as a measure of processing speed. MRI data was available from 78 individuals at baseline, and 70 at follow-up. SDMT scores and brain volumes (Cerebellum (total, grey, and white), intracranial, Grey Matter (GM), and White Matter (WM)) were compared based on 25(OH)D levels and their changes towards follow-up. Results indicated that patients with deficient 25(OH)D levels had lower SDMT scores when compared to those with sufficient levels, and SDMT scores improved as a function of 25(OH)D. For MRI measures, only patients with sufficient 25(OH)D levels during both assessment periods had significant changes in intracranial and total cerebellum volumes. We conclude that 25(OH)D levels seem to have an effect on processing speed in MS, thus the importance of clinical monitoring and supplementation in this regard is reinforced.
Collapse
Affiliation(s)
- Hala Darwish
- Hariri School of Nursing, American University of Beirut, PO Box 11 0236, Riad El-Solh 1107 2020 Beirut, Lebanon; Nehme and Therese Tohme Multiple Sclerosis Center, American University of Beirut Medical Center, PO Box 11 0236, Riad El-Solh 1107 2020 Beirut, Lebanon.
| | - Natali Farran
- Hariri School of Nursing, American University of Beirut, PO Box 11 0236, Riad El-Solh 1107 2020 Beirut, Lebanon
| | - Salem Hannoun
- Nehme and Therese Tohme Multiple Sclerosis Center, American University of Beirut Medical Center, PO Box 11 0236, Riad El-Solh 1107 2020 Beirut, Lebanon
| | - Natalie Tadros
- Hariri School of Nursing, American University of Beirut, PO Box 11 0236, Riad El-Solh 1107 2020 Beirut, Lebanon
| | - Bassem Yamout
- Nehme and Therese Tohme Multiple Sclerosis Center, American University of Beirut Medical Center, PO Box 11 0236, Riad El-Solh 1107 2020 Beirut, Lebanon; Neurology Department, Faculty of Medicine, American University of Beirut, PO Box 11 0236, Riad El-Solh 1107 2020 Beirut, Lebanon
| | - Nabil K El Ayoubi
- Nehme and Therese Tohme Multiple Sclerosis Center, American University of Beirut Medical Center, PO Box 11 0236, Riad El-Solh 1107 2020 Beirut, Lebanon; Neurology Department, Faculty of Medicine, American University of Beirut, PO Box 11 0236, Riad El-Solh 1107 2020 Beirut, Lebanon
| | - Samia J Khoury
- Nehme and Therese Tohme Multiple Sclerosis Center, American University of Beirut Medical Center, PO Box 11 0236, Riad El-Solh 1107 2020 Beirut, Lebanon; Neurology Department, Faculty of Medicine, American University of Beirut, PO Box 11 0236, Riad El-Solh 1107 2020 Beirut, Lebanon
| |
Collapse
|
30
|
Detecting Subtle Cognitive Impairment in Multiple Sclerosis with the Montreal Cognitive Assessment. Can J Neurol Sci 2020; 47:620-626. [PMID: 32450922 DOI: 10.1017/cjn.2020.97] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
BACKGROUND Although cognitive deficits are frequent in multiple sclerosis (MS), screening for them with tools such as the Montreal Cognitive Assessment (MoCA) test is usually not performed unless there is a subjective complaint. The Multiple Sclerosis Neuropsychological Questionnaire (MSNQ) is among the instruments most commonly used to assess self-reported subjective complaints in MS. Nonetheless, it does not always accurately reflect cognitive status; many patients with cognitive deficits thus fail to receive appropriate referral for detailed neuropsychological evaluation. The objective of this study was to examine the validity of the MoCA test to detect the presence of objective cognitive deficits among patients with MS without subjective complaints using the Minimal Assessment of Cognitive Function in MS (MACFIMS) as the gold standard. METHODS The sample included 98 patients who were recruited from a university hospital MS clinic. The MSNQ was used to select patients without subjective cognitive complaints who also completed the MACFIMS, MoCA test and MSQOL-54. RESULTS 23.5% of patients without subjective cognitive complaints had evidence of objective cognitive impairment on the MACFIMS (z score < -1.5 on two or more tests). The MoCA had a sensitivity of 87% and a specificity of 68% for detecting objective cognitive impairment in this patient population using a cut-off score of 27. CONCLUSION A significant proportion of patients without self-reported cognitive impairment do have evidence of cognitive deficits on more exhaustive cognitive assessment. The MoCA is a rapid screening test that could be used to target patients for whom a more detailed neuropsychological assessment would be recommended.
