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Song Y, Jiang W, Afridi SK, Wang T, Zhu F, Xu H, Nazir FH, Liu C, Wang Y, Long Y, Huang YWA, Qiu W, Tang C. Astrocyte-derived CHI3L1 signaling impairs neurogenesis and cognition in the demyelinated hippocampus. Cell Rep 2024; 43:114226. [PMID: 38733586 DOI: 10.1016/j.celrep.2024.114226] [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: 12/14/2023] [Revised: 03/15/2024] [Accepted: 04/26/2024] [Indexed: 05/13/2024] Open
Abstract
Cognitive dysfunction is a feature in multiple sclerosis (MS), a chronic inflammatory demyelinating disorder. A notable aspect of MS brains is hippocampal demyelination, which is closely associated with cognitive decline. However, the mechanisms underlying this phenomenon remain unclear. Chitinase-3-like (CHI3L1), secreted by activated astrocytes, has been identified as a biomarker for MS progression. Our study investigates CHI3L1's function within the demyelinating hippocampus and demonstrates a correlation between CHI3L1 expression and cognitive impairment in patients with MS. Activated astrocytes release CHI3L1 in reaction to induced demyelination, which adversely affects the proliferation and differentiation of neural stem cells and impairs dendritic growth, complexity, and spine formation in neurons. Our findings indicate that the astrocytic deletion of CHI3L1 can mitigate neurogenic deficits and cognitive dysfunction. We showed that CHI3L1 interacts with CRTH2/receptor for advanced glycation end (RAGE) by attenuating β-catenin signaling. The reactivation of β-catenin signaling can revitalize neurogenesis, which holds promise for therapy of inflammatory demyelination.
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Affiliation(s)
- Yanna Song
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-Sen University; 600 Tianhe Road, Guangzhou 510630, Guangdong Province, China
| | - Wei Jiang
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-Sen University; 600 Tianhe Road, Guangzhou 510630, Guangdong Province, China
| | - Shabbir Khan Afridi
- State Key Laboratory for Molecular and Developmental Biology, Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, Beijing 100101, China
| | - Tongtong Wang
- Department of Clinical Immunology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China
| | - Fan Zhu
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-Sen University; 600 Tianhe Road, Guangzhou 510630, Guangdong Province, China
| | - Huiming Xu
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-Sen University; 600 Tianhe Road, Guangzhou 510630, Guangdong Province, China
| | - Faisal Hayat Nazir
- Nash Family Department of Neuroscience, Ronald M. Loeb Center for Alzheimer's Disease, and Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Chunxin Liu
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-Sen University; 600 Tianhe Road, Guangzhou 510630, Guangdong Province, China
| | - Yuge Wang
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-Sen University; 600 Tianhe Road, Guangzhou 510630, Guangdong Province, China
| | - Youming Long
- Department of Neurology, The Second Affiliated Hospital of Guangzhou Medical University, 250 Changgang East Road, Guangzhou 510260, Guangdong Province, China; Institute of Neuroscience and the Second Affiliated Hospital of Guangzhou Medical University, Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Collaborative Innovation Center for Neurogenetics and Channelopathies, 250 Changgang East Road, Guangzhou 510260, Guangdong Province, China
| | - Yu-Wen Alvin Huang
- Department of Molecular Biology, Cell Biology, and Biochemistry, Brown University, 70 Ship Street, Providence, RI 02903, USA
| | - Wei Qiu
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-Sen University; 600 Tianhe Road, Guangzhou 510630, Guangdong Province, China.
| | - Changyong Tang
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-Sen University; 600 Tianhe Road, Guangzhou 510630, Guangdong Province, China; Guangdong Provincial Key Laboratory of Diabetology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong 510630, China.
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Wang J, Huang J, Sun Z, Dong H, Li K, Lu J. Structural changes in spinal cord following optic neuritis: Insights from quantitative spinal MRI. Brain Res 2024; 1831:148830. [PMID: 38408557 DOI: 10.1016/j.brainres.2024.148830] [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: 12/04/2023] [Revised: 02/16/2024] [Accepted: 02/23/2024] [Indexed: 02/28/2024]
Abstract
OBJECTIVES Previous studies have demonstrated that optic neuritis (ON) affects brain plasticity. However, whether ON affects the spinal cord remains unclear. We aimed to investigate the spinal cord changes in ON and their associations with disability. METHODS A total of 101 ON patients, and 41 healthy controls (HC) were retrospectively recruited. High-resolution imaging was conducted using a Magnetization Prepared Rapid Acquisition Gradient-Echo (MP-RAGE) sequence for T1-weighted images and an echo planar imaging (EPI) sequence for Diffusion Tensor Imaging (DTI) data collection. Additionally, patients' disability and cognitive impairment were evaluated using the Expanded Disability Status Scale (EDSS) and the Paced Auditory Serial Addition Test (PASAT), respectively. The quantitative spinal MRI was employed to examine the cross-sectional area (CSA) and diffusion indicators, with a specific focus on calculating the average values across the C2-C7 cervical spinal cord segments. CSA, fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) were compared between groups. Correlation analyses were performed between CSA, diffusion indicators, and clinical variables. RESULTS No significant differences were found in CSA between ON patients and HCs. MD (p = 0.007) and RD (p = 0.018) were increased in ON patients compared with HCs, and AD was decreased in ON (p = 0.013). The AD values of the ON patients were significantly positively correlated with PASAT scores (r = 0.37, p < 0.001). CONCLUSIONS This study provided imaging evidence for DTI abnormalities in patients with ON. Spinal cord DTI can improve our knowledge of the path physiology of ON, and clinical progression.
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Affiliation(s)
- Jiyuan Wang
- Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China; Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Capital Medical University, Beijing, China
| | - Jing Huang
- Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China; Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Capital Medical University, Beijing, China
| | - Zheng Sun
- Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China; Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Capital Medical University, Beijing, China
| | - Huiqing Dong
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Kuncheng Li
- Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China; Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Capital Medical University, Beijing, China
| | - Jie Lu
- Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China; Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Capital Medical University, Beijing, China.
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Taylor LA, Mhizha-Murira JR, Law G, Evangelou N, das Nair R. Understanding who benefits most from cognitive rehabilitation for multiple sclerosis: A secondary data analysis. Mult Scler 2023; 29:1482-1492. [PMID: 37528618 PMCID: PMC10580675 DOI: 10.1177/13524585231189470] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 07/03/2023] [Accepted: 07/06/2023] [Indexed: 08/03/2023]
Abstract
BACKGROUND Up to 70% of people with multiple sclerosis (MS) experience cognitive difficulties. Cognitive rehabilitation is a type of therapy that helps manage cognitive problems. OBJECTIVE The Cognitive Rehabilitation for Attention and Memory in MS (CRAMMS) trial showed some evidence of effectiveness of cognitive rehabilitation in improving cognitive function, with some participants benefitting more than others. We therefore conducted a secondary analysis of the CRAMMS data to understand who benefits most. METHODS We grouped baseline data into four categories of possible predictors. We used regression models to identify specific factors/characteristics that could predict the likelihood that an individual will benefit from cognitive rehabilitation. RESULTS The models predicted whether a participant improved or did not improve in neuropsychological function following cognitive rehabilitation in up to 86% of participants. Results suggest that younger participants with medium to high education, diagnosed with relapsing-remitting multiple sclerosis (RRMS) and primary-progressive multiple sclerosis (PPMS) who have not experienced any recent relapses, with mild to moderate cognitive difficulties were most likely to benefit from cognitive rehabilitation. CONCLUSION We can predict which participants are most likely to demonstrate significant improvements in neuropsychological function following group-based cognitive rehabilitation. Clinically, this allows us to optimise limited neuropsychology resources by offering such cognitive rehabilitation to those most likely to benefit.
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Affiliation(s)
- LA Taylor
- LA Taylor Mental Health and Clinical Neurosciences Unit, School of Medicine, Institute of Mental Health, University of Nottingham, B Floor, Jubilee Campus, Nottingham NG7 2TU, UK.
| | - JR Mhizha-Murira
- Mental Health and Clinical Neurosciences Unit, School of Medicine, Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - G Law
- College of Social Science, University of Lincoln, Lincoln, UK
| | - N Evangelou
- Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK
| | - R das Nair
- Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK; SINTEF Digital, Trondheim, Norway
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Miri Ashtiani SN, Daliri MR. Identification of cognitive load-dependent activation patterns using working memory task-based fMRI at various levels of difficulty. Sci Rep 2023; 13:16476. [PMID: 37777667 PMCID: PMC10543376 DOI: 10.1038/s41598-023-43837-w] [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] [Received: 12/12/2022] [Accepted: 09/28/2023] [Indexed: 10/02/2023] Open
Abstract
Working memory, which is regarded as the foundation of cognitive processes, is a system that stores, processes, and manipulates information in short intervals of time that are actually needed for daily functioning. This study aimed to assess the brain activity of healthy controls (HC) while performing the N-back task, which is one of the most popularly used tests for evaluating working memory along with functional magnetic resonance imaging (fMRI). In this regard, we collected fMRI data from right-handed individuals in a 3.0 T scanner during the Persian version of the visual variant N-back task performance with three levels of complexity varied throughout the experiment (1, 2, and 3-back conditions) to increase the cognitive demands. The statistical parametric mapping (SPM12) software was used to analyze fMRI data for the identification of cognitive load-dependent activation patterns based on contrast images obtained from different levels of task difficulty. Our findings showed that as cognitive complexity increased, the number of significant activation clusters and cluster extent increased in several areas distributed in the cerebellum, frontoparietal lobes, insula, SMA, and lenticular nucleus, the majority of which are recognized for their role in working memory. Furthermore, deactivation patterns during 1-, 2-, and 3-back vs. 0-back contrasts revealed significant clusters in brain regions that are mostly described as being part of the default mode network (DMN). Based on previous research, our results supported the recognized involvement of the mentioned cortical and subcortical areas in various types or levels of N-back tasks. This study found that altering activation patterns by increasing task difficulty could aid in evaluating the various stages of cognitive dysfunction in many brain diseases such as multiple sclerosis (MS) and Alzheimer's disease by comparing controls in future studies to apply early appropriate treatment strategies.
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Affiliation(s)
- Seyedeh Naghmeh Miri Ashtiani
- Biomedical Engineering Department, School of Electrical Engineering, Iran University of Science and Technology (IUST), Tehran, Iran
| | - Mohammad Reza Daliri
- Biomedical Engineering Department, School of Electrical Engineering, Iran University of Science and Technology (IUST), Tehran, Iran.
- School of Cognitive Sciences (SCS), Institute for Research in Fundamental Sciences (IPM), Tehran, Iran.
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Elmers J, Colzato LS, Akgün K, Ziemssen T, Beste C. Neurofilaments - Small proteins of physiological significance and predictive power for future neurodegeneration and cognitive decline across the life span. Ageing Res Rev 2023; 90:102037. [PMID: 37619618 DOI: 10.1016/j.arr.2023.102037] [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] [Received: 02/27/2023] [Revised: 05/15/2023] [Accepted: 08/17/2023] [Indexed: 08/26/2023]
Abstract
Neurofilaments (NFs) are not only important for axonal integrity and nerve conduction in large myelinated axons but they are also thought to be crucial for receptor and synaptic functioning. Therefore, NFs may play a critical role in cognitive functions, as cognitive processes are known to depend on synaptic integrity and are modulated by dopaminergic signaling. Here, we present a theory-driven interdisciplinary approach that NFs may link inflammation, neurodegeneration, and cognitive functions. We base our hypothesis on a wealth of evidence suggesting a causal link between inflammation and neurodegeneration and between these two and cognitive decline (see Fig. 1), also taking dopaminergic signaling into account. We conclude that NFs may not only serve as biomarkers for inflammatory, neurodegenerative, and cognitive processes but also represent a potential mechanical hinge between them, moreover, they may even have predictive power regarding future cognitive decline. In addition, we advocate the use of both NFs and MRI parameters, as their synthesis offers the opportunity to individualize medical treatment by providing a comprehensive view of underlying disease activity in neurological diseases. Since our society will become significantly older in the upcoming years and decades, maintaining cognitive functions and healthy aging will play an important role. Thanks to technological advances in recent decades, NFs could serve as a rapid, noninvasive, and relatively inexpensive early warning system to identify individuals at increased risk for cognitive decline and could facilitate the management of cognitive dysfunctions across the lifespan.
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Affiliation(s)
- Julia Elmers
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Germany; Center of Clinical Neuroscience, Department of Neurology, University Hospital Carl Gustav Carus, TU Dresden, Germany
| | - Lorenza S Colzato
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Germany; Cognitive Psychology, Faculty of Psychology, Shandong Normal University, Jinan, China.
| | - Katja Akgün
- Center of Clinical Neuroscience, Department of Neurology, University Hospital Carl Gustav Carus, TU Dresden, Germany
| | - Tjalf Ziemssen
- Center of Clinical Neuroscience, Department of Neurology, University Hospital Carl Gustav Carus, TU Dresden, Germany
| | - Christian Beste
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Germany; Cognitive Psychology, Faculty of Psychology, Shandong Normal University, Jinan, China.
