Differential effects of aging on motor and cognitive functioning in multiple sclerosis

2016 ◽  
Vol 23 (10) ◽  
pp. 1385-1393 ◽  
Author(s):  
Shumita Roy ◽  
Seth Frndak ◽  
Allison S Drake ◽  
Lauren Irwin ◽  
Robert Zivadinov ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
Motor Function ◽  
Cognitive Processing ◽  
Processing Speed ◽  
Cognitive Outcomes ◽  
Motor Dysfunction ◽  
Linear Regression Models ◽  
Information Processing Speed ◽  
Age Related

Background: Multiple sclerosis (MS) patients are impaired in motor and cognitive performance, but the extent to which these deficits are magnified by aging is unknown. In one prior study, differences in cognitive processing speed between MS patients and healthy individuals were of similar magnitude across the lifespan. Here, we have improved on this work by expanding assessment to multiple cognitive domains and motor functioning. Objective: To determine whether the degree of cognitive and motor dysfunction in MS is magnified with increasing age. Methods: In all, 698 MS patients (aged 29–71 years) and 226 healthy controls (HCs; aged 18–72 years) completed neuroperformance tests covering ambulation, upper extremity function, information processing speed, and memory. Results: Linear regression models predicting cognitive and motor function revealed main effects of MS/HC diagnosis, age, and education across all measures. There was also an interaction between age and diagnosis on measures of motor function, but not on cognitive outcomes. Conclusion: The progression of motor decline is amplified by aging in MS. However, the degree of cognitive impairment does not vary across the lifespan. Thus, evidence of accelerated cognitive impairment in older adults with MS may signal the presence of other age-related cognitive pathologies.

scholarly journals T1 Relaxation Times in the Cortex and Thalamus Are Associated With Working Memory and Information Processing Speed in Patients With Multiple Sclerosis

2021 ◽  
Vol 12 ◽  
Author(s):  
Christian Thaler ◽  
Isabelle Hartramph ◽  
Jan-Patrick Stellmann ◽  
Christoph Heesen ◽  
Maxim Bester ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Working Memory ◽  
Cognitive Impairment ◽  
Information Processing ◽  
Processing Speed ◽  
T1 Mapping ◽  
Relaxation Times ◽  
Healthy Controls ◽  
Information Processing Speed ◽  
T1 Relaxation

Background: Cortical and thalamic pathologies have been associated with cognitive impairment in patients with multiple sclerosis (MS).Objective: We aimed to quantify cortical and thalamic damage in patients with MS using a high-resolution T1 mapping technique and to evaluate the association of these changes with clinical and cognitive impairment.Methods: The study group consisted of 49 patients with mainly relapsing-remitting MS and 17 age-matched healthy controls who received 3T MRIs including a T1 mapping sequence (MP2RAGE). Mean T1 relaxation times (T1-RT) in the cortex and thalami were compared between patients with MS and healthy controls. Additionally, correlation analysis was performed to assess the relationship between MRI parameters and clinical and cognitive disability.Results: Patients with MS had significantly decreased normalized brain, gray matter, and white matter volumes, as well as increased T1-RT in the normal-appearing white matter, compared to healthy controls (p < 0.001). Partial correlation analysis with age, sex, and disease duration as covariates revealed correlations for T1-RT in the cortex (r = −0.33, p < 0.05), and thalami (right thalamus: r = −0.37, left thalamus: r = −0.50, both p < 0.05) with working memory and information processing speed, as measured by the Symbol-Digit Modalities Test.Conclusion: T1-RT in the cortex and thalamus correlate with information processing speed in patients with MS.

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

2017 ◽  
Vol 24 (6) ◽  
pp. 795-804 ◽  
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 .

scholarly journals Patients with paediatric-onset multiple sclerosis are at higher risk of cognitive impairment in adulthood: An Italian collaborative study

2017 ◽  
Vol 24 (9) ◽  
pp. 1234-1242 ◽  
Author(s):  
Luis Ruano ◽  
Mariana Branco ◽  
Emilio Portaccio ◽  
Benedetta Goretti ◽  
Claudia Niccolai ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
Information Processing ◽  
Processing Speed ◽  
Collaborative Study ◽  
Cognitive Disability ◽  
Information Processing Speed ◽  
Neuropsychological Profile ◽  
Increased Risk ◽  
History Of

