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Stavrogianni K, Kitsos DK, Giannopapas V, Chasiotis AK, Christouli N, Paraskevas PG, Zompola C, Tsivgoulis G, Paraskevas GP, Giannopoulos S. Neuropsychological profiles comparison between Multiple Sclerosis patients and Multiple Sclerosis patients with overlapping features of Systemic Lupus Erythematosus. J Neuroimmunol 2024; 387:578270. [PMID: 38176314 DOI: 10.1016/j.jneuroim.2023.578270] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 11/30/2023] [Accepted: 12/18/2023] [Indexed: 01/06/2024]
Abstract
AIM Multiple sclerosis (MS) and Systemic Lupus Erythematosus (SLE) are autoimmune disorders that may lead to cognitive impairment. This study aimed to compare the neuropsychological profiles of patients with MS, and MS and coexisting SLE features. METHODS We included a total of 90 participants, divided into 3 groups: 30 patients with clinically definite relapsing remitting MS, 30 with coexisting MS and incomplete SLE (overlap group) and 30 healthy controls (HC). All participants underwent neuropsychological assessment with the Montreal Cognitive Assessment (MoCA), Symbol Digit Modalities Test (SDMT), Paced Auditory Serial Addition Test (PASAT), and Selective Reminding Test (SRT). RESULTS Both groups scored lower on the MoCA compared to the HC (p < .001). The overlap group showed the lowest performance on the SDMT and PASAT compared to the other two groups (p < .01), while the MS group scored similarly to the HC in the PASAT (p > .05). Regarding the learning rate and long-term recall, the overlap group had lower scores compared to both the MS and HC (p < .001), but it outperformed both groups in the retention efficacy score (p < .001). The MS group did not differ significantly from the HC in these memory domains (p > .05). CONCLUSION The overlap group exhibited a broader range of impairments, including slower processing speed, decreased working memory, reduced learning rate, and long-term retrieval deficits. Their retention ability remained intact. The coexistence of MS with SLE pathology had additive impacts on cognitive function.
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Affiliation(s)
- Konstantina Stavrogianni
- Second Department of Neurology, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece; Department of Physiology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Dimitrios K Kitsos
- Second Department of Neurology, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Vasileios Giannopapas
- Second Department of Neurology, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece; Department of Physical Therapy, University of West Attica, Attica, Greece; Laboratory of Neuromuscular and Cardiovascular Study of Motion-LANECASM, University of West Attica, Attica, Greece
| | - Athanasios K Chasiotis
- Second Department of Neurology, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece; Department of Physical Therapy, University of West Attica, Attica, Greece; Laboratory of Neuromuscular and Cardiovascular Study of Motion-LANECASM, University of West Attica, Attica, Greece
| | - Niki Christouli
- Second Department of Neurology, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Panagiotis G Paraskevas
- Second Department of Neurology, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Christina Zompola
- Second Department of Neurology, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Georgios Tsivgoulis
- Second Department of Neurology, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - George P Paraskevas
- Second Department of Neurology, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Sotirios Giannopoulos
- Second Department of Neurology, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
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Giannopapas V, Kitsos DK, Panopoulou A, Mitsi Z, Stavrogianni K, Chasiotis AK, Gkika MK, Salakou S, Tsivgoulis G, Bakalidou D, Giannopoulos S. Interactions between fatigue and urinary quality of life in patients with Multiple Sclerosis. J Clin Neurosci 2024; 120:87-91. [PMID: 38237491 DOI: 10.1016/j.jocn.2024.01.008] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 12/19/2023] [Accepted: 01/08/2024] [Indexed: 02/12/2024]
Abstract
INTRODUCTION Neurogenic bladder as well as fatigue related symptoms are common in patients with Multiple Sclerosis (MS) and have a significant impact on the patients' Quality of Life (QoL). The aim of this study is to investigate the relationship between fatigue related symptomatology (FRS) and Urinary Quality of Life (UQoL). METHODS A total of 120 consecutive MS patients were recruited from the Outpatient Clinic of Demyelinating Diseases (Second Dept. of Neurology, Attikon University Hospital Greece). Participants were then asked to complete the Modified Fatigue Impact Scale (MFIS) and the Short Form Qualiveen questionnaire. Demographic and bladder function related characteristics (incontinence, urinary frequency, use of intermittent catheterization) were collected. RESULTS The physical and cognitive dimensions of MFIS had a moderate to high correlation with SF Qualiveen (r = 0.403, p <.000), (r = 0.329, p <.000).Multiple linear regression produced a fitted model (R2 = 0.150, F(3,111) = 5.554, p =.001) in IC use (β = 1.086, p =.036) and the physical dimension of MFIS (β = 0.66, p =.046) significantly predicted the SF Qualiveen score. CONCLUSION UQoL had a moderate correlation with both physical and cognitive dimensions of fatigue. Patients with MS who experience lower levels of physical fatigue and/or manage their neurogenic bladder symptomatology (mainly with the use of intermittent catheterization) appear to have higher levels of UQoL. Due to the versatile and subjective nature of both fatigue related and neurogenic bladder symptoms, more focused studies utilizing objective evaluation tools (e.g urodynamic urine bladder study) are necessary.