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Özden F, Özkeskin M, Tümtürk İ, Yüceyar N. Comparison of physical performance, gait, balance, falls efficacy, and step reaction time in individuals with multiple sclerosis. Clin Neurol Neurosurg 2023; 232:107872. [PMID: 37451088 DOI: 10.1016/j.clineuro.2023.107872] [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: 08/11/2022] [Revised: 06/28/2023] [Accepted: 07/02/2023] [Indexed: 07/18/2023]
Abstract
OBJECTIVE The study aimed to investigate the physical performance, gait, balance, falls efficacy, and step reaction time in individuals with MS. METHODS A total of 60 individuals (30 individuals with MS and 30 age and sex-matched healthy controls) were enrolled. Individuals' physical performance was evaluated with the Timed Up and Go Test (TUG) and Five-Times-Sit-to-Stand Test (FTSTS). Activities-specific Balance Confidence (ABC) Scale, 12-item Multiple Sclerosis Walking Scale (MSWS-12v2) and Falls Efficacy Scale International (FES-I) were used to assess the balance, gait and fall efficacy of the participants. Individuals' step reaction time (SRT) was calculated with video-based software. The time between the step command and the first contact of the foot with the ground in the first step was recorded. RESULTS The mean age of the individuals with MS and the control group was 38.5 ± 9.4 years and 33.9 ± 11.7 years, respectively. Significant differences existed between the groups in SRT, FES-I, ABC, and FTSTS (p < 0.05). There was no significant correlation between SRT with any other parameter (p > 0.05). TUG was moderately correlated with MSWS-12 and FES-I (r1 =0.426, r2 =0.495, p < 0.05). Besides, there was a moderate correlation between ABC with TUG and FTSTS (r1 =-0.605, r2 =-0.468, p < 0.05). A high degree correlation was found between MSWS-12 with FES-I and ABC (r1 =0.843, r2 =-0.834, p < 0.05). CONCLUSION Individuals with MS have decreased SRTs. However, this condition was not found to be related to physical performance. Further studies should focus on the association of SRT with cognitive and psychosocial parameters.
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Affiliation(s)
- Fatih Özden
- Muğla Sıtkı Koçman University, Köyceğiz Vocational School of Health Services, Department of Health Care Services, Muğla, Turkey
| | - Mehmet Özkeskin
- Ege University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, İzmir, Turkey.
| | - İsmet Tümtürk
- Süleyman Demirel University, Institute of Health Sciences, Department of Physiotherapy and Rehabilitation, Isparta, Turkey
| | - Nur Yüceyar
- Ege University, Faculty of Medicine, Department of Neurology, İzmir, Turkey
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Piacentini C, Argento O, Nocentini U. Cognitive impairment in multiple sclerosis: "classic" knowledge and recent acquisitions. ARQUIVOS DE NEURO-PSIQUIATRIA 2023; 81:585-596. [PMID: 37379870 PMCID: PMC10658666 DOI: 10.1055/s-0043-1763485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 10/11/2022] [Indexed: 06/30/2023]
Abstract
Multiple sclerosis (MS) is a central nervous system (CNS) disease characterized by inflammation, axonal demyelination, and neurodegeneration, which can have a strong impact on all aspects of the life of the patient. Multiple sclerosis causes motor, sensory, cerebellar, and autonomic dysfunctions, as well as cognitive and psychoemotional impairment. The most frequently compromised cognitive domains are complex attention/information processing, memory, executive and visuospatial functions. Recently, alterations have also been evidenced in complex cognitive functions, such as social cognition, moral judgment, and decision-making. Cognitive impairment is characterized by high variability and can affect work skills, social interactions, coping strategies and more generally the quality of life of patients and their families. With the use of sensitive and easy-to-administer test batteries, an increasingly accurate and early diagnosis is feasible: this allows to determine the effectiveness of possible preventive measures, to predict the future progression of the disease and to improve the quality of life of patients. There is currently limited evidence regarding the efficacy, on cognitive impairment, of disease-modifying therapies. The most promising approach, which has received strong empirical support, is cognitive rehabilitation.
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Affiliation(s)
- Chiara Piacentini
- Institute of Hospitalization and Care of a Scientific Character “Santa Lucia”
Foundation, Behavioral Neuropsychology, Rome, Italy.
| | - Ornella Argento
- Institute of Hospitalization and Care of a Scientific Character “Santa Lucia”
Foundation, Behavioral Neuropsychology, Rome, Italy.
| | - Ugo Nocentini
- Institute of Hospitalization and Care of a Scientific Character “Santa Lucia”
Foundation, Behavioral Neuropsychology, Rome, Italy.
- University of Rome “Tor Vergata”, Department of Clinical Sciences and
Translational Medicine, Rome, Italy.
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Ayromlou H, Hosseini S, Khalili M, Ayromlou S, Khamudchiyan S, Farajdokht F, Hassannezhad S, Amiri Moghadam S. Insulin resistance is associated with cognitive dysfunction in multiple sclerosis patients: A cross-sectional study. J Neuroendocrinol 2023; 35:e13288. [PMID: 37317829 DOI: 10.1111/jne.13288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 04/17/2023] [Accepted: 05/03/2023] [Indexed: 06/16/2023]
Abstract
Multiple sclerosis (MS) is a progressive inflammatory neurodegenerative disease of the nervous system accompanied by demyelination. MS-associated cognitive impairments mainly involve recent memory, information processing speed, stable memory, and executive function. Moreover, MS is associated with impaired glucose and insulin metabolism, which can exacerbate cognitive decline. The present study aimed to compare the cognitive status of MS patients with and without insulin resistance. In this cross-sectional study, 74 relapsing-remitting multiple sclerosis diagnosed patients were enrolled. Indicators of insulin resistance, including fasting blood glucose, insulin level, and homeostatic model assessment of insulin resistance (HOMA-IR) index, were measured. They were then divided into two groups based on the results of the HOMA-IR index. Cognition status was evaluated by the minimal assessment of cognitive function in multiple sclerosis battery. The prevalence of insulin resistance was 37.8%, and the prevalence of cognitive decline was estimated to be 67.56%. Mean scores of the California verbal learning test (CVLT), CVLT delayed free recall, controlled oral word association test, and judgment of line orientation tests were significantly lower in MS patients with insulin resistance than without. In addition, a negative correlation was demonstrated between the results of the CVLT, CVLT delayed free recall, controlled oral word association test, judgment of line orientation tests, brief visuospatial memory test, and Delis-Kaplan executive function system sorting tests and fasting insulin levels. Greater verbal memory and spatial comprehension impairments were observed in MS patients with insulin resistance.
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Affiliation(s)
- Hormoz Ayromlou
- Neurosciences Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Samaneh Hosseini
- Neurosciences Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Khalili
- School of Medicine, Islamic Azad Tabriz University of Medical Sciences, Tabriz, Iran
| | - Samin Ayromlou
- Neurosciences Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Fereshteh Farajdokht
- Neurosciences Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sina Hassannezhad
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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Kabiri S, Jameie M, Balali P, Adib Moradi S, Sanjari Moghaddam H, Aghamollaii V, Harirchian MH. Trail Making Test Could Predict Impairment in Cognitive Domains in Patients with Multiple Sclerosis: A Study of Diagnostic Accuracy. ARCHIVES OF CLINICAL NEUROPSYCHOLOGY : THE OFFICIAL JOURNAL OF THE NATIONAL ACADEMY OF NEUROPSYCHOLOGISTS 2023; 38:37-48. [PMID: 35901460 DOI: 10.1093/arclin/acac059] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/05/2022] [Indexed: 01/25/2023]
Abstract
OBJECTIVE Cognitive impairment (CI) and executive dysfunction (ED) are prevalent in patients with multiple sclerosis (PwMS). The Minimal Assessment of Cognitive Function in Multiple Sclerosis (MACFIMS) is the gold standard neuropsychological battery (NPB) for detecting CI. Delis-Kaplan Executive Function System (DKEFS) NPB evaluates ED. We aimed to find practical test(s) from DKEFS with acceptable diagnostic utility for early detection of impairment in cognitive and executive domains. METHODS Cognitive and executive tasks, physical disability, and depression scores of 30 PwMS were assessed (17 women, age: 38.1). Symbol Digit Modalities Test (SDMT), Paced Auditory Serial Addition Test (PASAT), and Controlled Oral Word Association Test (COWAT) from MACFIMS and Trail Making Test (TMT), Design Fluency Test (DFT), and Verbal Fluency Test (VFT) from DKEFS were selected. The association between patients' characteristics and performance in tests, and diagnostic accuracy of DKEFS tests in detecting impairment in cognitive tasks were evaluated, using Pearson correlation and receiver operator characteristic curve analyses, respectively. RESULTS A significant correlation was found between disease duration and SDMT and TMT subtests. Expanded Disability Status Scale was significantly related to SDMT, VFT-switching, and TMT subtests. Beck Depression Inventory was significantly related to DFT. TMT-switching detected abnormalities in SDMT and PASAT with 100% sensitivity, 93.3% (for SDMT), and 85.7% specificity (for PASAT). TMT-letter showed 100% sensitivity and 90% specificity in identifying abnormalities in COWAT. CONCLUSIONS TMT, particularly the switching condition, is a practical paper-based test that could predict impairment in cognitive tasks. Clinicians may use TMT as a screening tool among PwMS.
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Affiliation(s)
- Samaneh Kabiri
- Neurology Department, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Melika Jameie
- Iranian Center of Neurological Research, Neuroscience Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Pargol Balali
- Iranian Center of Neurological Research, Neuroscience Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Sahand Adib Moradi
- Iranian Center of Neurological Research, Neuroscience Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Sanjari Moghaddam
- Department of Neurology, Roozbeh Psychiatric Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Vajiheh Aghamollaii
- Department of Neurology, Roozbeh Psychiatric Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Hossein Harirchian
- Iranian Center of Neurological Research, Neuroscience Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
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Chen MH, Cherian C, Elenjickal K, Rafizadeh CM, Ross MK, Leow A, DeLuca J. Real-time associations among MS symptoms and cognitive dysfunction using ecological momentary assessment. Front Med (Lausanne) 2023; 9:1049686. [PMID: 36714150 PMCID: PMC9877417 DOI: 10.3389/fmed.2022.1049686] [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: 09/20/2022] [Accepted: 12/28/2022] [Indexed: 01/13/2023] Open
Abstract
Introduction Multiple sclerosis (MS) is characterized by a wide range of disabling symptoms, including cognitive dysfunction, fatigue, depression, anxiety, pain, and sleep difficulties. The current study aimed to examine real-time associations between non-cognitive and cognitive symptoms (latter measured both objectively and subjectively in real-time) using smartphone-administered ecological momentary assessment (EMA). Methods Forty-five persons with MS completed EMA four times per day for 3 weeks. For each EMA, participants completed mobile versions of the Trail-Making Test part B (mTMT-B) and a finger tapping task, as well as surveys about symptom severity. Multilevel models were conducted to account for within-person and within-day clustering. Results A total of 3,174 EMA sessions were collected; compliance rate was 84%. There was significant intra-day variability in mTMT-B performance (p < 0.001) and levels of self-reported fatigue (p < 0.001). When participants reported depressive symptoms that were worse than their usual levels, they also performed worse on the mTMT-B (p < 0.001), independent of upper extremity motor functioning. Other self-reported non-cognitive symptoms were not associated with real-time performance on the mTMT-B [p > 0.009 (Bonferroni-corrected)]. In contrast, when self-reported fatigue (p < 0.001), depression (p < 0.001), anxiety (p < 0.001), and pain (p < 0.001) were worse than the individual's typical levels, they also reported more severe cognitive dysfunction at the same time. Further, there was a statistical trend that self-reported cognitive dysfunction (not mTMT-B performance) predicted one's self-reported sense of accomplishment in real-time. Discussion The current study was the first to identify divergent factors that influence subjectively and objectively measured cognitive functioning in real time among persons with MS. Notably, it is when symptom severity was worse than the individual's usual levels (and not absolute levels) that led to cognitive fluctuations, which supports the use of EMA in MS symptom monitoring.