Collapse
|
31
|
Gromisch ES, Kulas JF, Altalib H, Kerns RD, Mattocks KM, Brandt CA, Haskell S. Neuropsychological assessments and psychotherapeutic services in Veterans with multiple sclerosis: Rates of utilization and their associations with socio-demographics and clinical characteristics using Veterans Health Administration-based data. Mult Scler Relat Disord 2020; 43:102220. [PMID: 32480347 DOI: 10.1016/j.msard.2020.102220] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 04/08/2020] [Accepted: 05/19/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND As cognitive, emotional, and health-related behavioral issues are prevalent among persons with multiple sclerosis (MS), mental health services are a valuable component of comprehensive care. However, it is unknown how many participate in neuropsychological and psychotherapeutic services, and whether the presence of certain co-occurring conditions increase service use. This study aimed to examine the frequency and associated factors (e.g., age, gender, education, race/ethnicity, and co-occurring conditions) of neuropsychological and psychotherapeutic service utilization in the Veterans Health Administration (VHA) among Veterans with MS. METHODS Data were extracted from VHA Corporate Data Warehouse as part of the Women Veterans Cohort Study (WVCS), a longitudinal project with Veterans who served during the Iraq and Afghanistan conflicts. Participants (n = 1,686) were Veterans from the overall WVCS dataset who had three or more VHA MS-related encounters (inpatient, outpatient, and/or disease modifying therapy) within one calendar year between fiscal years 2010 and 2015. Neuropsychological assessment participation was identified by procedural codes 96118 and 96119, while psychotherapeutic services were defined using 90804, 90806, 90808, 96150, 96151, and 96152. Bivariate analyses were conducted to identify socio-demographics and clinical characteristics that differed between Veterans who did and did not use these services. Service dates were compared to the diagnosis dates of the co-occurring conditions to determine whether the majority of the diagnoses preceded the service (e.g., a recognized problem) or were coded the day of or after the initial appointment (e.g., a suspected problem), which informed what co-occurring conditions and participants were included in the subsequent logistic regressions. RESULTS Two hundred eighty-one Veterans (16.67%) participated in a neuropsychological assessment. Veterans who had an evaluation had higher rates of several co-occurring conditions (ps <0.01), though no significant relationships emerged with any of the socio-demographic variables and participation. After controlling for age, gender, education, and race/ethnicity, two previously diagnosed co-occurring conditions predicted service utilization: traumatic brain injuries (TBIs; OR: 2.33, 95% CI: 1.60, 3.35) and mood disorders (i.e., depressive and bipolar disorders; OR: 1.71, 95% CI: 1.26, 2.31). Psychotherapeutic service usage was more common, occurring in over 45% (n = 771) of the sample. Service utilization was associated with several co-occurring conditions (ps <0.001), as well as level of education (p = .003). Focusing on participants who were diagnosed the day of or after the initial encounter, five co-occurring conditions were predictors of psychotherapeutic service use: mood disorders (OR: 1.81, 95% CI: 1.34, 2.46), anxiety disorders (OR: 1.38, 95% CI: 1.03, 1.85), sleep disorders (OR: 1.55, 95% CI: 1.19, 2.01), alcohol-related disorders (OR: 3.29, 95% CI: 1.79, 6.21), and cognitive disorders (OR: 3.72, 95% CI: 2.29, 6.16). CONCLUSIONS These findings suggest that these services are being utilized by clinicians and Veterans to address the clinical complexity related to having MS and one or more of these other conditions.
Collapse
Affiliation(s)
- Elizabeth S Gromisch
- Mandell Center for Multiple Sclerosis, Mount Sinai Rehabilitation Hospital, Trinity Health Of New England, 490 Blue Hills Avenue, Hartford, CT, 06112, USA; VA Connecticut Healthcare System, 950 Campbell Avenue, West Haven, CT, 06516, USA; University of Connecticut School of Medicine, 263 Farmington Avenue, Farmington, CT, 06030, USA; Frank H. Netter School of Medicine at Quinnipiac University, 370 Bassett Road, North Haven, CT, 06473, USA.
| | - Joseph F Kulas
- VA Connecticut Healthcare System, 950 Campbell Avenue, West Haven, CT, 06516, USA; Yale University School of Medicine, 333 Cedar Street, New Haven, CT, 06510, USA
| | - Hamada Altalib
- VA Connecticut Healthcare System, 950 Campbell Avenue, West Haven, CT, 06516, USA; Yale University School of Medicine, 333 Cedar Street, New Haven, CT, 06510, USA
| | - Robert D Kerns
- VA Connecticut Healthcare System, 950 Campbell Avenue, West Haven, CT, 06516, USA; Yale University School of Medicine, 333 Cedar Street, New Haven, CT, 06510, USA; Pain Research, Informatics, Multimorbidities and Education (PRIME) Center, VA Connecticut Healthcare System, 950 Campbell Avenue, West Haven, CT, 06516, USA
| | - Kristin M Mattocks
- VA Central Western Massachusetts Healthcare System, 421 North Main Street, Leeds, MA, 01053, USA; University of Massachusetts Medical School, 55 N Lake Avenue, Worcester, MA, 01655, USA
| | - Cynthia A Brandt
- VA Connecticut Healthcare System, 950 Campbell Avenue, West Haven, CT, 06516, USA; Yale University School of Medicine, 333 Cedar Street, New Haven, CT, 06510, USA; Pain Research, Informatics, Multimorbidities and Education (PRIME) Center, VA Connecticut Healthcare System, 950 Campbell Avenue, West Haven, CT, 06516, USA
| | - Sally Haskell
- VA Connecticut Healthcare System, 950 Campbell Avenue, West Haven, CT, 06516, USA; Yale University School of Medicine, 333 Cedar Street, New Haven, CT, 06510, USA; Pain Research, Informatics, Multimorbidities and Education (PRIME) Center, VA Connecticut Healthcare System, 950 Campbell Avenue, West Haven, CT, 06516, USA
| |
Collapse
|
32
|
Oturai DB, Bach Søndergaard H, Koch-Henriksen N, Andersen C, Laursen JH, Gustavsen S, Kristensen JT, Magyari M, Sørensen PS, Sellebjerg F, Thørner LW, Ullum H, Oturai AB. Exposure to passive smoking during adolescence is associated with an increased risk of developing multiple sclerosis. Mult Scler 2020; 27:188-197. [PMID: 32202196 DOI: 10.1177/1352458520912500] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Environmental factors are associated with acquiring multiple sclerosis (MS) particularly in adolescence. OBJECTIVE To test for association between MS and exposure to passive smoking at the age of 10-19. METHODS A total of 919 patients from the Danish MS Registry and Biobank and 3419 healthy blood donors who had not smoked before the age of 19 were targeted. We analyzed separately for each sex and for those never-smokers (cohort 1) and active smokers above the age of 19 (cohort 2). All participants completed standardized questionnaires about smoking and lifestyle. We matched cases and controls in the ratio of 1:2 by propensity scores discarding unmatchable individuals and used logistic regression adjusted for all covariates and interactions. RESULTS After matching, we included 110/213 male cases/controls and 232/377 female case/controls in cohort 1. In cohort 2, the numbers were 160/320 and 417/760, respectively. Among women in cohort 1, the odds ratio (OR) for MS by passive smoking at the age of 10-19 was 1.432 (p = 0.037) but in men it was 1.232 (p = 0.39). Among men in cohort 2, OR was 1.593 (p = 0.022) but among women it was only 1.102 (p = 0.44). CONCLUSION Among never smokers, female MS cases were more often than female controls reported with passive smoking between the age of 10 and 19, and among smokers above the age of 19, male MS patients were more often than male controls reported with passive smoking.