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Affiliation(s)
- Vasileios Giannopapas
- Second Department of Neurology, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece; Department of Physical Therapy, University of West Attica, Athens, Greece; Laboratory of Neuromuscular and Cardiovascular Study of Motion, University of West Attica, Athens, Greece.
| | - Dimitrios K Kitsos
- Second Department of Neurology, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Zarifoula Mitsi
- Department of Physical Therapy, University of West Attica, Athens, Greece
| | - Konstantina Stavrogianni
- Second Department of Neurology, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece; Department of Physiology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Athanasios K Chasiotis
- Second Department of Neurology, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece; Department of Physical Therapy, University of West Attica, Athens, Greece; Laboratory of Neuromuscular and Cardiovascular Study of Motion, University of West Attica, Athens, Greece
| | - Marinela K Gkika
- Second Department of Neurology, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Stavroula Salakou
- Second Department of Neurology, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Georgios Tsivgoulis
- Second Department of Neurology, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Daphne Bakalidou
- Department of Physical Therapy, University of West Attica, Athens, Greece; Laboratory of Neuromuscular and Cardiovascular Study of Motion, University of West Attica, Athens, Greece
| | - Sotirios Giannopoulos
- Second Department of Neurology, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
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Tsogka A, Kitsos DK, Stavrogianni K, Giannopapas V, Chasiotis A, Christouli N, Tsivgoulis G, Tzartos JS, Giannopoulos S. Modulating the Gut Microbiome in Multiple Sclerosis Management: A Systematic Review of Current Interventions. J Clin Med 2023; 12:7610. [PMID: 38137679 PMCID: PMC10743570 DOI: 10.3390/jcm12247610] [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] [Received: 10/23/2023] [Revised: 12/05/2023] [Accepted: 12/07/2023] [Indexed: 12/24/2023] Open
Abstract
This review attempted to explore all recent clinical studies that have investigated the clinical and autoimmune impact of gut microbiota interventions in multiple sclerosis (MS), including dietary protocols, probiotics, fecal microbiota transplantation (FMT), and intermittent fasting (IF). Methods: Thirteen studies were held between 2011 and 2023 this demonstrated interventions in gut microbiome among patients with MS and their impact the clinical parameters of the disease. These included specialized dietary interventions, the supply of probiotic mixtures, FMT, and IF. Results: Dietary interventions positively affected various aspects of MS, including relapse rates, EDSS disability scores, MS-related fatigue, and metabolic features. Probiotic mixtures showed promising results on MS-related fatigue, EDSS parameters, inflammation; meanwhile, FMT-though a limited number of studies was included-indicated some clinical improvement in similar variables. IF showed reductions in EDSS scores and significant improvement in patients' emotional statuses. Conclusions: In dietary protocols, clinical MS parameters, including relapse rate, EDSS, MFIS, FSS, and MSQoL54 scales, were significantly improved through the application of a specific diet each time. Probiotic nutritional mixtures promote a shift in inflammation towards an anti-inflammatory cytokine profile in patients with MS. The administration of such mixtures affected disability, mood levels, and quality of life among patients with MS. FMT protocols possibly demonstrate a therapeutic effect in some case reports. IF protocols were found to ameliorate EDSS and FAMS scores. All interventional means of gut microbiome modulation provided significant conclusions on several clinical aspects of MS and highlight the complexity in the relationship between MS and the gut microbiome.
