1
|
Pogoda-Wesołowska A, Dziedzic A, Maciak K, Stȩpień A, Dziaduch M, Saluk J. Neurodegeneration and its potential markers in the diagnosing of secondary progressive multiple sclerosis. A review. Front Mol Neurosci 2023; 16:1210091. [PMID: 37781097 PMCID: PMC10535108 DOI: 10.3389/fnmol.2023.1210091] [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: 04/24/2023] [Accepted: 08/25/2023] [Indexed: 10/03/2023] Open
Abstract
Approximately 70% of relapsing-remitting multiple sclerosis (RRMS) patients will develop secondary progressive multiple sclerosis (SPMS) within 10-15 years. This progression is characterized by a gradual decline in neurological functionality and increasing limitations of daily activities. Growing evidence suggests that both inflammation and neurodegeneration are associated with various pathological processes throughout the development of MS; therefore, to delay disease progression, it is critical to initiate disease-modifying therapy as soon as it is diagnosed. Currently, a diagnosis of SPMS requires a retrospective assessment of physical disability exacerbation, usually over the previous 6-12 months, which results in a delay of up to 3 years. Hence, there is a need to identify reliable and objective biomarkers for predicting and defining SPMS conversion. This review presents current knowledge of such biomarkers in the context of neurodegeneration associated with MS, and SPMS conversion.
Collapse
Affiliation(s)
| | - Angela Dziedzic
- Department of General Biochemistry, Faculty of Biology and Environmental Protection, University of Lodz, Lodz, Poland
| | - Karina Maciak
- Department of General Biochemistry, Faculty of Biology and Environmental Protection, University of Lodz, Lodz, Poland
| | - Adam Stȩpień
- Clinic of Neurology, Military Institute of Medicine–National Research Institute, Warsaw, Poland
| | - Marta Dziaduch
- Medical Radiology Department of Military Institute of Medicine – National Research Institute, Warsaw, Poland
| | - Joanna Saluk
- Department of General Biochemistry, Faculty of Biology and Environmental Protection, University of Lodz, Lodz, Poland
| |
Collapse
|
2
|
Pless S, Woelfle T, Naegelin Y, Lorscheider J, Wiencierz A, Reyes Ó, Calabrese P, Kappos L. Assessment of cognitive performance in multiple sclerosis using smartphone-based training games: a feasibility study. J Neurol 2023:10.1007/s00415-023-11671-9. [PMID: 36952010 DOI: 10.1007/s00415-023-11671-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 03/14/2023] [Accepted: 03/15/2023] [Indexed: 03/24/2023]
Abstract
BACKGROUND Cognitive impairment occurs in up to 70% of people with MS (pwMS) and has a large impact on quality of life and working capacity. As part of the development of a smartphone-app (dreaMS) for monitoring MS disease activity and progression, we assessed the feasibility and acceptance of using cognitive games as assessment tools for cognitive domains. METHODS We integrated ten cognitive games in the dreaMS app. Participants were asked to play these games twice a week for 5 weeks. All subjects underwent a battery of established neuropsychological tests. User feedback on acceptance was obtained via a five-point Likert-scale questionnaire. We correlated game performance measures with predetermined reference tests (Spearman's rho) and analyzed differences between pwMS and Healthy Controls (rank biserial correlation). RESULTS We included 31 pwMS (mean age 43.4 ± 12.0 years; 68% females; median Expanded Disability Status Scale score 3.0, range 1.0-6.0) and 31 age- and sex-matched HC. All but one game showed moderate-strong correlations with their reference tests, (|rs|= 0.34-0.77). Performance improved in both groups over the 5 weeks. Average ratings for overall impression and meaningfulness were 4.6 (range 4.2-4.9) and 4.7 (range 4.5-4.8), respectively. CONCLUSION Moderate-strong correlations with reference tests suggest that adaptive cognitive games may be used as measures of cognitive domains. The practice effects observed suggest that game-derived measures may capture change over time. All games were perceived as enjoyable and meaningful, features crucial for long-term adherence. Our results encourage further validation of adaptive cognitive games as monitoring tools for cognition in larger studies of longer duration. STUDY REGISTER ClinicalTrials.gov: NCT04413032.
Collapse
Affiliation(s)
- Silvan Pless
- Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), University Hospital Basel, University of Basel, Spitalstrasse 2, 4031, Basel, Switzerland
- Neuropsychology and Behavioral Neurology Unit, Department of Psychology and Interdisciplinary Platform Psychiatry and Psychology, Division of Molecular and Cognitive Neuroscience, University of Basel, Basel, Switzerland
| | - Tim Woelfle
- Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), University Hospital Basel, University of Basel, Spitalstrasse 2, 4031, Basel, Switzerland
- Department of Neurology, University Hospital Basel, Basel, Switzerland
| | - Yvonne Naegelin
- Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), University Hospital Basel, University of Basel, Spitalstrasse 2, 4031, Basel, Switzerland
- Department of Neurology, University Hospital Basel, Basel, Switzerland
| | - Johannes Lorscheider
- Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), University Hospital Basel, University of Basel, Spitalstrasse 2, 4031, Basel, Switzerland
- Department of Neurology, University Hospital Basel, Basel, Switzerland
| | - Andrea Wiencierz
- Clinical Trial Unit, University Hospital Basel, Basel, Switzerland
| | | | - Pasquale Calabrese
- Neuropsychology and Behavioral Neurology Unit, Department of Psychology and Interdisciplinary Platform Psychiatry and Psychology, Division of Molecular and Cognitive Neuroscience, University of Basel, Basel, Switzerland
| | - Ludwig Kappos
- Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), University Hospital Basel, University of Basel, Spitalstrasse 2, 4031, Basel, Switzerland.
