Cognitive deficits in multiple sclerosis correlate with changes in fronto-subcortical tracts

2008 ◽  
Vol 14 (3) ◽  
pp. 364-369 ◽  
Author(s):  
M. Roca ◽  
T. Torralva ◽  
F. Meli ◽  
M. Fiol ◽  
ML Calcagno ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Iowa Gambling Task ◽  
Diffusion Tensor ◽  
Verbal Learning ◽  
Apparent Diffusion Coefficients ◽  
Fiber Tracts ◽  
Multiple Sclerosis Disease ◽  
Apparent Diffusion ◽  
Learning Test ◽  
Serial Addition

Cognitive function and diffusion tensor imaging were assessed in a group of 12 patients with early relapsing—remitting multiple sclerosis (disease duration ≤3 years), and mild clinical disability (expanded disability status scale ≤2), as well as in 12 control subjects. Patients showed impairment in immediate logical memory and delayed recall with the Rey auditory verbal learning test. No significant differences in classical executive tests were observed. In contrast, differences were found for specific executive tests including IOWA Gambling Task, multiple errands test hospital version (MET) and Hotel Task, as well as in Paced-Auditory Serial Addition Test (PASAT). Significant correlation was found between PASAT performance and FA measures ( r = 0.64, P = 0.03), the apparent diffusion coefficients and the MET ( r = 0.72, P = 0.01), as well as in one subtask of Hotel ( r = -0.68, P = 0.02). Thus, executive deficits can best be appreciated at early stages of MS when a more specific battery of tests is used for patient evaluation. In this series, test failures observed correlated with changes in fronto-subcortical fiber tracts. Multiple Sclerosis 2008; 14: 364—369. http://msj.sagepub.com

scholarly journals Does cognitive dysfunction correlate with neurofilament light polypeptide levels in the CSF of patients with multiple sclerosis?

2019 ◽  
Vol 47 (5) ◽  
pp. 2187-2198 ◽  
Author(s):  
Thaleia Kalatha ◽  
Marianthi Arnaoutoglou ◽  
Theodoros Koukoulidis ◽  
Eleni Hatzifilippou ◽  
Emmanouil Bouras ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Dysfunction ◽  
Verbal Learning ◽  
Preliminary Evidence ◽  
Enzyme Linked Immunosorbent Assay ◽  
Neurofilament Light ◽  
Potential Biomarker ◽  
Z Scores ◽  
Learning Test ◽  
Serial Addition

Objective To investigate whether neurofilament light polypeptide (NfL) level in cerebrospinal fluid (CSF), currently a prognostic biomarker of neurodegeneration in patients with multiple sclerosis (MS), may be a potential biomarker of cognitive dysfunction in MS. Methods This observational case–control study included patients with MS. CSF levels of NfL were determined using enzyme-linked immunosorbent assay. Cognitive function was measured with the Brief International Cognitive Assessment for MS (BICAMS) battery and Paced Auditory Serial Addition Test (PASAT3), standardized to the Greek population. Results Of 39 patients enrolled (aged 42.7 ± 13.6 years), 36% were classified as cognitively impaired according to BICAMS z-scores (–0.34 ± 1.13). Relapsing MS was significantly better than progressive forms regarding BICAMS z-score (mean difference [MD] 1.39; 95% confidence interval [CI] 0.54, 2.24), Symbol Digit Modality Test score (MD 1.73; 95% CI 0.46, 3.0) and Greek Verbal Learning Test (MD 1.77; 95% CI 0.82, 2.72). An inversely proportional association between CSF NfL levels and BICAMS z-scores was found in progressive forms of MS (rp = –0.944). Conclusions This study provides preliminary evidence for an association between CSF NfL levels and cognition in progressive forms of MS, which requires validation in larger samples.

The association between California Verbal Learning Test performance and fibre impairment in multiple sclerosis: evidence from diffusion tensor imaging

2010 ◽  
Vol 16 (3) ◽  
pp. 332-341 ◽  
Author(s):  
Frauke Fink ◽  
Paul Eling ◽  
Eva Rischkau ◽  
Nicole Beyer ◽  
Bernd Tomandl ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Diffusion Tensor Imaging ◽  
Cognitive Processing ◽  
Verbal Memory ◽  
Test Performance ◽  
Diffusion Tensor ◽  
Verbal Learning ◽  
California Verbal Learning Test ◽  
Clinical Tool ◽  
Learning Test