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Affiliation(s)
- Anthi Tsogka
- Second Department of Neurology, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, 157 72 Athens, Greece; (A.T.); (D.K.K.); (K.S.); (V.G.); (A.C.); (N.C.); (G.T.); (J.S.T.)
| | - Dimitrios K. Kitsos
- Second Department of Neurology, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, 157 72 Athens, Greece; (A.T.); (D.K.K.); (K.S.); (V.G.); (A.C.); (N.C.); (G.T.); (J.S.T.)
| | - Konstantina Stavrogianni
- Second Department of Neurology, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, 157 72 Athens, Greece; (A.T.); (D.K.K.); (K.S.); (V.G.); (A.C.); (N.C.); (G.T.); (J.S.T.)
- Department of Physiology, Faculty of Medicine, School of Health Sciences, University of Ioannina, 451 10 Ioannina, Greece
| | - Vasileios Giannopapas
- Second Department of Neurology, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, 157 72 Athens, Greece; (A.T.); (D.K.K.); (K.S.); (V.G.); (A.C.); (N.C.); (G.T.); (J.S.T.)
- Department of Physical Therapy, University of West Attica, 122 43 Attica, Greece
- Laboratory of Neuromuscular and Cardiovascular Study of Motion-LANECASM, University of West Attica, 122 43 Attica, Greece
| | - Athanasios Chasiotis
- Second Department of Neurology, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, 157 72 Athens, Greece; (A.T.); (D.K.K.); (K.S.); (V.G.); (A.C.); (N.C.); (G.T.); (J.S.T.)
- Department of Physical Therapy, University of West Attica, 122 43 Attica, Greece
- Laboratory of Neuromuscular and Cardiovascular Study of Motion-LANECASM, University of West Attica, 122 43 Attica, Greece
| | - Niki Christouli
- Second Department of Neurology, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, 157 72 Athens, Greece; (A.T.); (D.K.K.); (K.S.); (V.G.); (A.C.); (N.C.); (G.T.); (J.S.T.)
| | - Georgios Tsivgoulis
- Second Department of Neurology, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, 157 72 Athens, Greece; (A.T.); (D.K.K.); (K.S.); (V.G.); (A.C.); (N.C.); (G.T.); (J.S.T.)
| | - John S. Tzartos
- Second Department of Neurology, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, 157 72 Athens, Greece; (A.T.); (D.K.K.); (K.S.); (V.G.); (A.C.); (N.C.); (G.T.); (J.S.T.)
| | - Sotirios Giannopoulos
- Second Department of Neurology, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, 157 72 Athens, Greece; (A.T.); (D.K.K.); (K.S.); (V.G.); (A.C.); (N.C.); (G.T.); (J.S.T.)