- Department of Neurology, University Hospital Basel, Basel, Switzerland.
| |
Collapse
|
3
|
Brown FS, Glasmacher SA, Taylor D, Jenkins R, Chandran S, Gillespie D, Foley P. Pain and cognitive performance in adults with multiple sclerosis: A systematic review. Mult Scler Relat Disord 2023; 71:104584. [PMID: 36871373 DOI: 10.1016/j.msard.2023.104584] [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: 12/18/2022] [Revised: 02/08/2023] [Accepted: 02/16/2023] [Indexed: 02/22/2023]
Abstract
INTRODUCTION Pain and cognitive dysfunction are separately known to be important manifestations of multiple sclerosis (MS). Although pain is a complex subjective phenomenon with affective and cognitive aspects, it is not known if people with MS reporting pain are at greater risk of reduced performance in objective tests of cognition. The presence or direction of any association remains to be clarified, as do the roles of confounders such as fatigue, medication and mood. METHODS We conducted a systematic review of studies examining the relationship between pain and objectively measured cognition in adults with confirmed MS, according to a pre-registered protocol (PROSPERO 42,020,171,469). We carried out searches in MEDLINE, Embase and PsychInfo. Studies of adults with any subtype of MS, with chronic pain and in which cognitive evaluation was conducted by validated instruments were included. We evaluated the role of potential confounders (medication, depression, anxiety, fatigue and sleep) and described findings by eight pre-specified cognitive domains. Risk of bias was assessed using the Newcastle-Ottawa Scale. RESULTS 11 studies (n = 3714 participants, range 16 to 1890 per study) were included in the review. Four studies included longitudinal data. Nine studies identified a relationship between pain and objectively measured cognitive performance. In seven of these studies, higher pain scores were associated with poorer cognitive performance. However, no evidence was available for some cognitive domains. Heterogeneous study methodology precluded meta-analysis. Studies infrequently controlled for the specified confounders. Most studies were judged to be at risk of bias. DISCUSSION Several studies, but not all, identified a negative relationship between pain severity and objectively measured cognitive performance. Our ability to further characterise this relationship is limited by study design and lack of evidence in many cognitive domains. Future studies should better establish this relationship and delineate the neurological substrate underpinning it.
Collapse
Affiliation(s)
| | - Stella A Glasmacher
- Anne Rowling Regenerative Neurology Clinic, University of Edinburgh, Chancellor's Building, Edinburgh, UK; Centre for Clinical Brain Sciences, University of Edinburgh, Chancellor's Building, Edinburgh, UK; Department of Neurology, RWTH Aachen University, Aachen, Germany
| | | | | | - Siddharthan Chandran
- Anne Rowling Regenerative Neurology Clinic, University of Edinburgh, Chancellor's Building, Edinburgh, UK; Centre for Clinical Brain Sciences, University of Edinburgh, Chancellor's Building, Edinburgh, UK; Euan MacDonald Centre for Motor Neurone Disease Research, University of Edinburgh, Chancellor's Building, Edinburgh, UK; UK Dementia Research Institute at University of Edinburgh, Chancellor's Building, Edinburgh, UK
| | - David Gillespie
- Department of Clinical Neurosciences, NHS Lothian, Edinburgh, UK
| | - Peter Foley
- Anne Rowling Regenerative Neurology Clinic, University of Edinburgh, Chancellor's Building, Edinburgh, UK; Centre for Clinical Brain Sciences, University of Edinburgh, Chancellor's Building, Edinburgh, UK
| |
Collapse
|
4
|
Krajnc N, Bsteh G, Berger T. Clinical and Paraclinical Biomarkers and the Hitches to Assess Conversion to Secondary Progressive Multiple Sclerosis: A Systematic Review. Front Neurol 2021; 12:666868. [PMID: 34512500 PMCID: PMC8427301 DOI: 10.3389/fneur.2021.666868] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 07/06/2021] [Indexed: 12/11/2022] Open
Abstract
Conversion to secondary progressive (SP) course is the decisive factor for long-term prognosis in relapsing multiple sclerosis (MS), generally considered the clinical equivalent of progressive MS-associated neuroaxonal degeneration. Evidence is accumulating that both inflammation and neurodegeneration are present along a continuum of pathologic processes in all phases of MS. While inflammation is the prominent feature in early stages, its quality changes and relative importance to disease course decreases while neurodegenerative processes prevail with ongoing disease. Consequently, anti-inflammatory disease-modifying therapies successfully used in relapsing MS are ineffective in SPMS, whereas specific treatment for the latter is increasingly a focus of MS research. Therefore, the prevention, but also the (anticipatory) diagnosis of SPMS, is of crucial importance. The problem is that currently SPMS diagnosis is exclusively based on retrospectively assessing the increase of overt physical disability usually over the past 6–12 months. This inevitably results in a delay of diagnosis of up to 3 years resulting in periods of uncertainty and, thus, making early therapy adaptation to prevent SPMS conversion impossible. Hence, there is an urgent need for reliable and objective biomarkers to prospectively predict and define SPMS conversion. Here, we review current evidence on clinical parameters, magnetic resonance imaging and optical coherence tomography measures, and serum and cerebrospinal fluid biomarkers in the context of MS-associated neurodegeneration and SPMS conversion. Ultimately, we discuss the necessity of multimodal approaches in order to approach objective definition and prediction of conversion to SPMS.