Background: Patients with paediatric-onset multiple sclerosis (POMS) could be at an increased risk for cognitive impairment (CI), given the potential harmful effects of disease activity in neurodevelopment. However, there is scarce information on their long-term cognitive outcomes. Objective: To compare the prevalence and profile of CI between adults with a history of POMS and those with classic, adult-onset multiple sclerosis (AOMS). Methods: Cognitive performance was assessed through the Brief Repeatable Battery (BRB) and the Stroop Test in consecutive patients referred to six Italian MS centres. CI was defined as impairment in ⩾2 cognitive domains. Results: In all, 119 patients with POMS and 712 with AOMS were included in this analysis. The prevalence of CI was 48.0% in AOMS, 44.5% in POMS; with similar neuropsychological profile between the two groups. However, when adjusting for current age, we found a significantly increased risk for CI (odds ratio (OR) = 1.71; p = 0.02) and for impairment in information processing speed (OR = 1.86; p < 0.01) in patients with POMS. A higher Expanded Disability Status Scale (EDSS) was also identified in POMS ( p = 0.03) compared with AOMS patients. Conclusion: Patients with a history of POMS appear to be at higher risk of physical and cognitive disability than AOMS patients, after correcting for age effects, with particular involvement of information processing speed.

scholarly journals A comparison of cognitive performances between neuromyelitis optica spectrum disorder and multiple sclerosis patients in Indian context

2021 ◽  
Vol 57 (1) ◽  
Author(s):  
Swati Kumar ◽  
Goutam Gangopadhyay ◽  
Atanu Biswas ◽  
Souvik Dubey ◽  
Alak Pandit ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
Information Processing ◽  
Executive Function ◽  
Neuromyelitis Optica ◽  
Processing Speed ◽  
Verbal Fluency ◽  
Spectrum Disorder ◽  
Neuromyelitis Optica Spectrum Disorder ◽  
Information Processing Speed

Abstract Background To compare the frequency and pattern of cognitive impairment in neuromyelitis optica spectrum disorder (NMOSD) and multiple sclerosis (MS) patients. Results Twenty NMOSD and forty MS patients were included. Clinical and detailed neuropsychological assessment was done using frontal assessment battery and Kolkata cognitive battery supplemented with additional standard tests for different domains of cognitive functions. Domain wise tests were performed and compared. 15/20 (75%) NMOSD and 32/40 (80%) MS patients had cognitive impairment (p = 0.65). Executive function, verbal fluency, information processing speed, visuo-constructional ability, attention, complex calculation, and memory were more commonly involved in NMOSD in decreasing order. Compared to MS, the pattern was similar except that verbal fluency was more impaired in NMOSD. Expanded Disability Status scale (EDSS) correlated with cognitive involvement in NMOSD (p = 0.02) as against MS. Conclusions Executive function, verbal fluencies, and information processing speed were more affected compared to visual and verbal memory in NMOSD patients. The pattern of cognitive performance was similar in the MS group, even though clinical and radiological characteristics and pathophysiology is different, suggesting similar brain involvement.

Targeted Cognitive Game Training Enhances Cognitive Performance in Multiple Sclerosis Patients Treated With Interferon Beta 1-a

2021 ◽  
Author(s):  
Shay Menascu ◽  
Roy Aloni ◽  
Mark Dolev ◽  
David Magalashvili ◽  
Keren Gutman ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
Information Processing ◽  
Executive Function ◽  
Mild Cognitive Impairment ◽  
Cognitive Performance ◽  
Processing Speed ◽  
Interferon Beta ◽  
Training Group ◽  
Information Processing Speed

Abstract BackgroundPrevention of cognitive decline in Multiple Sclerosis (MS) is of major importance. We explored the effect of short-term computerized game training on cognitive performance in MS patients with mild cognitive impairment.MethodsWe enrolled in this prospective study 100 eligible MS patients treated with Interferon-beta-1a (Rebif). All had mild cognitive impairment in either executive function or information processing speed. Patients were randomized 1:1 to either use the cognitive games platform byHappyNeuron (HN) or receive no intervention. Executive function and information processing speed scores were measured at 3 and 6 months from baseline to evaluate the effect of game training on cognitive scores.ResultsIn both executive function and information processing speed, the game Training group showed significant improvement after 3 and 6 months. The Non-Training group showed mild deterioration in both domains at 3 months, and further deterioration that became significant at 6 months in executive function. Furthermore, at 6 months, the percent of patients in the Training group that improved or remained stable in both cognitive domains was significantly higher compared to the Non-Training group.ConclusionsOur findings suggest that cognitive game training has a beneficial effect on cognitive performance in MS patients suffering from mild cognitive impairment. While further evaluation is required to assess the longevity of that effect, we nonetheless recommend to MS patients to be engaged in cognitive gaming practice as part of a holistic approach to treating their condition.