The California Verbal Learning Test (CVLT) is recognized as a standard clinical tool for assessing episodic memory difficulties in multiple sclerosis (MS), but its neural correlates have not yet been examined in detail in this patient population. We combined neuropsychological examination and diffusion tensor imaging (DTI) analysis in a group of MS patients ( N = 50) and demographically matched healthy participants ( N = 20). We investigated the degree of impairment of the uncinate fascicle (UF), the superior longitudinal fascicle (SLF), the fornix (FX) and the cingulum (CG). The patients were impaired on all CVLT parameters and the DTI parameters correlated moderately with disease-related variables. Regression analyses in the complete study sample showed that CVLT learning scores correlated with impairment of the right UF. This association reached marginal significance in the patient sample. In contrast to other studies claiming retrieval deficits, our results suggest that encoding and consolidation deficits may play a major role in verbal memory impairments in MS. The findings also provide evidence for an association between degree of myelination of prefrontal fibre pathways and encoding efficiency. Finally, DTI-derived measurements appear to reflect disease progression in MS. The results are discussed in light of functional MRI studies investigating compensatory brain activity during cognitive processing in MS.

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 Diffusion Tensor Imaging in Rat Models of Preclinical Diabetic Nephropathy: A Preliminary Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Xiaoyan Hu ◽  
Min Kuang ◽  
Bo Peng ◽  
Yang Yang ◽  
Wei Lin ◽  
...  
Keyword(s):  
Diabetic Nephropathy ◽  
Diffusion Tensor Imaging ◽  
Mr Imaging ◽  
Serum Creatinine ◽  
Fractional Anisotropy ◽  
Diffusion Coefficients ◽  
Diffusion Tensor ◽  
Quantitative Detection ◽  
Apparent Diffusion Coefficients ◽  
Apparent Diffusion

PurposeThis study aimed to investigate the value of diffusion tensor imaging to assess renal injury in a rat model of preclinical diabetic nephropathy.MethodsTwenty-eight male Sprague Dawley rats were divided into two groups: the normal control (NC) group of 10 rats and the diabetic nephropathy (DN) group of 18 rats. Eight weeks after diabetes induction by streptozotocin, 3.0-T magnetic resonance (MR) imaging (b = 0 and 600 s/mm2, 15 diffusion directions) using a 32-channel knee coil was performed. After MR imaging, we measured serum creatinine, and collected double kidney tissues for pathology. The apparent diffusion coefficients(ADC) and fractional anisotropy(FA) values of the renal cortex and medulla were calculated for all kidneys. Physiological parameters, laboratory parameters, and imaging results were compared between the two groups.ResultsAll DN group animals developed hyperglycemia, polyuria, and emaciation. Serum creatinine was not significantly different between the groups (P > 0.05). Urinary albumin at 2, 4, and 8 weeks was higher in the DN group than in the NC group but <20 µg/min (P < 0.05). Pathologically, renal damage in the DN rats was observed. The ADC value was significantly increased in DN animals in the cortex (1.75×10-3mm2/s),medulla(1.53×10-3mm2/s)compared with NC group(cortex, 1.52×10-3mm2/s; medulla,1.35×10-3mm2/s). The FA value was significantly reduced in DN animals in the cortex (0.21),medulla(0.25)compared with NC group(cortex,0.26;medulla,0.3).ConclusionsIncreased apparent diffusion coefficients and decreased fractional anisotropy values on diffusion tensor imaging were associated with preclinical DN. Diffusion tensor imaging may be useful in early, non-invasive, quantitative detection, and therapy monitoring of DN.

Diffusion tensor imaging of brainstem tumors: axonal degeneration of motor and sensory tracts

2008 ◽  
Vol 1 (4) ◽  
pp. 270-276 ◽  
Author(s):  
Kathleen J. Helton ◽  
James K. Weeks ◽  
Nicholas S. Phillips ◽  
Ping Zou ◽  
Larry E. Kun ◽  
...  
Keyword(s):  
White Matter ◽  
Axonal Degeneration ◽  
Diffusion Tensor ◽  
Imaging Data ◽  
Cross Sectional ◽  
Apparent Diffusion Coefficients ◽  
Apparent Diffusion ◽  
Motor Tracts ◽  
Brainstem Tumors ◽  
White Matter Tractography