Collapse
Affiliation(s)
- Nik Krajnc
- Department of Neurology, Medical University of Vienna, Vienna, Austria.,Department of Neurology, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Gabriel Bsteh
- Department of Neurology, Medical University of Vienna, Vienna, Austria
| | - Thomas Berger
- Department of Neurology, Medical University of Vienna, Vienna, Austria
| |
Collapse
|
5
|
Kneebone II, Fife-Schaw C, Lam LT, das Nair R. The factor structure of the Center for Epidemiological Study - Depression Scale in people with multiple sclerosis. F1000Res 2021; 9:1038. [PMID: 33564395 PMCID: PMC7851711 DOI: 10.12688/f1000research.25129.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/04/2020] [Indexed: 11/29/2022] Open
Abstract
Background: Depression is common in multiple sclerosis (MS); however, its assessment is complicated by biological processes. In this context it is important to consider the performance of depression screening measures including that their factor structure is consistent with expectation. This study sought to identify the factor structure of the Center for Epidemiological Study - Depression Scale (CES-D) in people with MS (PwMS). Methods: Participants (N = 493) were those who had consented to take part in a large three-phase longitudinal study of depression in PwMS. CES-D questionnaires completed at phase 1 of the study were utilised. An error in the questionnaire meant it was most appropriate to consider data for 19 of the 20 CES-D questionnaire items. The data was split into two samples by a random selection process to create an exploratory, model development sample and a validation sample. The first sample was subject to confirmatory factor analysis. Following examination of model fit and specification errors, the original model was modified. The revised model was tested in the confirmation sample to assess reproducibility. Results: The analysis results supported the original four factor solution for the CES-D, that is: Depressed Affect, Positive Affect, Somatic Complaints/Activity Inhibition, and Interpersonal Difficulties. Conclusions: The CES-D appears to have a coherent structure with which to examine depression in PwMS.
Collapse
Affiliation(s)
- Ian I Kneebone
- Discipline of Clinical Psychology, Graduate School of Health, University of Technology Sydney, Ultimo, NSW, 2007, Australia
| | - Chris Fife-Schaw
- School of Psychology, University of Surrey, Guildford, Surrey, GU2 7XH, UK
| | - Lawrence T Lam
- Discipline of Clinical Psychology, Graduate School of Health, University of Technology Sydney, Ultimo, NSW, 2007, Australia.,Vice President (Academic), Tung Wah College, Hong Kong, Homantin, SAR, Hong Kong
| | - Roshan das Nair
- Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Lenton, Nottingham, Nottinghamshire, NG7 2RD, UK
| |
Collapse
|
6
|
Tao L, Wang Q, Liu D, Wang J, Zhu Z, Feng L. Eye tracking metrics to screen and assess cognitive impairment in patients with neurological disorders. Neurol Sci 2020; 41:1697-1704. [PMID: 32125540 DOI: 10.1007/s10072-020-04310-y] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2019] [Accepted: 02/20/2020] [Indexed: 12/11/2022]
Abstract
PURPOSE OF REVIEW Eye tracking is a powerful method to investigate the relationship between behavior and neural mechanisms. In recent years, eye movement analysis has been used in patients with neurological disorders to assess cognitive function. In this review, we explore the latest eye tracking researches in neurological disorders that are commonly associated with cognitive deficits, specifically, amyotrophic lateral sclerosis (ALS), Alzheimer's disease (AD), Parkinson's disease (PD), multiple sclerosis (MS), and epilepsy. We focus on the application of ocular measures in these disorders, with the goal of understanding how eye tracking technology can be used in the clinical setting. FINDINGS Eye tracking tasks (especially saccadic tasks) are often used as an adjunct to traditional scales for cognitive assessment. Eye tracking data confirmed that executive dysfunction is common in PD and ALS, whereas AD and MS are characterized by attention deficits. Research in evaluating cognitive function in epilepsy using eye tracking is still in its early stages, but this approach has shown advantages as a sensitive quantitative method with high temporal and spatial resolution. Eye tracking technology can facilitate the assessment of cognitive impairment with higher temporal resolution and finer granularity than traditional cognitive assessment. Oculomotor data collected during cognitive tasks can provide insight into biological processes. Eye tracking provides a nonverbal and less cognitively demanding method of measuring disease progression in cognitively impaired patients.