scholarly journals Thalamus volume change and cognitive impairment in early relapsing–remitting multiple sclerosis patients

2018 ◽  
Vol 31 (4) ◽  
pp. 350-355 ◽  
Author(s):  
Juan I Rojas ◽  
Georgina Murphy ◽  
Francisco Sanchez ◽  
Liliana Patrucco ◽  
Maria C Fernandez ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
Magnetic Resonance ◽  
Processing Speed ◽  
Resonance Imaging ◽  
Information Processing Speed ◽  
Relapsing Remitting ◽  
Relapsing Remitting Multiple Sclerosis

Aims The objective of the study was to assess whether changes in the volume of the thalamus during the onset of multiple sclerosis predict cognitive impairment after accounting for the effects of brain volume loss. Methods A prospective study included patients with relapsing–remitting multiple sclerosis less than 3 years after disease onset (defined as the first demyelinating symptom), Expanded Disability Status Scale of 3 or less, no history of cognitive impairment and at least 2 years of follow-up. Patients were clinically followed up with annual brain magnetic resonance imaging and neuropsychological evaluations for 2 years. Measures of memory, information processing speed and executive function were evaluated at baseline and follow-up with a comprehensive neuropsychological test battery. After 2 years, the patients were classified into two groups, one with and the other without cognitive impairment. Brain dual-echo, high-resolution three-dimensional T1-weighted magnetic resonance imaging scans were acquired at baseline and every 12 months for 2 years. Between-group differences in thalamus volume, total and neocortical grey matter and white matter volumes were assessed using FIRST, SIENA, SIENAXr, FIRST software (logistic regression analysis P < 0.05 significant). Results Sixty-one patients, mean age 38.4 years, 35 (57%) women were included. At 2 years of follow-up, 17 (28%) had cognitive impairment. Cognitive impairment patients exhibited significantly slower information processing speed and attentional deficits compared with patients without cognitive impairment ( P < 0.001 and P = 0.02, respectively). In the cognitive impairment group a significant reduction in the percentage of thalamus volume ( P < 0.001) was observed compared with the group without cognitive impairment. Conclusion We observed a significant decrease in thalamus volume in multiple sclerosis-related cognitive impairment.

Do subcortical gray matter volumes and aerobic capacity account for cognitive-motor coupling in multiple sclerosis?

2020 ◽  
pp. 135245852091482
Author(s):  
Robert W Motl ◽  
Brian M Sandroff ◽  
Ralph HB Benedict ◽  
Elizabeth A Hubbard ◽  
Lara A Pilutti ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Processing ◽  
Gray Matter ◽  
Aerobic Capacity ◽  
Processing Speed ◽  
Motor Dysfunction ◽  
Strong Correlations ◽  
Walking Performance ◽  
Magnetic Resonance Imaging Mri ◽  
Cognitive Processing Speed

Background: There is evidence of cognitive-motor coupling in multiple sclerosis (MS) such that the slowing of cognitive processing speed correlates with the worsening of walking speed and endurance. Objective: The current study first established the presence of cognitive-motor coupling and second examined the possibility that volumes of subcortical gray matter (SGM) structures and aerobic capacity might explain the coupling of cognitive and motor functions in persons with MS. Methods: We included data from 62 persons with clinically definite MS who underwent assessments of cognitive processing speed, walking performance, and aerobic capacity, and completed magnetic resonance imaging (MRI) within 7 days of the aforementioned assessments. Results: The strong correlations between cognitive processing speed and walking performance were attenuated in magnitude and not statistically significant when controlling for aerobic capacity alone and aerobic capacity and SGM volumes together. The associations between cognitive processing speed and walking performance remained statistically significant when controlling for SGM volumes alone. Conclusion: Aerobic capacity may be an important target for neurorehabilitation-based approaches for managing co-occurring cognitive and motor dysfunction in MS.