Collapse
Affiliation(s)
- Ditte Bang Oturai
- Danish Multiple Sclerosis Center, Department of Neurology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Helle Bach Søndergaard
- Danish Multiple Sclerosis Center, Department of Neurology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Nils Koch-Henriksen
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark/The Danish Multiple Sclerosis Registry, Department of Neurology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Christina Andersen
- Danish Multiple Sclerosis Center, Department of Neurology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Julie Hejgaard Laursen
- Danish Multiple Sclerosis Center, Department of Neurology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Stefan Gustavsen
- Danish Multiple Sclerosis Center, Department of Neurology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Joachim Tilsted Kristensen
- Danish Multiple Sclerosis Center, Department of Neurology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Melinda Magyari
- The Danish Multiple Sclerosis Registry, Department of Neurology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Per Soelberg Sørensen
- Danish Multiple Sclerosis Center, Department of Neurology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Finn Sellebjerg
- Danish Multiple Sclerosis Center, Department of Neurology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Lise Wegner Thørner
- Department of Clinical Immunology, Center of Clinical Investigation, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Henrik Ullum
- Department of Clinical Immunology, Center of Clinical Investigation, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Annette Bang Oturai
- Danish Multiple Sclerosis Center, Department of Neurology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| |
Collapse
|
33
|
Gómez-Moreno SM, Cuadrado ML, Cruz-Orduña I, Martínez-Acebes EM, Gordo-Mañas R, Fernández-Pérez C, García-Ramos R. Validation of the Spanish-language version of the Montreal Cognitive Assessment as a screening test for cognitive impairment in multiple sclerosis. Neurologia 2020; 37:S0213-4853(19)30149-5. [PMID: 31983477 DOI: 10.1016/j.nrl.2019.11.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 11/04/2019] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION The neuropsychological batteries traditionally used for the assessment of cognitive impairment (CI) in patients with multiple sclerosis are complex tests requiring a long time to administer. Simpler tests are needed to detect cognitive impairment in daily clinical practice. OBJECTIVE We aimed to evaluate the diagnostic validity and reliability of the Montreal Cognitive Assessment (MoCA) test as a screening tool for CI in patients with multiple sclerosis, as compared against the Brief Neuropsychological Battery. MATERIAL AND METHODS We recruited 52 patients with multiple sclerosis (61.5% women; mean age [standard deviation]: 41.7 [11.5] years). We analysed the reliability (internal consistency, interobserver reliability, and test-retest reliability), construct validity (factor analysis, Pearson correlation coefficient, and coefficient of determination), and criterion validity (ROC curve, sensitivity, specificity, total agreement, positive and negative predictive values, positive and negative likelihood ratios, and Fagan nomogram) of the MoCA test in this population. RESULTS The prevalence of CI was 21.2% according to findings from the Brief Neuropsychological Battery, and 25% according to the MoCA test. The MoCA test showed good internal consistency (Cronbach alpha, 0.822) and interobserver and test-retest reliability (intraclass correlation coefficient 0.80 and 0.96, respectively). The correlation coefficient between total Brief Neuropsychological Battery and MoCA test scores was 0.82. The optimal cut-off point on the ROC curve was 25-26, yielding 91% sensitivity and 93% specificity. CONCLUSION The MoCA test is a valid and reliable tool for screening for CI in patients with multiple sclerosis.
Collapse
Affiliation(s)
- S M Gómez-Moreno
- Sección de Neurología, Hospital Universitario Infanta Leonor, Madrid, España.
| | - M L Cuadrado
- Servicio de Neurología, Hospital Clínico San Carlos, Madrid, España; Departamento de Medicina, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, España
| | - I Cruz-Orduña
- Sección de Neurología, Hospital Universitario Infanta Leonor, Madrid, España
| | - E M Martínez-Acebes
- Sección de Neurología, Hospital Universitario Infanta Leonor, Madrid, España
| | - R Gordo-Mañas
- Sección de Neurología, Hospital Universitario Infanta Leonor, Madrid, España; La afiliación de R. Gordo-Mañas en el momento de la publicación de este artículo es: Servicio de Neurología, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, España
| | - C Fernández-Pérez
- Servicio de Medicina Preventiva, Hospital Clínico San Carlos, Madrid, España
| | - R García-Ramos
- Servicio de Neurología, Hospital Clínico San Carlos, Madrid, España; Departamento de Medicina, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, España
| |
Collapse
|
34
|
Morales-Ortiz M, Peña-Cardenas F. DIF in the Spanish Version of the Verbal Selective Reminding Test Using Samples From Hispanics in the United States, Mexicans, and Spaniards. Front Psychol 2020; 10:2687. [PMID: 31920778 PMCID: PMC6923262 DOI: 10.3389/fpsyg.2019.02687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 11/14/2019] [Indexed: 11/13/2022] Open
Abstract
Aim Before a test can be used in the target population, it is necessary to demonstrate that there is measurement equivalence. One way to do this is by studying differential item functioning (DIF). Objective In this study, we used the Mantel-Haenszel procedure and logistic regression to analyze DIF in the Spanish version of the Verbal Selective Reminding Test between Spaniards, Mexicans, and Hispanics in the United States. Method Three balanced samples, matched by age, education, and sex, were studied: Spaniards, Mexicans, and Hispanics [616 healthy participants from Spain (n = 211), Mexico (n = 201), and the United States (n = 205)]. A six-trial version of the Spanish version of the Verbal Selective Reminding Test was administered and scored according to standard procedures. Results Statistical analysis showed some DIF between the samples of Spaniards, Mexicans, and Hispanics. A bootstrap validation of results confirmed that the item pollo showed DIF: the Mexicans and Hispanics outperformed the Spaniards, holding a total score constant. The item oído also showed DIF and was remembered in greater measure by the Spaniards. Conclusion The Spanish version of the Verbal Selective Reminding Test can be used with Hispanic populations.