Collapse
Affiliation(s)
- Ling Tao
- XiangYa School of Medicine, Central South University, Changsha, Hunan, China
| | - Quan Wang
- Key Laboratory of Biomedical Spectroscopy of Xi' An, Key Laboratory of Spectral Imaging technology, Xi'an, Institute of Optics and Precision Mechanics (XIOPM), Chinese Academy of Sciences, Xi' An, China
| | - Ding Liu
- Department of Neurology, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Jing Wang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Ziqing Zhu
- XiangYa School of Medicine, Central South University, Changsha, Hunan, China
| | - Li Feng
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China.
| |
Collapse
|
7
|
Giedraitiene N, Kaubrys G. Distinctive Pattern of Cognitive Disorders During Multiple Sclerosis Relapse and Recovery Based on Computerized CANTAB Tests. Front Neurol 2019; 10:572. [PMID: 31214108 PMCID: PMC6558046 DOI: 10.3389/fneur.2019.00572] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Accepted: 05/15/2019] [Indexed: 01/23/2023] Open
Abstract
Background: Cognition may be affected at least as seriously as physical function during multiple sclerosis (MS) relapse, however MS relapse related cognitive disorders are still underdiagnosed and poorly characterized. The limited number of paper-pencil tests were used for assessment, and nevertheless, some significant changes were found. Unlike the paper-pencil tests, computerized batteries and tests are more sensitive and highly standardized, produce instant scoring and can minimize the learning and practice effects on follow-up. We investigated the cognition during MS relapse with the Cambridge Neuropsychological Test Automated Battery (CANTAB), which has shown sensitivity to cognitive dysfunction across different clinical groups, including patients with MS. Objective: The objective of the study was to assess the cognitive functions with CANTAB battery in MS patients during relapse, in stable MS patients, and healthy controls, and to establish the timing and pattern of cognitive recovery after relapse. Methods: Sixty relapsing, thirty stable MS patients, and thirty controls were assessed with CANTAB. The relapse group was assessed during multiple sclerosis relapse and 1 and 3 months after the first assessment. Results: The score of the difficult task of spatial planning was worse in MS relapse group than in MS stable group (p < 0.05). The scores of medium difficulty tasks of spatial planning, episodic visual recall and working memory were worse in the relapse group than in the control group (p < 0.05), while in stable MS and control groups, the scores of these tasks didn't differ. The most significant improvement of speed of response, spatial planning, episodic visual recall memory and spatial working memory, was established at 1 month after the first assessment, additional improvement of spatial planning and working memory was observed at 3 months after the first assessment. Conclusions: The results of this study indicate that cognitive function is affected during MS relapse. The difficult task of CANTAB battery, which assesses the spatial planning, showed MS relapse related cognitive dysfunction. The changes in scores of episodic visual recall and working memory may be related to MS relapse. A significant improvement in the speed of response, spatial planning, episodic visual recall and working memory was established at 1 month after MS relapse. The additional improvement in spatial planning for the most difficult task and working memory was observed at 3 months after MS relapse. It may be possible that the practice effect had the impact on the improvement of cognitive scores that was noted in relapsing MS patients.
Collapse
Affiliation(s)
- Natasa Giedraitiene
- Clinic of Neurology and Neurosurgery, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | | |
Collapse
|
8
|
Cabeça HLS, Rocha LC, Sabbá AF, Tomás AM, Bento-Torres NVO, Anthony DC, Diniz CWP. The subtleties of cognitive decline in multiple sclerosis: an exploratory study using hierarchichal cluster analysis of CANTAB results. BMC Neurol 2018; 18:140. [PMID: 30200902 PMCID: PMC6131879 DOI: 10.1186/s12883-018-1141-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Accepted: 08/24/2018] [Indexed: 12/26/2022] Open
Abstract
Background It is essential to investigate cognitive deficits in multiple sclerosis (MS) to develop evidence-based cognitive rehabilitation strategies. Here we refined cognitive decline assessment using the automated tests of the Cambridge Neuropsychological Test Automated Battery (CANTAB) and hierarchical cluster analysis. Methods We searched for groups of distinct cognitive profiles in 35 relapsing-remitting MS outpatients and 32 healthy controls. All individuals participated in an automated assessment (CANTAB) and in a pencil and paper general neuropsychological evaluation. Results Hierarchical cluster analysis of the CANTAB results revealed two distinct groups of patients based mainly on the Simple Reaction Time (RTI) and on the Mean Latency of Rapid Visual Processing (RVP). The general neuropsychological assessment did not show any statistically significant differences between the cluster groups. Compared to the healthy control group, all MS outpatients had lower scores for RTI, RVP, paired associate learning, and delayed matching to sample. We