Hyperconnectivity of the dorsolateral prefrontal cortex following mental effort in multiple sclerosis patients with cognitive fatigue

2016 ◽  
Vol 22 (13) ◽  
pp. 1665-1675 ◽  
Author(s):  
Emanuele Pravatà ◽  
Chiara Zecca ◽  
Carlo Sestieri ◽  
Massimo Caulo ◽  
Gianna Carla Riccitelli ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
A Priori ◽  
Mental Effort ◽  
Resting State Functional Connectivity ◽  
Cognitive Fatigue ◽  
Dorsolateral Prefrontal ◽  
Data Driven Approach ◽  
Left Caudate ◽  
Serial Addition ◽  
Multiple Sclerosis Patients

Objective: To investigate the dynamic temporal changes of brain resting-state functional connectivity (RS-FC) following mental effort in multiple sclerosis (MS) patients with cognitive fatigue (CF). Methods: Twenty-two MS patients, 11 with (F) and 11 without CF, and 12 healthy controls were included. Separate RS-FC scans were acquired on a 3T MR scanner immediately before ( t0), immediately after ( t1) and 30 minutes after ( t2) execution of the paced auditory serial addition test (PASAT), a cognitively demanding task. Subjectively perceived CF after PASAT execution was also assessed. RS-FC changes were investigated by using a data-driven approach (the Intrinsic Connectivity Contrast-power), complemented by a priori defined regions of interest analyses. Results: The F-group patients experienced stronger RS-FC at t2 between the left superior frontal gyrus (L-SFG) and occipital, frontal and temporal areas, which increased over time after PASAT execution. In the F-group patients, the L-SFG was hyperconnected at t1 with the left caudate nucleus and hypoconnected at t2 with the left anterior thalamus. These variations were correlated with both subjectively perceived and clinically assessed CF, and—for the left thalamus—with PASAT performance. Conclusion: The development of cortico–cortical and cortico–subcortical hyperconnectivity following mental effort is related to CF symptoms in MS patients.

scholarly journals Monitoring cognitive change in multiple sclerosis using a computerized cognitive battery

2018 ◽  
Vol 4 (4) ◽  
pp. 205521731881551 ◽  
Author(s):  
L De Meijer ◽  
D Merlo ◽  
O Skibina ◽  
EJ Grobbee ◽  
J Gale ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Change ◽  
Progressive Multiple Sclerosis ◽  
Healthy Controls ◽  
Relapsing Remitting ◽  
Remitting Multiple Sclerosis ◽  
Serial Addition ◽  
Multiple Sclerosis Patients ◽  
Relapsing Remitting Multiple Sclerosis ◽  
Cognitive Monitoring

Background Cognitive monitoring that can detect short-term change in multiple sclerosis is challenging. Computerized cognitive batteries such as the CogState Brief Battery can rapidly assess commonly affected cognitive domains. Objectives The purpose of this study was to establish the acceptability and sensitivity of the CogState Brief Battery in multiple sclerosis patients compared to controls. We compared the sensitivity of the CogState Brief Battery to that of the Paced Auditory Serial Addition Test over 12 months. Methods Demographics, Expanded Disability Status Scale scores, depression and anxiety scores were compared with CogState Brief Battery and Paced Auditory Serial Addition Test performances of 51 patients with relapsing–remitting multiple sclerosis, 19 with secondary progressive multiple sclerosis and 40 healthy controls. Longitudinal data in 37 relapsing–remitting multiple sclerosis patients were evaluated using linear mixed models. Results Both the CogState Brief Battery and the Paced Auditory Serial Addition Test discriminated between multiple sclerosis and healthy controls at baseline ( p<0.001). CogState Brief Battery tasks were more acceptable and caused less anxiety than the Paced Auditory Serial Addition Test ( p<0.001). In relapsing–remitting multiple sclerosis patients, reaction time slowed over 12 months ( p<0.001) for the CogState Brief Battery Detection (mean change –34.23 ms) and Identification (–25.31 ms) tasks. Paced Auditory Serial Addition Test scores did not change over this time. Conclusions The CogState Brief Battery is highly acceptable and better able to detect cognitive change than the Paced Auditory Serial Addition Test. The CogState Brief Battery could potentially be used as a practical cognitive monitoring tool in the multiple sclerosis clinic setting.