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Chasiotis AK, Kitsos DK, Stavrogianni K, Giannopapas V, Papadopoulou M, Zompola C, Paraskevas GP, Bakalidou D, Giannopoulos S. Rehabilitation on cerebellar ataxic patients with multiple sclerosis: A systematic review. J Neurosci Res 2023; 101:1773-1780. [PMID: 37621200 DOI: 10.1002/jnr.25235] [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] [Received: 05/15/2023] [Revised: 07/06/2023] [Accepted: 07/22/2023] [Indexed: 08/26/2023]
Abstract
Multiple Sclerosis (MS) is a chronic inflammatory, autoimmune disease of the Central Nervous System with a vast spectrum of clinical phenotypes. A major aspect of its clinical presentation is cerebellar ataxia where physiotherapy and treatment modalities play a significant role on its management. This systematic review aims to investigate the physiotherapeutic rehabilitation techniques regarding the management of cerebellar ataxia due to MS and secondary to stratify each protocol as part of a multi structural personalized rehabilitation approach based on the gravity of the symptoms. A Pubmed Medline, Scopus and Web of Science research was performed using the corresponding databases. The results were screened by the authors in pairs. In our study, six (6) non-pharmacological interventional protocols, 3 Randomized Controlled Trials and 3 pilot studies, were included with a total of 145 MS patients. Physiotherapeutic techniques, such as NDT-Bobath, robotic and visual biofeedback re-education protocols and functional rehabilitation techniques were included. In most cases cerebellar ataxic symptoms were decreased post-treatment. The overall quality of the studies included was of moderate level (level B). Rehabilitation in cerebellar ataxia due to MS should be based on multicentric studies with the scope of adjusting different types of treatments and physiotherapeutic techniques based on the severity of the symptom.
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Affiliation(s)
- Athanasios K Chasiotis
- Second Department of Neurology, "Attikon" University Hospital, School of Medicine National & Kapodistrian University of Athens, National & Kapodistrian University of Athens, Athens, Greece
- Department of Physical Therapy, University of West Attica, Athens, Greece
- Laboratory of Neuromuscular & Cardiovascular Study of Motion (LANECASM), Department of Physiotherapy, Faculty oh Health and Care Sciences, University of West Attica, Athens, Greece
| | - Dimitrios K Kitsos
- Second Department of Neurology, "Attikon" University Hospital, School of Medicine National & Kapodistrian University of Athens, National & Kapodistrian University of Athens, Athens, Greece
| | - Konstantina Stavrogianni
- Second Department of Neurology, "Attikon" University Hospital, School of Medicine National & Kapodistrian University of Athens, National & Kapodistrian University of Athens, Athens, Greece
| | - Vasileios Giannopapas
- Second Department of Neurology, "Attikon" University Hospital, School of Medicine National & Kapodistrian University of Athens, National & Kapodistrian University of Athens, Athens, Greece
- Department of Physical Therapy, University of West Attica, Athens, Greece
- Laboratory of Neuromuscular & Cardiovascular Study of Motion (LANECASM), Department of Physiotherapy, Faculty oh Health and Care Sciences, University of West Attica, Athens, Greece
| | - Marianna Papadopoulou
- Second Department of Neurology, "Attikon" University Hospital, School of Medicine National & Kapodistrian University of Athens, National & Kapodistrian University of Athens, Athens, Greece
- Laboratory of Neuromuscular & Cardiovascular Study of Motion (LANECASM), Department of Physiotherapy, Faculty oh Health and Care Sciences, University of West Attica, Athens, Greece
| | - Christina Zompola
- Second Department of Neurology, "Attikon" University Hospital, School of Medicine National & Kapodistrian University of Athens, National & Kapodistrian University of Athens, Athens, Greece
| | - George P Paraskevas
- Second Department of Neurology, "Attikon" University Hospital, School of Medicine National & Kapodistrian University of Athens, National & Kapodistrian University of Athens, Athens, Greece
| | - Daphne Bakalidou
- Second Department of Neurology, "Attikon" University Hospital, School of Medicine National & Kapodistrian University of Athens, National & Kapodistrian University of Athens, Athens, Greece
- Department of Physical Therapy, University of West Attica, Athens, Greece