also analyzed the associations between CANTAB results and age, education, sex, pharmacological treatment, physical activity, employment status, and the Expanded Disability Status Scale (EDSS). Although limited by the small number of observations, our findings suggest a weak correlation between performance on the CANTAB and age, education, and EDSS scores. Conclusions We suggest that the use of selected large-scale automated visuospatial tests from the CANTAB in combination with multivariate statistical analyses may reveal subtle and earlier changes in information processing speed and cognition. This may expand our ability to define the limits between normal and impaired cognition in patients with Multiple Sclerosis. Electronic supplementary material The online version of this article (10.1186/s12883-018-1141-1) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
| | - Luciano Chaves Rocha
- Laboratório de Investigações em Neurodegeneração e Infecção, Hospital Universitário João de Barros Barreto, Universidade Federal do Pará, Instituto de Ciências Biológicas, Belém, PA, Brazil
| | - Amanda Ferreira Sabbá
- Laboratório de Investigações em Neurodegeneração e Infecção, Hospital Universitário João de Barros Barreto, Universidade Federal do Pará, Instituto de Ciências Biológicas, Belém, PA, Brazil
| | - Alessandra Mendonça Tomás
- Laboratório de Investigações em Neurodegeneração e Infecção, Hospital Universitário João de Barros Barreto, Universidade Federal do Pará, Instituto de Ciências Biológicas, Belém, PA, Brazil
| | - Natali Valim Oliver Bento-Torres
- Laboratório de Investigações em Neurodegeneração e Infecção, Hospital Universitário João de Barros Barreto, Universidade Federal do Pará, Instituto de Ciências Biológicas, Belém, PA, Brazil.,Faculdade de Fisioterapia e Terapia Ocupacional, Instituto de Ciências da Saúde, Universidade Federal do Pará, Belém, PA, Brazil
| | - Daniel Clive Anthony
- Laboratory of Experimental Neuropathology, Department of Pharmacology, University of Oxford, Oxford, UK
| | - Cristovam Wanderley Picanço Diniz
- Laboratório de Investigações em Neurodegeneração e Infecção, Hospital Universitário João de Barros Barreto, Universidade Federal do Pará, Instituto de Ciências Biológicas, Belém, PA, Brazil.
| |
Collapse
|
9
|
Cui C, Wang J, Mullin AP, Caggiano AO, Parry TJ, Colburn RW, Pavlopoulos E. The antibody rHIgM22 facilitates hippocampal remyelination and ameliorates memory deficits in the cuprizone mouse model of demyelination. Brain Res 2018; 1694:73-86. [DOI: 10.1016/j.brainres.2018.05.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Revised: 05/13/2018] [Accepted: 05/14/2018] [Indexed: 12/26/2022]
|
10
|
Ozakbas S, Turkoglu R, Tamam Y, Terzi M, Taskapilioglu O, Yucesan C, Baser HL, Gencer M, Akil E, Sen S, Turan OF, Sorgun MH, Yigit P, Turkes N. Prevalence of and risk factors for cognitive impairment in patients with relapsing-remitting multiple sclerosis: Multi-center, controlled trial. Mult Scler Relat Disord 2018; 22:70-76. [DOI: 10.1016/j.msard.2018.03.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 03/13/2018] [Indexed: 10/17/2022]
|
11
|
Ntoskou K, Messinis L, Nasios G, Martzoukou M, Makris G, Panagiotopoulos E, Papathanasopoulos P. Cognitive and Language Deficits in Multiple Sclerosis: Comparison of Relapsing Remitting and Secondary Progressive Subtypes. Open Neurol J 2018; 12:19-30. [PMID: 29576812 PMCID: PMC5850485 DOI: 10.2174/1874205x01812010019] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Revised: 01/24/2018] [Accepted: 02/22/2018] [Indexed: 11/22/2022] Open
Abstract
Objective: The objective of this study was to investigate the pattern and severity of cognitive and language impairment in Greek patients with Relapsing-remitting (RRMS) and Secondary Progressive Multiple Sclerosis (SPMS), relative to control participants. Method: A prospective study was conducted in 27 patients with multiple sclerosis (PwMS), (N= 15) with RRMS, (N= 12) with SPMS, and (N= 12) healthy controls. All participants were assessed with a flexible comprehensive neuropsychological – language battery of tests that have been standardized in Greece and validated in Greek MS patients. They were also assessed on measures of disability (Expanded Disability Status Scale; EDSS), fatigue (Fatigue Severity Scale; FSS) and depression (Beck Depression Inventory - fast screen; BDI-FS). Results: Our results revealed that groups were well matched on baseline demographic and clinical characteristics. The two clinical groups (RRMS; SPMS) did not differ on overall global cognitive impairment but differed in the initial encoding of verbal material, mental processing speed, response inhibition and set-shifting. RRMS patients differed from controls in the initial encoding of verbal material, learning curve, delayed recall of verbal information, processing speed, and response inhibition. SPMS patients differed in all utilized measures compared to controls. Moreover, we noted increased impairment frequency on individualized measures in the progressive SPMS group. Conclusion: We conclude that MS patients, irrespective of clinical subtype, have cognitive deficits compared to healthy participants, which become increasingly worse when they convert from RRMS to SPMS.On the contrary,the pattern of impairment remains relatively stable.
