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Zajac L, Chiesa P, Deloire M, Scaramozza M, Sun Z, Tang M, Juraver A, Bartholomé E, Saubusse A, Charre-Morrin J, Campbell N, Van Beek J, Guymard T, Scotland A, Brochet B, Belachew S, Ruet A. Performances cognitives variables associées aux codes fixe ou dynamique au sein du test de vitesse de traitement cognitif (CPS) de l’application KonectomTM sur smartphone. Rev Neurol (Paris) 2023. [DOI: 10.1016/j.neurol.2023.01.697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
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Blyau S, Koubiyr I, Saranathan M, Coupé P, Deloire M, Charré-Morin J, Saubusse A, Zhang B, Rutt B, Dousset V, Brochet B, Ruet A, Tourdias T. Differential vulnerability of thalamic nuclei in multiple sclerosis. Mult Scler 2023; 29:295-300. [PMID: 35959722 DOI: 10.1177/13524585221114247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Investigating differential vulnerability of thalamic nuclei in multiple sclerosis (MS). METHODS In a secondary analysis of prospectively collected datasets, we pooled 136 patients with MS or clinically isolated syndrome and 71 healthy controls all scanned with conventional 3D-T1 and white-matter-nulled magnetization-prepared rapid gradient echo (WMn-MPRAGE) and tested for cognitive performance. T1-based thalamic segmentation was compared with the reference WMn-MPRAGE method. Volumes of thalamic nuclei were compared according to clinical phenotypes and cognitive profile. RESULTS T1- and WMn-MPRAGE provided comparable segmentations (0.84 ± 0.13 < volume-similarity-index < 0.95 ± 0.03). Medial and posterior thalamic groups were significantly more affected than anterior and lateral groups. Cognitive impairment related to volume loss of the anterior group. CONCLUSION Thalamic nuclei closest to the third ventricle are more affected, with cognitive consequences.
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Affiliation(s)
- Simon Blyau
- Neuroimagerie diagnostique et thérapeutique, CHU de Bordeaux, Bordeaux, France
| | - Ismail Koubiyr
- University of Bordeaux, INSERM, Neurocentre Magendie, U1215, Bordeaux, France
| | | | - Pierrick Coupé
- University of Bordeaux, CNRS, Bordeaux INP, LABRI, UMR5800, Talence, France
| | | | | | | | - Bei Zhang
- Canon Medical Systems Europe, Zoetermeer, The Netherlands
| | - Brian Rutt
- Department of Radiology, Stanford University, Stanford, CA, USA
| | - Vincent Dousset
- Neuroimagerie diagnostique et thérapeutique, CHU de Bordeaux, Bordeaux, France/University of Bordeaux, INSERM, Neurocentre Magendie, U1215, Bordeaux, France
| | - Bruno Brochet
- University of Bordeaux, INSERM, Neurocentre Magendie, U1215, Bordeaux, France
| | - Aurélie Ruet
- University of Bordeaux, INSERM, Neurocentre Magendie, U1215, Bordeaux, France/Service de neurologie, CHU de Bordeaux, Bordeaux, France
| | - Thomas Tourdias
- Neuroimagerie diagnostique et thérapeutique, CHU de Bordeaux, Bordeaux, France/University of Bordeaux, INSERM, Neurocentre Magendie, U1215, Bordeaux, France
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Koubiyr I, Dulau-Metras C, Deloire M, Charré-Morin J, Saubusse A, Brochet B, Ruet A. Amygdala network reorganization mediates the theory of mind performances in multiple sclerosis. J Neurosci Res 2021; 100:537-550. [PMID: 34796987 DOI: 10.1002/jnr.24986] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 09/28/2021] [Accepted: 10/04/2021] [Indexed: 01/23/2023]
Abstract
Theory of mind (ToM) seems to be affected in multiple sclerosis (MS). MRI studies suggested a role of the amygdala in social cognitive performances. Therefore, we explored the role of the amygdala network in ToM using a multimodal MRI approach. In MS, patients with impaired ToM showed contradictory dysexecutive neuropsychological profile. Therefore, we compared neural networks involved in ToM and executive functions (EFs). Twenty patients with relapsing-remitting MS and 15 matched healthy controls were selected. ToM (Faux Pas test and mind stories) and EFs were assessed within and outside the scanner. All subjects underwent a battery of neuropsychological tests. Multimodal MRI with structural (diffusion imaging) and functional (resting-state and task-based) sequences was used to analyze the role and connections of the amygdala in ToM functioning. Cognitive and ToM performances were similar between patients and controls. Resting-state data revealed decreased connectivity of the left amygdala with frontal areas in patients compared to controls (p < 0.0001). During the task-based functional MRI, patients demonstrated increased connectivity between the amygdala and several cerebellar and left temporal regions (all p < 0.05). The microstructural alterations between the left amygdala and left temporal regions were associated with increased functional connectivity within the same pathway (r = 0.74; p < 0.01). No overlap was observed between functional networks involved in ToM and EFs. Our study demonstrates more connectivity recruitment between the amygdala and cerebellar and temporal regions in MS patients to reach preserved ToM performance. Microstructural abnormalities have been related to this compensatory network. Finally, different networks were involved in EFs and ToM.
