A Multidimensional Assessment of Metacognition Across Domains in Multiple Sclerosis

2020 ◽  
pp. 1-12
Author(s):  
Audrey Mazancieux ◽  
Chris J.A. Moulin ◽  
Olivier Casez ◽  
Céline Souchay
Keyword(s):  
Multiple Sclerosis ◽  
Processing Speed ◽  
Verbal Fluency ◽  
Neuropsychological Tests ◽  
Neurological Diseases ◽  
Adaptive Strategies ◽  
Disease Awareness ◽  
Feeling Of Knowing ◽  
Metacognitive Processes ◽  
Relapsing Remitting

Abstract Objective: In neurological diseases, metacognitive judgements have been widely used in order to assess the degree of disease awareness. However, as yet little research of this type has focused on multiple sclerosis (MS). Method: We here focused on an investigation of item-by-item metacognitive predictions (using feeling-of-knowing judgements) in episodic and semantic memory and global metacognitive predictions in standard neuropsychological tests pertinent to MS (processing speed and verbal fluency). Twenty-seven relapsing–remitting MS (RR-MS) patients and 27 comparison participants took part. Results: We found that RR-MS patients were as accurate as the group of comparison participants on our episodic and semantic item-by-item judgements. However, for the global predictions, we found that the MS group initially overestimated their performance (ds = .64), but only on a task on which performance was also impaired (ds = .89; processing speed). We suggest that MS patients, under certain conditions, show inaccurate metacognitive knowledge. However, postdictions and item-by-item predictions indicate that online metacognitive processes are no different from participants without MS. Conclusion: We conclude that there is no monitoring deficit in RR-MS and as such these patients should benefit from adaptive strategies and symptom education.

scholarly journals Cognitive Impairment in Relapsing Remitting and Secondary Progressive Multiple Sclerosis Patients: Efficacy of a Computerized Cognitive Screening Battery

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Athanasios Papathanasiou ◽  
Lambros Messinis ◽  
Vasileios L. Georgiou ◽  
Panagiotis Papathanasopoulos
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
Processing Speed ◽  
Verbal Fluency ◽  
Progressive Multiple Sclerosis ◽  
Effect Sizes ◽  
Medium Effect ◽  
Psychomotor Speed ◽  
Secondary Progressive ◽  
Relapsing Remitting

Objective. To investigate the pattern of cognitive impairment in relapsing remitting multiple sclerosis (RRMS) and secondary progressive multiple sclerosis (SPMS) patients using a computerized battery. Methods. RRMS patients N=50, SPMS patients N=30, and controls N=31 were assessed by Central Nervous System Vital Signs (CNS VS) computerized battery, Trail Making Tests (TMT) A and B, and semantic and phonological verbal fluency tasks. Results. The overall prevalence of cognitive dysfunction was 53.75% (RRMS 38%, SPMS 80%). RRMS patients differed from controls with large effect size on reaction time, medium effect size on TMT A and small on TMT B, phonological verbal fluency, composite memory, psychomotor speed, and cognitive flexibility. SPMS patients differed from controls in all neuropsychological measures (except complex attention) with large effect sizes on TMT A and B, phonological verbal fluency, composite memory, psychomotor speed, reaction time, and cognitive flexibility. Between patient groups, medium effect sizes were present on TMT B and psychomotor speed, while small effect sizes were present on composite memory and processing speed. Conclusion. CNS VS is sensitive in detecting cognitive impairment in RRMS and SPMS patients. Significant impairment in episodic memory, executive function, and processing speed were identified, with gradual increment of the frequency as disease progresses.

Cognition in Early Relapsing-Remitting Multiple Sclerosis: Consequences May Be Relative to Working Memory

2013 ◽  
Vol 19 (8) ◽  
pp. 938-949 ◽  
Author(s):  
Lindsay I. Berrigan ◽  
Jo-Anne LeFevre ◽  
Laura M. Rees ◽  
Jason Berard ◽  
Mark S. Freedman ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Working Memory ◽  
Processing Speed ◽  
Cognitive Functions ◽  
Group Membership ◽  
Equation Modeling ◽  
Mediating Role ◽  
Relapsing Remitting ◽  
Disease Stages