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Affiliation(s)
- Michelle H. Chen
- Institute for Health, Health Care Policy and Aging Research, Rutgers University, New Brunswick, NJ, United States,Department of Neurology, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ, United States,*Correspondence: Michelle H. Chen,
| | - Christine Cherian
- Institute for Health, Health Care Policy and Aging Research, Rutgers University, New Brunswick, NJ, United States
| | - Karen Elenjickal
- Institute for Health, Health Care Policy and Aging Research, Rutgers University, New Brunswick, NJ, United States
| | - Caroline M. Rafizadeh
- Kessler Foundation, East Hanover, NJ, United States,Department of Physical Medicine and Rehabilitation, New Jersey Medical School, Rutgers University, Newark, NJ, United States
| | - Mindy K. Ross
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, United States
| | - Alex Leow
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, United States
| | - John DeLuca
- Kessler Foundation, East Hanover, NJ, United States,Department of Physical Medicine and Rehabilitation, New Jersey Medical School, Rutgers University, Newark, NJ, United States
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Cuerda-Ballester M, Martínez-Rubio D, García-Pardo MP, Proaño B, Cubero L, Calvo-Capilla A, Sancho-Cantus D, de la Rubia Ortí JE. Relationship of Motor Impairment with Cognitive and Emotional Alterations in Patients with Multiple Sclerosis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1387. [PMID: 36674140 PMCID: PMC9864158 DOI: 10.3390/ijerph20021387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 01/09/2023] [Accepted: 01/10/2023] [Indexed: 06/17/2023]
Abstract
Introduction. Multiple sclerosis (MS) is a neurodegenerative disease that, despite mainly affecting women, is more severe in men and causes motor, cognitive and emotional alterations. The objective of this study was to determine the possible relationship between motor, cognitive and emotional alterations. Materials and Methods. This is a descriptive, observational and cross-sectional study, with 67 patients with MS (20 men and 47 women), who were given the following questionnaires: Expanded Disability Status Scale (EDSS), Two-Minute Walk Test (2MWT), Berg Balance Scale, Beck’s Depression Inventory (BDI-II), State-Trait Anxiety Inventory (STAI) and Prefrontal Symptoms Inventory (PSI) to analyze their cognitive level, body mass index (BMI) and percentage of muscle mass. In addition, regression analysis was conducted to study the relationship among variables. Results. No significant differences were found between men and women in any of the variables. Regarding the relationship between parameters, the regression analysis was statistically significant, showing an effect of age on the walking and balance performance (β ≅ −0.4, p < 0.05); in addition, there was a relationship between 2MWT and STAI A/S, indicating that both older age and a high anxiety state could impact walking performance. On the other hand, prefrontal symptoms showed moderate relationships with both anxiety and depression (β ≅ 0.6, p < 0.05); thus, high levels of anxiety and depression could increase prefrontal alterations. Conclusions. There is a relationship between motor and emotional variables. Specifically, state anxiety is related to walking resistance. No relationship was found between depression and cognitive alteration and balance or walking ability. Only age has an effect in these relationships.
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Affiliation(s)
- María Cuerda-Ballester
- Doctoral School, Catholic University of Valencia San Vicente Mártir, 46001 Valencia, Spain
| | - David Martínez-Rubio
- Psicoforma Integral Psychology Center, 46001 Valencia, Spain
- Department of Psychology, European University of Valencia, 46010 Valencia, Spain
| | - María Pilar García-Pardo
- Department of Psychology and Sociology, University of Zaragoza, Campus Teruel, 44003 Teruel, Spain
| | - Belén Proaño
- Department of Basic Medical Sciences, Catholic University of Valencia, 46001 Valencia, Spain
| | - Laura Cubero
- Department of Basic Medical Sciences, Catholic University of Valencia, 46001 Valencia, Spain
| | - Antonio Calvo-Capilla
- Department of Medicine and Animal Surgery, Catholic University of Valencia, 46001 Valencia, Spain
| | - David Sancho-Cantus
- Department of Basic Medical Sciences, Catholic University of Valencia, 46001 Valencia, Spain
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12
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Argento O, Piacentini C, Bossa M, Caltagirone C, Santamato A, Saraceni V, Nocentini U. Motor, cognitive, and combined rehabilitation approaches on MS patients' cognitive impairment. Neurol Sci 2023; 44:1109-1118. [PMID: 36542204 PMCID: PMC9769485 DOI: 10.1007/s10072-022-06552-4] [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: 07/21/2022] [Accepted: 12/08/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND At the moment, the possible options for the management of cognitive dysfunctions in patients with MS (pMS) are pharmacological interventions, cognitive rehabilitation (CR), and physical exercise. However, worldwide, multimodal programs are infrequently applied in pMS and CR is not easily accessible through the National Health System as MR. OBJECTIVE The aim of the study is to explore if the combination of motor and cognitive rehabilitation may favor better outcomes on cognitive efficiency compared to separate trainings. METHODS Forty-eight pMS were submitted to detailed neuropsychological and motor assessments, before (T0) and after (T1) having performed one of three rehabilitation conditions (two cognitive trainings/week-Reha1; one cognitive and one motor training/week-Reha2; two motor trainings/week-Reha3, for 12 weeks); they were randomly assigned to one condition or another. The CR was focused on memory functioning and performed with the Rehacom program. RESULTS No significant differences in age, sex, education, and disease course were found between the three groups (sig. > .05). Reha1 patients increased only their cognitive performance, and Reha3 only increased their motor performance, while Reha2 increased both cognitive and motor performances. This benefit was also confirmed by the cognitive efficiency expressed by the Cognitive Impairment Index. CONCLUSIONS These data confirm that to include cognitive training within rehabilitation programs may induce important benefits in pMS. Furthermore, pMS seem to benefit from a combined approach (cognitive and motor) more than from CR and motor rehabilitation separately (ClinicalTrial.gov ID: NCT05462678; 14 July 2022, retrospectively registered).
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Affiliation(s)
- Ornella Argento
- Behavioral Neuropsychology Unit, I.R.C.C.S. "Santa Lucia" Foundation, Via Ardeatina, 306, 00179, Rome, Italy.
| | - Chiara Piacentini
- Behavioral Neuropsychology Unit, I.R.C.C.S. “Santa Lucia” Foundation, Via Ardeatina, 306, 00179 Rome, Italy
| | - Michela Bossa
- Behavioral Neuropsychology Unit, I.R.C.C.S. “Santa Lucia” Foundation, Via Ardeatina, 306, 00179 Rome, Italy
| | - Carlo Caltagirone
- Scientific Direction, I.R.C.C.S. “Santa Lucia” Foundation, Rome, Italy
| | - Andrea Santamato
- Rehabilitation Centre-Physical Medicine and Rehabilitation Section, OORR-Hospital-University of Foggia, Foggia, Italy
| | - Vincenzo Saraceni
- Scientific Direction, “Filippo Turati” Foundation, Rehabilitation Centre, Pistoia, Italy
| | - Ugo Nocentini
- Behavioral Neuropsychology Unit, I.R.C.C.S. “Santa Lucia” Foundation, Via Ardeatina, 306, 00179 Rome, Italy ,Department of Clinical Sciences and Translational Medicine, University of Rome “Tor Vergata”, Rome, Italy
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13
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Elliott-Wherry AN, Lee JE, Pearlman AM, Wahls TL. The Wahls Behavior Change Model for Complex Chronic Diseases: A Clinician's Guide. Degener Neurol Neuromuscul Dis 2022; 12:111-125. [PMID: 36110247 PMCID: PMC9469801 DOI: 10.2147/dnnd.s370173] [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: 04/27/2022] [Accepted: 07/19/2022] [Indexed: 12/04/2022] Open
Abstract
Behavior change models are used to understand and intervene on health-related behaviors and outcomes. However, there is a gap in the literature regarding how to create and maintain behavior change in patients with complex chronic diseases such as Multiple Sclerosis (MS). To address this gap, the Wahls Behavior ChangeTM Model (WBCM) (The trademark applies to subsequent mention of the model.) was developed based on existing behavior change theory, empirical evidence, and extensive clinical experience caring for patients with complex chronic diseases. A patient-centered, comprehensive, and multimodal approach, this model provides a framework for understanding and implementing lifestyle behavior change. The overall goals of this paper are to: (1) review existing behavior change theories; (2) introduce the WBCM, including the model's 11 Principles for behavior change in patients with complex chronic diseases; and (3) share how providers can be trained to implement the WBCM. The WBCM can potentially improve short- and longer-term function and quality of life outcomes for people with complex chronic diseases.
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Affiliation(s)
- Alaina N Elliott-Wherry
- Department of Community and Behavioral Health, University of Iowa College of Public Health, Iowa City, IA, USA
| | - Jennifer E Lee
- College of Nursing, The University of Iowa, Iowa City, IA, USA
| | - Amy M Pearlman
- Department of Urology, University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Terry L Wahls
- Department of Internal Medicine-General Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA, USA
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14
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Fouad A, Shawky A, Farghaly M, Naseer MA, Hegazy MI. Validation of cognitive screening questionnaire for neurological disorders (CSQND) for screening of cognitive complaints among patients with multiple sclerosis. THE EGYPTIAN JOURNAL OF NEUROLOGY, PSYCHIATRY AND NEUROSURGERY 2022. [DOI: 10.1186/s41983-022-00529-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
The prevalence of cognitive impairment (CI) can reach up to 65% among multiple sclerosis (MS) patients. Self-administered screening questionnaires can offer a valuable solution for screening MS patients for cognitive complaints. The cognitive screening questionnaire for neurological disorders (CSQND) is an Arabic self-administered questionnaire that has been developed to screen patients with various neurological disorders attending neurology clinics. The aim of this study was to assess cognitive complaints and to validate the CSQND as a screening tool among Egyptian MS patients.
Results
Four-hundred MS patients and 400 controls were included in this study. All 400 patients and 400 controls were subjected to the CSQND, only 50 out of the 400 patients and 50 out of the 400 controls retook the CSQND 1 week later to establish test–retest reliability. Fifty patients and 50 controls were assessed by the symbol digit modalities test (SDMT) to establish concurrent validity. Thirty-four percent of patients complained of memory problems, 51% complained of concentration difficulties, 34% complained of language difficulties and 22.5% complained of space and time disorientation. Multiple sclerosis patients had significantly more cognitive complaints (12.4 ± 12.6) compared to controls (6.2 ± 6.8) when screened using the CSQND (P < 0.000001). Total scores of CSQND were positively significantly correlated to age at onset, total disease duration, EDSS scores and total number of relapses, (r = 0.14; 0.275; 0.3; 0.167, respectively), P < 0.05 for all. Agreement was found between CSQND results and the SDMT results, where the line of equality lied within the 95% confidence interval of the mean. A significant positive correlation was found between the CSQND results at the first application and upon retesting both in patients (R = 0.9, P = 0.0001) and controls (R = 0.85, P = 0.0001).
Conclusions
The CSQND was found to be a simple, valid, and reliable self-administered questionnaire to screen for cognitive complaints in MS patients.
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15
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Validation of the Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) in the Russian Population. J Int Neuropsychol Soc 2022; 28:503-510. [PMID: 34132190 DOI: 10.1017/s1355617721000722] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Cognitive dysfunction is common in multiple sclerosis (MS). The Brief International Cognitive Assessment for MS (BICAMS) battery of tests has been suggested as a measure for the evaluation of the cognitive status of MS patients. This study aims to validate the BICAMS battery in the Russian population of MS patients. METHODS Age- and sex-matched MS patients (n = 98) and healthy individuals (n = 86) were included in the study. Symbol Digit Modalities Test (SDMT), California Verbal Learning Test, 2nd edition (CVLT-II) and the Brief Visuospatial Memory Test - Revised (BVMT-R) were administered to all participants. The battery was readministered 1 month later to 44 MS patients to investigate the test-retest reliability. RESULTS MS patients exhibited a significantly lower performance in testing with BICAMS than the control group in all three neuropsychological tests. Test-retest reliability was good for SDMT and CVLT-II (r = .82 and r = .85, respectively) and adequate for BVMT-R (r = .70). Based on the proposed criterion for impairment as z score below 1.5 SD the mean of the control group, we found that 34/98 (35%) of MS patients were found impaired at least in one cognitive domain. Patients with Expanded Disability Status Scale score ≥3.5 performed significantly worse than controls (SDMT, p < .0001; CVLT-II, p = .03; BVMT-R, p = .0004), while those with ≤3.0 scores did not. CONCLUSION This study demonstrates that the BICAMS battery is a valid instrument to identify cognitive impairment in MS patients and it can be recommended for routine use in the Russian Federation.
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16
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Moumdjian L, Six J, Veldkamp R, Geys J, Van Der Linden C, Goetschalckx M, Van Nieuwenhoven J, Bosmans I, Leman M, Feys P. Embodied learning in multiple sclerosis using melodic, sound, and visual feedback: a potential rehabilitation approach. Ann N Y Acad Sci 2022; 1513:153-169. [PMID: 35437776 DOI: 10.1111/nyas.14777] [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: 11/27/2022]
Abstract
Given the prevalence of motor and cognitive functions in persons with multiple sclerosis (PwMS), we proposed that the theoretical framework of embodiment could provide a rehabilitation avenue to train these functions as one functional unit. PwMS (n = 31) and age- and gender-matched healthy controls (n = 30) underwent an embodied learning protocol. This involved learning a cognitive sequence while performing it through bodily stepping movement under three feedback conditions (melody, sound, and visual). Cognitive and movement performance was assessed by a delayed recall 15 min after undergoing the embodied learning protocol. Half of participants correctly recalled the sequence in all three conditions, while 70% of healthy controls achieved correct recall within the melody condition. Balance impairment predicted the speed of executing the sequence irrespective of learning, most apparent in the melody condition. Information processing speed predicted the speed of executing the sequence in the melody and sound conditions between participants as well as over time. Those who learned performed the sequence faster in the melody condition only and overall were faster over time. We propose how embodied learning could expand the current context of rehabilitation of cognitive and motor control in PwMS.