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Affiliation(s)
- Ismail Koubiyr
- Neurocentre Magendie, INSERM U1215, Univ. Bordeaux, Bordeaux, France
| | | | | | | | | | - Bruno Brochet
- Neurocentre Magendie, INSERM U1215, Univ. Bordeaux, Bordeaux, France
| | - Aurélie Ruet
- Neurocentre Magendie, INSERM U1215, Univ. Bordeaux, Bordeaux, France.,CHU de Bordeaux, Bordeaux, France
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Maubeuge N, Deloire MS, Brochet B, Charré-Morin J, Saubusse A, Ruet A. Validation of a Brief Computerized Cognitive Assessment in Multiple Sclerosis (BCCAMS) and comparison with reference batteries. Mult Scler 2021; 28:1112-1120. [PMID: 34766866 DOI: 10.1177/13524585211054006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND The Brief Computerized Cognitive Assessment in Multiple Sclerosis (BCCAMS) is a short neuropsychological battery for persons with multiple sclerosis (PwMS). OBJECTIVES The main objective of the study is to validate the BCCAMS. METHODS PwMS and healthy subjects (HS) were evaluated using the BCCAMS which include two computerized tests, the Computerized Speed Cognitive Test and the Computerized Episodic Visual Memory Test (CEVMT), a newly developed visuospatial memory test, and the French learning test. The Minimal Assessment of Cognitive Function in MS (MACFIMS), including the Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) tests, was also administered. Regression-based norms of the BCCAMS were calculated in 276 HS. BCCAMS was compared with BICAMS and MACFIMS for detection of cognitive impairment (CI). RESULTS Out of 120 PwMS, CI was detected using the BCCAMS, BICAMS (one impaired test), and MACFIMS (two impaired tests) in 59.1%, 50%, and 37.9%, respectively. The BCCAMS produced the same predictive value as that of the BICAMS battery for detecting CI in the MACFIMS. CONCLUSION This study validated the BCCAMS as a validated computerized short assessment for information processing speed and learning in MS.
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Affiliation(s)
| | | | - Bruno Brochet
- INSERM U1215, Neurocentre Magendie, Université de Bordeaux, Bordeaux, France/Univ. Bordeaux, Bordeaux, France
| | | | | | - Aurélie Ruet
- CHU de Bordeaux, Bordeaux, France/INSERM U1215, Neurocentre Magendie, Bordeaux, France/Univ. Bordeaux, Bordeaux, France
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Boscheron J, Ruet A, Deloire M, Charré-Morin J, Saubusse A, Brochet B, Tourdias T, Koubiyr I. Insights on the Relationship Between Hippocampal Connectivity and Memory Performances at the Early Stage of Multiple Sclerosis. Front Neurol 2021; 12:667531. [PMID: 34093415 PMCID: PMC8170471 DOI: 10.3389/fneur.2021.667531] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Accepted: 04/19/2021] [Indexed: 11/13/2022] Open
Abstract
While memory impairment in multiple sclerosis (MS) is known to be associated with hippocampal alterations, whether hippocampal networks could dynamically reorganize as a compensation mechanism is still a matter of debate. In this context, our aim was to identify the patterns of structural and functional connectivity between the hippocampus and the rest of the brain and their possible relevance to memory performances in early MS. Thirty-two patients with a first episode suggestive of MS together with 10 matched healthy controls were prospectively explored at baseline, 1 and 5 years follow up. They were scanned with MRI and underwent a neuropsychological battery of tests that included the Selective Reminding Test and the Brief Visual Memory Test Revised to assess verbal and visuo-spatial memory, respectively. Hippocampal volume was computed together with four graph theory metrics to study the structural and functional connectivity of both hippocampi with the rest of the brain. Associations between network parameters and memory performances were assessed using linear mixed-effects (LME) models. Considering cognitive abilities, verbal memory performances of patients decreased over time while visuo-spatial memory performances were maintained. In parallel, hippocampal volumes decreased significantly while structural and functional connectivity metrics were modified, with an increase in hippocampal connections over time. More precisely, these modifications were indicating a reinforcement of hippocampal short-distance connections. LME models revealed that the drop in verbal memory performances was associated with hippocampal volume loss, while the preservation of visuo-spatial memory performances was linked to decreased hippocampal functional shortest path length. In conclusion, we demonstrated a differential impairment in memory performances in the early stages of MS and an important interplay between hippocampal-related structural and functional networks and those performances. As the structural damage increases, functional reorganization seems to be able to maintain visuo-spatial memory performances with strengthened short-distance connections.