- Laboratory of Neuromuscular & Cardiovascular Study of Motion (LANECASM), Department of Physiotherapy, Faculty oh Health and Care Sciences, University of West Attica, Athens, Greece
| | - Sotirios Giannopoulos
- Second Department of Neurology, "Attikon" University Hospital, School of Medicine National & Kapodistrian University of Athens, National & Kapodistrian University of Athens, Athens, Greece
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Giannopapas V, Palaiodimou L, Kitsos D, Papagiannopoulou G, Stavrogianni K, Chasiotis A, Kosmidou M, Tzartos JS, Paraskevas GP, Bakalidou D, Tsivgoulis G, Giannopoulos S. The Prevalence of Diabetes Mellitus Type II (DMII) in the Multiple Sclerosis Population: A Systematic Review and Meta-Analysis. J Clin Med 2023; 12:4948. [PMID: 37568348 PMCID: PMC10420178 DOI: 10.3390/jcm12154948] [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] [Received: 06/22/2023] [Revised: 07/24/2023] [Accepted: 07/26/2023] [Indexed: 08/13/2023] Open
Abstract
Introduction: The interactions between Diabetes Mellitus type II (DMII) and Multiple Sclerosis (MS) lead to higher levels of fatigue, higher risk of physical disability, faster cognitive decline, and in general a lower quality of life and a higher frequency of depression compared to the general population. All of the above accelerate the disability progression of patients with MS, reduce the patients' functional capacity, and further increase their psychological and economic burden. Methods: This systematic review and meta-analysis aims to calculate the prevalence of DMII in the MS population. Following PRISMA guidelines, a thorough search of the Medline Pubmed, Cochrane Library, and Scopus databases was performed, focusing on the frequency of DMII in the MS population. Results: A total of 19 studies were included in the synthesis. The results of the main meta-analysis of random effects using R studio 3.3.0 for Windows and the Meta r package showed that the prevalence of DMII in the MS population is 5% (95% CI [0.03, 0.07], 19 studies, I2 = 95%, pQ < 0.001). Additional subgroup analysis based on region showed a difference of 4.4% (I2 = 95.2%, pQ < 0.001), psubgroupdifference = 0.003) between European and non-European participants, while demographic- and MS-specific characteristic (EDSS, Disease Duration) did not seem to affect the prevalence of DMII in the MS population (p = 0.30, p = 0.539, p = 0.19, p = 0.838). No publication bias was discovered (Egger's p test value: 0.896). Conclusions: Even though the prevalence of DMII in the MS population is lower than 10% (the reported prevalence of DMII in the general population) the interactions between the two conditions create significant challenges for MS patients, their caregivers, and physicians. DΜΙΙ should be systematically recorded in the case of MS patients to clearly delineate any potential relationship between the two conditions. Additionally, more structured studies investigating the interactions of MS and DMΙΙ as well as the direction of the causation between those two conditions are necessary in order to gain a deeper insight into the nature of the interaction between MS and DMII.
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Affiliation(s)
- Vasileios Giannopapas
- Second Department of Neurology, Attikon University Hospital, School of Medicine, National & Kapodistrian University of Athens, 15784 Athens, Greece; (V.G.); (L.P.); (G.P.); (K.S.); (A.C.); (J.S.T.); (G.P.P.); (G.T.)
- Physical Therapy Department, University of West Attica, 12210 Athens, Greece;
- Laboratory of Neuromuscular and Cardiovascular Study of Motion (Lanecasm), 12243 Athens, Greece
| | - Lina Palaiodimou
- Second Department of Neurology, Attikon University Hospital, School of Medicine, National & Kapodistrian University of Athens, 15784 Athens, Greece; (V.G.); (L.P.); (G.P.); (K.S.); (A.C.); (J.S.T.); (G.P.P.); (G.T.)
| | - Dimitrios Kitsos
- Second Department of Neurology, Attikon University Hospital, School of Medicine, National & Kapodistrian University of Athens, 15784 Athens, Greece; (V.G.); (L.P.); (G.P.); (K.S.); (A.C.); (J.S.T.); (G.P.P.); (G.T.)
| | - Georgia Papagiannopoulou
- Second Department of Neurology, Attikon University Hospital, School of Medicine, National & Kapodistrian University of Athens, 15784 Athens, Greece; (V.G.); (L.P.); (G.P.); (K.S.); (A.C.); (J.S.T.); (G.P.P.); (G.T.)
| | - Konstantina Stavrogianni
- Second Department of Neurology, Attikon University Hospital, School of Medicine, National & Kapodistrian University of Athens, 15784 Athens, Greece; (V.G.); (L.P.); (G.P.); (K.S.); (A.C.); (J.S.T.); (G.P.P.); (G.T.)