Collapse
Affiliation(s)
- Katerina Ntoskou
- Rehabilitation unit for Patients with Spinal Cord Injury, "Demetrios and Vera Sfikas", Department of Medicine, University of Patras, 26504 Patras, Greece
| | - Lambros Messinis
- Neuropsychology Section, Department of Neurology, University of Patras Medical School, 26504 Patras, Greece
| | - Grigorios Nasios
- Higher Educational Institute of Epirus, Department of Speech and Language Therapy, Ioannina, Greece
| | - Maria Martzoukou
- Higher Educational Institute of Epirus, Department of Speech and Language Therapy, Ioannina, Greece
| | - Giorgos Makris
- Higher Educational Institute of Peloponnese, Department of Speech and Language Therapy, Patras, Greece
| | - Elias Panagiotopoulos
- Rehabilitation unit for Patients with Spinal Cord Injury, "Demetrios and Vera Sfikas", Department of Medicine, University of Patras, 26504 Patras, Greece
| | | |
Collapse
|
12
|
Neuropsychological Features of Multiple Sclerosis: Impact and Rehabilitation. Behav Neurol 2018; 2018:4831647. [PMID: 29576817 PMCID: PMC5848101 DOI: 10.1155/2018/4831647] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 01/16/2018] [Indexed: 12/26/2022] Open
|
13
|
Efficacy of a Computer-Assisted Cognitive Rehabilitation Intervention in Relapsing-Remitting Multiple Sclerosis Patients: A Multicenter Randomized Controlled Trial. Behav Neurol 2017; 2017:5919841. [PMID: 29463950 PMCID: PMC5804109 DOI: 10.1155/2017/5919841] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2017] [Revised: 09/25/2017] [Accepted: 10/04/2017] [Indexed: 11/17/2022] Open
Abstract
Cognitive impairment is frequently encountered in multiple sclerosis (MS) affecting between 40-65% of individuals, irrespective of disease duration and severity of physical disability. In the present multicenter randomized controlled trial, fifty-eight clinically stable RRMS patients with mild to moderate cognitive impairment and relatively low disability status were randomized to receive either computer-assisted (RehaCom) functional cognitive training with an emphasis on episodic memory, information processing speed/attention, and executive functions for 10 weeks (IG; n = 32) or standard clinical care (CG; n = 26). Outcome measures included a flexible comprehensive neuropsychological battery of tests sensitive to MS patient deficits and feedback regarding personal benefit gained from the intervention on four verbal questions. Only the IG group showed significant improvements in verbal and visuospatial episodic memory, processing speed/attention, and executive functioning from pre - to postassessment. Moreover, the improvement obtained on attention was retained over 6 months providing evidence on the long-term benefits of this intervention. Group by time interactions revealed significant improvements in composite cognitive domain scores in the IG relative to the demographically and clinically matched CG for verbal episodic memory, processing speed, verbal fluency, and attention. Treated patients rated the intervention positively and were more confident about their cognitive abilities following treatment.
Collapse
|
14
|
Mückschel M, Beste C, Ziemssen T. Immunomodulatory treatments and cognition in MS. Acta Neurol Scand 2016; 134 Suppl 200:55-9. [PMID: 27580907 DOI: 10.1111/ane.12656] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/07/2016] [Indexed: 01/11/2023]
Abstract
Cognitive impairments occur frequently and early in multiple sclerosis (MS) and contribute significantly to a reduced quality of life of patients with MS. Executive functions (EFs) play a pivotal role for the behavioral adaption to the environment and are also crucial for compensatory processes of cognitive impairments. Disease-modifying drugs (DMDs) are effective in reducing the frequency of relapses and slow the disease progression in MS. The effects of DMDs on cognitive impairments were reviewed with a special focus on EFs. Most studies show some beneficial effects of DMDs on cognition in MS, but the evidence for effects on EFs is sparse. Additionally, most studies suffer from methodological issues, small sample sizes and learning effects. We discuss that EFs may constitute a viable cognitive endpoint for cognitive impairments in MS, which could foster the early detection of subtle cognitive changes in MS.