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Affiliation(s)
| | - Aurélie Ruet
- Univ. Bordeaux, INSERM, Neurocentre Magendie, U1215, Bordeaux, France.,CHU de Bordeaux, Service de Neurologie, Bordeaux, France
| | | | | | | | - Bruno Brochet
- Univ. Bordeaux, INSERM, Neurocentre Magendie, U1215, Bordeaux, France
| | - Thomas Tourdias
- Univ. Bordeaux, INSERM, Neurocentre Magendie, U1215, Bordeaux, France.,CHU de Bordeaux, Neuroimagerie diagnostique et thérapeutique, Bordeaux, France
| | - Ismail Koubiyr
- Univ. Bordeaux, INSERM, Neurocentre Magendie, U1215, Bordeaux, France
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Maubeuge N, Deloire MSA, Brochet B, Ehrlé N, Charré-Morin J, Saubusse A, Ruet A. Validation of the French version of the minimal assessment of cognitive function in multiple sclerosis (MACFIMS). Mult Scler Relat Disord 2020; 48:102692. [PMID: 33352358 DOI: 10.1016/j.msard.2020.102692] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 11/18/2020] [Accepted: 12/13/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND The Minimal Assessment of Cognitive Function in Multiple sclerosis (MACFIMS) is an internationally recognised battery of neuropsychological tests for patients with multiple sclerosis (MS). OBJECTIVES To establish regression-based norms for the MACFIMS in French-speaking healthy subjects (HS) and validate its use in persons with multiple sclerosis (PwMS). METHODS 136 PwMS, including 43 with relapsing-remitting MS, 46 with secondary progressive MS and 45 with primary progressive MS, as well as 276 HS were enrolled. Regression-based norms and validity were established for the seven tests of the MACIMS: the Symbol Digit Modalities Test (SDMT), the Paced Auditory Serial Addition Test (PASAT), the French learning test (FLT) a French-adapted memory test (or the California Verbal Learning Test (CVLT) at re-testing), the Judgment of Line Orientation Test (JLO), the 'épreuve de classement de cartes de Champagne' (ECCC), a French adaptation of the DKEF-sorting test, the Brief Visuospatial Memory Test (BVMT-R) and the Controlled Oral Word Association Test (COWAT). RESULTS Regression-based norms of MACFIMS tests were established in the HS population. The MACFIMS battery was able to identify cognitive impairment (CI) (at least two abnormal tests in different domains) in 32.7% of PwMS. The domains with more frequent impairment were (in descending order): learning followed by IPS, delayed memory, verbal fluency and working memory. CONCLUSION This study established the regression-based norms for French subjects of the French adaptation of the MACFIMS and its validity in PwMS.
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Affiliation(s)
| | | | - Bruno Brochet
- CHU de Bordeaux, F-33000 Bordeaux, France; Inserm U1215 - Neurocentre Magendie, F-33000 Bordeaux, France; Univ. Bordeaux, F-33076 Bordeaux, France.
| | | | | | | | - Aurélie Ruet
- CHU de Bordeaux, F-33000 Bordeaux, France; Inserm U1215 - Neurocentre Magendie, F-33000 Bordeaux, France; Univ. Bordeaux, F-33076 Bordeaux, France
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Koubiyr I, Deloire M, Brochet B, Besson P, Charré-Morin J, Saubusse A, Tourdias T, Ruet A. Structural constraints of functional connectivity drive cognitive impairment in the early stages of multiple sclerosis. Mult Scler 2020; 27:559-567. [PMID: 33283582 DOI: 10.1177/1352458520971807] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The relationship between structural and functional deficits in multiple sclerosis (MS) is unclear. OBJECTIVE This study explored structure-function relationships during the 5 years following a clinically isolated syndrome and their role in cognitive performance. METHODS Thirty-two patients were enrolled after their first neurological episode suggestive of MS and followed for 5 years, along with 10 matched healthy controls. We assessed structural (using diffusion tensor imaging) and functional (using resting-state functional magnetic resonance imaging (fMRI)) brain network metrics, clinical and cognitive scores at each follow-up visit. Structural-functional coupling, calculated as the correlation coefficient between strengths of structural and functional networks, was used to assess structure-function relationships. RESULTS Structural clustering coefficient was significantly increased after 5 years, whereas characteristic path length decreased. Structural connections decreased after 1 year and increased after 5 years. Functional connections and related path lengths were decreased after 5 years. Structural-functional coupling had increased significantly after 5 years. This structural-functional coupling was associated with cognitive and clinical evolution, with stronger coupling associated with a decline in both domains. CONCLUSION Our findings provide novel biological evidence that MS leads to a more constrained anatomical-dependant functional connectivity. The collapse of this network seems to lead to both cognitive worsening and clinical disability.
