Myelin Damage in Normal Appearing White Matter Contributes to Impaired Cognitive Processing Speed in Multiple Sclerosis

AbstractObjective:There is accumulating evidence regarding the beneficial effects of physical activity (PA) on cognitive processing speed in persons with multiple sclerosis (MS). However, one overarching limitation of this research is that researchers have not recruited samples who have the actual problem of being studied (i.e., cognitive processing speed impairment). This study examined associations between device-measured PA and cognitive processing speed in a large sample of persons with MS overall and between those with and without cognitive processing speed impairment.Method:Three hundred eighty-five persons with MS underwent the oral Symbol Digit Modalities Test (SDMT) and wore an accelerometer for 7 days for PA measurement. We divided the overall sample into subsamples with (n = 140) and without (n = 245) cognitive processing speed impairment based on age, sex, and education-adjusted SDMT Z-scores.Results:After controlling for age and disability status, higher levels of device-measured PA were significantly associated with faster cognitive processing speed overall, and the association was significantly stronger among persons with MS who presented with cognitive processing speed impairment.Conclusions:This examination provides initial cross-sectional support for informing the development of PA interventions as a possible approach for managing MS-related cognitive processing speed impairment. This highlights the importance of developing purposefully designed trials involving PA interventions for targeting cognitive processing speed as a primary end point among persons with MS with impaired cognitive processing speed.

Download Full-text

Changes in Cognitive Processing Speed, Mood, and Fatigue in an Observational Study of Persons With Multiple Sclerosis Treated With Dalfampridine-ER

Clinical Neuropharmacology ◽

10.1097/wnf.0000000000000130 ◽

2016 ◽

Vol 39 (2) ◽

pp. 73-80 ◽

Cited By ~ 10

Author(s):

Elizabeth W. Triche ◽

Jennifer A. Ruiz ◽

Kayla M. Olson ◽

Albert C. Lo

Keyword(s):

Multiple Sclerosis ◽

Observational Study ◽

Cognitive Processing ◽

Processing Speed ◽

Cognitive Processing Speed

Download Full-text

Improved cognitive outcomes in patients with relapsing–remitting multiple sclerosis treated with daclizumab beta: Results from the DECIDE study

Multiple Sclerosis Journal ◽

10.1177/1352458517707345 ◽

2017 ◽

Vol 24 (6) ◽

pp. 795-804 ◽

Cited By ~ 17

Author(s):

Ralph HB Benedict ◽

Stanley Cohan ◽

Sharon G Lynch ◽

Katherine Riester ◽

Ping Wang ◽

...

Keyword(s):

Multiple Sclerosis ◽

Cognitive Processing ◽

Processing Speed ◽

Cognitive Outcomes ◽

High Yield ◽

Meaningful Improvement ◽

Relapsing Remitting ◽

Remitting Multiple Sclerosis ◽

Relapsing Remitting Multiple Sclerosis ◽

Cognitive Processing Speed

Background: Cognitive impairment is common in multiple sclerosis (MS), with cognitive processing speed being the most frequently affected domain. Objective: Examine the effects of daclizumab beta versus intramuscular (IM) interferon (IFN) beta-1a on cognitive processing speed as assessed by Symbol Digit Modalities Test (SDMT). Methods: In DECIDE, patients with relapsing–remitting multiple sclerosis (RRMS) (age: 18–55 years; Expanded Disability Status Scale (EDSS) score 0–5.0) were randomized to daclizumab beta ( n = 919) or IM IFN beta-1a ( n = 922) for 96–144 weeks. SDMT was administered at baseline and at 24-week intervals. Results: At week 96, significantly greater mean improvement from baseline in SDMT was observed with daclizumab beta versus IM IFN beta-1a ( p = 0.0274). Significantly more patients treated with daclizumab beta showed clinically meaningful improvement in SDMT (increase from baseline of ⩾3 points ( p = 0.0153) or ⩾4 points ( p = 0.0366)), and significantly fewer patients showed clinically meaningful worsening (decrease from baseline of ⩾3 points ( p = 0.0103)). Odds representing risk of worsening versus stability or improvement on SDMT were significantly smaller for daclizumab beta ( p = 0.0088 (3-point threshold); p = 0.0267 (4-point threshold)). In patients completing 144 weeks of treatment, the effects of daclizumab beta were generally sustained. Conclusion: These results provide evidence for a benefit of daclizumab beta versus IM IFN beta-1a on cognitive processing speed in RRMS. Trial registration: ClinicalTrials.gov identifier NCT01064401 (Efficacy and Safety of BIIB019 (Daclizumab High Yield Process) Versus Interferon β 1a in Participants With Relapsing-Remitting Multiple Sclerosis (DECIDE)): https://clinicaltrials.gov/ct2/show/NCT01064401 .

Download Full-text