Collapse
|
35
|
Associations between cognitive impairment at onset and disability accrual in young people with multiple sclerosis. Sci Rep 2019; 9:18074. [PMID: 31792347 PMCID: PMC6889418 DOI: 10.1038/s41598-019-54153-7] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2019] [Accepted: 11/10/2019] [Indexed: 12/12/2022] Open
Abstract
Differently from the adult multiple sclerosis (MS) population, the predictive value of cognitive impairment in early-onset MS is still unknown. We aim to evaluate whether cognitive performances at disease onset predict disease progression in young people with MS. This is a retrospective study on early onset (<25 years) MS patients, who had a baseline cognitive evaluation at disease onset. Demographic and longitudinal clinical data were collected up to 7 years follow up. Cognitive abilities were assessed at baseline through the Brief Repeatable Battery. Associations between cognitive abilities and clinical outcomes (occurrence of a relapse, and 1-point EDSS progression) were evaluated with stepwise logistic and Cox regression models. We included 51 patients (26 females), with a mean age at MS onset of 17.2 ± 3.9 years, and an EDSS of 2.5 (1.0–6.0). Over the follow-up, twenty-five patients had at least one relapse, and 7 patients had 1-point EDSS progression. Relapse occurrence was associated with lower 10/36 SPART scores (HR = 0.92; p = 0.002) and higher WLG scores (HR = 1.05; p = 0.01). EDSS progression was associated with lower SDMT score (OR: 0.70; p = 0.04). Worse visual memory and attention/information processing were associated with relapses and with increased motor disability after up to 7-years follow-up. Therefor, specific cognitive subdomains might better predict clinical outcomes than the overall cognitive impairment in early-onset MS.
Collapse
|
36
|
Baetge SJ, Filser M, Renner A, Ullrich S, Lassek C, Penner IK. On the validity of single tests, two-test combinations and the full Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) in detecting patients with cognitive impairment. Mult Scler 2019; 26:1919-1928. [DOI: 10.1177/1352458519887897] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: The international standard to screen for cognitive impairment in multiple sclerosis (MS) is BICAMS (Brief International Cognitive Assessment for MS). However, with an application time of approximately 20 minutes, the battery might be too time consuming from a pragmatic perspective of a routine examination. Objectives: To examine the relative sensitivity and specificity of a BICAMS short version and its validity compared to the total battery. Methods: The German BICAMS version was applied comprising the Symbol Digit Modalities Test (SDMT), the Brief Visuospatial Memory Test–Revised (BVMT-R) and the Rey Auditory Verbal Learning Test (RAVLT; German VLMT). Single tests and two-test combinations were compared regarding conformity with the total battery. Results: Examining 1320 MS patients, the two-test combination of SDMT-BVMT-R was the most sensitive (92.7%) to impairment and showed the strongest agreement with the total battery (κ = 0.95). Performing binary logistic regression analyses, this combination was also validated by its association with employment status. Conclusion: Application of the total BICAMS battery should be the goal to strive for. However, in time-restricted clinical settings, the combined application of SDMT and BVMT-R is a recommendable alternative with an application time of 10 minutes, while single tests alone are not sufficiently sensitive.
Collapse
Affiliation(s)
- Sharon Jean Baetge
- COGITO Center for Applied Neurocognition and Neuropsychological Research, Düsseldorf, Germany
| | - Melanie Filser
- COGITO Center for Applied Neurocognition and Neuropsychological Research, Düsseldorf, Germany
| | - Alina Renner
- COGITO Center for Applied Neurocognition and Neuropsychological Research, Düsseldorf, Germany
| | | | | | - Iris-Katharina Penner
- COGITO Center for Applied Neurocognition and Neuropsychological Research, Düsseldorf, Germany/Department of Neurology, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
| |
Collapse
|
37
|
Kober SE, Pinter D, Enzinger C, Damulina A, Duckstein H, Fuchs S, Neuper C, Wood G. Self-regulation of brain activity and its effect on cognitive function in patients with multiple sclerosis - First insights from an interventional study using neurofeedback. Clin Neurophysiol 2019; 130:2124-2131. [PMID: 31546180 DOI: 10.1016/j.clinph.2019.08.025] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 07/26/2019] [Accepted: 08/19/2019] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To investigate the effects of EEG-based neurofeedback training, in which one can learn to self-regulate one's own brain activity, on cognitive function in patients with multiple sclerosis (pwMS). METHODS Fourteen pwMS performed ten neurofeedback training sessions within 3-4 weeks at home using a tele-rehabilitation system. The aim of the neurofeedback training was to increase voluntarily the sensorimotor rhythm (SMR, 12-15 Hz) in the EEG over central brain areas by receiving visual real-time feedback thereof. Cognitive function was assessed before and after all neurofeedback training sessions using a comprehensive standardized neuropsychological test battery. RESULTS Half of the pwMS (N = 7) showed cognitive improvements in long-term memory and executive functions after neurofeedback training. These patients successfully learned to self-regulate their own brain activity by means of neurofeedback training. The other half of pwMS (N = 7) did neither show any cognitive changes when comparing the pre- and post-assessment nor were they able to modulate their own brain activity in the desired direction during neurofeedback training. CONCLUSIONS Data from this interventional study provide first preliminary evidence that successful self-regulation of one's own brain activity may be associated with cognitive improvements in pwMS. SIGNIFICANCE These promising results should stimulate further studies. Neurofeedback might be a promising and alternative tool for future cognitive rehabilitation.