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Affiliation(s)
- Ismail Koubiyr
- University of Bordeaux, Bordeaux, France; Inserm U1215 - Neurocentre Magendie, Bordeaux, France
| | | | - Bruno Brochet
- University of Bordeaux, Bordeaux, France; Inserm U1215 - Neurocentre Magendie, Bordeaux, France; CHU Pellegrin Bordeaux, Bordeaux, France
| | - Pierre Besson
- Department of Radiology, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA; Department of Neurological Surgery, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | | | | | - Thomas Tourdias
- University of Bordeaux, Bordeaux, France; Inserm U1215 - Neurocentre Magendie, Bordeaux, France; CHU Pellegrin Bordeaux, Bordeaux, France
| | - Aurélie Ruet
- University of Bordeaux, Bordeaux, France; Inserm U1215 - Neurocentre Magendie, Bordeaux, France; CHU Pellegrin Bordeaux, Bordeaux, France
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Lamargue D, Koubiyr I, Deloire M, Saubusse A, Charre-Morin J, Moroso A, Coupé P, Brochet B, Ruet A. Effect of cognitive rehabilitation on neuropsychological and semiecological testing and on daily cognitive functioning in multiple sclerosis: The REACTIV randomized controlled study. J Neurol Sci 2020; 415:116929. [PMID: 32460145 DOI: 10.1016/j.jns.2020.116929] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 04/22/2020] [Accepted: 05/15/2020] [Indexed: 01/05/2023]
Abstract
BACKGROUND Specific cognitive rehabilitation (SCR) has been suggested for multiple sclerosis (MS). A randomized controlled trial (RCT) evaluating the therapeutic effects of SCR is necessary. OBJECTIVE To demonstrate the superiority of a SCR program (REACTIV) over nonspecific intervention (NSI) for neuropsychological (NP) assessment, virtual reality (VR) cognitive testing and daily cognitive functioning. METHODS A single-blind RCT compared SCR and NSI in patients with MS with cognitive complaint. Both programs included 50 individual sessions, 3 times a week for 17 weeks in a real-world setting. The primary end-point was NP assessment. Secondary end-points included semiecological VR tasks (Urban Daily Cog®) and daily cognitive functioning assessment. Maintenance of the effects at 8 months was studied. RESULTS Of the 35 patients, 18 completed the SCR, and 17 completed the NSI. Several NP and semiecological scores improved significantly more after SCR than after NSI. More NP scores improved significantly after SCR than after NSI. SCR improved daily cognitive functioning. Most improvements were maintained at 8 months. CONCLUSION SCR performed in a real-world setting is superior to NSI for improving performance in specific cognitive domains and information processing speed, and for improving cognitive functioning, as evaluated by ecological tools close to daily life and a daily cognitive functioning questionnaire.
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Affiliation(s)
- D Lamargue
- Univ. Bordeaux, F-33000 Bordeaux, France; Inserm U1215 - Neurocentre Magendie, F-33000 Bordeaux, France
| | - I Koubiyr
- Univ. Bordeaux, F-33000 Bordeaux, France; Inserm U1215 - Neurocentre Magendie, F-33000 Bordeaux, France
| | - M Deloire
- CHU de Bordeaux, F-33000 Bordeaux, France
| | - A Saubusse
- CHU de Bordeaux, F-33000 Bordeaux, France
| | | | - A Moroso
- CHU de Bordeaux, F-33000 Bordeaux, France
| | - P Coupé
- Laboratoire Bordelais de Recherche en Informatique, UMR CNRS 5800, PICTURA, F-33405 Talence, France
| | - B Brochet
- Univ. Bordeaux, F-33000 Bordeaux, France; Inserm U1215 - Neurocentre Magendie, F-33000 Bordeaux, France; CHU de Bordeaux, F-33000 Bordeaux, France.
| | - A Ruet
- Univ. Bordeaux, F-33000 Bordeaux, France; Inserm U1215 - Neurocentre Magendie, F-33000 Bordeaux, France; CHU de Bordeaux, F-33000 Bordeaux, France
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Koubiyr I, Besson P, Deloire M, Charre-Morin J, Saubusse A, Tourdias T, Brochet B, Ruet A. Dynamic modular-level alterations of structural-functional coupling in clinically isolated syndrome. Brain 2020; 142:3428-3439. [PMID: 31504228 DOI: 10.1093/brain/awz270] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 06/24/2019] [Accepted: 07/11/2019] [Indexed: 11/14/2022] Open
Abstract
Structural and functional connectivity abnormalities have been reported previously in multiple sclerosis. However, little is known about how each modality evolution relates to the other. Recent studies in other neurological disorders have suggested that structural-functional coupling may be more sensitive in detecting brain alterations than any single modality. Accordingly, this study aimed to investigate the longitudinal evolution of structural-functional coupling, both at the global and modular levels, in the first year following clinically isolated syndrome. We hypothesized that during the course of multiple sclerosis, patients exhibit a decoupling between functional and structural connectivity due to the disruptive nature of the disease. Forty-one consecutive patients with clinically isolated syndrome were prospectively enrolled in this study, along with 19 age-, sex- and educational level-matched healthy control subjects. These participants were followed for 1 year and underwent resting-state functional MRI and diffusion tensor imaging at each time point, along with an extensive neuropsychological assessment. Graph theory analysis revealed structural reorganization at baseline that appeared as an increase in the clustering coefficient in patients compared to controls (P < 0.05), as well as modular-specific alterations. After 1 year of follow-up, both structural and functional reorganization was depicted with abnormal modular-specific connectivity and an increase of the functional betweenness centrality in patients compared to controls (P < 0.01). More importantly, structural-functional decoupling was observed in the salience, visual and somatomotor networks. These alterations were present along with preserved cognitive performance at this stage. These results depict structural damage preceding functional reorganization at a global and modular level during the first year following clinically isolated syndrome along with normal cognitive performance, suggesting a compensation mechanism at this stage of the disease. Principally, structural-functional decoupling observed for the first time in multiple sclerosis suggests that functional reorganization occurs along indirect anatomical pathways.
