scholarly journals Disease correlates of quantitative susceptibility mapping rim lesions in multiple sclerosis

2021 ◽  
Author(s):  
Melanie Marcille ◽  
Sandra Hurtado Rua ◽  
Charles Tyshkov ◽  
Abhishek Jaywant ◽  
Joseph Comunale ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Regression Model ◽  
Verbal Learning ◽  
Susceptibility Mapping ◽  
California Verbal Learning Test ◽  
Quantitative Susceptibility Mapping ◽  
Cognitive Assessments ◽  
Learning Test ◽  
Multiple Sclerosis Patients ◽  
Relapsing Remitting Multiple Sclerosis

Objective: This study aimed to explore the association between chronic active rim+ lesions, identified as having a hyperintense rim on quantitative susceptibility mapping (QSM), on both clinical disability and imaging measures of neurodegeneration in patients with multiple sclerosis. Methods: The patient cohort was composed of 159 relapsing remitting multiple sclerosis patients aged 42.17 +/- 10.25 years and disease duration of 10.74 +/- 7.51 years. The Brief International Cognitive Assessment for Multiple Sclerosis and Expanded Disability Status Scale (EDSS) were used to assess clinical disability. Cortical thickness and thalamic volume were evaluated as imaging measures of neurodegeneration. Results: A total of 4,469 multiple sclerosis lesions were identified, of which 171 QSM rim+ (3.8%) lesions were identified among 57 patients (35.9%). In a multivariate regression model, as the overall total lesion burden increased, patients with at least one rim+ lesion on QSM performed worse on both physical disability and cognitive assessments, specifically the Symbol Digit Modalities Test (p=0.010), California Verbal Learning Test-II (p=0.030), and EDSS (p=0.001). In a separate univariate regression model, controlling for age (p<0.001), having at least one rim+ lesion was related to more cortical thinning (p= 0.03) in younger patients (< 45 years). Lower thalamic volume was associated with older patients (p=0.038) and larger total lesion burden (p<0.001) however, the association did not remain significant with rim+ lesions (p=0.10). Interpretation: Our findings demonstrate the significant impact of chronic active lesions, as identified on QSM, on both clinical disability and imaging measures of neurodegeneration in patients with multiple sclerosis.

scholarly journals Disease Correlates of Rim Lesions on Quantitative Susceptibility Mapping in Multiple Sclerosis

2021 ◽  
Author(s):  
Melanie Marcille ◽  
Sandra Hurtado Rúa ◽  
Charles Tyshkov ◽  
Abhishek Jaywant ◽  
Joseph Comunale ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Regression Model ◽  
Verbal Learning ◽  
Susceptibility Mapping ◽  
California Verbal Learning Test ◽  
Quantitative Susceptibility Mapping ◽  
Cognitive Assessments ◽  
Learning Test ◽  
Multiple Sclerosis Patients ◽  
The Impact

Abstract Quantitative susceptibility mapping (QSM), an imaging technique sensitive to brain iron, has been used to detect paramagnetic rims of iron-laden active microglia and macrophages in a subset of multiple sclerosis (MS) lesions, known as rim+ lesions, and are consistent with chronic active lesions. Because of their potential impact on disease progression and tissue damage, investigating the influence of rim+ lesions on disability and neurodegeneration is critical to establish the impact of these lesions on the disease course. This study aimed to explore the relationship between chronic active rim+ lesions, identified as having a hyperintense rim on QSM, and both clinical disability and imaging measures of neurodegeneration in patients with MS. The patient cohort was composed of 159 relapsing-remitting multiple sclerosis patients. The Expanded Disability Status Scale (EDSS) and Brief International Cognitive Assessment for Multiple Sclerosis, which includes both the Symbol Digit Modalities Test and California Verbal Learning Test-II, were used to assess clinical disability. Cortical thickness and thalamic volume were evaluated as imaging measures of neurodegeneration. A total of 4,469 MS lesions were identified, of which 171 QSM rim+ (3.8%) lesions were identified among 57 patients (35.8%). In a multivariate regression model, as the overall total lesion burden increased, patients with at least one rim+ lesion on QSM performed worse on both physical disability and cognitive assessments, specifically the Symbol Digit Modalities Test (p=0.010), California Verbal Learning Test-II (p=0.030), and EDSS (p=0.001). In a separate univariate regression model, controlling for age (p<0.001), having at least one rim+ lesion was related to more cortical thinning (p= 0.03) in younger patients (< 45 years). Lower thalamic volume was associated with older patients (p=0.038) and larger total lesion burden (p<0.001); however, the association did not remain significant with rim+ lesions (p=0.10). Our findings demonstrate a novel observation that chronic active lesions, as identified on QSM, modify the impact of lesion burden on clinical disability in MS patients. These results support further exploration of rim+ lesions for therapeutic targeting in MS to reduce disability and subsequent neurodegeneration.