AbstractThe Relative Consequence Model proposes multiple sclerosis (MS) patients have a fundamental deficit in processing speed that compromises other cognitive functions. The present study examined the mediating role of processing speed, as well as working memory, in the MS-related effects on other cognitive functions for early relapsing-remitting patients. Seventy relapsing-remitting MS patients with disease duration not greater than 10 years and 72 controls completed tasks assessing processing speed, working memory, learning, and executive functioning. The possible mediating roles of speed and working memory in the MS-related effects on other cognitive functions were evaluated using structural equation modeling. Processing speed was not significantly related to group membership and could not have a mediating role. Working memory was related to group membership and functioned as a mediating/intervening factor. The results do not support the Relative Consequence Model in this sample and they challenge the notion that working memory impairment only emerges at later disease stages. The results do support a mediating/intervening role of working memory. These results were obtained for early relapsing-remitting MS patients and should not be generalized to the broader MS population. Instead, future research should examine the relations that exist at other disease stages. (JINS, 2013, 19, 1–12)

scholarly journals Short Report: Prevalence of Cognitive Impairment in Newly Diagnosed Relapsing-Remitting Multiple Sclerosis

2018 ◽  
Vol 20 (4) ◽  
pp. 153-157 ◽  
Author(s):  
Giulia DiGiuseppe ◽  
Mervin Blair ◽  
Sarah A. Morrow
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
Processing Speed ◽  
Clinical Population ◽  
Clinical Event ◽  
Routine Practice ◽  
Short Report ◽  
Newly Diagnosed ◽  
Mood Symptoms ◽  
Relapsing Remitting

Abstract Background: Cognitive impairment is common in multiple sclerosis (MS) and can manifest early in the disease process, sometimes as early as the first demyelinating event. However, the frequency of cognitive impairment in a newly diagnosed MS population has not been evaluated comprehensively in a clinical population. We sought to examine the prevalence of cognitive impairment in relapsing-remitting MS (RRMS) within a year of diagnosis in a clinic where cognitive testing at diagnosis is part of routine practice. Methods: A retrospective medical record review of persons with RRMS assessed in a cognitive MS clinic identified 107 patients assessed by the Minimal Assessment of Cognitive Function in Multiple Sclerosis battery within 1 year of a confirmed RRMS diagnosis. Results: The cohort was predominantly female (n = 82 [76.6%]) and white (n = 93 [86.9%]). Only 36 patients (33.6%) were diagnosed as having RRMS based on a second clinical event. Processing speed was the most frequently impaired domain (n = 38 [35.5%]). Only 37 patients (34.6%) were within normal limits on all cognitive domains. Regarding mood symptoms, 25 patients (23.4%) were positive for depressive symptoms; 59 (55.1%), for anxiety. Severe fatigue was correlated with a lower score on the Symbol Digit Modalities Test (SDMT) (r = −0.380, P < .001), and higher depressive scores were correlated with lower performance on the SDMT (r = −0.397, P < .001) and the Paced Auditory Serial Addition Test (r = −0.254, P = .009). Conclusions: Cognitive impairment, specifically processing speed, and mood symptoms are frequently present in persons with newly diagnosed RRMS.

25-Hydroxyvitamin D in cerebrospinal fluid during relapse and remission of multiple sclerosis

2009 ◽  
Vol 15 (11) ◽  
pp. 1280-1285 ◽  
Author(s):  
Trygve Holmøy ◽  
Stine Marit Moen ◽  
Thomas A Gundersen ◽  
Michael F Holick ◽  
Enrico Fainardi ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Mass Spectrometry ◽  
Cerebrospinal Fluid ◽  
Neurological Diseases ◽  
Hypovitaminosis D ◽  
Serum Levels ◽  
Liquid Chromatography Mass Spectrometry ◽  
Hydroxyvitamin D ◽  
Relapsing Remitting ◽  
25 Hydroxyvitamin D