Collapse
Affiliation(s)
- M. Mückschel
- Department of Neurology; Faculty of Medicine; MS Centre Dresden; Centre of Clinical Neuroscience; TU Dresden; Dresden Germany
- Department of Child and Adolescent Psychiatry; Faculty of Medicine; Cognitive Neurophysiology; TU Dresden; Dresden Germany
| | - C. Beste
- Department of Child and Adolescent Psychiatry; Faculty of Medicine; Cognitive Neurophysiology; TU Dresden; Dresden Germany
- Experimental Neurobiology; National Institute of Mental Health; Klecany Czech Republic
| | - T. Ziemssen
- Department of Neurology; Faculty of Medicine; MS Centre Dresden; Centre of Clinical Neuroscience; TU Dresden; Dresden Germany
| |
Collapse
|
15
|
Majdinasab N, Siahpush A, Mousavinejad SK, Malayeri A, Sajedi SA, Bizhanzadeh P. Effect of Boswellia serrata on cognitive impairment in multiple sclerosis patients. J Herb Med 2016. [DOI: 10.1016/j.hermed.2016.05.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
16
|
Sayyah M, Bagheri P, Karimi N, Ghasemzadeh A. The Effectiveness of Group Cognitive Behavioral Therapy in Treating Obsessive-Compulsive Disorder in Women with Multiple Sclerosis (MS): A randomized double-blind controlled trial. Electron Physician 2016; 8:2243-8. [PMID: 27279999 PMCID: PMC4886565 DOI: 10.19082/2243] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2015] [Accepted: 11/26/2015] [Indexed: 11/30/2022] Open
Abstract
Background Obsessive-compulsive disorder (OCD) is one of the most prevalent psychiatric disorders and can cause problems for individuals in all aspects of life, including social and personal dimensions. Objective To study the effect of group cognitive-behavioral therapy on the reduction of OCD symptoms in female participants with multiple sclerosis (MS). Methods This double-blind randomized control trial was conducted from May 2012 to December 2014. The participants included 75 patients with MS who suffered from OCD and were referred to the Loghman Hakim and Imam Khomeini hospitals in Tehran, Iran. Thirty participants had been diagnosed through Yale-Brown Obsessive-Compulsive Symptoms (Y-BOCS). The participants were randomly divided into an experimental group (n=15) and a control group (n=15). Eleven sessions of cognitive-behavioral therapy were provided for the experimental group. Patients in the control group continued with their normal living. Hypotheses were tested using an analysis of covariance (ANCOVA). Results A significant reduction was found in the experimental group’s obsessive-compulsive symptoms after cognitive-behavioral therapy (p<0.001). In addition, mean scores for participants in the experimental group were significantly lower than for those in the control group (p=0.000). Conclusion It can be inferred that cognitive-behavioral therapy could considerably reduce OCD symptoms in women with MS. The application of this method by therapists, especially Iranian clinicians, is recommended.
Collapse
Affiliation(s)
- Mehdi Sayyah
- Psychiatrist, Associate Professor, Faculty member of Jundishapur University, Ahvaz, Iran
| | - Parisa Bagheri
- Master in Clinical Psychology, Education and Psychology Faculty, Islamic Azad University, Khomein Branch, Iran
| | - Negar Karimi
- Master in Cognitive Psychology, Institute of Cognitive Science Studies, Tehran, Iran
| | - Azizreza Ghasemzadeh
- Lecturer in Rehabilitation Science, University of Applied Sciences, Tehran Welfare Organization, Tehran, Iran
| |
Collapse
|
17
|
Cognitive impairment in relapsing remitting and secondary progressive multiple sclerosis patients: efficacy of a computerized cognitive screening battery. ISRN NEUROLOGY 2014; 2014:151379. [PMID: 25006497 PMCID: PMC3976849 DOI: 10.1155/2014/151379] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/04/2014] [Accepted: 02/02/2014] [Indexed: 11/29/2022]
Abstract
Objective. To investigate the pattern of cognitive impairment in relapsing remitting multiple sclerosis (RRMS) and secondary progressive multiple sclerosis (SPMS) patients using a computerized battery. Methods. RRMS patients (N = 50), SPMS patients (N = 30), and controls (N = 31) were assessed by Central Nervous System Vital Signs (CNS VS) computerized battery, Trail Making Tests (TMT) A and B, and semantic and phonological verbal fluency tasks. Results. The overall prevalence of cognitive dysfunction was 53.75% (RRMS 38%, SPMS 80%). RRMS patients differed from controls with large effect size on reaction time, medium effect size on TMT A and small on TMT B, phonological verbal fluency, composite memory, psychomotor speed, and cognitive flexibility. SPMS patients differed from controls in all neuropsychological measures (except complex attention) with large effect sizes on TMT A and B, phonological verbal fluency, composite memory, psychomotor speed, reaction time, and cognitive flexibility. Between patient groups, medium effect sizes were present on TMT B and psychomotor speed, while small effect sizes were present on composite memory and processing speed. Conclusion. CNS VS is sensitive in detecting cognitive impairment in RRMS and SPMS patients. Significant impairment in episodic memory, executive function, and processing speed were identified, with gradual increment of the frequency as disease progresses.
Collapse
|
18
|
Zakzanis KK, Azarbehi R. Introducing BRAINscreen: Web-Based Real-Time Examination and Interpretation of Cognitive Function. APPLIED NEUROPSYCHOLOGY-ADULT 2013; 21:77-86. [DOI: 10.1080/09084282.2012.742994] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
| | - Rostam Azarbehi
- a Department of Psychology , University of Toronto Scarborough , Toronto , Ontario , Canada
| |
Collapse
|
19
|
Brooks JBB, Borela MCM, Fragoso YD. Assessment of cognition using the Rao's Brief Repeatable Battery of Neuropsychological Tests on a group of Brazilian patients with multiple sclerosis. ARQUIVOS DE NEURO-PSIQUIATRIA 2012; 69:887-91. [PMID: 22297873 DOI: 10.1590/s0004-282x2011000700007] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2011] [Accepted: 06/20/2011] [Indexed: 11/22/2022]
Abstract
UNLABELLED To assess the cognition of patients with multiple sclerosis (MS) using the Rao's Brief Repeatable Battery of Neuropsychological Tests (BRB-N). METHOD BRB-N was translated and adapted for control subjects. Subsequently, it was applied to a group of patients with relapsing-remitting (RR) MS. RESULTS The assessment on the healthy controls (n=47) showed that the correlation between tests on the same cognitive domain was high and that there was a five-factor solution that explained 90% of the total variance. Except for the Word List Generation subset of tests, the performance of patients with RRMS (n=39) was worse than that of the healthy controls. CONCLUSION BRB-N is a relatively simple method to assess cognition of patients with MS in the daily clinic. It does not take long to apply and does not require special skills or equipment.