Memantine for cognitive impairment in multiple sclerosis: a randomized placebo-controlled trial

2010 ◽  
Vol 16 (6) ◽  
pp. 715-723 ◽  
Author(s):  
JF Lovera ◽  
E. Frohman ◽  
TR Brown ◽  
D. Bandari ◽  
L. Nguyen ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
Free Recall ◽  
Controlled Trial ◽  
Neuropsychiatric Symptoms ◽  
Verbal Learning ◽  
Self Report ◽  
California Verbal Learning Test ◽  
Cognitive Improvement ◽  
Learning Test

Background: Memantine, an NMDA antagonist, is effective for moderate to severe Alzheimer’s disease. Objective: Determine whether memantine improves cognitive performance (CP) among subjects with multiple sclerosis (MS) and cognitive impairment (CI). Methods: This double-blind, randomized, placebo-controlled trial (Clinicaltrials.gov NCT00300716) compared memantine 10 mg twice a day (4 week titration followed by 12 weeks on the highest tolerated dose) with placebo. The primary outcome was the change from baseline to exit on the Paced Auditory Serial Addition Test (PASAT) and the California Verbal Learning Test-II (CVLT-II) Long Delay Free Recall (LDFR). Secondary outcomes included additional neuropsychological tests; self-report measures of quality of life, fatigue, and depression; and family/caregiver reports of subjects’ CI and neuropsychiatric symptoms. Results: The differences between the groups on the change on the PASAT (placebo—memantine = 0.0 correct responses, 95% CI 3.4, 3.4; p = 0.9) and on CVLT-II LDFR (placebo—memantine =—0.6 words, 95% CI —2.1, 0.8; p = 0.4) as well as on the other cognitive tests were not significant. Subjects on memantine had no serious adverse events (AEs) but had more fatigue and neurological AEs as well as, per family members’ reports, less cognitive improvement and greater neuropsychiatric symptoms than subjects on placebo. Conclusion: Memantine 10 mg twice a day does not improve CP in subjects with MS, ages 18—65, without major depression, who have subjective cognitive complaints and perform worse than one SD below the mean on the PASAT or on the California Verbal Learning Test-II (total recall or delayed free recall).

scholarly journals The correlation between EDSS and cognitive impairment in MS patients. Assessment of a Brazilian population using a BICAMS version

2016 ◽  
Vol 74 (12) ◽  
pp. 974-981 ◽  
Author(s):  
Marco A. G. de Caneda ◽  
Maria Cecília A. de Vecino
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
Neuropsychological Tests ◽  
Verbal Learning ◽  
Therapeutic Interventions ◽  
California Verbal Learning Test ◽  
Cognitive Evaluation ◽  
Disability Status ◽  
Learning Test

ABSTRACT Multiple sclerosis (MS) may present with a cognitive impairment as disabling as the physical disabilities. Therefore, routine cognitive evaluation is pivotal. Valid and reliable neuropsychological tests are essential in follow-up and to define future therapeutic interventions. Objectives To investigate the correlation between the disabilities of MS patients and their cognitive impairment assessed by the Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS). Methods Forty patients with definitive diagnoses of MS were selected. The correlation coefficient (r) between the Expanded Disability Status Scale (EDSS) and the neuropsychological tests of BICAMS were calculated. Results The correlation was clinically substantial and significant with r = 0.55 (p < 0.01) in the Symbol Digit Modalities Test (SDMT), 0.54 (p < 0.01) in the Brief Visuospacial Memory Test (BVMT) and 0.40 (p < 0.05) in the California Verbal Learning Test (CVLT). Conclusion BICAMS has easy and satisfactory application and evaluation for routine visits and presents a significant correlation with the EDSS. Its use may be indicated for screening and monitoring of cognitive impairment in patients with MS.

scholarly journals A Longitudinal Analysis of the Association Between Subclinical Hearing Loss and Cognition

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 895-896
Author(s):  
Alexandria Irace ◽  
Nicole Armstrong ◽  
Jennifer Deal ◽  
Alexander Chern ◽  
Luigi Ferrucci ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Standardized Test ◽  
Verbal Learning ◽  
Covariance Structure ◽  
California Verbal Learning Test ◽  
Cognitive Assessments ◽  
Delayed Recall ◽  
Age Related ◽  
Learning Test ◽  
Age Related Hearing Loss

