A-67Cognition, Depression, and Physical Disability in Multiple Sclerosis as Predictors of Illness Intrusiveness

Background: The ability of conventional magnetic resonance imaging (MRI) to predict subsequent physical disability and cognitive deterioration after a clinically isolated syndrome (CIS) is weak. Objectives: We aimed to investigate whether conventional MRI changes over 1 year could predict cognitive and physical disability 5 years later in CIS. We performed analyses using a global approach (T2 lesion load, number of T2 lesions), but also a topographic approach. Methods: This study included 38 patients with a CIS. At inclusion, 10 out of 38 patients fulfilled the 2010 revised McDonald’s criteria for the diagnosis of multiple sclerosis. Expanded Disability Status Scale (EDSS) evaluation was performed at baseline, year 1 and year 5, and cognitive evaluation at baseline and year 5. T2-weighted MRI was performed at baseline and year 1. We used voxelwise analysis to analyse the predictive value of lesions location for subsequent disability. Results: Using the global approach, no correlation was found between MRI and clinical data. The occurrence or growth of new lesions in the brainstem was correlated with EDSS changes over the 5 years of follow-up. The occurrence or growth of new lesions in cerebellum, thalami, corpus callosum and frontal lobes over 1 year was correlated with cognitive impairment at 5 years. Conclusion: The assessment of lesion location at the first stage of multiple sclerosis may be of value to predict future clinical disability.

Download Full-text

Relationship between Physical Disability and Black Holes in Multiple Sclerosis: Upper Extremity Functions - an Important Parameter

10.4274/jmsr.galenos.2021.6-2 ◽

2021 ◽

Vol 1 (1) ◽

pp. 17-21

Author(s):

Bilge Piri Cinar ◽

Gülcan Kalaycı ◽

Mustafa Acikgoz ◽

Serkan Ozakbas

Keyword(s):

Multiple Sclerosis ◽

Black Holes ◽

Upper Extremity ◽

Physical Disability

Download Full-text

Pre-existing anxiety, depression, and neurological disability are associated with long COVID: A prospective and longitudinal cohort study of the United Kingdom Multiple Sclerosis Register

10.1101/2021.06.25.21259256 ◽

2021 ◽

Author(s):

Afagh Garjani ◽

Rodden M Middleton ◽

Richard Nicholas ◽

Nikos Evangelou

Keyword(s):

Multiple Sclerosis ◽

United Kingdom ◽

Physical Disability ◽

Mental Health Problems ◽

Cox Regression ◽

Depression Scale ◽

Symptom Duration ◽

Cox Regression Analysis ◽

The United Kingdom ◽

Recovery Status

Objectives: To assess the prevalence of and factors associated with developing long COVID among patients with multiple sclerosis (MS), a condition which shares the neurological and psychological symptomatology of long COVID Design: Community-based prospective and longitudinal observational study Setting: The United Kingdom (UK) MS Register (UKMSR) COVID-19 study Participants: A national cohort of MS patients with COVID-19 Main outcome measures: Participants used the online questionnaire-based platform of the UKMSR to update their COVID-19 symptoms and recovery status. Questionnaires were date-stamped for estimation of COVID-19 symptom duration. The UKMSR also holds demographic and up-to-date clinical data on participants including comorbidities, MS type, date of MS diagnosis, disease-modifying therapies, web-based Expanded Disability Status Scale scores (a measure of physical disability in MS), and Hospital Anxiety and Depression Scale. The association between these factors and recovery from COVID-19 was assessed using multivariable Cox regression analysis. Results: Out of 7,977 MS patients who participated in the UKMSR COVID-19 study, 599 had COVID-19 and updated their recovery status prospectively. At least 181 participants (31.1%) had long-standing COVID-19 symptoms for ≥4 weeks and 76 (13.1 %) for ≥12 weeks. Participants with higher levels of pre-COVID-19 physical disability, participants with anxiety and/or depression prior to COVID-19 onset, and women were less likely to recover from COVID-19. Conclusions: Long COVID appears to affect patients with a pre-existing chronic condition, especially those with physical disabilities or mental health problems disproportionately when compared to reports in the general population. Long COVID research and the development of post-COVID-19 rehabilitation services need to be inclusive of these at-risk populations. Trial Registration: ClinicalTrials.gov: NCT04354519

Download Full-text

P.5.c.001 Cognitive impairment in multiple sclerosis: methods of assessment and correlation with physical disability

European Neuropsychopharmacology ◽

10.1016/s0924-977x(11)70897-5 ◽

2011 ◽

Vol 21 ◽

pp. S551

Author(s):

P. Ionescu ◽

S. Petrescu ◽

E. Sandu ◽

G.D. Vanghelie ◽

N. Munjev ◽

...

Keyword(s):

Multiple Sclerosis ◽

Cognitive Impairment ◽

Physical Disability

Download Full-text

Corrigendum for Multiple Sclerosis: Associations Between Physical Disability and Depression Are Not Mediated by Self-Reported Physical Activity

Perceptual and Motor Skills ◽

10.1177/0031512519898070 ◽

2019 ◽

Vol 127 (2) ◽

pp. 510-510

Keyword(s):

Physical Activity ◽

Multiple Sclerosis ◽

Physical Disability

Download Full-text

Microstructural fronto-striatal and temporo-insular alterations are associated with fatigue in patients with multiple sclerosis independent of white matter lesion load and depression

Multiple Sclerosis Journal ◽

10.1177/1352458519869185 ◽

2019 ◽

Vol 26 (13) ◽

pp. 1708-1718 ◽

Cited By ~ 7

Author(s):

Miklos Palotai ◽

Michele Cavallari ◽

Ismail Koubiyr ◽

Alfredo Morales Pinzon ◽

Aria Nazeri ◽

...

Keyword(s):

Multiple Sclerosis ◽

White Matter ◽

Physical Disability ◽

Disease Duration ◽

White Matter Lesion ◽

Brain Magnetic Resonance Imaging ◽

Brain Regions ◽

Specific Substrate ◽

Patient Stratification ◽

Lesion Load

Background: Fatigue in multiple sclerosis (MS) has been inconsistently associated with disruption of specific brain circuitries. Temporal fluctuations of fatigue have not been considered. Objective: The aim of this study was to investigate the association of fatigue with brain diffusion abnormalities, using robust criteria for patient stratification based on longitudinal patterns of fatigue. Methods: Patient stratification: (1) sustained fatigue (SF, n = 26): latest two Modified Fatigue Impact Scale (MFIS) ⩾ 38; (2) reversible fatigue (RF, n = 25): latest MFIS < 38 and minimum one previous MFIS ⩾ 38; and (3) never fatigued (NF, n = 42): MFIS always < 38 (five assessments minimum). 3T brain magnetic resonance imaging (MRI) was used to perform voxel-wise comparison of fractional anisotropy (FA) between the groups controlling for age, sex, disease duration, physical disability, white matter lesion load (T2LV), and depression. Results: SF and, to a lesser extent, RF patients showed lower FA in multiple brain regions compared to NF patients, independent of age, sex, disease duration, and physical disability. In cingulo-postcommissural-striato-thalamic regions, the differences in FA between SF and NF (but not between RF and NF or SF) patients were independent of T2LV, and in ventromedial prefronto-precommissuro-striatal and temporo-insular areas, independent of T2LV and depression. Conclusion: Damage to ventromedial prefronto-precommissuro-striatal and temporo-insular pathways appears to be a specific substrate of SF in MS.

Download Full-text