Collapse
|
20
|
Skokou M, Soubasi E, Gourzis P. Depression in multiple sclerosis: a review of assessment and treatment approaches in adult and pediatric populations. ISRN NEUROLOGY 2012; 2012:427102. [PMID: 23097716 PMCID: PMC3477767 DOI: 10.5402/2012/427102] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/26/2012] [Accepted: 09/17/2012] [Indexed: 12/18/2022]
Abstract
Multiple sclerosis is a chronic demyelinating disease affecting one million people worldwide, with a significant burden of psychiatric comorbidity. Depression is the commonest psychiatric manifestation but still remains largely underdiagnosed and undertreated. The present work reviews current knowledge on diagnosis, assessment, and somatic and psychotherapeutic treatment interventions for depression in adult and pediatric populations of patients with multiple sclerosis.
Collapse
Affiliation(s)
- Maria Skokou
- Department of Psychiatry, School of Medicine and University Hospital of Patras, University of Patras, Rio, 26504 Patras, Greece
| | | | | |
Collapse
|
21
|
Guimarães J, Sá MJ. Cognitive dysfunction in multiple sclerosis. Front Neurol 2012; 3:74. [PMID: 22654782 PMCID: PMC3359427 DOI: 10.3389/fneur.2012.00074] [Citation(s) in RCA: 79] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2012] [Accepted: 04/14/2012] [Indexed: 01/21/2023] Open
Abstract
In Multiple Sclerosis (MS) prevalence studies of community and clinical samples, indicate that 45-60% of patients are cognitively impaired. These cognitive dysfunctions have been traditionally described as heterogeneous, but more recent studies suggest that there is a specific pattern of MS-related cognitive dysfunctions. With the advent of disease-modifying medications for MS and emphasis on early intervention and treatment, detection of cognitive impairment at its earliest stage becomes particularly important. In this review the authors address: the cognitive domains most commonly impaired in MS (memory, attention, executive functions, speed of information processing, and visual-spatial abilities); the pathophysiological mechanism implied in MS cognitive dysfunction and correlated brain MRI features; the importance of neuropsychological assessment of MS patients in different stages of the disease and the influence of its course on cognitive performance; the most used tests and batteries for neuropsychological assessment; therapeutic strategies to improve cognitive abilities.
Collapse
Affiliation(s)
- Joana Guimarães
- MS Clinic, Department of Neurology, Centro Hospitalar São JoãoPorto, Portugal
- Faculty of Medicine, University of PortoPorto, Portugal
| | - Maria José Sá
- MS Clinic, Department of Neurology, Centro Hospitalar São JoãoPorto, Portugal
- Faculty of Health Sciences, University Fernando PessoaPorto, Portugal
| |
Collapse
|
22
|
Stuifbergen A, Becker H, Morgan S, Morrison J, Perez F. Home-Based Computer-Assisted Cognitive Training: Feasibility and Perceptions of People with Multiple Sclerosis. Int J MS Care 2011; 13:189-198. [PMID: 22740777 DOI: 10.7224/1537-2073-13.4.189] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Initial evidence suggests that computer-assisted cognitive rehabilitation may improve cognitive performance among people with multiple sclerosis (MS). Most studies of computer-assisted cognitive training have incorporated an individualized in-office/clinic approach for training. The purpose of this study was to explore the feasibility of home-based computer-assisted training and systematically examine the perceptions of people with MS regarding home use of the program. Qualitative data (written and verbal) obtained as part of a larger randomized clinical trial of a cognitive rehabilitation intervention were analyzed. The computer training component of the intervention included prescribed tracks and exercises on the Internet-based Neuropsychonline program. The majority of the participants used the program the recommended number of times per week and for the minimum number of minutes over the 8-week intervention. Although participants had notable negative perceptions and complaints about the program during the training experience, most of them acknowledged during training that use of the program helped them recognize cognitive limitations, create and practice strategies to increase cognitive function, and improve the quality of their daily life. Data from focus groups 3 months after the training included similar criticisms regarding lack of feedback and difficulties with the program as well as acknowledgment of the positive effects and a desire for continued access to the program. The findings suggest that while home training is feasible, careful preparation for use of the program is required.
Collapse
Affiliation(s)
- Alexa Stuifbergen
- University of Texas at Austin School of Nursing, Austin, TX, USA (AS, HB, SM, JM); and Baylor College of Medicine, Houston, TX, USA (FP)
| | | | | | | | | |
Collapse
|