- Department of Physiology, Faculty of Medicine, University of Ioannina, 45110 Ioannina, Greece
| | - Athanasios Chasiotis
- Second Department of Neurology, Attikon University Hospital, School of Medicine, National & Kapodistrian University of Athens, 15784 Athens, Greece; (V.G.); (L.P.); (G.P.); (K.S.); (A.C.); (J.S.T.); (G.P.P.); (G.T.)
- Physical Therapy Department, University of West Attica, 12210 Athens, Greece;
- Laboratory of Neuromuscular and Cardiovascular Study of Motion (Lanecasm), 12243 Athens, Greece
| | - Maria Kosmidou
- Department of Internal Medicine, Faculty of Medicine, University of Ioannina, 45110 Ioannina, Greece;
| | - John S. Tzartos
- Second Department of Neurology, Attikon University Hospital, School of Medicine, National & Kapodistrian University of Athens, 15784 Athens, Greece; (V.G.); (L.P.); (G.P.); (K.S.); (A.C.); (J.S.T.); (G.P.P.); (G.T.)
| | - George P. Paraskevas
- Second Department of Neurology, Attikon University Hospital, School of Medicine, National & Kapodistrian University of Athens, 15784 Athens, Greece; (V.G.); (L.P.); (G.P.); (K.S.); (A.C.); (J.S.T.); (G.P.P.); (G.T.)
| | - Daphne Bakalidou
- Physical Therapy Department, University of West Attica, 12210 Athens, Greece;
- Laboratory of Neuromuscular and Cardiovascular Study of Motion (Lanecasm), 12243 Athens, Greece
| | - Georgios Tsivgoulis
- Second Department of Neurology, Attikon University Hospital, School of Medicine, National & Kapodistrian University of Athens, 15784 Athens, Greece; (V.G.); (L.P.); (G.P.); (K.S.); (A.C.); (J.S.T.); (G.P.P.); (G.T.)
| | - Sotirios Giannopoulos
- Second Department of Neurology, Attikon University Hospital, School of Medicine, National & Kapodistrian University of Athens, 15784 Athens, Greece; (V.G.); (L.P.); (G.P.); (K.S.); (A.C.); (J.S.T.); (G.P.P.); (G.T.)
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Giannopapas V, Stavrogianni K, Christouli N, Kitsos D, Sideri E, Bakalidou D, Voumvourakis K, Papagiannopoulou G, Tzartos J, Paraskevas G, Tsivgoulis G, Giannopoulos S. Do cardiovascular disease comorbidities affect the cognitive function of Multiple Sclerosis patients? J Clin Neurosci 2023; 112:20-24. [PMID: 37031630 DOI: 10.1016/j.jocn.2023.04.005] [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] [Received: 02/13/2023] [Revised: 03/30/2023] [Accepted: 04/03/2023] [Indexed: 04/11/2023]
Abstract
INTRODUCTION Cognitive impairment is a core symptom of multiple sclerosis, leading to disability in 40-70% of patients. The most common cognitive domains affected by MS are information processing speed, complex attention, executive functions and less frequently, episodic declarative memory. Cardiovascular disease comorbidities have been shown to increase the decline rate in many neurological conditions. Our study aims to examine the possible impact of CVD risk factors in the cognitive decline rate of PwMS. METHODS Over the course of a year, 248 PwMS with and without Cardiovascular comorbidity were cognitively evaluated using the written version of SDMT and the MoCA. RESULTS Compared to control, MS patients with comorbid CVD had greater general cognitive decline and decreased processing speed. Patients with comorbid diabetes and dyslipidemia had the highest impairment, followed by those with hypertension, compared to the control group and those patients with a high BMI. CONCLUSION The presence of cardiovascular comorbidities and especially dyslipidemia increases the rate of cognitive decline in MS patients. In such cases, patients should be evaluated every 6 months instead of a year and the use of the SDMT is advised since it's time efficient,it requires minimal training and correlates with MRI findings.