scholarly journals Subjective Cognitive Fatigue and Autonomic Abnormalities in Multiple Sclerosis Patients

2017 ◽  
Vol 8 ◽  
Author(s):  
Carina Sander ◽  
Helmut Hildebrandt ◽  
Hans-Peter Schlake ◽  
Paul Eling ◽  
Katrin Hanken
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Fatigue ◽  
Multiple Sclerosis Patients

The effects of rivastigmine on processing speed and brain activation in patients with multiple sclerosis and subjective cognitive fatigue

2011 ◽  
Vol 17 (11) ◽  
pp. 1351-1361 ◽  
Author(s):  
S Huolman ◽  
P Hämäläinen ◽  
V Vorobyev ◽  
J Ruutiainen ◽  
R Parkkola ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Single Dose ◽  
Cognitive Processing ◽  
Processing Speed ◽  
Brain Activity ◽  
Brain Activation ◽  
Cognitive Effort ◽  
Cognitive Fatigue ◽  
Serial Addition ◽  
The Right

Background: Cognitive decline and fatigue are typical in multiple sclerosis (MS). However, there is no official medication for either of these symptoms. Objective: The purpose of this study was to estimate the effects of a single dose of rivastigmine on processing speed and associated brain activity in patients with MS and subjective cognitive fatigue. Methods: Fifteen patients with MS and subjective cognitive fatigue and 13 healthy controls (HCs) matched for age, gender and education performed a neuropsychological assessment and functional (f)MRI. A modified version of the Paced Visual Serial Addition Test (mPVSAT) was used as the behavioural task during fMRIs. After the first scanning session, both groups were randomly divided into two subgroups receiving either rivastigmine or placebo. A single dose of rivastigmine or placebo was administrated double-blindly and 2.5 hours later the scanning was repeated. Results: At baseline, the patients with MS showed slower processing speed in mPVSAT compared with the HCs. They also demonstrated stronger bilateral frontal activation after sustained cognitive effort than the HCs. Performance improvement and a further activation increase in the left anterior frontal cortex and additional activation in the right cerebellum were observed in patients who received rivastigmine but not in patients on placebo, or in HCs with placebo or rivastigmine. Conclusion: These preliminary findings suggest that rivastigmine may improve cognitive processing speed by enhancing compensatory brain activation in patients with MS.

scholarly journals Clinical features in adult multiple sclerosis patients

2020 ◽  
Vol 54 (2) ◽  
pp. 104-112
Author(s):  
Matej Koprivnik ◽  
Tanja Hojs Fabjan
Keyword(s):  
Multiple Sclerosis ◽  
Negative Correlation ◽  
Berg Balance Scale ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Positive Correlation ◽  
Disability Status ◽  
Serial Addition ◽  
Multiple Sclerosis Patients ◽  
Eq Vas

Introduction: The purpose of the study was to identify possible correlations between the quality of life, neurological disability, and functional ability in patients with multiple sclerosis.Methods: 258 patients with multiple sclerosis were included in the cross-sectional study. They were assessed with the Expanded Disability Status Scale (EDSS), the Berg Balance Scale (BBS), the Timed 25-Foot Walk Test (T25-FW), the 9-Hole Peg Test (9HPT), the Paced Auditory Serial Addition Test (PASAT-3) and the EQ visual analogue scale (EQ-VAS). Inferential statistics were used.Results: A positive correlation between the EQ-VAS and the BBS (r = 0.43, p < 0.01 ) and the PASAT-3 (r =¸0.19, p < 0.01), and a negative correlation between the EQ-VAS and the T25FW (r = –0.42, p < 0.01) and the 9-HPT (r = –0.40, p < 0.01) were shown. A negative correlation was also observed between the EDSS and the BBS (r = –0.77, p < 0.05) as well as the EDSS and the PASAT-3 (r = –0.25, p < 0.01), and a positive correlation between the EDSS and the 9 HPT (r = 0.67, p < 0.01) and the T25-FW (r = 0.80, p < 0.01).Discussion and conclusion: Associations between the variables indicate the need for complex, personalized and rational monitoring of patients with multiple sclerosis.