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Affiliation(s)
- Lousin Moumdjian
- UMSC Hasselt, Pelt, Belgium.,REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium.,IPEM, Institute for Psychoacoustics and Electronic Music, Department of Art History, Musicology and Theater Studies, Faculty of Arts and Philosophy, Ghent University, Ghent, Belgium
| | - Joren Six
- IPEM, Institute for Psychoacoustics and Electronic Music, Department of Art History, Musicology and Theater Studies, Faculty of Arts and Philosophy, Ghent University, Ghent, Belgium
| | - Renee Veldkamp
- UMSC Hasselt, Pelt, Belgium.,REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium
| | - Jenke Geys
- REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium
| | - Channa Van Der Linden
- REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium
| | - Mieke Goetschalckx
- REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium
| | | | - Ilse Bosmans
- Noorderhart Rehabilitation & MS Center, Pelt, Belgium
| | - Marc Leman
- IPEM, Institute for Psychoacoustics and Electronic Music, Department of Art History, Musicology and Theater Studies, Faculty of Arts and Philosophy, Ghent University, Ghent, Belgium
| | - Peter Feys
- UMSC Hasselt, Pelt, Belgium.,REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium
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17
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Borragán G, Benoit CE, Schul N, Strauss M, De Schepper M, Roekens V, Peigneux P. Impaired sequential but preserved motor memory consolidation in multiple sclerosis disease. Neuroscience 2022; 487:99-106. [DOI: 10.1016/j.neuroscience.2021.12.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 12/17/2021] [Accepted: 12/21/2021] [Indexed: 11/16/2022]
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18
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Comparison of the Effects of Cuprizone on Demyelination in the Corpus Callosum and Hippocampal Progenitors in Young Adult and Aged Mice. Neurochem Res 2022; 47:1073-1082. [DOI: 10.1007/s11064-021-03506-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 11/22/2021] [Accepted: 12/07/2021] [Indexed: 01/08/2023]
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19
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Mooshekhian A, Sandini T, Wei Z, Van Bruggen R, Li H, Li XM, Zhang Y. Low‑field magnetic stimulation improved cuprizone‑induced depression‑like symptoms and demyelination in female mice. Exp Ther Med 2022; 23:210. [PMID: 35126713 PMCID: PMC8796645 DOI: 10.3892/etm.2022.11133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 11/19/2021] [Indexed: 11/25/2022] Open
Abstract
Depression is a common and disabling comorbidity of multiple sclerosis (MS), with currently no clear guidelines for treatment. Low-field magnetic stimulation (LFMS), a novel non-invasive neuromodulation intervention, has been previously demonstrated to rapidly alleviate mood disorders. The aim of the present study was to investigate the effects of LFMS on depression-like behaviors and demyelination in a well-established mouse model of MS. C57BL/6 female mice were fed a 0.2% cuprizone (CPZ) diet for 3 or 6 weeks to induce acute demyelination. During this time, the mice were treated with either sham or LFMS for 20 min/day, 5 days/week. After 3 or 6 weeks of treatment, behavior was assessed with the open field task, Y-maze and the forced swim test. The prefrontal cortex and hippocampus were then collected to perform immunohistochemistry and western blot analysis to verify myelination status. The CPZ diet did not cause significant locomotor deficits; however, working memory, measured using the Y maze, depression-like behavior and adaptive learning, assayed using the forced swim test, were significantly impaired in these animals. LFMS treatment demonstrated a significant antidepressant-like effect and markedly attenuated the CPZ-induced demyelination in the prefrontal cortex after 3- and 6-weeks of treatment, as observed by changes in myelin basic protein immunostaining and western blot analysis. Therefore, the results of the present study indicated that LFMS may be a promising therapy for demyelinating diseases due to the improvement of depressive symptoms via regulation of myelination in cortical areas.
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Affiliation(s)
- Ali Mooshekhian
- Department of Psychiatry, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan S7N 5E5, USA
| | - Thaisa Sandini
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta T6G 2B7, Canada
| | - Zelan Wei
- Department of Psychiatry, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan S7N 5E5, USA
| | - Rebekah Van Bruggen
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta T6G 2B7, Canada
| | - Haibo Li
- Department of Microbiology and Immunology, Geisel School of Medicine at Dartmouth, Lebanon, NH 03756, USA
| | - Xin-Min Li
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta T6G 2B7, Canada
| | - Yanbo Zhang
- Department of Psychiatry, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan S7N 5E5, USA
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20
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Information Processing Speed Assessed with Letter Digit Substitution Test in Croatian Sample of Multiple Sclerosis Patients. Diagnostics (Basel) 2022; 12:diagnostics12010111. [PMID: 35054278 PMCID: PMC8774378 DOI: 10.3390/diagnostics12010111] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 12/29/2021] [Accepted: 12/30/2021] [Indexed: 12/12/2022] Open
Abstract
Cognitive impairment is a common complaint in people with multiple sclerosis (pwMS). The study objective was to determine the psychometric properties of the letter digit substitution test (LDST) that measures information processing speed and to investigate the impact of relevant predictors of LDST achievement in pwMS. The design was cross-sectional. The study included 87 pwMS and 154 control subjects. The validity of LDST was examined, and a hierarchical regression model was used to explore relevant predictors of LDST success. The LDST had excellent construct validity, as expressed by differences between pwMS and control subjects. Convergent validity of the LDST was supported by a significant moderate correlation with the expanded disability status scale (EDSS) (ρ = −0.36; p < 0.05) and a significantly strong correlation with the multiple sclerosis impact scale (MSIS-29) physical subscale (r = −0.64; p < 0.01). The LDTS score well differentiated the pwMS considering age, education, EDSS, disease duration, comorbidity, and medication therapy. Using the LDST as a criterion variable in pwMS results showed consistent evidence for the age, education, and EDSS impact on LDST performance. The best cut-off score of ≤35 discriminated the control and MS group. LDST proved to be a valid test for assessing information processing speed in pwMS.
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21
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OUP accepted manuscript. Arch Clin Neuropsychol 2022; 37:891-903. [DOI: 10.1093/arclin/acac012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/05/2022] [Indexed: 11/12/2022] Open
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22
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Spedo CT, Pereira DDA, Frndak SE, Marques VD, Barreira AA, Smerbeck A, Silva PHRD, Benedict RHB. Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS): discrete and regression-based norms for the Brazilian context. ARQUIVOS DE NEURO-PSIQUIATRIA 2021; 80:62-68. [PMID: 34852072 PMCID: PMC9651501 DOI: 10.1590/0004-282x-anp-2020-0526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 01/26/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND The Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) has been recently developed as a brief, practical, and feasible tool for cognitive impairment in multiple sclerosis (MS). OBJECTIVE This study aimed to provide continuous and discrete normative values for the BICAMS in the Brazilian context. METHODS Normatization was achieved using six hundred and one healthy controls from the community assessed at five Brazilian geopolitical regions. RESULTS Mean raw scores, T scores, percentiles, and Z scores for each BICAMS measure are provided, stratified by age and educational level. Regression-based norms were provided by converting raw scores to scaled scores, which were regressed on age, gender, and education, yielding equations that can be used to calculate the predicted scores. Regression analyses revealed that age, gender, and education significantly influenced test results, as in previous studies. CONCLUSIONS The normative data of the BICAMS to the Brazilian context presented good representativeness, improving its use in daily clinical practice.
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Affiliation(s)
- Carina Tellaroli Spedo
- Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Hospital das Clínicas de Ribeirão Preto, Departamento de Neurociências e Ciências do Comportamento, Ribeirão Preto SP, Brazil.,Instituto Brasileiro de Neuropsicologia e Ciências Cognitivas, Brasília DF, Brazil
| | | | - Seth Edward Frndak
- State University of New York, School of Medicine and Biomedical Sciences, Departments of Neurology and Psychiatry, Buffalo, New York, United States
| | - Vanessa Daccach Marques
- Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Hospital das Clínicas de Ribeirão Preto, Departamento de Neurociências e Ciências do Comportamento, Ribeirão Preto SP, Brazil
| | - Amilton Antunes Barreira
- Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Hospital das Clínicas de Ribeirão Preto, Departamento de Neurociências e Ciências do Comportamento, Ribeirão Preto SP, Brazil
| | - Alan Smerbeck
- Institute of Technology Rochester, Rochester, New York, United States
| | - Pedro Henrique Rodrigues da Silva
- Universidade de São Paulo, Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto, Departamento de Física, Laboratório Inbrain, Ribeirão Preto SP, Brazil
| | - Ralph H B Benedict
- State University of New York, School of Medicine and Biomedical Sciences, Departments of Neurology and Psychiatry, Buffalo, New York, United States
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Aryanpour R, Zibara K, Pasbakhsh P, Jame'ei SB, Namjoo Z, Ghanbari A, Mahmoudi R, Amani S, Kashani IR. 17β-Estradiol Reduces Demyelination in Cuprizone-fed Mice by Promoting M2 Microglia Polarity and Regulating NLRP3 Inflammasome. Neuroscience 2021; 463:116-127. [PMID: 33794337 DOI: 10.1016/j.neuroscience.2021.03.025] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 03/18/2021] [Accepted: 03/21/2021] [Indexed: 11/26/2022]
Abstract
Estrogen produces a beneficial role in animal models of multiple sclerosis (MS). The effect of 17β-estradiol therapy on microglia polarization and neuroinflammation in the corpus callosum of the cuprizone-induced demyelination model has not been elucidated. In this study, mice were given 0.2% cuprizone (CPZ) for 5 weeks to induce demyelination during which they received 50 ng of 17β-estradiol (EST), injected subcutaneously in the neck region, twice weekly. Data revealed that treatment with 17β-estradiol therapy (CPZ+EST) improved neurological behavioral deficits, displayed by a significant reduction in escape latencies, in comparison to untreated CPZ mice. Also, administration of 17β-estradiol caused a decrease in demyelination levels and axonal injury, as demonstrated by staining with Luxol fast blue, immunofluorescence to myelin basic protein, and transmission electron microscopy analysis. In addition, at the transcriptional level in the brain, mice treated with 17β-estradiol (CPZ+EST) showed a decrease in the levels of M1-assosicted microglia markers (CD86, iNOS and MHC-II) whereas M2-associated genes (Arg-1, CD206 and Trem-2) were increased, compared to CPZ mice. Moreover, administration of 17β-estradiol resulted in a significant reduction (∼3-fold) in transcript levels of NLRP3 inflammasome and its downstream product IL-18, compared to controls. In summary, this study demonstrated for the first time that exogenous 17β-estradiol therapy robustly leads to the reduction of M1 phenotype, stimulation of polarized M2 microglia, and repression of NLRP3 inflammasome in the corpus callosum of CPZ demyelination model of MS. The positive effects of 17β-estradiol on microglia and inflammasome seems to facilitate and accelerate the remyelination process.
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Affiliation(s)
- Roya Aryanpour
- Department of Anatomy, Faculty of Medicine, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Kazem Zibara
- PRASE and Biology Department, Faculty of Sciences-I, Lebanese University, Beirut, Lebanon.
| | - Parichehr Pasbakhsh
- Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Zeinab Namjoo
- Department of Anatomical Science, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Amir Ghanbari
- Cell and Molecular Research Center, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Reza Mahmoudi
- Cell and Molecular Research Center, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Showan Amani
- Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Iraj Ragerdi Kashani
- Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
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24
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Turalde CWR, Espiritu AI, Anlacan VMM. Memantine for Multiple Sclerosis: A Systematic Review and Meta-Analysis of Randomized Trials. Front Neurol 2021; 11:574748. [PMID: 33658967 PMCID: PMC7917060 DOI: 10.3389/fneur.2020.574748] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Accepted: 12/22/2020] [Indexed: 01/06/2023] Open
Abstract
Background: Multiple sclerosis (MS), a disabling demyelinating disease of the central nervous system, is associated with cognitive impairment, spasticity, and fatigue. There are still no established guidelines on the management of MS-related sequela. Memantine has the potential to reduce glutamate toxicity, thereby reducing consequent cognitive impairment, spasticity, and fatigue. Objectives: This study aims to determine the efficacy and safety of memantine in preventing cognitive impairment, reducing spasticity and fatigue, and controlling disability in MS patients through a review of relevant randomized trials. Methods: MEDLINE, CENTRAL, Scopus, Embase, LILACS, ClinicalTrials.gov, and HERDIN were searched from inception to May 2020 for relevant trials. Results: The search yielded 203 articles; four studies were included in the analysis. Pooled evidence shows that memantine compared with placebo does not significantly improve PASAT, ASS, MFIS, and EDSS scores of patients with MS. Memantine is associated with mild adverse drug events such as dizziness, fatigue, and anxiety. Conclusion: There is not enough evidence to support the efficacy of memantine in preventing cognitive decline, controlling spasticity, reducing fatigue, and preventing disability. Future researches should consider the different MS subtypes, effect of co-administration of disease-modifying therapies, longer duration of administration, and more sensitive outcome measures to evaluate the potential benefit of memantine in MS.