Hypovitaminosis D may play a role in multiple sclerosis (MS), but little is known about intrathecal vitamin D. 25-Hydroxyvitamin D was measured in cerebrospinal fluid and sera from 36 patients with relapsing-remitting MS, 20 patients with other inflammatory neurological diseases and 18 patients with non-inflammatory neurological diseases with liquid chromatography-mass spectrometry. There were no significant differences in cerebrospinal fluid concentrations of 25-hydroxyvitamin D, but the cerebrospinal fluid:serum ratio was significantly lower in MS compared with other inflammatory neurological diseases (p=0.0012) and non-inflammatory neurological diseases (p=0.041) patients. The concentrations of 25-hydroxyvitamin D in cerebrospinal fluid and serum were positively correlated and their ratio was similar to that of albumin. Neither the concentrations of 25-hydroxyvitamin D in cerebrospinal fluid or serum nor their ratio were associated with the presence of relapses or gadolinium-enhanced lesions. These results do not support that 25-hydroxyvitamin D is actively transported to the cerebrospinal fluid, or that the cerebrospinal fluid or serum levels or their ratio exert a major impact on MS activity.

Altered functional connectivity and performance variability in relapsing–remitting multiple sclerosis

2014 ◽  
Vol 20 (11) ◽  
pp. 1453-1463 ◽  
Author(s):  
Magdalena Wojtowicz ◽  
Erin L Mazerolle ◽  
Virender Bhan ◽  
John D Fisk
Keyword(s):  
Multiple Sclerosis ◽  
Information Processing ◽  
Functional Connectivity ◽  
Processing Speed ◽  
Resting State ◽  
Healthy Controls ◽  
Information Processing Speed ◽  
Frontal Pole ◽  
Performance Variability ◽  
Relapsing Remitting

Background: Patients with multiple sclerosis (MS) demonstrate slower and more variable performance on attention and information processing speed tasks. Greater variability in cognitive task performance has been shown to be an important predictor of neurologic status and provides a unique measure of cognitive performance in MS patients. Objectives: This study investigated alterations in resting-state functional connectivity associated with within-person performance variability in MS patients. Methods: Relapsing–remitting MS patients and matched healthy controls completed structural MRI and resting-state fMRI (rsfMRI) scans, as well as tests of information processing speed. Performance variability was calculated from reaction time tests of processing speed. rsfMRI connectivity was investigated within regions associated with the default mode network (DMN). Relations between performance variability and functional connectivity in the DMN within MS patients were evaluated. Results: MS patients demonstrated greater reaction time performance variability compared to healthy controls ( p<0.05). For MS patients, more stable performance on a complex processing speed task was associated with greater resting-state connectivity between the ventral medial prefrontal cortex and the frontal pole. Conclusions: Among MS patients, greater functional connectivity between medial prefrontal and frontal pole regions appears to facilitate performance stability on complex speed-dependent information processing tasks.

Cerebrospinal fluid CXCL13 in multiple sclerosis: a suggestive prognostic marker for the disease course

2010 ◽  
Vol 17 (3) ◽  
pp. 335-343 ◽  
Author(s):  
Mohsen Khademi ◽  
Ingrid Kockum ◽  
Magnus L Andersson ◽  
Ellen Iacobaeus ◽  
Lou Brundin ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cerebrospinal Fluid ◽  
Bacterial Infections ◽  
Neurological Diseases ◽  
Activity Levels ◽  
Disability Status ◽  
Relapsing Remitting ◽  
Diagnostic Work ◽  
In Cis ◽  
Work Up

Background: Levels of CXCL13, a potent B-cell chemoattractant, are elevated in the cerebrospinal fluid (CSF) during multiple sclerosis (MS) and are associated with markers of MS activity. Levels decrease upon effective treatments. Objective: Here we validate the potential role of CSF CXCL13 as a biomarker for aspects of MS in a large amount of clinical material, the majority collected at early diagnostic work-up. Methods: CXCL13 was measured by ELISA in 837 subjects: relapsing–remitting MS (RRMS; n = 323), secondary progressive MS (SPMS; n = 40), primary progressive MS (PPMS; n = 24), clinically isolated syndrome (CIS; n = 79), other neurological diseases (ONDs; n = 181), ONDs with signs of inflammation or viral/bacterial infections (iONDs; n = 176) and healthy controls ( n = 14). Results: Subjects with viral/bacterial infections had extremely high CXCL13 levels compared to all included groups ( p < 0.0001). CXCL13 was otherwise significantly higher in MS compared to the remaining controls ( p < 0.0001), and CIS ( p < 0.01). A significant and positive correlation between CXCL13 and relapse rate, the results obtained for the Expanded Disability Status Scale (EDSS) and the number of lesions detected by MRI was demonstrated. CXCL13 was increased in CIS conversion to clinically definite MS ( p < 0.001). Oligoclonal immunoglobulin band (OCB)-positive CIS or MS had significantly increased CXCL13 levels compared to OCB-negative CIS or MS ( p < 0.001 and p < 0.0001, respectively). Conclusion: CXCL13 was associated with disease exacerbations and unfavourable prognosis in RRMS. Increased CXCL13 was not specific for MS since subjects with viral/bacterial infections exhibited even higher levels. High levels predicted CIS conversion to MS. We suggest that measurement of CSF CXCL13 can be part of the armamentarium in the diagnostic and prognostic work-up in MS and be of help in future treatment decisions.