Collapse
Affiliation(s)
- Silvia Erika Kober
- University of Graz, Institute of Psychology, Graz, Austria; BioTechMed-Graz, Graz, Austria.
| | - Daniela Pinter
- Medical University of Graz, Department of Neurology, Graz, Austria.
| | - Christian Enzinger
- Medical University of Graz, Department of Neurology, Graz, Austria; Medical University of Graz, Division of Neuroradiology, Vascular and Interventional Radiology, Department of Radiology, Graz, Austria.
| | - Anna Damulina
- Medical University of Graz, Department of Neurology, Graz, Austria.
| | | | - Siegrid Fuchs
- Medical University of Graz, Department of Neurology, Graz, Austria.
| | - Christa Neuper
- University of Graz, Institute of Psychology, Graz, Austria; BioTechMed-Graz, Graz, Austria; Graz University of Technology, Laboratory of Brain-Computer Interfaces, Institute of Neural Engineering, Graz, Austria.
| | - Guilherme Wood
- University of Graz, Institute of Psychology, Graz, Austria; BioTechMed-Graz, Graz, Austria.
| |
Collapse
|
38
|
Oreja-Guevara C, Ayuso Blanco T, Brieva Ruiz L, Hernández Pérez MÁ, Meca-Lallana V, Ramió-Torrentà L. Cognitive Dysfunctions and Assessments in Multiple Sclerosis. Front Neurol 2019; 10:581. [PMID: 31214113 PMCID: PMC6558141 DOI: 10.3389/fneur.2019.00581] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Accepted: 05/16/2019] [Indexed: 12/22/2022] Open
Abstract
Cognitive impairment has been reported at all phases and all subtypes of multiple sclerosis. It remains a major cause of neurological disability in young and middle-aged adults suffering from the disease. The severity and type of cognitive impairment varies considerably among individuals and can be observed both in early and in later stages. The areas which have commonly shown more deficits are: information processing speed, complex attention, memory, and executive function. Even though an alteration in both the white matter and in the gray matter has been found in patients with multiple sclerosis and cognitive impairment, the underlying process still remains unknown. Standardized neurological examinations fail to detect emerging cognitive deficits and self-reported cognitive complaints by the patients can be confounded by other subjective symptoms. This review is a comprehensive and short update of the literature on cognitive dysfunctions, the possible confounders and the impact of quality of life in patients with multiple sclerosis.
Collapse
Affiliation(s)
- Celia Oreja-Guevara
- Servicio de Neurología, Hospital Clínico San Carlos, IdISSC, Departamento de Medicina, Universidad Complutense, Madrid, Spain
| | | | | | - Miguel Ángel Hernández Pérez
- Servicio de Neurología, Hospital Universitario Nuestra Señora de Candelaria, Universidad de La Laguna, Santa Cruz de Tenerife, Spain
| | - Virginia Meca-Lallana
- Unidad de Esclerosis Múltiple, Servicio de Neurología, Fundación de Investigación Biomédica, Hospital Universitario de la Princesa, Madrid, Spain
| | - Lluís Ramió-Torrentà
- Unidad de Esclerosis Múltiple y Neuroinmunología de Girona, Servicio de Neurología, IDIBGI, Hospital Universitario Dr. Josep Trueta, Girona, Spain
| |
Collapse
|
39
|
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.
Collapse
|
40
|
Slavković S, Lazić M, Honan C, Nađ Č, Brkić-Jovanović N, Golubović Š. Differentiation of Cognitive Deficit Profiles in Multiple Sclerosis Patients: Latent Profile Analysis. Med Princ Pract 2019; 28:373-379. [PMID: 30831571 PMCID: PMC6639583 DOI: 10.1159/000499312] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Accepted: 03/03/2019] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE The purpose of this study was to ascertain whether the application of the Audio Recorded Cognitive Screen (ARCS) in cognitive functioning screening of persons with multiple sclerosis (MS) differentiates profiles of existing cognitive deficits (CDs) and whether this instrument can discriminate accurately between subjects who are cognitively intact (CI) and those with a cognitive disorder. SUBJECTS AND METHODS The research was conducted on a sample of 359 subjects, with two subsets of participants: 108 persons with a relapsing-remitting form of MS and 251 persons from the general population. RESULTS We labeled the three profiles obtained by applying the ARCS questionnaire: the CI profile, the profile of CI with visuospatial difficulties, and the profile of persons with CD. CONCLUSION ARCS has the ability to differentiate persons with a CD from those without, both in a sample of persons suffering from MS and in a sample of persons from the general population. This finding indicates that this instrument is well suited for profiling the cognitive status into specific categories, which puts it among the instruments with a wide range of implementation.