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Affiliation(s)
- Christian Wilson R Turalde
- Department of Neurosciences, College of Medicine, Philippine General Hospital, University of the Philippines Manila, Manila, Philippines
| | - Adrian I Espiritu
- Department of Neurosciences, College of Medicine, Philippine General Hospital, University of the Philippines Manila, Manila, Philippines.,Department of Clinical Epidemiology, College of Medicine, University of the Philippines Manila, Manila, Philippines
| | - Veeda Michelle M Anlacan
- Department of Neurosciences, College of Medicine, Philippine General Hospital, University of the Philippines Manila, Manila, Philippines.,Department of Neurosciences, Center for Memory and Cognition, Philippine General Hospital, University of the Philippines Manila, Manila, Philippines
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25
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Sehanovic A, Smajlovic D, Tupkovic E, Ibrahimagic OC, Kunic S, Dostovic Z, Zoletic E, Pasic Z. Cognitive Disorders in Patients with Multiple Sclerosis. Mater Sociomed 2021; 32:191-195. [PMID: 33424448 PMCID: PMC7780783 DOI: 10.5455/msm.2020.32.191-195] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Introduction: Multiple sclerosis (MS) is a chronic, inflammatory, (auto) immune disease of the central nervous system (CNS). Cognitive disorders are found in over 50% of patients. Aim: The aim of the study was to determine the distribution of cognitive disorders in people with MS. Methods: The prospective study included 135 respondents with MS and 50 healthy respondents. The respondents were divided into three groups: the first group consisted of 85 respondents where the disease lasted longer than one year, the second group consisted of 50 respondents with newly diagnosed MS, the third group consisted of 50 healthy respondents. Clinical assessment instruments were: Extended Disability Score in Multiple Sclerosis Patients, Mini Mental Status, Battery of Tests to Assess Cognitive Functions: Wechsler Intelligence Scale, Revised Beta Test, Raven Colored Progressive Matrices, Wechsler Memory Scale, Rey Audio Verbal Learning Test -Osterriecht’s complex character test, verbal fluency test. Results: Cognitive disorders were present in 40-60% of respondents with MS. Visuospatial, visuoconstructive and visuoperceptive functions are worse in the first group. Mnestic functions (learning process, short-term and long-term memory, recollection, verbal-logical memory) were most affected in both groups of respondents, ranging from 30-60%. Poorer cognitive domains are in the first groups of respondents. Immediate working process memory (current learning), memory, attention, short-term and logical memory is worse in the examinees of the first group. At the beginning of the disease, 16% had verbal fluency difficulties, and as the disease progresses, the difficulties become more pronounced. Conclusion: Cognitive disorders are heterogeneous, they can be noticed in the early stages of the disease. They refer to impairments of working memory, executive functions and attention, while global intellectual efficiency is later reduced.
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Affiliation(s)
- Aida Sehanovic
- Clinic of Neurology, University Medical Center Tuzla, Tuzla, Bosnia and Herzegovina.,Faculty of Medicine, University of Tuzla, Tuzla, Bosnia and Herzegovina
| | - Dzevdet Smajlovic
- Clinic of Neurology, University Medical Center Tuzla, Tuzla, Bosnia and Herzegovina.,Faculty of Medicine, University of Tuzla, Tuzla, Bosnia and Herzegovina
| | - Emir Tupkovic
- Faculty of Medicine, University of Tuzla, Tuzla, Bosnia and Herzegovina.,Center for Neurology, Health Center Tuzla, Tuzla, Bosnia and Herzegovina
| | - Omer C Ibrahimagic
- Faculty of Medicine, University of Tuzla, Tuzla, Bosnia and Herzegovina.,Center for Neurology, Health Center Tuzla, Tuzla, Bosnia and Herzegovina
| | - Suljo Kunic
- Faculty of Medicine, University of Tuzla, Tuzla, Bosnia and Herzegovina.,Center for Neurology, Health Center Tuzla, Tuzla, Bosnia and Herzegovina
| | - Zikrija Dostovic
- Clinic of Neurology, University Medical Center Tuzla, Tuzla, Bosnia and Herzegovina.,Faculty of Medicine, University of Tuzla, Tuzla, Bosnia and Herzegovina
| | - Emina Zoletic
- Clinic of Neurology, Medical Center of University in Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Zejneba Pasic
- Clinic of Neurology, University Medical Center Tuzla, Tuzla, Bosnia and Herzegovina.,Faculty of Medicine, University of Tuzla, Tuzla, Bosnia and Herzegovina
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26
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Hernández-Ledesma AL, Rodríguez-Méndez AJ, Gallardo-Vidal LS, García-Gasca T, Alatorre-Cruz JM, García-Solís P, López Reyes J, Solís-Saínz JC. Lipid profile: causal relationship on cognitive performance in multiple sclerosis? Mol Biol Rep 2020; 47:9667-9676. [PMID: 33259011 DOI: 10.1007/s11033-020-06011-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 11/16/2020] [Indexed: 12/16/2022]
Abstract
Although cognitive impairment (CI) is classically associated with aging, it has been proposed that neurological pathologies may increase the risk to suffer CI. Despite the evidence of an elevated prevalence of CI in patients with multiple sclerosis (MS), it is not considered among standard clinical evaluations, due the lack of specialists and time required. The aim of this study was to evaluate if lipid profile is associated with cognitive performance in persons with MS. Twenty patients with MS were evaluated. Montreal Cognitive Assessment (MoCA) was employed to determine cognitive performance. CI was observed in 85% of patients, with memory recall and language as the most affected domains. Despite biomarkers were mostly found within reference values, several correlations were observed. MoCA total score was correlated with cholesterol (r = - 0.468, p = 0.037) and LDL (r = - 0.453, p = 0.045). Visuospatial domain was correlated with LDL (r = - 0.493, p = 0.027). Attention domain correlated with triglycerides (r = - 0.455, p = 0.044) and cholesterol (r = - 0.549, p = 0.012). When the person reaches borderline levels of triglycerides, LDL and cholesterol a decrease in cognitive performance can be observed. The mechanism underlying this association has not been established still, it has been proposed that it could be linked with neuroinflammation, alterations in synapses and in the metabolism of amyloid-β protein. This study settles the potential importance that lipid profile could have on cognitive performance in MS. Further studies are needed to establish optimal levels and implication of lipid profile in the diagnosis and monitoring of cognitive performance in Mexican people with MS.
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Affiliation(s)
- Ana Laura Hernández-Ledesma
- Laboratorio de Neuroinmunoendocrinología, Departamento de Investigación Biomédica, Facultad de Medicina, Universidad Autónoma de Querétaro, Clavel #200. Prados de la Capilla. CP 76170, Santiago de Querétaro, México
| | - Adriana Jheny Rodríguez-Méndez
- Laboratorio de Neuroinmunoendocrinología, Departamento de Investigación Biomédica, Facultad de Medicina, Universidad Autónoma de Querétaro, Clavel #200. Prados de la Capilla. CP 76170, Santiago de Querétaro, México.
| | | | - Teresa García-Gasca
- Facultad de Ciencias Naturales, Universidad Autónoma de Querétaro, Santiago de Querétaro, México
| | | | - Pablo García-Solís
- Departamento de Investigación Biomédica, Facultad de Medicina, Universidad Autónoma de Querétaro, Santiago de Querétaro, México
| | - Julián López Reyes
- Facultad de Medicina, Clínica del Sistema Nervioso, Universidad Autónoma de Querétaro, Santiago de Querétaro, México
| | - Juan Carlos Solís-Saínz
- Departamento de Investigación Biomédica, Facultad de Medicina, Universidad Autónoma de Querétaro, Santiago de Querétaro, México
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27
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Grigorescu C, Chalah MA, Lefaucheur JP, Kümpfel T, Padberg F, Ayache SS, Palm U. Effects of Transcranial Direct Current Stimulation on Information Processing Speed, Working Memory, Attention, and Social Cognition in Multiple Sclerosis. Front Neurol 2020; 11:545377. [PMID: 33178103 PMCID: PMC7593675 DOI: 10.3389/fneur.2020.545377] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 08/26/2020] [Indexed: 01/17/2023] Open
Abstract
Multiple Sclerosis (MS) is a chronic inflammatory disease of the central nervous system. Cognitive impairment occurs in 40-65% of patients and could drastically affect their quality of life. Deficits could involve general cognition (e.g., attention and working memory) as well as social cognition. Transcranial direct current stimulation (tDCS), is a novel brain stimulation technique that has been assessed in the context of several neuropsychiatric symptoms, including those described in the context of MS. However, very rare trials have assessed tDCS effects on general cognition in MS, and none has tackled social cognition. The aim of this work was to assess tDCS effects on general and social cognition in MS. Eleven right-handed patients with MS received two blocks (bifrontal tDCS and sham, 2 mA, 20 min, anode/cathode over left/right prefrontal cortex) of 5 daily stimulations separated by a 3-week washout interval. Working memory and attention were, respectively, measured using N-Back Test (0-Back, 1-Back, and 2-Back) and Symbol Digit Modalities Test (SDMT) at the first and fifth day of each block and 1 week later. Social cognition was evaluated using Faux Pas Test and Eyes Test at baseline and 1 week after each block. Interestingly, accuracy of 1-Back test improved following sham but not active bifrontal tDCS. Therefore, active bifrontal tDCS could have impaired working memory via cathodal stimulation of the right prefrontal cortex. No significant tDCS effects were observed on social cognitive measures and SDMT. Admitting the small sample size and the learning (practice) effect that might arise from the repetitive administration of each task, the current results should be considered as preliminary and further investigations in larger patient samples are needed to gain a closer understanding of tDCS effects on cognition in MS.
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Affiliation(s)
- Christina Grigorescu
- Department of Psychiatry and Psychotherapy, Klinikum der Universität München, Munich, Germany
| | - Moussa A Chalah
- EA 4391, Excitabilité nerveuse et thérapeutique, Université Paris-Est-Créteil, Créteil, France.,Service de Physiologie-Explorations Fonctionnelles, Hôpital Henri-Mondor, Assistance Publique-Hôpitaux de Paris, Créteil, France
| | - Jean-Pascal Lefaucheur
- EA 4391, Excitabilité nerveuse et thérapeutique, Université Paris-Est-Créteil, Créteil, France.,Service de Physiologie-Explorations Fonctionnelles, Hôpital Henri-Mondor, Assistance Publique-Hôpitaux de Paris, Créteil, France
| | - Tania Kümpfel
- Institute for Clinical Neuroimmunology, Klinikum der Universität München, Munich, Germany
| | - Frank Padberg
- Department of Psychiatry and Psychotherapy, Klinikum der Universität München, Munich, Germany
| | - Samar S Ayache
- EA 4391, Excitabilité nerveuse et thérapeutique, Université Paris-Est-Créteil, Créteil, France.,Service de Physiologie-Explorations Fonctionnelles, Hôpital Henri-Mondor, Assistance Publique-Hôpitaux de Paris, Créteil, France
| | - Ulrich Palm
- Department of Psychiatry and Psychotherapy, Klinikum der Universität München, Munich, Germany.,Medical Park Chiemseeblick, Bernau, Germany
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28
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Talebi M, Majdi A, Nasiri E, Naseri A, Sadigh-Eteghad S. The correlation between circulating inflammatory, oxidative stress, and neurotrophic factors level with the cognitive outcomes in multiple sclerosis patients. Neurol Sci 2020; 42:2291-2300. [DOI: 10.1007/s10072-020-04807-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 10/06/2020] [Indexed: 10/23/2022]
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29
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Nasios G, Bakirtzis C, Messinis L. Cognitive Impairment and Brain Reorganization in MS: Underlying Mechanisms and the Role of Neurorehabilitation. Front Neurol 2020; 11:147. [PMID: 32210905 PMCID: PMC7068711 DOI: 10.3389/fneur.2020.00147] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 02/14/2020] [Indexed: 12/29/2022] Open
Abstract
Multiple sclerosis (MS) is a chronic, immune-mediated, inflammatory, and degenerative disease of the central nervous system (CNS) that affects both white and gray matter. Various mechanisms throughout its course, mainly regarding gray matter lesions and brain atrophy, result in cognitive network dysfunction and can cause clinically significant cognitive impairment in roughly half the persons living with MS. Altered cognition is responsible for many negative aspects of patients' lives, independently of physical disability, such as higher unemployment and divorce rates, reduced social activities, and an overall decrease in quality of life. Despite its devastating impact it is not included in clinical ratings and decision making in the way it should be. It is interesting that only half the persons with MS exhibit cognitive dysfunction, as this implies that the other half remain cognitively intact. It appears that a dynamic balance between brain destruction and brain reorganization is taking place. This balance acts in favor of keeping brain systems functioning effectively, but this is not so in all cases, and the effect does not last forever. When these systems collapse, functional brain reorganization is not effective anymore, and clinically apparent impairments are evident. It is therefore important to reveal which factors could make provision for the subpopulation of patients in whom cognitive impairment occurs. Even if we manage to detect this subpopulation earlier, effective pharmaceutical treatments will still be lacking. Nevertheless, recent evidence shows that cognitive rehabilitation and neuromodulation, using non-invasive techniques such as transcranial magnetic or direct current stimulation, could be effective in cognitively impaired patients with MS. In this Mini Review, we discuss the mechanisms underlying cognitive impairment in MS. We also focus on mechanisms of reorganization of cognitive networks, which occur throughout the disease course. Finally, we review theoretical and practical issues of neurorehabilitation and neuromodulation for cognition in MS as well as factors that influence them and prevent them from being widely applied in clinical settings.