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Affiliation(s)
- Ismail Koubiyr
- University of Bordeaux, F Bordeaux, France.,Inserm U1215 - Neurocentre Magendie, F Bordeaux, France
| | - Pierre Besson
- Department of Radiology, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA.,Department of Neurological Surgery, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | | | | | | | - Thomas Tourdias
- University of Bordeaux, F Bordeaux, France.,Inserm U1215 - Neurocentre Magendie, F Bordeaux, France.,CHU de Bordeaux, F Bordeaux, France
| | - Bruno Brochet
- University of Bordeaux, F Bordeaux, France.,Inserm U1215 - Neurocentre Magendie, F Bordeaux, France.,CHU de Bordeaux, F Bordeaux, France
| | - Aurélie Ruet
- University of Bordeaux, F Bordeaux, France.,Inserm U1215 - Neurocentre Magendie, F Bordeaux, France.,CHU de Bordeaux, F Bordeaux, France
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Gagnol A, Ruet A, Mathilde D, Charre-Morrin J, Saubusse A, Brochet B. Étude et description des déterminants de la qualité de vie au stade de syndrome cliniquement isolé. Rev Neurol (Paris) 2018. [DOI: 10.1016/j.neurol.2018.01.363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Moroso A, Ruet A, Lamargue-Hamel D, Munsch F, Deloire M, Ouallet JC, Cubizolle S, Charré-Morin J, Saubusse A, Tourdias T, Dousset V, Brochet B. Preliminary evidence of the cerebellar role on cognitive performances in clinically isolated syndrome. J Neurol Sci 2017; 385:1-6. [PMID: 29406885 DOI: 10.1016/j.jns.2017.11.037] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Revised: 11/02/2017] [Accepted: 11/29/2017] [Indexed: 01/29/2023]
Abstract
BACKGROUND Cerebellar and cognitive dysfunction can occur early in clinically isolated syndrome (CIS). Eye tracking is a reliable tool for the evaluation of both subtle cerebellar symptoms and cognitive impairment. OBJECTIVES To investigate the early cognitive profile using neuropsychological and ocular motor (OM) testing in CIS with and without cerebellar dysfunction with OM testing compared to healthy subjects (HS). METHODS Twenty-eight patients and 12 HC underwent OM and neuropsychological testing. Cerebellar impairment was defined by the registration of saccadic intrusions and/or at least 10% of dysmetria during ocular motor recording. Visually guided saccade (VGS), memory-guided saccade (MGS) and antisaccade (AS) paradigms were compared to neuropsychological assessments. RESULTS The group of patients with cerebellar dysfunction (n=16) performed worse on MGS latencies and error rates, and had worse working memory, executive function and information processing speed (IPS) z scores than patients without cerebellar dysfunction. IPS was correlated with the AS error rate in all patients and with the VGS error rate and the MGS final eye position ratio in cerebellar patients. CONCLUSION Eye tracking is a sensitive tool to assess cognitive and cerebellar dysfunctions in CIS. In CIS patients, cerebellar impairment is associated with working memory, executive functions and IPS slowness.
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Affiliation(s)
- Amandine Moroso
- CHU de Bordeaux, INSERM-CHU CIC-P 0005, Service de Neurologie, Bordeaux F-33076, France; Université de Bordeaux, Bordeaux F-33076, France; Neurocentre Magendie, INSERM U1215, Team Glia-neuron Interactions, Bordeaux F-33077, France
| | - Aurélie Ruet
- CHU de Bordeaux, INSERM-CHU CIC-P 0005, Service de Neurologie, Bordeaux F-33076, France; Université de Bordeaux, Bordeaux F-33076, France; Neurocentre Magendie, INSERM U1215, Team Glia-neuron Interactions, Bordeaux F-33077, France
| | - Delphine Lamargue-Hamel
- Université de Bordeaux, Bordeaux F-33076, France; Neurocentre Magendie, INSERM U1215, Team Glia-neuron Interactions, Bordeaux F-33077, France
| | - Fanny Munsch
- Université de Bordeaux, Bordeaux F-33076, France; Neurocentre Magendie, INSERM U1215, Team Glia-neuron Interactions, Bordeaux F-33077, France
| | - Mathilde Deloire
- CHU de Bordeaux, INSERM-CHU CIC-P 0005, Service de Neurologie, Bordeaux F-33076, France
| | | | - Stéphanie Cubizolle
- CHU de Bordeaux, INSERM-CHU CIC-P 0005, Service de Neurologie, Bordeaux F-33076, France
| | - Julie Charré-Morin
- CHU de Bordeaux, INSERM-CHU CIC-P 0005, Service de Neurologie, Bordeaux F-33076, France
| | - Aurore Saubusse
- CHU de Bordeaux, INSERM-CHU CIC-P 0005, Service de Neurologie, Bordeaux F-33076, France
| | - Thomas Tourdias
- CHU de Bordeaux, INSERM-CHU CIC-P 0005, Service de Neurologie, Bordeaux F-33076, France; Université de Bordeaux, Bordeaux F-33076, France; Neurocentre Magendie, INSERM U1215, Team Glia-neuron Interactions, Bordeaux F-33077, France
| | - Vincent Dousset
- CHU de Bordeaux, INSERM-CHU CIC-P 0005, Service de Neurologie, Bordeaux F-33076, France; Université de Bordeaux, Bordeaux F-33076, France; Neurocentre Magendie, INSERM U1215, Team Glia-neuron Interactions, Bordeaux F-33077, France
| | - Bruno Brochet
- CHU de Bordeaux, INSERM-CHU CIC-P 0005, Service de Neurologie, Bordeaux F-33076, France; Université de Bordeaux, Bordeaux F-33076, France; Neurocentre Magendie, INSERM U1215, Team Glia-neuron Interactions, Bordeaux F-33077, France.
