scholarly journals Differential Impact of Cognitive Impairment in MCI Patients: A Case-Based Report

2020 ◽  
Vol 12 (2) ◽  
pp. 222-231
Author(s):  
Valentina Pergher ◽  
Birgitte Schoenmakers ◽  
Philippe Demaerel ◽  
Jos Tournoy ◽  
Marc M. Van Hulle
Keyword(s):  
Cognitive Impairment ◽  
White Matter ◽  
Test Performance ◽  
Intermediate Stage ◽  
Cognitive Test ◽  
White Matter Volume ◽  
Matter Volume ◽  
Mri Scans ◽  
Cognitive Test Performance ◽  
The Impact

Mild cognitive impairment (MCI) traditionally refers to an intermediate stage between healthy individuals and early Alzheimer disease. Evidence shows grey and white matter volume changes and decrease in several executive functions, albeit the relation between cognitive performance and brain volume remains unclear. Here, we discuss 3 individual cases of MCI by investigating their MRI scans and cognitive test performance. We also recruited age-matched healthy older adults serving as gold standard for both grey and white matter volume and cognitive test outcomes. Our results show the impact of cognitive impairment on cognitive test performance and grey and white matter volumes, and the role played by cognitive and brain reserve on mitigating cognitive decline. Furthermore, we add evidence to previous studies by showing an increase in white matter volume compared to healthy controls, in all 3 patients. This pattern of increased white matter volume might help us to better understand the pathological mechanisms underlying MCI which in turn could contribute to future investigations.

Disease-modifying treatments and cognition in relapsing-remitting multiple sclerosis

Neurology ◽  
2020 ◽  
Vol 94 (22) ◽  
pp. e2373-e2383 ◽  
Author(s):  
Nils C. Landmeyer ◽  
Paul-Christian Bürkner ◽  
Heinz Wiendl ◽  
Tobias Ruck ◽  
Hans-Peter Hartung ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Systematic Review ◽  
Cognitive Impairment ◽  
Test Performance ◽  
Meta Analysis ◽  
Cognitive Test ◽  
Current Evidence ◽  
Relapsing Remitting ◽  
Disease Modifying ◽  
Cognitive Test Performance

ObjectiveDisease-modifying treatments (DMTs) are the gold standard for slowing disability progression in multiple sclerosis (MS), but their effects on cognitive impairment, a key symptom of the disease, are mostly unknown. We conducted a systematic review and meta-analysis to evaluate the differential effects of DMTs on cognitive test performance in relapsing-remitting MS (RRMS).MethodsPubMed, Scopus, and Cochrane Library were searched for studies reporting longitudinal cognitive performance data related to all major DMTs. The standardized mean difference (Hedges g) between baseline and follow-up cognitive assessment was used as the main effect size measure.ResultsForty-four studies, including 55 distinct MS patient samples, were found eligible for the systematic review. Twenty-five studies were related to platform therapies (mainly β-interferon [n = 17] and glatiramer acetate [n = 4]), whereas 22 studies were related to escalation therapies (mainly natalizumab [n = 14] and fingolimod [n = 6]). Reported data were mostly confined to the cognitive domain processing speed. A meta-analysis including 41 studies and 7,131 patients revealed a small to moderate positive effect on cognitive test performance of DMTs in general (g = 0.27, 95% confidence interval [CI] = [0.21–0.33]), but no statistically significant differences between platform (g = 0.27, 95% CI = [0.18–0.35]) and escalation therapies (g = 0.28, 95% CI = [0.19–0.37]) or between any single DMT and β-interferon.ConclusionsDMTs are effective in improving cognitive test performance in RRMS, but a treatment escalation mainly to amend cognition is not supported by the current evidence. Given the multitude of DMTs and their widespread use, the available data regarding differential treatment effects on cognitive impairment are remarkably scant. Clinical drug trials that use more extensive cognitive outcome measures are urgently needed.