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Affiliation(s)
- Grigorios Nasios
- Department of Speech and Language Therapy, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Christos Bakirtzis
- Department of Neurology, The Multiple Sclerosis Center, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Lambros Messinis
- Neuropsychology Section, Departments of Neurology and Psychiatry, University of Patras Medical School, Patras, Greece
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30
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das Neves SP, Santos G, Barros C, Pereira DR, Ferreira R, Mota C, Monteiro S, Fernandes A, Marques F, Cerqueira JJ. Enhanced cognitive performance in experimental autoimmune encephalomyelitis mice treated with dimethyl fumarate after the appearance of disease symptoms. J Neuroimmunol 2020; 340:577163. [PMID: 31982706 DOI: 10.1016/j.jneuroim.2020.577163] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 01/02/2020] [Accepted: 01/10/2020] [Indexed: 12/23/2022]
Abstract
In multiple sclerosis (MS), cognitive dysfunction is common but difficult to treat. We analyzed the impact of dimethyl fumarate, an MS drug with neuroprotective properties, in spatial memory performance in a mouse model of MS and looked for structural correlates in the hippocampus. Treated mice presented better cognitive performance which was not associated with structural hippocampal damage but with decreased demyelination in the fimbria. Dimethyl fumarate, even if initiated after hindlimb paralysis, ameliorated memory deficits in the MS mouse model due, at least in part, to its positive impact in the demyelination of the main hippocampal output pathway.
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Affiliation(s)
- Sofia P das Neves
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus Gualtar, 4710-057 Braga, Portugal; ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Gisela Santos
- Neuron-Glia Biology in Health and Disease, Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, Universidade de Lisboa, Portugal
| | - Catarina Barros
- Neuron-Glia Biology in Health and Disease, Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, Universidade de Lisboa, Portugal
| | - Diana Rodrigues Pereira
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus Gualtar, 4710-057 Braga, Portugal; ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Ricardo Ferreira
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus Gualtar, 4710-057 Braga, Portugal; ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Cristina Mota
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus Gualtar, 4710-057 Braga, Portugal; ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Susana Monteiro
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus Gualtar, 4710-057 Braga, Portugal; ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Adelaide Fernandes
- Neuron-Glia Biology in Health and Disease, Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, Universidade de Lisboa, Portugal; Department of Biochemistry and Human Biology, Faculty of Pharmacy, Universidade de Lisboa, Portugal
| | - Fernanda Marques
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus Gualtar, 4710-057 Braga, Portugal; ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - João José Cerqueira
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus Gualtar, 4710-057 Braga, Portugal; ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal; 2CA, Clinical Academic Center - Braga, Braga, Portugal.
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31
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Abou Elmaaty AA, Flifel ME, Zarad CA. Correlation between brain magnetic resonance imaging, cognitive dysfunction and physical dysability in multiple sclerosis. THE EGYPTIAN JOURNAL OF NEUROLOGY, PSYCHIATRY AND NEUROSURGERY 2019. [DOI: 10.1186/s41983-019-0100-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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32
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Svindt V, Bóna J, Hoffmann I. Changes in temporal features of speech in secondary progressive multiple sclerosis (SPMS) - case studies. CLINICAL LINGUISTICS & PHONETICS 2019; 34:339-356. [PMID: 31342810 DOI: 10.1080/02699206.2019.1645885] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Accepted: 07/16/2019] [Indexed: 06/10/2023]
Abstract
Multiple sclerosis (MS) is a chronic inflammatory disease which, in addition to affecting motor and cognitive functions, may involve language disorders. Despite the importance of speech and language disorders in the quality of life of patients, there are only a few studies about language and speech production difficulties in MS. The aim of this research is to describe the limitation patterns of speech and temporal characteristics of the suprasegmental level in two SPMS cases related to various types of spontaneous speech tasks. We assumed the change of the cognitive load has a greater effect on spontaneous speech in MS patients than in controls. Two SPMS patients, and two sex-, age- and education matched healthy controls were studied. We applied verbal fluency tests (phonemic, episodic, semantic, verb), digit span test, non-word repetition test, Corsi Block Tapping Test, Stroop Colour and Word Test, and Trail Making Test. Token Test was used to measure speech comprehension. The four speech tasks required relatively different degrees of cognitive effort: (a) spontaneous narrative about own life; (b) event description; (c) picture description; (d) narrative recall. Our results show that there are differences between MS patients and controls: MS patients produced slower speech and articulation rate, and they had more and longer pauses in every speech task. Speech tasks and the degree of the cognitive load had a greater effect on MS patients than on control speakers.
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Affiliation(s)
- Veronika Svindt
- Department of Psycholinguistics, Neurolinguistics and Sociolinguistics, Research Institute for Linguistics of the Hungarian Academy of Sciences, Budapest, Hungary
| | - Judit Bóna
- Department of Applied Linguistics and Phonetics, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Ildikó Hoffmann
- Department of Psycholinguistics, Neurolinguistics and Sociolinguistics, Research Institute for Linguistics of the Hungarian Academy of Sciences, Budapest, Hungary
- Department of Hungarian Linguistics, University of Szeged, Szeged, Hungary
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33
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Pereira GM, Becker J, Soares NM, de Azeredo LA, Grassi-Oliveira R, Rysdyk A, de Almeida RMM. Hair cortisol concentration, cognitive, behavioral, and motor impairment in multiple sclerosis. J Neural Transm (Vienna) 2019; 126:1145-1154. [PMID: 31250284 DOI: 10.1007/s00702-019-02040-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Accepted: 06/22/2019] [Indexed: 12/16/2022]
Abstract
Multiple sclerosis (MS) is an autoimmune neurodegenerative disease that is characterized by the demyelinated inflammatory processes that occur within the central nervous system. Hypothalamus-pituitary-adrenal axis (HPA axis) dysfunctions have been associated with the triggering or increase in MS symptoms. We thus aimed at evaluating motor and behavioral functions, planning skills, processing speed, and their relationship with stress through measuring hair cortisol concentration from patients with MS. The sample was composed of 40 volunteers that were clinically diagnosed with MS, along with 33 healthy adults. Evaluations included: Clinical Evaluation Form, Mini-Mental State Exam, Hamilton Depression Rating Scale, Multiple Sclerosis Functional Composite Measure, Expanded Disability Status Scale, Berg Balance Scale, Perceived Stress Scale, Zoo Map task, and a hair sample to analyze cortisol levels in the last 30 days. MS patients showed highly elevated hair cortisol levels in comparison to the control group (p = 0.048). All groups presented some degree of depressive and anxiety symptoms, aside from considerable perceived stress levels. The MS group presented deficits in gait, balance, manual skills and processing speed, and this was particularly so in individuals with moderate impairments when compared to control group (p < 0.001). Individuals with MS spent less time planning on ZooMap1 (p = 0.024) and made more mistakes (p < 0.001). No correlation was found between hair cortisol and the symptoms we assessed. However, depressive symptoms and anxiety were related to perceived stress, and higher hair cortisol suggests a change in levels in the HPA axis in MS. Nevertheless, future studies will be necessary to further understand how basal hair cortisol is related to MS symptoms.
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Affiliation(s)
- Gabriela Magalhães Pereira
- Programa de Pós-Graduação em Ciências Médicas, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400, Porto Alegre, RS, 90035-003, Brazil. .,Instituto de Psicologia, Laboratório de Psicologia Experimental, Neurociências e Comportamento (LPNeC), Universidade Federal do Rio Grande do Sul, Ramiro Barcelos, 2600, Sala 116, Santa Cecilia, Porto Alegre, RS, 90035-003, Brazil. .,Hospital de Clinicas de Porto Alegre (HCPA), Rua Ramiro Barcelos, 2350, Porto Alegre, RS, 90035-003, Brazil.
| | - Jefferson Becker
- Escola de Medicina, Neurologia, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, 90619-900, Brazil.,Instituto do Cérebro do Rio Grande do Sul (InsCer), Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Hospital São Lucas da PUCRS, 90610-000, Porto Alegre, Brazil
| | - Nayron Medeiros Soares
- Programa de Pós-Graduação em Ciências Médicas, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400, Porto Alegre, RS, 90035-003, Brazil.,Instituto de Psicologia, Laboratório de Psicologia Experimental, Neurociências e Comportamento (LPNeC), Universidade Federal do Rio Grande do Sul, Ramiro Barcelos, 2600, Sala 116, Santa Cecilia, Porto Alegre, RS, 90035-003, Brazil.,Hospital de Clinicas de Porto Alegre (HCPA), Rua Ramiro Barcelos, 2350, Porto Alegre, RS, 90035-003, Brazil
| | - Lucas Araújo de Azeredo
- Instituto do Cérebro do Rio Grande do Sul (InsCer), Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Hospital São Lucas da PUCRS, 90610-000, Porto Alegre, Brazil.,Escola de Medicina, Programa de Pós-Graduação em Medicina e Ciências da Saúde, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, 90619-900, Brazil
| | - Rodrigo Grassi-Oliveira
- Instituto do Cérebro do Rio Grande do Sul (InsCer), Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Hospital São Lucas da PUCRS, 90610-000, Porto Alegre, Brazil.,Escola de Medicina, Programa de Pós-Graduação em Medicina e Ciências da Saúde, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, 90619-900, Brazil
| | - Andreo Rysdyk
- Instituto de Psicologia, Laboratório de Psicologia Experimental, Neurociências e Comportamento (LPNeC), Universidade Federal do Rio Grande do Sul, Ramiro Barcelos, 2600, Sala 116, Santa Cecilia, Porto Alegre, RS, 90035-003, Brazil
| | - Rosa Maria Martins de Almeida
- Instituto de Psicologia, Laboratório de Psicologia Experimental, Neurociências e Comportamento (LPNeC), Universidade Federal do Rio Grande do Sul, Ramiro Barcelos, 2600, Sala 116, Santa Cecilia, Porto Alegre, RS, 90035-003, Brazil.
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34
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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.
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Affiliation(s)
- Natasa Giedraitiene
- Clinic of Neurology and Neurosurgery, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
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Dana A, Rafiee S, Gholami A. Motor reaction time and accuracy in patients with multiple sclerosis: effects of an active computerized training program. Neurol Sci 2019; 40:1849-1854. [PMID: 31055729 DOI: 10.1007/s10072-019-03892-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Accepted: 04/10/2019] [Indexed: 11/28/2022]
Abstract
In this study, we aimed to determine the difference of motor reaction time and accuracy between the patients with moderate multiple sclerosis (MS) and healthy subjects and to determine whether a specified cognitive-motor training can improve the speed and accuracy of information processing in patients with MS. A total of 205 patients (30% males) and 276 age-/gender-matched healthy subjects (31% males) were included in the study. Furthermore, using a stratified randomization method, patients with MS were randomly assigned to one of two groups: active information processing training (AIPT) (n = 49) or post-control (n = 55). The AIPT group was asked to complete a computerized visual-manual training program and the post-control group asked to complete the same task without an increase in difficulty. Before and after the intervention phase, the simple, choice, and semantic reaction times and accuracies of all participants were evaluated using the VLS measurement battery. Our results demonstrated that the case and control group were significantly different in terms of the simple, choice, and semantic motor reaction times and accuracies. Compared with the pre-intervention phase, the AIPT and control group's performances in the post-intervention phase were considerably improved in simple, choice, and semantic motor reaction times and choice and semantic motor reaction accuracies. The results also showed that the AIPT group performed significantly better than the post-control group in terms of simple and choice motor reaction times. We showed the positive effects of training on the performance of patients with MS in motor reaction time and accuracy.