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Planche V, Moisset X, Morello R, Dumont E, Gibelin M, Charré-Morin J, Saubusse A, Mondou A, Reuter F, Defer G, Pelletier J, Brochet B, Clavelou P. Improvement of quality of life and its relationship with neuropsychiatric outcomes in patients with multiple sclerosis starting treatment with natalizumab: A 3-year follow-up multicentric study. J Neurol Sci 2017; 382:148-154. [PMID: 29111011 DOI: 10.1016/j.jns.2017.10.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 09/25/2017] [Accepted: 10/05/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND Health-related quality of life (HRQoL) is impaired in multiple sclerosis (MS) but can be improved by disease-modifying therapies such as natalizumab. However, the predictive factors and neuropsychiatric correlates of HRQoL improvement are unknown. METHODS In this study, 48 patients with relapsing-remitting MS were included in a 3-year open-label, single group, multicenter, clinical trial (NCT01392872). HRQoL was measured by the disease-specific MusiQoL questionnaire, together with physical disability, cognition, fatigue, anxiety and depression scores at baseline, 6months, 12months, 18months and 36months after starting natalizumab therapy. RESULTS Compared to baseline, global HRQoL, as measured with the index of the MusiQoL, was significantly increased 6months after the beginning of natalizumab therapy, with medium effect-size (58.6±16.2 vs 69.8±18.9, p<0.001, Cohen's d=0.63). This improvement was maintained over time for up to 3years and mainly concerned activity of daily living, psychological well-being, symptoms and coping (p<0.001 for every dimensions). The variation of global HRQoL after 3years was negatively correlated with the variation of fatigue score (r=-0.44, p=0.015). Furthermore, a higher fatigue score at baseline was correlated with improvement in global HRQoL 3years afterwards (r=0.34, p=0.041), independently of age, educational level, disease duration and disability at baseline (β=2.45, p=0.020). Disability at baseline, cognitive impairment, anxiety and depression failed to predict or correlate with global HRQoL improvement in multivariate analyses. CONCLUSION Natalizumab improved HRQoL quickly and sustainably in patients with relapsing-remitting MS. In terms of HRQoL, natalizumab seems to benefit mostly patients with more marked fatigue at baseline.
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Affiliation(s)
- Vincent Planche
- Service de Neurologie, CHU de Clermont-Ferrand, Université Clermont Auvergne, F-63000 Clermont-Ferrand, France.