Perceived Cognitive Difficulties and Cognitive Test Performance as Predictors of Employment Outcomes in People with Multiple Sclerosis

2015 ◽  
Vol 21 (2) ◽  
pp. 156-168 ◽  
Author(s):  
Cynthia A. Honan ◽  
Rhonda F. Brown ◽  
Jennifer Batchelor
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
Prospective Memory ◽  
Test Performance ◽  
Work Hours ◽  
Work Outcomes ◽  
Cognitive Test ◽  
Cognitive Difficulties ◽  
Cognitive Test Performance ◽  
The Relationship

AbstractPerceived cognitive difficulties and cognitive impairment are important determinants of employment in people with multiple sclerosis (pwMS). However, it is not clear how they are related to adverse work outcomes and whether the relationship is influenced by depressive symptoms. Thus, this study examined perceived and actual general cognitive and prospective memory function, and cognitive appraisal accuracy, in relation to adverse work outcomes. The possible mediating and/or moderating role of depression was also examined. A cross-sectional community-based sample of 111 participants (33 males, 78 females) completed the Multiple Sclerosis Work Difficulties Questionnaire (MSWDQ), Beck Depression Inventory – Fast Screen (BDI-FS), and questions related to their current or past employment. They then underwent cognitive testing using the Screening Examination for Cognitive Impairment, Auditory Consonant Trigrams test, Zoo Map Test, and Cambridge Prospective Memory Test. Perceived general cognitive and prospective memory difficulties in the workplace and performance on the respective cognitive tests were found to predict unemployment and reduced work hours since MS diagnosis due to MS. Depression was also related to reduced work hours, but it did not explain the relationship between perceived cognitive difficulties and the work outcomes. Nor was it related to cognitive test performance. The results highlight a need to address the perceptions of cognitive difficulties together with cognitive impairment and levels of depression in vocational rehabilitation programs in pwMS. (JINS, 2015,21, 156–168)

scholarly journals Cerebellar white-matter changes in cannabis users with and without schizophrenia

2011 ◽  
Vol 41 (11) ◽  
pp. 2349-2359 ◽  
Author(s):  
N. Solowij ◽  
M. Yücel ◽  
C. Respondek ◽  
S. Whittle ◽  
E. Lindsay ◽  
...  
Keyword(s):  
White Matter ◽  
Cannabinoid Receptors ◽  
Cannabis Use ◽  
Analysis Of Covariance ◽  
Psychotic Symptoms ◽  
White Matter Volume ◽  
Cerebellar White Matter ◽  
Matter Volume ◽  
Mri Scans

BackgroundThe cerebellum is rich in cannabinoid receptors and implicated in the neuropathology of schizophrenia. Long-term cannabis use is associated with functional and structural brain changes similar to those evident in schizophrenia, yet its impact on cerebellar structure has not been determined. We examined cerebellar grey and white matter in cannabis users with and without schizophrenia.MethodSeventeen patients with schizophrenia and 31 healthy controls were recruited; 48% of the healthy group and 47% of the patients were long-term heavy cannabis users (mean 19.7 and 17.9 years near daily use respectively). Cerebellar measures were extracted from structural 3-T magnetic resonance imaging (MRI) scans using semi-automated methods, and examined using analysis of covariance (ANCOVA) and correlational analyses.ResultsCerebellar white-matter volume was reduced in cannabis users with and without schizophrenia compared to healthy non-users, by 29.7% and 23.9% respectively, and by 17.7% in patients without cannabis use. Healthy cannabis users did not differ in white-matter volume from either of the schizophrenia groups. There were no group differences in cerebellar grey matter or total volumes. Total cerebellar volume decreased as a function of duration of cannabis use in the healthy users. Psychotic symptoms and illness duration correlated with cerebellar measures differentially between patients with and without cannabis use.ConclusionsLong-term heavy cannabis use in healthy individuals is associated with smaller cerebellar white-matter volume similar to that observed in schizophrenia. Reduced volumes were even more pronounced in patients with schizophrenia who use cannabis. Cannabis use may alter the course of brain maturational processes associated with schizophrenia.

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