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Affiliation(s)
- Amir Dana
- Department of Physical Education, Tabriz Branch, Islamic Azad University, Tabriz, Iran.
| | - Saleh Rafiee
- Sport Science Research Institute of Iran (SSRI)
- , Tehran, Iran
| | - Amin Gholami
- Sport Science Research Institute of Iran (SSRI)
- , Tehran, Iran
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Valavanis AV, Tsitsipa E, Intzes S, Psoma E, Tegos T. The impact of athrosclerosis on cognition and disability in multiple sclerosis patients: the ATHUS score. Hippokratia 2019; 23:81-86. [PMID: 32265589 PMCID: PMC7127921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
AIM Atherosclerosis of the large arteries of the neck could be related to the cognitive and motor deficit. We investigated if the atherosclerosis of common carotid and femoral arteries in patients with multiple sclerosis (MS) is directly linked with a disability and has an inverse relationship with cognitive performance. METHODS We enrolled, in this prospective study, a random sample of 105 patients with MS and 22 healthy controls. All participants received a comprehensive neuropsychological assessment. The physical disability was quantified with the Expanded Disability Status Scale (EDSS). We utilized ultrasound of the carotid and femoral arteries to evaluate the degree of stenosis and intima-media thickness (IMT). We created a novice ultrasound index of atherosclerosis (ATHUS score) based on the arterial stenosis and the IMT of the carotid and femoral arteries. We then compared the results of the psychometric assessment and EDSS with the ATHUS score. RESULTS The analysis demonstrated that higher cognitive function is correlated with lower values of ATHUS score (p =0.01). Also, there was a direct correlation between the ATHUS score and EDSS (p =0.001). CONCLUSION Our results suggest that the degree of atherosclerosis, as calculated by the ATHUS score, is directly related to low cognitive score and higher sensory and motor disability. HIPPOKRATIA 2019, 23(2): 81-86.
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Affiliation(s)
- A V Valavanis
- Department of Neurology, Royal Surrey County Hospital, Surrey, United Kingdom
- 1 Department of Neurology, AHEPA University Hospital, Aristotle University of Thessaloniki, Greece
| | - E Tsitsipa
- Division of Psychiatry, University College London, United Kingdom
| | | | - E Psoma
- Department of Radiology, AHEPA University Hospital, Aristotle University of Thessaloniki, Greece
| | - T Tegos
- 1 Department of Neurology, AHEPA University Hospital, Aristotle University of Thessaloniki, Greece
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37
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Body image in multiple sclerosis patients: a descriptive review. Neurol Sci 2019; 40:923-928. [DOI: 10.1007/s10072-019-3722-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Accepted: 01/12/2019] [Indexed: 12/18/2022]
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Enhanced GABAergic Tonic Inhibition Reduces Intrinsic Excitability of Hippocampal CA1 Pyramidal Cells in Experimental Autoimmune Encephalomyelitis. Neuroscience 2018; 395:89-100. [PMID: 30447391 DOI: 10.1016/j.neuroscience.2018.11.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Revised: 11/03/2018] [Accepted: 11/05/2018] [Indexed: 11/24/2022]
Abstract
Cognitive impairment (CI), a debilitating and pervasive feature of multiple sclerosis (MS), is correlated with hippocampal atrophy. Findings from postmortem MS hippocampi indicate that expression of genes involved in both excitatory and inhibitory neurotransmission are altered in MS, and although deficits in excitatory neurotransmission have been reported in the MS model experimental autoimmune encephalomyelitis (EAE), the functional consequence of altered inhibitory neurotransmission remains poorly understood. In this study, we used electrophysiological and biochemical techniques to examine inhibitory neurotransmission in the CA1 region of the hippocampus in EAE. We find that tonic, GABAergic inhibition is enhanced in CA1 pyramidal cells from EAE mice. Although plasma membrane expression of the GABA transporter GAT-3 was decreased in the EAE hippocampus, an increased surface expression of α5 subunit-containing GABAA receptors appears to be primarily responsible for the increase in tonic inhibition during EAE. Enhanced tonic inhibition during EAE was associated with decreased CA1 pyramidal cell excitability and inhibition of α5 subunit-containing GABAA receptors with the negative allosteric modulator L-655,708 enhanced pyramidal cell excitability in EAE mice. Together, our results suggest that altered GABAergic neurotransmission may underlie deficits in hippocampus-dependent cognitive function in EAE and MS.
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Fritz NE, Kloos AD, Kegelmeyer DA, Kaur P, Nichols-Larsen DS. Supplementary motor area connectivity and dual-task walking variability in multiple sclerosis. J Neurol Sci 2018; 396:159-164. [PMID: 30472552 DOI: 10.1016/j.jns.2018.11.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 10/15/2018] [Accepted: 11/09/2018] [Indexed: 01/21/2023]
Abstract
BACKGROUND Despite the prevalence of dual-task (e.g., walking while talking) deficits in people with multiple sclerosis (MS), no neuroimaging studies to date have examined neuronal networks used for dual-task processing or specific brain areas related to dual-task performance in this population. A better understanding of the relationship among underlying brain areas and dual-task performance may improve targeted rehabilitation programs. The objective of this study was to examine relationships between neuroimaging measures and clinical measures of dual-task performance, and reported falls in persons with MS. MATERIALS AND METHODS All participants completed measures of dual-task performance, a fall history, and neuroimaging on a 3 T MRI scanner. Spearman correlations were used to examine relationships among dual-task performance, falls and neuroimaging measures. RESULTS Eighteen females with relapsing-remitting MS [mean age = 45.5 ± 8.2 SD; mean symptom duration = 12.3 ± 6.7 years; Expanded Disability Status Scale median 2.25 (range 1.5-4)] participated in this study. Structural imaging measures of supplementary motor area (SMA) interhemispheric connectivity were significantly related to dual-task walking variability. CONCLUSIONS The SMA interhemispheric tract may play a role in dual-task performance. Structural neuroimaging may be a useful adjunct to clinical measures to predict performance and provide information about recovery patterns in MS. Functional recovery can be challenging to objectively report in MS; diffusion tensor imaging could show microstructural improvements and suggest improved connectivity.
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Affiliation(s)
- Nora E Fritz
- Program in Physical Therapy and Department of Neurology, Wayne State University, Detroit, MI, United States; Division of Physical Therapy, The Ohio State University, Columbus, OH, United States; School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, OH, United States.
| | - Anne D Kloos
- Division of Physical Therapy, The Ohio State University, Columbus, OH, United States; School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, OH, United States
| | - Deborah A Kegelmeyer
- Division of Physical Therapy, The Ohio State University, Columbus, OH, United States; School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, OH, United States
| | - Parminder Kaur
- School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, OH, United States
| | - Deborah S Nichols-Larsen
- School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, OH, United States
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Silverstein SM, Paterno D, Cherneski L, Green S. Optical coherence tomography indices of structural retinal pathology in schizophrenia. Psychol Med 2018; 48:2023-2033. [PMID: 29233210 DOI: 10.1017/s0033291717003555] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Prior optical coherence tomography (OCT) studies of schizophrenia have identified thinning of retinal layers. However, findings have varied across reports, and most studies have had serious methodological limitations. To address unresolved issues, we determined whether: (1) retinal thinning in schizophrenia occurs independently of comorbid medical conditions that affect the retina; (2) thinning is independent of antipsychotic medication dose; (3) optic nerve parameters are abnormal in schizophrenia; and (4) OCT indices are related to visual and cognitive impairments common in schizophrenia. METHODS A total of 32 people with schizophrenia and 32 matched controls participated. Spectral domain OCT generated data on retinal nerve fiber layer (RNFL), macula, and ganglion cell-inner plexiform layer (GCL-IPL) thickness, in addition to cup volume and the cup-to-disc ratio at the optic nerve head. Subjects with schizophrenia also completed measures of symptoms, visual processing, and IQ. RESULTS The groups did not differ on RNFL, macula, or GCL-IPL thickness. However, thinning of these layers was related to the presence of diabetes or hypertension across the sample as a whole. The schizophrenia group demonstrated enlarged cup volume and an enlarged cup-to-disc ratio in both eyes, which were unrelated to medical comorbidity, but were related to increased cognitive symptoms. CONCLUSIONS Past reports of retinal thinning may be artifacts of medical comorbidity that is over-represented in schizophrenia, or other confounds. However, optic nerve head abnormalities may hold promise as biomarkers of central nervous system abnormality, including cognitive decline, in schizophrenia.
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Affiliation(s)
| | | | | | - Stuart Green
- Department of Ophthalmology,Robert Wood Johnson University Hospital,New Brunswick, NJ,USA
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Bagatini MD, dos Santos AA, Cardoso AM, Mânica A, Reschke CR, Carvalho FB. The Impact of Purinergic System Enzymes on Noncommunicable, Neurological, and Degenerative Diseases. J Immunol Res 2018; 2018:4892473. [PMID: 30159340 PMCID: PMC6109496 DOI: 10.1155/2018/4892473] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Revised: 07/03/2018] [Accepted: 07/22/2018] [Indexed: 12/11/2022] Open
Abstract
Evidences show that purinergic signaling is involved in processes associated with health and disease, including noncommunicable, neurological, and degenerative diseases. These diseases strike from children to elderly and are generally characterized by progressive deterioration of cells, eventually leading to tissue or organ degeneration. These pathological conditions can be associated with disturbance in the signaling mediated by nucleotides and nucleosides of adenine, in expression or activity of extracellular ectonucleotidases and in activation of P2X and P2Y receptors. Among the best known of these diseases are atherosclerosis, hypertension, cancer, epilepsy, Alzheimer's disease (AD), Parkinson's disease (PD), and multiple sclerosis (MS). The currently available treatments present limited effectiveness and are mostly palliative. This review aims to present the role of purinergic signaling highlighting the ectonucleotidases E-NTPDase, E-NPP, E-5'-nucleotidase, and adenosine deaminase in noncommunicable, neurological, and degenerative diseases associated with the cardiovascular and central nervous systems and cancer. In conclusion, changes in the activity of ectonucleotidases were verified in all reviewed diseases. Although the role of ectonucleotidases still remains to be further investigated, evidences reviewed here can contribute to a better understanding of the molecular mechanisms of highly complex diseases, which majorly impact on patients' quality of life.
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Affiliation(s)
- Margarete Dulce Bagatini
- Coordenação Acadêmica, Universidade Federal da Fronteira Sul, Campus Chapecó, Chapecó, SC, Brazil
- Programa de Pós-graduação em Ciências Biológicas-Bioquímica Toxicológica, Universidade Federal de Santa Maria, Santa Maria, RS, Brazil
| | | | - Andréia Machado Cardoso
- Coordenação Acadêmica, Universidade Federal da Fronteira Sul, Campus Chapecó, Chapecó, SC, Brazil
- Programa de Pós-graduação em Ciências Biológicas-Bioquímica Toxicológica, Universidade Federal de Santa Maria, Santa Maria, RS, Brazil
| | - Aline Mânica
- Programa de Pós-graduação em Ciências Biológicas-Bioquímica Toxicológica, Universidade Federal de Santa Maria, Santa Maria, RS, Brazil
| | - Cristina Ruedell Reschke
- Department of Physiology and Medical Physics, Royal College of Surgeons in Ireland, Dublin 2, Ireland
| | - Fabiano Barbosa Carvalho
- Programa de Pós-graduação em Ciências Biológicas-Bioquímica Toxicológica, Universidade Federal de Santa Maria, Santa Maria, RS, Brazil
- Laboratório de Pesquisa em Patologia, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil
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Roth AK, Denney DR, Burns JM, Lynch SG. Cognition in older patients with multiple sclerosis compared to patients with amnestic mild cognitive impairment and healthy older adults. Neuropsychology 2018; 32:654-663. [PMID: 29939057 PMCID: PMC6126957 DOI: 10.1037/neu0000453] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE Progress in the treatment of multiple sclerosis (MS) has resulted in larger numbers of patients living to an advanced age, but little is known about the cognitive status of these individuals. The primary purpose of this study was to identify differences in the cognitive performance between elderly individuals with MS and those with amnestic mild cognitive impairment (aMCI). METHOD Three groups ranging in age from 60 to 80 were compared: patients with MS (n = 64), patients with aMCI (n = 58), and healthy adults (n = 70). All participants completed a standard neuropsychological test battery that evaluated domains of attention, processing speed, executive function, memory, language, and visual spatial function. RESULTS Compared to age- and gender-matched healthy controls, elderly MS patients exhibited a pattern of cognitive impairment centering on information processing speed and memory that was consistent with the deficits observed in other studies of MS patients regardless of age. Compared to aMCI patients, the MS patients exhibited worse performance on measures of processing speed, but better performance on a measure of memory under cued conditions (Selective Reminding Test), a nonspeeded measure of language (Boston Naming Test), and measures of executive function with processing speed statistically controlled (Trail Making Test, Stroop Test). CONCLUSIONS Differences on neuropsychological measures can serve to distinguish aMCI from MS-related cognitive impairment in older patients, but it is essential that these measures control for the deficit in processing speed that is such a primary feature of MS. (PsycINFO Database Record
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Affiliation(s)
| | | | - Jeffrey M Burns
- Department of Neurology, University of Kansas Medical Center
| | - Sharon G Lynch
- Department of Neurology, University of Kansas Medical Center
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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]
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Crescentini C, Matiz A, Cimenti M, Pascoli E, Eleopra R, Fabbro F. Effect of Mindfulness Meditation on Personality and Psychological Well-being in Patients with Multiple Sclerosis. Int J MS Care 2018; 20:101-108. [PMID: 29896046 PMCID: PMC5991502 DOI: 10.7224/1537-2073.2016-093] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Varied evidence shows that mindfulness-oriented meditation improves individuals' mental health, positively influencing practitioners' personality profiles as well. A limited number of studies are beginning to show that this type of meditation may also be a helpful therapeutic option for persons with multiple sclerosis (MS). METHODS We evaluated the effects of an 8-week mindfulness-oriented meditation training on the personality profiles, anxiety and depression symptoms, and mindfulness skills of a group of patients with MS. A control group of patients with MS not enrolled in any training was also tested. RESULTS After mindfulness-oriented meditation training, participants in this group (n = 15) showed an increase in character traits reflecting the maturity of the self at the intrapersonal (self-directedness) and interpersonal (cooperativeness) levels. Moreover, increased mindfulness and conscientiousness and decreased trait anxiety were observed in participants after the training. CONCLUSIONS These data support the utility for patients with MS of therapeutic interventions based on mindfulness meditation that may lead to enhanced character and self-maturity.