Cognitive processing speed in pediatric-onset multiple sclerosis: Baseline characteristics of impairment and prediction of decline

2019 ◽  
Vol 26 (14) ◽  
pp. 1938-1947 ◽  
Author(s):  
Asya I Wallach ◽  
Michael Waltz ◽  
T Charles Casper ◽  
Gregory Aaen ◽  
Anita Belman ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
Cognitive Processing ◽  
Processing Speed ◽  
Disease Onset ◽  
Initial Assessment ◽  
The Mean ◽  
Cognitive Screen ◽  
Pediatric Onset

Background: Cognitive impairment occurs in approximately one-third of pediatric-onset multiple sclerosis (POMS) patients. The Symbol Digit Modalities Test (SDMT), a widely used cognitive screen in adults, has yet to be incorporated early into the standard care of POMS. Objective: To screen for cognitive impairment early in the course of POMS and analyze predictive factors. Methods: Of the 955 POMS or clinically isolated syndrome (CIS) patients prospectively assessed from March 2014 to July 2018, 500 POMS and 116 CIS patients met inclusion criteria (disease onset before the age of 18, one or more SDMTs, and 8 years or older at the time of testing). Those with relapse were analyzed separately from those who were relapse-free. Results: At initial assessment, the mean (interquartile range (IQR)) age at symptom onset was 13.5 years (12.0, 15.9) and the mean (±SD) disease duration was 3.0 ± 2.9 years. Impaired processing speed occurred in 23.4% of POMS and in 16.4% of CIS. On serial testing ( n = 383, mean follow-up: 1.8 years), 14.1% had clinically meaningful decline predicted by older age of multiple sclerosis (MS) onset and male gender. Disease relapse or steroid use led to transient worsening on the SDMT. Conclusion: Early in the disease, some POMS and CIS patients are at risk for cognitive impairment and subsequent decline.

Can we define a rehabilitation strategy for cognitive impairment in progressive multiple sclerosis? A critical appraisal

2016 ◽  
Vol 22 (5) ◽  
pp. 581-589 ◽  
Author(s):  
Emanuele D’Amico ◽  
Carmela Leone ◽  
Tumani Hayrettin ◽  
Francesco Patti
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
Information Processing ◽  
Processing Speed ◽  
Cognitive Rehabilitation ◽  
Critical Appraisal ◽  
Progressive Multiple Sclerosis ◽  
Information Processing Speed ◽  
Specific Approach ◽  
Rehabilitation Strategy

Cognitive impairment (CI) has been shown to be severe in patients with progressive forms of multiple sclerosis (MS), and the most frequently impaired domains are sustained attention, information processing speed, memory, and executive functions. In contrast to relapsing forms of MS, where studies have shown favorable results from cognitive rehabilitation, there is a lack of data on cognitive rehabilitation in progressive forms of MS. A specific approach in assessing CI and in designing and administering rehabilitation training for patients with progressive forms of MS is needed.

scholarly journals Increased connectivity of hub networks and cognitive impairment in multiple sclerosis

Neurology ◽  
2017 ◽  
Vol 88 (22) ◽  
pp. 2107-2114 ◽  
Author(s):  
Kim A. Meijer ◽  
Anand J.C. Eijlers ◽  
Linda Douw ◽  
Bernard M.J. Uitdehaag ◽  
Frederik Barkhof ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
Processing Speed ◽  
Network Connectivity ◽  
Resting State Fmri ◽  
Cognitively Impaired ◽  
Information Processing Speed ◽  
Frontoparietal Network ◽  
Neuropsychological Assessments ◽  
The Brain

Objective:To investigate default-mode network (DMN) and frontoparietal network (FPN) dysfunction in cognitively impaired (CI) patients with multiple sclerosis (MS) because these networks strongly relate to cognition and contain most of the hubs of the brain.Methods:Resting-state fMRI and neuropsychological assessments were performed in 322 patients with MS and 96 healthy controls (HCs). Patients with MS were classified as CI (z score < −2.0 on at least 2 tests; n = 87), mildly cognitively impaired (z score < −1.5 on at least 2 tests and not CI; n = 65), and cognitively preserved (CP; n = 180). Within-network connectivity, connectivity with the rest of the brain, and between-network connectivity were calculated and compared between groups. Connectivity values were normalized for individual means and SDs.Results:Only in CI, both the DMN and FPN showed increased connectivity with the rest of the brain compared to HCs and CP, with no change in within- or between-network connectivity. Regionally, this increased connectivity was driven by the inferior parietal, posterior cingulate, and angular gyri. Increased connectivity with the rest of the brain correlated with worse cognitive performance, namely attention for the FPN as well as information processing speed and working memory for both networks.Conclusions:In CI patients with MS, the DMN and FPN showed increased connectivity with the rest of the brain, while normal within- and between-network connectivity levels were maintained. These findings indicate that cognitive impairment in MS features disturbed communication of hub-rich networks, but only with the more peripheral (i.e., nonhub) regions of the brain.

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