| | - Xavier Moisset
- Service de Neurologie, CHU de Clermont-Ferrand, Université Clermont Auvergne, F-63000 Clermont-Ferrand, France; Neuro-Dol, Inserm U1107, Université Clermont Auvergne, F-63000 Clermont-Ferrand, France
| | - Remy Morello
- Unité de Biostatistique et Recherche Clinique, CHU de Caen, Université de Normandie, F-14033 Caen, France
| | - Emilie Dumont
- Service de Neurologie, CHU de Clermont-Ferrand, Université Clermont Auvergne, F-63000 Clermont-Ferrand, France
| | | | - Julie Charré-Morin
- Service de Neurologie, CHU de Bordeaux, Université de Bordeaux, F-33007 Bordeaux, France
| | - Aurore Saubusse
- Service de Neurologie, CHU de Bordeaux, Université de Bordeaux, F-33007 Bordeaux, France
| | - Audrey Mondou
- Service de Neurologie, CHU de Caen, Université de Normandie, F-14033 Caen, France
| | - Françoise Reuter
- APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, F-13000 Marseille, France
| | - Gilles Defer
- Service de Neurologie, CHU de Caen, Université de Normandie, F-14033 Caen, France
| | - Jean Pelletier
- APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, F-13000 Marseille, France
| | - Bruno Brochet
- Service de Neurologie, CHU de Bordeaux, Université de Bordeaux, F-33007 Bordeaux, France
| | - Pierre Clavelou
- Service de Neurologie, CHU de Clermont-Ferrand, Université Clermont Auvergne, F-63000 Clermont-Ferrand, France; Neuro-Dol, Inserm U1107, Université Clermont Auvergne, F-63000 Clermont-Ferrand, France
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Moroso A, Ruet A, Lamargue-Hamel D, Munsch F, Deloire M, Coupé P, Charré-Morin J, Saubusse A, Ouallet JC, Planche V, Tourdias T, Dousset V, Brochet B. Microstructural analyses of the posterior cerebellar lobules in relapsing-onset multiple sclerosis and their implication in cognitive impairment. PLoS One 2017; 12:e0182479. [PMID: 28792528 PMCID: PMC5549727 DOI: 10.1371/journal.pone.0182479] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Accepted: 07/19/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The posterior cerebellar lobules seem to be the anatomical substrate of cognitive cerebellar processes, but their microstructural alterations in multiple sclerosis (MS) remain unclear. OBJECTIVES To correlate diffusion metrics in lobules VI to VIIIb in persons with clinically isolated syndrome (PwCIS) and in cognitively impaired persons with MS (CIPwMS) with their cognitive performances. METHODS Sixty-nine patients (37 PwCIS, 32 CIPwMS) and 36 matched healthy subjects (HS) underwent 3T magnetic resonance imaging, including 3D T1-weighted and diffusion tensor imaging (DTI). Fractional anisotropy (FA) and mean diffusivity (MD) were calculated within each lobule and in the cerebellar peduncles. We investigated the correlations between cognitive outcomes and the diffusion parameters of cerebellar sub-structures and performed multiple linear regression analysis to predict cognitive disability. RESULTS FA was generally lower and MD was higher in the cerebellum and specifically in the vermis Crus II, lobules VIIb and VIIIb in CIPwMS compared with PwCIS and HS. In hierarchical regression analyses, 31% of the working memory z score variance was explained by FA in the left lobule VI and in the left superior peduncle. Working memory was also associated with MD in the vermis Crus II. FA in the left lobule VI and right VIIIa predicted part of the information processing speed (IPS) z scores. CONCLUSION DTI indicators of cerebellar microstructural damage were associated with cognitive deficits in MS. Our results suggested that cerebellar lobular alterations have an impact on attention, working memory and IPS.
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Affiliation(s)
- Amandine Moroso
- Univ. Bordeaux, Bordeaux, France
- CHU de Bordeaux, INSERM-CHU CIC-P 0005, & Services de Neurologie et Neuroradiologie, Bordeaux, France
- Neurocentre Magendie, INSERM U1215, Bordeaux, France
| | - Aurélie Ruet
- Univ. Bordeaux, Bordeaux, France
- CHU de Bordeaux, INSERM-CHU CIC-P 0005, & Services de Neurologie et Neuroradiologie, Bordeaux, France
- Neurocentre Magendie, INSERM U1215, Bordeaux, France
| | | | - Fanny Munsch
- Univ. Bordeaux, Bordeaux, France
- Neurocentre Magendie, INSERM U1215, Bordeaux, France
| | - Mathilde Deloire
- CHU de Bordeaux, INSERM-CHU CIC-P 0005, & Services de Neurologie et Neuroradiologie, Bordeaux, France
| | - Pierrick Coupé
- Univ. Bordeaux, Bordeaux, France
- LaBRI, UMR 5800, PICTURA, Talence, France
| | - Julie Charré-Morin
- CHU de Bordeaux, INSERM-CHU CIC-P 0005, & Services de Neurologie et Neuroradiologie, Bordeaux, France
| | - Aurore Saubusse
- CHU de Bordeaux, INSERM-CHU CIC-P 0005, & Services de Neurologie et Neuroradiologie, Bordeaux, France
| | - Jean-Christophe Ouallet
- CHU de Bordeaux, INSERM-CHU CIC-P 0005, & Services de Neurologie et Neuroradiologie, Bordeaux, France
| | - Vincent Planche
- Univ. Bordeaux, Bordeaux, France
- Neurocentre Magendie, INSERM U1215, Bordeaux, France
| | - Thomas Tourdias