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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.
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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
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Beste C, Mückschel M, Paucke M, Ziemssen T. Dual-Tasking in Multiple Sclerosis - Implications for a Cognitive Screening Instrument. Front Hum Neurosci 2018; 12:24. [PMID: 29445335 PMCID: PMC5797790 DOI: 10.3389/fnhum.2018.00024] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Accepted: 01/16/2018] [Indexed: 01/22/2023] Open
Abstract
The monitoring of cognitive functions is central to the assessment and consecutive management of multiple sclerosis (MS). Though, especially cognitive processes that are central to everyday behavior like dual-tasking are often neglected. We examined dual-task performance using a psychological-refractory period (PRP) task in N = 21 patients and healthy controls and conducted standard neuropsychological tests. In dual-tasking, MS patients committed more erroneous responses when dual-tasking was difficult. In easier conditions, performance of MS patients did not differ to controls. Interestingly, the response times were generally not affected by the difficulty of the dual task, showing that the deficits observed do not reflect simple motor deficits or deficits in information processing speed but point out deficits in executive control functions and response selection in particular. Effect sizes were considerably large with d∼0.80 in mild affected patients and the achieved power was above 99%. There are cognitive control and dual tasking deficits in MS that are not attributable to simple motor speed deficits. Scaling of the difficulty of dual-tasking makes the test applied suitable for a wide variety of MS-patients and may complement neuropsychological assessments in clinical care and research setting.
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Affiliation(s)
- Christian Beste
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Moritz Mückschel
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany.,Multiple Sclerosis Center, Center of Clinical Neuroscience, Department of Neurology, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Madlen Paucke
- Multiple Sclerosis Center, Center of Clinical Neuroscience, Department of Neurology, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Tjalf Ziemssen
- Multiple Sclerosis Center, Center of Clinical Neuroscience, Department of Neurology, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
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Matias-Guiu JA, Cortés-Martínez A, Valles-Salgado M, Oreja-Guevara C, Pytel V, Montero P, Moreno-Ramos T, Matias-Guiu J. Functional Components of Cognitive Impairment in Multiple Sclerosis: A Cross-Sectional Investigation. Front Neurol 2017; 8:643. [PMID: 29234305 PMCID: PMC5712315 DOI: 10.3389/fneur.2017.00643] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Accepted: 11/16/2017] [Indexed: 12/14/2022] Open
Abstract
Background Cognitive impairment is frequent and disabling in multiple sclerosis (MS). Changes in information processing speed constitute the most important cognitive deficit in MS. However, given the clinical and topographical variability of the disease, cognitive impairment may vary greatly and appear in other forms in addition to slower information processing speed. Our aim was to determine the frequency of cognitive impairment, the principal cognitive domains, and components involved in MS and to identify factors associated with presence of cognitive impairment in these patients in a large series of patients. Methods Cross-sectional study of 311 patients with MS [236 with relapsing-remitting MS (RRMS), 52 with secondary progressive MS (SPMS), and 23 with primary progressive MS (PPMS)]. Patients' cognitive function was assessed with a comprehensive neuropsychological assessment protocol. Patients displaying deficits in 2 or more cognitive domains were considered to have cognitive impairment associated with MS. We conducted a principal component analysis to detect different cognitive patterns by identifying clusters of tests highly correlated to one another. Results Cognitive impairment was detected in 41.5% of the sample, and it was more frequent in patients with SPMS and PPMS (P = 0.002). Expanded Disability Status Scale scores and education were independent predictors of cognitive impairment. Principal component analysis identified seven clusters: attention and basic executive function (including information processing speed), planning and high-level executive function, verbal memory and language, executive and visuospatial performance time, fatigue-depression, visuospatial function, and basic attention and verbal/visual working memory. Mean scoring of components 2 (high-order executive functioning) and 3 (verbal memory-language) was higher in patients with RRMS than in those with PPMS (component 2) and SPMS (component 3). Conclusion MS is linked to multiple cognitive profiles and disturbances in different domains. This suggests that cognitive alterations in MS are heterogeneous and affect other domains in addition to information processing speed.
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Affiliation(s)
- Jordi A Matias-Guiu
- Department of Neurology, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Universidad Complutense de Madrid, Madrid, Spain
| | - Ana Cortés-Martínez
- Department of Neurology, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Universidad Complutense de Madrid, Madrid, Spain
| | - María Valles-Salgado
- Department of Neurology, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Universidad Complutense de Madrid, Madrid, Spain
| | - Celia Oreja-Guevara
- Department of Neurology, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Universidad Complutense de Madrid, Madrid, Spain
| | - Vanesa Pytel
- Department of Neurology, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Universidad Complutense de Madrid, Madrid, Spain
| | - Paloma Montero
- Department of Neurology, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Universidad Complutense de Madrid, Madrid, Spain
| | - Teresa Moreno-Ramos
- Department of Neurology, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Universidad Complutense de Madrid, Madrid, Spain
| | - Jorge Matias-Guiu
- Department of Neurology, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Universidad Complutense de Madrid, Madrid, Spain
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48
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Merkt H, Sadeghi Bahmani D, Calabrese P, Naegelin Y, Gerber M, Pühse U, Holsboer-Trachsler E, Brand S. Multiple Sclerosis: Associations Between Physical Disability and Depression Are Not Mediated by Self-Reported Physical Activity. Percept Mot Skills 2017; 124:974-991. [DOI: 10.1177/0031512517711851] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study investigated the interrelatedness of physical disability, physical activity, and depression among patients with multiple sclerosis (MS). We hypothesized that self-reported physical activity would mediate the effect of disability on depressive symptoms. Twenty-seven patients with MS (mean age: 49 years; 44.5% females) completed self-rating scales covering sociodemographic variables, intake of antidepressants, physical activity, and symptoms of depression; disability was measured by the Expanded Disability Status Scale. We found a higher level of disability to be significantly associated with more symptoms of depression. While higher reported physical activity was descriptively associated with lower depression scores and unrelated to Expanded Disability Status Scale, physical activity levels did not mediate the effect of disability on depressive symptoms.
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Affiliation(s)
- Helene Merkt
- Division of Molecular and Cognitive Neurosciences, Faculty of Psychology, University of Basel, Basel, Switzerland
| | - Dena Sadeghi Bahmani
- Psychiatric Clinics (UPK), Center for Affective, Stress and Sleep Disorders (ZASS), University of Basel, Basel, Switzerland
| | - Pasquale Calabrese
- Division of Molecular and Cognitive Neurosciences, Faculty of Psychology, University of Basel, Basel, Switzerland
| | - Yvonne Naegelin
- Department of Neurology, University Hospital, Basel, Switzerland
| | - Markus Gerber
- Department of Sport, Exercise and Health, Division of Sport and Psychosocial Health, Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Uwe Pühse
- Department of Sport, Exercise and Health, Division of Sport and Psychosocial Health, Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Edith Holsboer-Trachsler
- Psychiatric Clinics (UPK), Center for Affective, Stress and Sleep Disorders (ZASS), University of Basel, Basel, Switzerland
| | - Serge Brand
- Psychiatric Clinics (UPK), Center for Affective, Stress and Sleep Disorders (ZASS), University of Basel, Basel, Switzerland
- Department of Sport, Exercise and Health, Division of Sport and Psychosocial Health, Faculty of Medicine, University of Basel, Basel, Switzerland
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49
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Linck JF, Ostermeyer B, Valles NL, Flores A, Shah AA. The Role of Psychologists in Adult Attention-Deficit/Hyperactivity Disorder Testing. Psychiatr Ann 2017. [DOI: 10.3928/00485713-20170511-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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50
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De Looze C, Moreau N, Renié L, Kelly F, Ghio A, Rico A, Audoin B, Viallet F, Pelletier J, Petrone C. Effects of cognitive impairment on prosodic parameters of speech production planning in multiple sclerosis. J Neuropsychol 2017; 13:22-45. [PMID: 28544439 DOI: 10.1111/jnp.12127] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Revised: 03/17/2017] [Indexed: 12/14/2022]
Abstract
Cognitive impairment (CI) affects 40-65% of patients with multiple sclerosis (MS). CI can have a negative impact on a patient's everyday activities, such as engaging in conversations. Speech production planning ability is crucial for successful verbal interactions and thus for preserving social and occupational skills. This study investigates the effect of cognitive-linguistic demand and CI on speech production planning in MS, as reflected in speech prosody. A secondary aim is to explore the clinical potential of prosodic features for the prediction of an individual's cognitive status in MS. A total of 45 subjects, that is 22 healthy controls (HC) and 23 patients in early stages of relapsing-remitting MS, underwent neuropsychological tests probing specific cognitive processes involved in speech production planning. All subjects also performed a read speech task, in which they had to read isolated sentences manipulated as for phonological length. Results show that the speech of MS patients with CI is mainly affected at the temporal level (articulation and speech rate, pause duration). Regression analyses further indicate that rate measures are correlated with working memory scores. In addition, linear discriminant analysis shows the ROC AUC of identifying MS patients with CI is 0.70 (95% confidence interval: 0.68-0.73). Our findings indicate that prosodic planning is deficient in patients with MS-CI and that the scope of planning depends on patients' cognitive abilities. We discuss how speech-based approaches could be used as an ecological method for the assessment and monitoring of CI in MS.
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Affiliation(s)
- Céline De Looze
- Laboratoire Parole et Langage, UMR 7309, Aix-Marseille University, Aix-en-Provence, France.,Trinity Centre for Bioengineering, TBSI, Trinity College Dublin, Ireland
| | - Noémie Moreau
- Laboratoire Parole et Langage, UMR 7309, Aix-Marseille University, Aix-en-Provence, France.,Neurology Department, Aix en Provence Hospital, Aix-en-Provence, France
| | - Laurent Renié
- Neurology Department, Aix en Provence Hospital, Aix-en-Provence, France
| | - Finnian Kelly
- Trinity Centre for Bioengineering, TBSI, Trinity College Dublin, Ireland
| | - Alain Ghio
- Laboratoire Parole et Langage, UMR 7309, Aix-Marseille University, Aix-en-Provence, France
| | - Audrey Rico
- Department of Neurology, CHU Timone, APHM, Aix-Marseille University, Marseille, France
| | - Bertrand Audoin
- Department of Neurology, CHU Timone, APHM, Aix-Marseille University, Marseille, France
| | - François Viallet
- Laboratoire Parole et Langage, UMR 7309, Aix-Marseille University, Aix-en-Provence, France.,Neurology Department, Aix en Provence Hospital, Aix-en-Provence, France
| | - Jean Pelletier
- Department of Neurology, CHU Timone, APHM, Aix-Marseille University, Marseille, France
| | - Caterina Petrone
- Laboratoire Parole et Langage, UMR 7309, Aix-Marseille University, Aix-en-Provence, France
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