Abstract Several studies have demonstrated that age-related hearing loss (defined as &gt;25 dB pure tone average [PTA]) is longitudinally associated with worse cognition. We aimed to investigate whether subclinical hearing loss (SCHL), or imperfect hearing traditionally categorized as normal (PTA ≤25 dB), may be similarly linked to cognitive decline. Subjects included cognitively normal adults ≥50 years old in the Baltimore Longitudinal Study of Aging with PTA ≤25 dB measured between January 1991 - September 1994 who had repeated cognitive assessments from January 1991 - November 2019 (n=263). The exposure was hearing based on the better ear PTA. The outcomes were standardized test scores in the following domains: learning/memory, mental status, executive function, visuospatial ability, and language. Multivariable linear-mixed effects models with random intercepts and slopes and unstructured variance-covariance structure were used to model the association between hearing and change in cognition over time, adjusting for baseline age, sex, years of education, and race. Mean age was 68.3 years (standard deviation [SD]=8.9) and follow-up ranged from 0-27.7 years (mean=12.5, SD=7.9). A 10-dB worsening in hearing was longitudinally associated with an annual decline of 0.016 SDs (95% confidence interval [CI]: 0.0002, 0.033) in California Verbal Learning Test (CVLT) short-delayed recall, 0.019 SDs (95% CI: 0.002, 0.036) in CVLT long-delayed recall, and 0.017 SDs (95% CI: 0.006, 0.028) in letter fluency after covariate adjustment. Poorer hearing among those with SCHL was associated with steeper declines in memory and verbal fluency scores. This relationship may begin at earlier levels of hearing loss than previously recognized.

scholarly journals A validation study for remote testing of cognitive function in multiple sclerosis

2020 ◽  
pp. 135245852093738
Author(s):  
Lisa F Barcellos ◽  
Mary Horton ◽  
Xiaorong Shao ◽  
Kalliope H Bellesis ◽  
Terrence Chinn ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Function ◽  
Cognitive Assessment ◽  
Verbal Learning ◽  
California Verbal Learning Test ◽  
Validity And Reliability ◽  
Remote Testing ◽  
Remote Assessment ◽  
Learning Test ◽  
Test Retest Reliability

Objectives: Determine the validity and reliability of a remote, technician-guided cognitive assessment for multiple sclerosis (MS), incorporating the Symbol Digit Modalities Test (SDMT) and the California Verbal Learning Test, Second Edition (CVLT-II). Methods: In 100 patients, we compared conventional in-person testing to remote, web-assisted assessments, and in 36 patients, we assessed test–retest reliability using two equivalent, alternative forms. Results: In-person and remote-administered SDMT ( r = 0.85) and CVLT-II ( r = 0.71) results were very similar. Reliability was adequate and alternative forms of SDMT ( r = 0.92) and CVLT-II ( r = 0.81) produced similar results. Conclusions: Findings indicate remote assessment can provide valid, reliable measures of cognitive function in MS.

Validity of the California Verbal Learning Test–II in Multiple Sclerosis

2010 ◽  
Vol 24 (2) ◽  
pp. 189-202 ◽  
Author(s):  
Shane Stegen ◽  
Igor Stepanov ◽  
Diane Cookfair ◽  
Eben Schwartz ◽  
David Hojnacki ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Verbal Learning ◽  
California Verbal Learning Test ◽  
Learning Test

Decreased hippocampal volume, indirectly measured, is associated with depressive symptoms and consolidation deficits in multiple sclerosis

2011 ◽  
Vol 17 (9) ◽  
pp. 1088-1097 ◽  
Author(s):  
Gevrey Kiy ◽  
Pia Lehmann ◽  
Horst K Hahn ◽  
Paul Eling ◽  
Andreas Kastrup ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Memory Performance ◽  
Verbal Learning ◽  
Hippocampal Volume ◽  
Depressive Mood ◽  
California Verbal Learning Test ◽  
Hippocampal Atrophy ◽  
Indirect Measure ◽  
Temporal Horn ◽  
Learning Test

Background: The human hippocampus plays a role in episodic memory and depression. Recently, it has been shown, using manual tracings, that the hippocampus is smaller in volume in MS patients compared with healthy controls, and that, at least for depression, hippocampal atrophy correlates with symptom severity. Methods: Because manual tracing of the hippocampus is time consuming, we used a semi-automatic procedure for temporal horn volumetry in 72 multiple sclerosis (MS) patients and 16 control subjects as an indirect measure of hippocampal volume. We analysed memory performance with the California Verbal Learning Test (using separate indices for encoding, consolidation and retrieval) and depressive mood with the Beck’s Depression Inventory (distinguishing between psychic and somatic aspects). Results: MS patients had significantly larger temporal horn volumes and volume correlated with psychic symptoms of depressive mood. Temporal horn volume was also associated with consolidation, in particular in the most impaired group. Conclusions: Temporal horn volume can be measured relatively easily and appears to correlate with two major clinical problems in MS patients: memory performance and depressive mood. The link between temporal horn volume, consolidation and depression may be hippocampal atrophy, as suggested by their adjacent neuroanatomical localization, and by the similarity in functional loss following impairment of these two structures.

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