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Affiliation(s)
- Vasileios Giannopapas
- Department of Neurology, Attikon University Hospital Greece, School of Medicine, National and Kapodistrian University of Athens, Greece; Department of Physical Therapy, University of West Attica, Greece; Laboratory of Neuromuscular and Cardiovascular Study of Motion-LANECASM, University of West Attica, Greece
| | - Konstantina Stavrogianni
- Department of Neurology, Attikon University Hospital Greece, School of Medicine, National and Kapodistrian University of Athens, Greece
| | - Niki Christouli
- Department of Neurology, Attikon University Hospital Greece, School of Medicine, National and Kapodistrian University of Athens, Greece
| | - Dimitrios Kitsos
- Department of Neurology, Attikon University Hospital Greece, School of Medicine, National and Kapodistrian University of Athens, Greece
| | - Eleni Sideri
- Department of Neurology, Attikon University Hospital Greece, School of Medicine, National and Kapodistrian University of Athens, Greece
| | - Daphne Bakalidou
- Department of Physical Therapy, University of West Attica, Greece; Laboratory of Neuromuscular and Cardiovascular Study of Motion-LANECASM, University of West Attica, Greece
| | - Konstantinos Voumvourakis
- Department of Neurology, Attikon University Hospital Greece, School of Medicine, National and Kapodistrian University of Athens, Greece
| | - Georgia Papagiannopoulou
- Department of Neurology, Attikon University Hospital Greece, School of Medicine, National and Kapodistrian University of Athens, Greece
| | - John Tzartos
- Department of Neurology, Attikon University Hospital Greece, School of Medicine, National and Kapodistrian University of Athens, Greece
| | - Georgios Paraskevas
- Department of Neurology, Attikon University Hospital Greece, School of Medicine, National and Kapodistrian University of Athens, Greece
| | - Georgios Tsivgoulis
- Department of Neurology, Attikon University Hospital Greece, School of Medicine, National and Kapodistrian University of Athens, Greece
| | - Sotirios Giannopoulos
- Department of Neurology, Attikon University Hospital Greece, School of Medicine, National and Kapodistrian University of Athens, Greece.
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Doskas T, Vavougios GD, Karampetsou P, Kormas C, Synadinakis E, Stavrogianni K, Sionidou P, Serdari A, Vorvolakos T, Iliopoulos I, Vadikolias Κ. Neurocognitive impairment and social cognition in multiple sclerosis. Int J Neurosci 2021; 132:1229-1244. [PMID: 33527857 DOI: 10.1080/00207454.2021.1879066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
PURPOSE/AIM OF THE STUDY The impairment of neurocognitive functions occurs in all subtypes of multiple sclerosis, even from the earliest stages of the disease. Commonly reported manifestations of cognitive impairment include deficits in attention, conceptual reasoning, processing efficiency, information processing speed, memory (episodic and working), verbal fluency (language), and executive functions. Multiple sclerosis patients also suffer from social cognition impairment, which affects their social functioning. The objective of the current paper is to assess the effect of neurocognitive impairment and its potential correlation with social cognition performance and impairment in multiple sclerosis patients. MATERIALS AND METHODS An overview of the available-to-date literature on neurocognitive impairment and social cognition performance in multiple sclerosis patients by disease subtype was performed. RESULTS It is not clear if social cognition impairment occurs independently or secondarily to neurocognitive impairment. There are associations of variable strengths between neurocognitive and social cognition deficits and their neural basis is increasingly investigated. CONCLUSIONS The prompt detection of neurocognitive predictors of social cognition impairment that may be applicable to all multiple sclerosis subtypes and intervention are crucial to prevent further neural and social cognition decline in multiple sclerosis patients.
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Affiliation(s)
- Triantafyllos Doskas
- Department of Neurology, Athens Naval Hospital, Athens, Greece.,Department of Neurology, University Hospital of Alexandroupolis, Alexandroupolis, Greece
| | | | | | | | | | | | | | - Aspasia Serdari
- Department of Psychiatry, University Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - Theofanis Vorvolakos
- Department of Psychiatry, University Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - Ioannis Iliopoulos
- Department of Neurology, University Hospital of Alexandroupolis, Alexandroupolis, Greece
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