scholarly journals Designing a Self-Perception Cognitive Questionnaire for Italian Multiple Sclerosis Patients (Sclerosi Multipla Autovalutazione Cognitiva, SMAC). A Preliminary Exploratory Pilot Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Alice Riccardi ◽  
Francesca Ognibene ◽  
Sara Mondini ◽  
Massimo Nucci ◽  
Monica Margoni ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Neuropsychological Tests ◽  
Patient Reported Outcome ◽  
Self Perception ◽  
Item Questionnaire ◽  
Patient Reported ◽  
Sclerosi Multipla ◽  
Relapsing Remitting ◽  
Multiple Sclerosis Patients ◽  
Sorting Test

Background: Although cognition in multiple sclerosis (MS) is assessed by means of several neuropsychological tests, only a few tools exist to investigate patients' perspectives on cognitive functioning.Objective: To develop a new questionnaire aimed at exploring patients' self-perception with respect to cognition in Italian MS patients.Methods: A total of 120 relapsing-remitting MS (RRMS) patients and 120 matched healthy controls (HC) completed a 25-item questionnaire called the Sclerosi Multipla Autovalutazione Cognitiva (SMAC). The Symbol Digit Modalities Test (SDMT), the Delis-Kaplan Executive Function System Sorting Test (D-KEFS ST), the Beck Depression Inventory (BDI-II), and the Fatigue Scale (FSS) were also administered to the patients.Results: Significantly higher SMAC scores were displayed by RRMS patients compared with HC (30.1 ± 16.9 vs. 23.4 ± 10.4, p = 0.003). SMAC inversely correlated with SDMT (r = −0.31, p &lt; 0.001), D-KEFS ST FSC (r = −0.21, p = 0.017), D-KEFS ST FSD (r = −0.22, p = 0.015) and D-KEFS ST SR (r = −0.19, p = 0.035) and positively correlated with FSS (r = 0.42, p &lt; 0.001) and BDI-II (r = 0.59, p &lt; 0.001). Cronbach's alpha coefficient for the questionnaire was 0.94.Conclusion: Preliminary findings suggest that SMAC is a promising patient-reported outcome to be included in MS neuropsychological evaluation and thus warrants being further tested and developed.

scholarly journals Leptomeningeal Enhancement in Multiple Sclerosis and Other Neurological Diseases: A Systematic Review and Meta-Analysis

2021 ◽  
Author(s):  
Benjamin Victor Ineichen ◽  
Charidimos Tsagkas ◽  
Martina Absinta ◽  
Daniel S Reich
Keyword(s):  
Multiple Sclerosis ◽  
Systematic Review ◽  
Neurological Diseases ◽  
Meta Analysis ◽  
Mean Difference ◽  
Clinical Settings ◽  
Imaging Features ◽  
Qualitative Synthesis ◽  
Leptomeningeal Enhancement ◽  
Relapsing Remitting