Collapse
Affiliation(s)
- Sanela Slavković
- Department of Special Education and Rehabilitation, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia,
| | - Milica Lazić
- Department of Psychology, Faculty of Philosophy, University of Novi Sad, Novi Sad, Serbia
| | - Cynthia Honan
- Faculty of Health, School of Medicine, University of Tasmania, Hobart, Tasmania, Australia
| | - Čongor Nađ
- Department of Neurology, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - Nina Brkić-Jovanović
- Department of Psychology, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - Špela Golubović
- Department of Special Education and Rehabilitation, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| |
Collapse
|
41
|
Dymecka J, Bidzan M. Biomedical Variables and Adaptation to Disease and Health-Related Quality of Life in Polish Patients with MS. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15122678. [PMID: 30486508 PMCID: PMC6313333 DOI: 10.3390/ijerph15122678] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/21/2018] [Revised: 11/14/2018] [Accepted: 11/24/2018] [Indexed: 02/03/2023]
Abstract
The aim of this research was to assess the level of adaptation to multiple sclerosis (Sclerosis multiplex; MS) and health-related quality of life (HRQoL) of the study population as well as to determine the relationship between biomedical factors related to the course of multiple sclerosis, adaptation to the disease, and HRQoL. Analysis of medical records, clinical and psychological interviews, the Extended Disability Status Scale (EDSS), Guy’s Neurological Disability Scale (GNDS), the Acceptance of Illness Scale (AIS), and the Multiple Sclerosis Impact Scale 29 (MSIS-29) were collected from 137 patients with MS. It was found that there was a relation between motor impairment, neurological disability, adaptation to illness, and HRQoL; it was also found that there were negative correlations between adaptation to illness and the severity of lower-limb disability, fatigue, mood disorders, other problems related to MS, and upper-limb disability. Of all the symptoms, lower-limb disability, fatigue, and mood disorders had the strongest relation with adaptation. All of the analysed symptoms were found to correlate with HRQoL. Of all the symptoms, HRQoL was most affected by lower- and upper-limb disability, fatigue, other MS problems, and mood disorders.
Collapse
Affiliation(s)
- Joanna Dymecka
- Institute of Psychology, University of Opole, 45-052 Opole, Poland.
| | - Mariola Bidzan
- Institute of Psychology, University of Gdansk, 80-309 Gdansk, Poland.
| |
Collapse
|
42
|
Aladro Y, López-Alvarez L, Sánchez-Reyes JM, Hernández-Tamames JA, Melero H, Rubio-Fernández S, Thuissard I, Cerezo-García M. Relationship between episodic memory and volume of the brain regions of two functional cortical memory systems in multiple sclerosis. J Neurol 2018; 265:2182-2189. [PMID: 29995292 DOI: 10.1007/s00415-018-8965-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 06/23/2018] [Accepted: 06/28/2018] [Indexed: 12/01/2022]
Abstract
BACKGROUND/OBJECTIVE Two functional networks are proposed as neuronal support for the complex processes of memory: the anterior temporal and the medial posterior systems. We examined the atrophy of hippocampus (HC) and of those areas constituting the two functional memory systems in multiple sclerosis (MS) patients with low disability. METHODS Episodic memory (EM) was assessed in 88 relapsing MS patients and in 40 healthy controls using Wechsler Memory Scale III (Spanish adaptation). FreeSurfer software was used to calculate normalized volume of total cortex, grey matter, white matter, subcortical grey matter (thalamus and striatum), HC and both the anterior temporal (entorhinal, ventral temporopolar, lateral orbitofrontal, amygdala) and posterior medial systems (thalamus, parahippocampal, posterior cingulate, precuneus, lateral parietal and medial prefrontal). Linear regression analysis was used to identify predictors of memory performance. RESULTS Total grey matter and cortex volumes correlated with all subtypes of EM, and the precuneus volume correlated with overall, immediate and delayed memories. Univariant regression analysis identified an association between the volumes of the posterior medial memory network regions and EM scores. The volume of the left precuneus area was the unique and independent predictor for all EM subtypes except for visual memory, for which left HC volume was also an independent predictor. CONCLUSION Left precuneus volume was the best predictor of memory in relapsing MS patients with low disability and mild deficits in EM.
Collapse
Affiliation(s)
- Yolanda Aladro
- Multiple Sclerosis Unit, Department of Neurology, Getafe University Hospital, European University of Madrid, Carretera de Toledo km 12,5, 28905, Madrid, Spain.
| | | | | | | | - Helena Melero
- Laboratorio de Análisis de Imagen Médica y Biometría (LAIMBIO), Rey Juan Carlos University, Móstoles, Madrid, Spain
| | | | - Israel Thuissard
- Department of Statistic, European University of Madrid, Madrid, Spain
| | - Marta Cerezo-García
- Multiple Sclerosis Unit, Department of Neurology, Getafe University Hospital, European University of Madrid, Carretera de Toledo km 12,5, 28905, Madrid, Spain
| |
Collapse
|
43
|
Silva BA, Leal MC, Farías MI, Avalos JC, Besada CH, Pitossi FJ, Ferrari CC. A new focal model resembling features of cortical pathology of the progressive forms of multiple sclerosis: Influence of innate immunity. Brain Behav Immun 2018; 69:515-531. [PMID: 29378262 DOI: 10.1016/j.bbi.2018.01.010] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Revised: 01/10/2018] [Accepted: 01/19/2018] [Indexed: 02/07/2023] Open
Abstract
Multiple sclerosis (MS) is an inflammatory and demyelinating disease of unknown aetiology that causes neurological disabilities in young adults. MS displays different clinical patterns, including recurrent episodes with remission periods ("relapsing-remitting MS" (RRMS)), which can progress over several years to a secondary progressive form (SPMS). However, 10% of patients display persistent progression at the onset of disease ("primary progressive MS" (PPMS)). Currently, no specific therapeutic agents are available for the progressive forms, mainly because the underlying pathogenic mechanisms are not clear and because no animal models have been specifically developed for these forms. The development of MS animal models is required to clarify the pathological mechanisms and to test novel therapeutic agents. In the present work, we overexpressed interleukin 1 beta (IL-1β) in the cortex to develop an animal model reflecting the main pathological hallmarks of MS. The treated animals presented with neuroinflammation, demyelination, glial activation, and neurodegeneration along with cognitive symptoms and MRI images consistent with MS pathology. We also demonstrated the presence of meningeal inflammation close to cortical lesions, with characteristics similar to those described in MS patients. Systemic pro-inflammatory stimulation caused a flare-up of the cortical lesions and behavioural symptoms, including impairment of working memory and the appearance of anxiety-like symptoms. Our work demonstrated induced cortical lesions, reflecting the main histopathological hallmarks and cognitive impairments characterizing the cortical pathology described in MS patients with progressive forms of the disease.