scholarly journals Migraine in Multiple Sclerosis Patients Affects Functional Connectivity of the Brain Circuitry Involved in Pain Processing

2021 ◽  
Vol 12 ◽  
Author(s):  
Emanuele Pravatà ◽  
Gianna C. Riccitelli ◽  
Carlo Sestieri ◽  
Rosaria Sacco ◽  
Alessandro Cianfoni ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Functional Connectivity ◽  
Pain Perception ◽  
Brain Regions ◽  
Daily Activities ◽  
Control Group ◽  
Resting State Functional Connectivity ◽  
Brain Circuitry ◽  
Multiple Sclerosis Patients ◽  
The Brain

Migraine is particularly common in patients with multiple sclerosis (MS) and has been linked to the dysfunction of the brain circuitry modulating the peripheral nociceptive stimuli. Using MRI, we explored whether changes in the resting state-functional connectivity (RS-FC) may characterize the occurrence of migraine in patients with MS. The RS-FC characteristics in concerned brain regions were explored in 20 MS patients with migraine (MS+M) during the interictal phase, and compared with 19 MS patients without migraine (MS-M), which served as a control group. Functional differences were correlated to the frequency and severity of previous migraine attacks, and with the resulting impact on daily activities. In MS+M, the loss of periaqueductal gray matter (PAG) positive connectivity with the default mode network and the left posterior cranial pons was associated with an increase of migraine attacks frequency. In contrast, the loss of PAG negative connectivity with sensorimotor and visual network was linked to migraine symptom severity and related daily activities impact. Finally, a PAG negative connection was established with the prefrontal executive control network. Migraine in MS+M patients and its impact on daily activities, underlies RS-FC rearrangements between brain regions involved in pain perception and modulation.

scholarly journals The paced auditory serial addition test in multiple sclerosis patients: the effect of brain atrophy and T1 lesion load

2006 ◽  
Vol 5 (S1) ◽  
Author(s):  
Zoe Kouvatsou ◽  
Vasilios Kimiskidis ◽  
Vasiliki Kapina ◽  
Konstantinos Kapinas ◽  
Ria Pita ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Brain Atrophy ◽  
Lesion Load ◽  
Serial Addition ◽  
Multiple Sclerosis Patients

Cingulum bundle alterations underlie subjective fatigue in multiple sclerosis

2014 ◽  
Vol 21 (4) ◽  
pp. 442-447 ◽  
Author(s):  
Matteo Pardini ◽  
Laura Bonzano ◽  
Maurizio Bergamino ◽  
Giulia Bommarito ◽  
Paola Feraco ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
White Matter ◽  
Structural Damage ◽  
Structural Connectivity ◽  
Neural Basis ◽  
Cingulum Bundle ◽  
Subjective Fatigue ◽  
Relapsing Remitting ◽  
Dorsolateral Prefrontal ◽  
Left Caudate

Objective: To evaluate the neural basis of subjective fatigue in subjects with multiple sclerosis (MS) using a connectionist framework. Methods: Seventy seven subjects with relapsing–remitting MS were recruited in the study and underwent subjective fatigue evaluations and a diffusion MRI scan. Firstly, local white matter Fractional Anisotropy values were correlated with subjective fatigue scores using a voxel-wise approach. The long-range loss of connectivity due to structural damage in the white matter voxels thus associated with subjective fatigue was then assessed using the Network Modification (NeMo) package. Results: A voxel-wise regression analysis with fatigue scores revealed a significant association between structural damage and fatigue levels in two discrete white matter clusters, both included in the left cingulate bundle. The connectivity analysis revealed that damage in these clusters was associated with loss of structural connectivity in the anterior and medial cingulate cortices, dorsolateral prefrontal areas and in the left caudate. Discussion: Our data point to the cingulum bundle and its projections as the key network involved in subjective fatigue perception in MS. More generally, these results suggest the potential of the connectionist framework to generate coherent models of the neural basis of complex symptomatology in MS.