- Univ. Bordeaux, Bordeaux, France
- CHU de Bordeaux, INSERM-CHU CIC-P 0005, & Services de Neurologie et Neuroradiologie, Bordeaux, France
- Neurocentre Magendie, INSERM U1215, Bordeaux, France
| | - Vincent Dousset
- Univ. Bordeaux, Bordeaux, France
- CHU de Bordeaux, INSERM-CHU CIC-P 0005, & Services de Neurologie et Neuroradiologie, Bordeaux, France
- Neurocentre Magendie, INSERM U1215, Bordeaux, France
| | - Bruno Brochet
- Univ. Bordeaux, Bordeaux, France
- CHU de Bordeaux, INSERM-CHU CIC-P 0005, & Services de Neurologie et Neuroradiologie, Bordeaux, France
- Neurocentre Magendie, INSERM U1215, Bordeaux, France
- * E-mail:
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Lamargue Hamel D, Deloire M, Ruet A, Charré-Morin J, Saubusse A, Ouallet JC, Brochet B. Deciphering Depressive Mood in Relapsing-Remitting and Progressive Multiple Sclerosis and Its Consequence on Quality of Life. PLoS One 2015; 10:e0142152. [PMID: 26555230 PMCID: PMC4640551 DOI: 10.1371/journal.pone.0142152] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Accepted: 10/19/2015] [Indexed: 01/21/2023] Open
Abstract
Background Depressive mood and other emotional symptoms are common in multiple sclerosis (MS). The patient-reported outcome version of the “Echelle d’Humeur Dépressive” (EHD-PRO) aims to differentiate between two dimensions of depressive mood in people living with MS (PwMS). Objectives First, to compare EHD-PRO assessment and its two dimensions, lack of emotional control and emotional blunting, between a large sample of healthy controls (HCs) and two samples of PwMS, relapsing-remitting MS (RRMS) and primary progressive MS (PPMS); and second, to analyse the relationships between EHD-PRO scores with neurological disability, cognitive function, fatigue and health-related quality of life (HR-QOL). Results Regardless of their phenotype, PwMS had significantly higher EHD-PRO scores than HCs. EHD-PRO scores did not differ between the two MS groups. EHD-PRO scores did not correlate with disability and fatigue scores, disease duration or cognitive z scores. In RRMS, the lack of emotional control was independently associated with a decrease in HR-QOL. Conclusion The EHD-PRO is able to easily detect depressive mood and to differentiate between two clinical dimensions, emotional blunting and lack of emotional control. The scale is sensitive and seems robust to confounding factors. Lack of emotional control seems to contribute significantly to altered HR-QOL in RRMS.
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Affiliation(s)
| | - Mathilde Deloire
- INSERM-CHU CIC-P 0005, & Service de Neurologie, CHU de Bordeaux, F-33076, Bordeaux, France
| | - Aurélie Ruet
- INSERM U.862, Neurocentre Magendie, Université de Bordeaux, Bordeaux, France
- INSERM-CHU CIC-P 0005, & Service de Neurologie, CHU de Bordeaux, F-33076, Bordeaux, France
| | - Julie Charré-Morin
- INSERM-CHU CIC-P 0005, & Service de Neurologie, CHU de Bordeaux, F-33076, Bordeaux, France
| | - Aurore Saubusse
- INSERM-CHU CIC-P 0005, & Service de Neurologie, CHU de Bordeaux, F-33076, Bordeaux, France
| | | | - Bruno Brochet
- INSERM U.862, Neurocentre Magendie, Université de Bordeaux, Bordeaux, France
- INSERM-CHU CIC-P 0005, & Service de Neurologie, CHU de Bordeaux, F-33076, Bordeaux, France
- * E-mail:
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Ruet A, Hamel D, Deloire MSA, Charré-Morin J, Saubusse A, Brochet B. Information processing speed impairment and cerebellar dysfunction in relapsing–remitting multiple sclerosis. J Neurol Sci 2014; 347:246-50. [DOI: 10.1016/j.jns.2014.10.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2014] [Revised: 09/30/2014] [Accepted: 10/06/2014] [Indexed: 10/24/2022]
Affiliation(s)
- Aurélie Ruet
- Service de Neurologie, CHU de Bordeaux, F-33076 Bordeaux, France; INSERM-CHU CIC-P 0005, CHU de Bordeaux, F-33076 Bordeaux, France
| | - Delphine Hamel
- Neurocentre Magendie, INSERM U862, Université de Bordeaux, F-33076 Bordeaux, France; Translational Research and Advanced Imaging Laboratory (TRAIL) cluster of excellence, Université de Bordeaux, F-33076 Bordeaux, France
| | - Mathilde S A Deloire
- Service de Neurologie, CHU de Bordeaux, F-33076 Bordeaux, France; INSERM-CHU CIC-P 0005, CHU de Bordeaux, F-33076 Bordeaux, France
| | - Julie Charré-Morin
- Service de Neurologie, CHU de Bordeaux, F-33076 Bordeaux, France; INSERM-CHU CIC-P 0005, CHU de Bordeaux, F-33076 Bordeaux, France
| | - Aurore Saubusse
- Service de Neurologie, CHU de Bordeaux, F-33076 Bordeaux, France; INSERM-CHU CIC-P 0005, CHU de Bordeaux, F-33076 Bordeaux, France
| | - Bruno Brochet
- Service de Neurologie, CHU de Bordeaux, F-33076 Bordeaux, France; INSERM-CHU CIC-P 0005, CHU de Bordeaux, F-33076 Bordeaux, France; Neurocentre Magendie, INSERM U862, Université de Bordeaux, F-33076 Bordeaux, France; Translational Research and Advanced Imaging Laboratory (TRAIL) cluster of excellence, Université de Bordeaux, F-33076 Bordeaux, France.
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