Object Diffusion tensor (DT) imaging has been used to predict postoperative motor function in patients with supratentorial tumors. The authors sought to determine whether DT imaging and white matter tractography could detect axonal degeneration in patients with brainstem tumors. Methods A cross-sectional, retrospective study of 7 patients with brainstem tumors and 8 healthy volunteers was performed. The DT imaging data were normalized and regions of interest (ROIs) with the highest probability of sensory and motor connections were selected using the Talairach Atlas to identify the 3D millimetric coordinates of white matter tracts. An iterative process involving fractional anisotropy (FA), apparent diffusion coefficients (ADCs), and color maps was developed to precisely select ROIs in the bilateral sensory and motor tracts. The FA and ADC values were calculated for each ROI. Results The FA values of sensory and motor tracts significantly differed between the patient and healthy volunteer groups (p < 0.05), whereas no significant changes were found in the splenium or genu of the corpus callosum. The FA values were altered proximal and distal to the brainstem tumors with a bimodal peak of antegrade decreased FA involving second- and third-order sensory axons and retrograde decreased FA of motor axons. Conclusions This study demonstrates changes in diffusion properties of sensory and motor tracts consistent with degeneration to further characterize brainstem tumors in children, and the results warrant the planning of prospective trials. The rigorous methods the authors describe may provide valuable information when planning biopsies or debulking of unusual brainstem tumors, as well as improve prognostication of the possible functional tract recovery following therapy.

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 Integrity of white matter structure is related to episodic memory performance in the low-educated elderly

2017 ◽  
Vol 75 (11) ◽  
pp. 778-784 ◽  
Author(s):  
Elisa de Paula França Resende ◽  
Fernanda Freire Tovar-Moll ◽  
Fernanda Meireles Ferreira ◽  
Ivanei Bramati ◽  
Leonardo Cruz de Souza ◽  
...  
Keyword(s):  
White Matter ◽  
Episodic Memory ◽  
Diffusion Tensor ◽  
Memory Performance ◽  
Verbal Learning ◽  
Cognitive Screening ◽  
Delayed Recall ◽  
Learning Test ◽  
Low Educated ◽  
The Right

ABSTRACT The low-educated elderly are a vulnerable population in whom studying the role of white matter integrity on memory may provide insights for understanding how memory declines with aging and disease. Methods: Thirty-one participants (22 women), 23 cognitively healthy and eight with cognitive impairment-no dementia, aged 80.4 ± 3.8 years, with 2.2 ± 1.9 years of education, underwent an MRI scan with diffusion tensor imaging (DTI) acquisition. We verified if there were correlations between the performance on the Brief Cognitive Screening Battery (BCSB) and the Rey Auditory Verbal Learning Test (RAVLT) with DTI parameters. Results: The BCSB delayed recall task correlated with frontotemporoparietal connection bundles, with the hippocampal part of the cingulum bilaterally and with the right superior longitudinal fasciculus. The RAVLT learning and delayed recall scores also correlated with the hippocampal part of the cingulum bilaterally. Conclusions: Although preliminary, our study suggests that the integrity of white matter frontotemporoparietal fasciculi seems to play a role in episodic memory performance in the low-educated elderly. This finding opens opportunities to study potential targets for memory decline prevention in vulnerable populations.

On the validity of single tests, two-test combinations and the full Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) in detecting patients with cognitive impairment

2019 ◽  
Vol 26 (14) ◽  
pp. 1919-1928 ◽  
Author(s):  
Sharon Jean Baetge ◽  
Melanie Filser ◽  
Alina Renner ◽  
Sebastian Ullrich ◽  
Christoph Lassek ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
Cognitive Assessment ◽  
Verbal Learning ◽  
Binary Logistic Regression ◽  
Relative Sensitivity ◽  
Short Version ◽  
Application Time ◽  
Combined Application ◽  
Learning Test

Background: The international standard to screen for cognitive impairment in multiple sclerosis (MS) is BICAMS (Brief International Cognitive Assessment for MS). However, with an application time of approximately 20 minutes, the battery might be too time consuming from a pragmatic perspective of a routine examination. Objectives: To examine the relative sensitivity and specificity of a BICAMS short version and its validity compared to the total battery. Methods: The German BICAMS version was applied comprising the Symbol Digit Modalities Test (SDMT), the Brief Visuospatial Memory Test–Revised (BVMT-R) and the Rey Auditory Verbal Learning Test (RAVLT; German VLMT). Single tests and two-test combinations were compared regarding conformity with the total battery. Results: Examining 1320 MS patients, the two-test combination of SDMT-BVMT-R was the most sensitive (92.7%) to impairment and showed the strongest agreement with the total battery (κ = 0.95). Performing binary logistic regression analyses, this combination was also validated by its association with employment status. Conclusion: Application of the total BICAMS battery should be the goal to strive for. However, in time-restricted clinical settings, the combined application of SDMT and BVMT-R is a recommendable alternative with an application time of 10 minutes, while single tests alone are not sufficiently sensitive.

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