Neuroenhancement through cognitive training and anodal tDCS in multiple sclerosis

2015 ◽  
Vol 22 (2) ◽  
pp. 222-230 ◽  
Author(s):  
Flavia Mattioli ◽  
Fabio Bellomi ◽  
Chiara Stampatori ◽  
Ruggero Capra ◽  
Carlo Miniussi
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Training ◽  
Wisconsin Card Sorting Test ◽  
Card Sorting ◽  
Speed Of Information Processing ◽  
Left Dlpfc ◽  
Dorsolateral Prefrontal ◽  
Neuropsychological Evaluations ◽  
Serial Addition ◽  
Sorting Test

Background: Cognitive training has been shown to improve cognitive function and quality of life in multiple sclerosis (MS) patients and is correlated with increased activity in the left dorsolateral prefrontal cortex (DLPFC). Objective: This study aims to test whether combining attention training with anodal transcranial direct current stimulation (a-tDCS) over the left DLPFC can improve training efficacy. Methods: Twenty patients impaired in attention/speed of information processing were randomly assigned to cognitive training during a-tDCS over the left DLPFC or cognitive training during sham tDCS for 10 daily sessions. Neuropsychological evaluations were conducted at baseline, after treatment and six months later. Results: When a-tDCS, rather than sham, was applied during the cognitive training, patients showed a significantly greater improvement in the Symbol Digit Modality Test (SDMT) and Wisconsin Card Sorting Test (WCST) after treatment ( p < 0.05) and in the Paced Auditory Serial Addition Test (PASAT) 2” and WCST six months later ( p < 0.05). They also had significantly shorter time to reach the most difficult exercise level, compared to sham treatment (6.3 vs. 7.4 sessions; p < 0.05). Conclusions: These results indicate that a-tDCS on the DLPFC during cognitive training fosters improvements in attention and executive function in MS patients and shortens treatment duration.

Changes of brain resting state functional connectivity predict the persistence of cognitive rehabilitation effects in patients with multiple sclerosis

2013 ◽  
Vol 20 (6) ◽  
pp. 686-694 ◽  
Author(s):  
Laura Parisi ◽  
Maria A Rocca ◽  
Flavia Mattioli ◽  
Massimiliano Copetti ◽  
Ruggero Capra ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Functional Connectivity ◽  
Resting State ◽  
Cognitive Rehabilitation ◽  
Severe Depression ◽  
Control Group ◽  
Neuropsychological Performance ◽  
Resting State Functional Connectivity ◽  
Multiple Sclerosis Patients

Objective: We investigated whether the efficacy of 12-week cognitive rehabilitation in MS patients persists six months after treatment termination and, together with resting state (RS) functional connectivity (FC), changes on neuropsychological performance at follow-up. Methods: Eighteen MS patients with cognitive deficits, assigned randomly either to undergo treatment ( n=9) or not ( n=9), underwent neuropsychological evaluation at baseline (t0), after 12 weeks of rehabilitation (t1) and at six-month follow-up (t2). RS fMRI was obtained at t0 and t1. Changes in neuropsychological performance and their correlations with RS FC modifications were assessed using longitudinal linear models. Results: At t2 vs. t0, compared with the control group, treated group patients improved in tests of attention, executive function, depression and quality of life (QoL). Neuropsychological scores in these tests at t2 were significantly correlated with RS FC changes in cognitive-related networks and RS FC of the anterior cingulum. RS FC changes in the default mode network predicted cognitive performance and less severe depression, whereas RS FC changes of the executive network predicted better QoL. Discussion: Changes in RS FC of cognitive-related networks helps to explain the persistence of the effects of cognitive rehabilitation after several months in relapsing–remitting multiple sclerosis patients and their improvement on depression and QoL scales.

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