Collapse
Affiliation(s)
- Berenice Anabel Silva
- Institute of Basic Science and Experimental Medicine (ICBME), University Institute, Italian Hospital, Buenos Aires, Argentina; Leloir Institute Foundation, Institute for Biochemical Investigations of Buenos Aires, (IIBBA, CONICET), Buenos Aires, Argentina
| | - María Celeste Leal
- Leloir Institute Foundation, Institute for Biochemical Investigations of Buenos Aires, (IIBBA, CONICET), Buenos Aires, Argentina
| | - María Isabel Farías
- Leloir Institute Foundation, Institute for Biochemical Investigations of Buenos Aires, (IIBBA, CONICET), Buenos Aires, Argentina
| | | | | | - Fernando Juan Pitossi
- Leloir Institute Foundation, Institute for Biochemical Investigations of Buenos Aires, (IIBBA, CONICET), Buenos Aires, Argentina
| | - Carina Cintia Ferrari
- Institute of Basic Science and Experimental Medicine (ICBME), University Institute, Italian Hospital, Buenos Aires, Argentina; Leloir Institute Foundation, Institute for Biochemical Investigations of Buenos Aires, (IIBBA, CONICET), Buenos Aires, Argentina.
| |
Collapse
|
44
|
Beier M, Gromisch ES, Hughes AJ, Alschuler KN, Madathil R, Chiaravalloti N, Foley FW. Proposed cut scores for tests of the Brief International Cognitive Assessment of Multiple Sclerosis (BICAMS). J Neurol Sci 2017; 381:110-116. [DOI: 10.1016/j.jns.2017.08.019] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2017] [Revised: 08/11/2017] [Accepted: 08/14/2017] [Indexed: 11/16/2022]
|
45
|
Does the radiologically isolated syndrome exist? A dual-task cost pilot study. Neurol Sci 2017; 38:2007-2013. [PMID: 28831591 DOI: 10.1007/s10072-017-3094-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Accepted: 08/09/2017] [Indexed: 10/19/2022]
Abstract
Simultaneous performance of motor and cognitive tasks may compete for common brain network resources in aging or patients with some neurological diseases, suggesting the occurrence of a cognitive-motor interference. While this phenomenon has been well described for multiple sclerosis (MS) patients, it never has been tested on asymptomatic subject with magnetic resonance imaging (MRI) findings suggestive of demyelinating disease (i.e., radiologically isolated syndrome: RIS). In this pilot study, 10 RIS subjects and 10 sex/age-matched healthy controls were tested by means of static posturography under eyes opened (single-task trial) and while performing two different cognitive tasks (semantic modified word list generation for first dual-task trial and phonemic semantic modified word list generation for second dual-task trial), to estimate the dual-task cost (DTC) of standing balance. In our sample, under cognitive interference (without any substantial differences between semantic and phonemic modified word list generation), the RIS group showed significance differences in CoP (center of pressure) total sway area, ellipse eccentricity, CoP sway path length, CoP median sway velocity along the AP (anteroposterior) axis and along the ML (mediolateral) axis, reflecting a higher negative DTC respect to healthy subjects (which have simply shown a statistical trend, failing to reach a significance, in some trials). The phenomenon of cognitive-motor interference might be unmasked by a dual-task posturography in RIS subjects, too. We hypothesize that this approach could be useful to early reveal the presence of a demyelinating disease and to reach a MS diagnosis in subjects otherwise classified as RIS.
Collapse
|
46
|
Mousavi S, Zare H, Etemadifar M, Taher Neshatdoost H. Memory rehabilitation for the working memory of patients with multiple sclerosis (MS). J Clin Exp Neuropsychol 2017; 40:405-410. [DOI: 10.1080/13803395.2017.1356269] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
| | - Hossein Zare
- Department of Psychology, Payame Noor University, Tehran, Iran
| | - Masoud Etemadifar
- Department of Neurology Medical School, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hamid Taher Neshatdoost
- Department of Psychology, Faculty of Psychology and Education, University of Isfahan, Isfahan, Iran
| |
Collapse
|
47
|
Grasso M, Broccoli M, Casillo P, Catani S, Pace L, Pompa A, Rizzi F, Troisi E. Evaluation of the Impact of Cognitive Training on Quality of Life in Patients with Multiple Sclerosis. Eur Neurol 2017; 78:111-117. [DOI: 10.1159/000478726] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Accepted: 06/13/2017] [Indexed: 11/19/2022]
|
48
|
Ciol MA, Matsuda PN, Khurana SR, Cline MJ, Sosnoff JJ, Kraft GH. Effect of Cognitive Demand on Functional Mobility in Ambulatory Individuals with Multiple Sclerosis. Int J MS Care 2017; 19:217-224. [PMID: 28835746 DOI: 10.7224/1537-2073.2016-120] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND As disease progresses, cognitive demands may affect functional mobility in individuals with multiple sclerosis (MS). The Timed Up and Go (TUG) test assesses functional mobilityin populationssuch as MS. A cognitive-demanding task can be added to the TUG test to assess its effect on functional mobility. METHODS People with MS (n = 52) and controls (n = 57) performed three versions of the TUG test: TUG alone (TUG-alone), TUG plus reciting the alphabet (TUG-alpha), and TUG plus subtracting numbers by 3s (TUG-3s). Times to complete the TUG tests were compared among controls and three groups of participants with MS created using Expanded Disability Status Scale (EDSS) scores 0 to 3.5, 4.0 to 5.5, and 6. Differences among groups were analyzed using split-plot analysis of variance. RESULTS Group and TUG type were significant (P < .001 for both), with no interaction effect of group × TUG type (P = .21). Mean times were 8.7, 9.4, and 11.1 seconds to perform the TUG-alone, TUG-alpha, and TUG-3s, respectively. Mean times for groups were 8.0, 8.2, 11.1, and 11.6 seconds for controls and individuals with MS and EDSS 0 to 3.5, 4.0 to 5.5, and 6, respectively. CONCLUSIONS People with MS with an EDSS score greater than 3.5 had a statistically significant reduction in performance of the TUG test even with the addition of a simple cognitive task, which might have implications for a person's more complex everyday activities.