Background: The lack of systematic evidence on leptomeningeal enhancement (LME) on MRI in neurological diseases, including multiple sclerosis (MS), hampers its interpretation in clinical routine and research settings. Purpose: To perform a systematic review and meta-analysis of MRI LME in MS and other neurologi-cal diseases. Materials and Methods: In a comprehensive literature search in Medline, Scopus, and Embase, out of 2292 publications, 459 records assessing LME in neurological diseases were eligible for qualitative synthesis. Of these, 135 were included in a random effects model meta-analysis with subgroup analyses for MS. Results: Of eligible publications, 161 investigated LME in neoplastic neurological (n=2392), 91 in neuroinfectious (n=1890), and 75 in primary neuroinflammatory diseases (n=4038). The LME proportions for these disease classes were 0.47 [95%CI: 0.37 to 0.57], 0.59 [95%CI: 0.47 to 0.69], and 0.26 [95%CI: 0.20 to 0.35], respectively. In a subgroup analysis comprising 1605 MS cases, LME proportion was 0.30 [95%CI 0.21 to 0.42] with lower proportions in relapsing-remitting (0.19 [95%CI 0.13 to 0.27]) compared to progressive MS (0.39 [95%CI 0.30 to 0.49], p=0.002) and higher proportions in studies imaging at 7T (0.79 [95%CI 0.64 to 0.89]) compared to lower field strengths (0.21 [95%CI 0.15 to 0.29], p<0.001). LME in MS was associated with longer disease duration (mean difference 2.2 years [95%CI 0.2 to 4.2], p=0.03), higher Expanded Disability Status Scale (mean difference 0.6 points [95%CI 0.2 to 1.0], p=0.006), higher T1 (mean difference 1.6ml [95%CI 0.1 to 3.0], p=0.04) and T2 lesion load (mean difference 5.9ml [95%CI 3.2 to 8.6], p<0.001), and lower cortical volume (mean difference -21.3ml [95%CI -34.7 to -7.9], p=0.002). Conclusions: Our study provides high-grade evidence for the substantial presence of LME in MS and a comprehensive panel of other neurological diseases. Our data could facilitate differential diagnosis of LME in clinical settings. Additionally, our meta-analysis corroborates that LME is associ-ated with key clinical and imaging features of MS. PROSPERO No: CRD42021235026.

Chitinase effects on immune cell response in neuromyelitis optica and multiple sclerosis

2010 ◽  
Vol 17 (5) ◽  
pp. 521-531 ◽  
Author(s):  
Jorge Correale ◽  
Marcela Fiol
Keyword(s):  
Multiple Sclerosis ◽  
Neuromyelitis Optica ◽  
Immune Cell ◽  
Neurological Diseases ◽  
Relapsing Remitting ◽  
Inflammatory Processes ◽  
Csf Levels ◽  
Immune Cell Response ◽  
In Vitro Bbb Model

Background: Recent studies conducted in arthritis, asthma, and inflammatory bowel disease suggest that chitinases are important in inflammatory processes and tissue remodeling. Objective: To investigate the role of chitinases in multiple sclerosis (MS) and neuromyelitis optica (NMO). Methods: Levels of chitotriosidase, acid mammalian chitinase (AMCase), and chitinase 3-like-1 (CHI3L1) were measured using ELISA, in cerebrospinal fluid (CSF) and in serum from 24 patients with relapsing remitting (RR) MS, 24 patients with secondary progressive (SP) MS, 12 patients with NMO, 24 patients with other inflammatory neurological diseases (OIND), and 24 healthy controls (HCs). The number of anti-MOG cytokine-secreting cells was studied using ELISPOT. Eotaxins, MCP-1, RANTES, and IL-8 were assessed using ELISA. Cell transmigration was determined using an in vitro blood–brain barrier (BBB) model, in the presence and absence of chitinases. Results: CSF chitinase levels were significantly increased in patients with RRMS and NMO compared with HCs and patients with SPMS and OIND. In contrast, no significant differences were detected in serum chitinase levels between groups. Chitinase CSF levels showed correlation with anti-MOG IL-13-producing cells, and eotaxin levels. In vitro experiments showed macrophage chitinase secretion was significantly increased by IL-13, but not by IL-5, IL-6, IL-12, or IFN-γ. Moreover, chitinases enhanced IL-8, RANTES, MCP-1, and eotaxin production, increasing migratory capacity in eosinophils, T cells, and macrophages across an in vitro BBB model. Conclusions: Chitinases increased in the CSF from patients with NMO in response to IL-13. These enhanced levels could contribute to central nervous system inflammation by increasing immune cell migration across the BBB.

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