Collapse
|
49
|
Effect of Vitamin D Replacement on Cognition in Multiple Sclerosis Patients. Sci Rep 2017; 7:45926. [PMID: 28374837 PMCID: PMC5379671 DOI: 10.1038/srep45926] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Accepted: 03/06/2017] [Indexed: 11/08/2022] Open
Abstract
Multiple Sclerosis is associated with deficient serum 25 hydroxyvitamin D (25 (OH)D) level and cognitive impairment. The aim of this study is to evaluate cognitive performance in MS patients with deficient 25 (OH)D (<25 ng/ml) compared to patients with sufficient levels (>35 ng/ml), then to evaluate the change in cognitive performance after 3 months of vitamin D3 oral replacement. Eighty-eight MS patients with relapsing remitting and clinically isolated type of MS, older than 18 years treated with interferon beta were enrolled. Cognitive testing was performed at baseline and at 3 months using the Montreal Cognitive Assessment (MoCA), Stroop, Symbol Digit Modalities (SDMT) and Brief Visuospatial Memory Test (BVMT-R). Serum 25 (OH)D was measured at baseline and at the end of the study. Vitamin D3 replacement improved the MS patients' cognitive performance after 3 months on the MoCA and BVMT-Delayed Recall (DR). Sufficient serum 25 (OH)D level predicted better cognitive performance on the BVMT-DR at baseline (β: 1.74, p: <0.008) and 3 months (β: 1.93, p: <0.01) after adjusting for all measured confounding variables. Vitamin D3 replacement could improve cognitive performance in MS patients and make a significant difference in the patient's quality of life.
Collapse
|
50
|
Prokopova B, Hlavacova N, Vlcek M, Penesova A, Grunnerova L, Garafova A, Turcani P, Kollar B, Jezova D. Early cognitive impairment along with decreased stress-induced BDNF in male and female patients with newly diagnosed multiple sclerosis. J Neuroimmunol 2016; 302:34-40. [PMID: 27979325 DOI: 10.1016/j.jneuroim.2016.11.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 11/07/2016] [Accepted: 11/17/2016] [Indexed: 12/12/2022]
Abstract
The aim of this study was to evaluate neuroendocrine activation during stress in patients with recently diagnosed multiple sclerosis before starting the immunomodulatory therapy (EDSS score≤2.0). We verified the hypothesis that certain cognitive and affective dysfunction is present already at this early stage of the disease. The sample consisted of 38 subjects, which involved patients who were recently diagnosed multiple sclerosis and age- and sex-matched healthy volunteers. Stroop test served as mental stress model enabling measurement of cognitive performance. Present results showed increased state anxiety, depression scores and poorer performance in the Stroop test in the group of patients compared to healthy subjects. The cognitive dysfunction was particularly evident in male patients with simultaneously decreased concentrations of the brain-derived neurotrophic factor (BDNF) in plasma. The patients at this stage of the disease have not yet developed the hyperactivity of the hypothalamic-pituitary-adrenocortical axis. They showed normal levels of plasma copeptin and reduced aldosterone response to mental stress test in women only. Concentrations of plasma copeptin were higher in men compared to women. Very early stages of multiple sclerosis are accompanied by disturbances in psychological well-being, mild cognitive dysfunction and decreased plasma concentrations of BDNF, particularly in male patients.
Collapse
Affiliation(s)
- Barbora Prokopova
- Institute of Experimental Endocrinology, Biomedical Research Center, Slovak Academy of Sciences, Bratislava, Slovakia; Department of Pharmacology and Toxicology, Faculty of Pharmacy, Comenius University Bratislava, Bratislava, Slovakia
| | - Natasa Hlavacova
- Institute of Experimental Endocrinology, Biomedical Research Center, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Miroslav Vlcek
- Institute of Clinical and Translational Research, Biomedical Research Center, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Adela Penesova
- Institute of Clinical and Translational Research, Biomedical Research Center, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Lucia Grunnerova
- 1st Department of Neurology, Faculty of Medicine, Comenius University Bratislava, Bratislava, Slovakia
| | | | - Peter Turcani
- 1st Department of Neurology, Faculty of Medicine, Comenius University Bratislava, Bratislava, Slovakia
| | - Branislav Kollar
- 1st Department of Neurology, Faculty of Medicine, Comenius University Bratislava, Bratislava, Slovakia
| | - Daniela Jezova
- Institute of Experimental Endocrinology, Biomedical Research Center, Slovak Academy of Sciences, Bratislava, Slovakia.
| |
Collapse
|