scholarly journals Cardiorespiratory fitness and free-living physical activity are not associated with cognition in persons with progressive multiple sclerosis: Baseline analyses from the CogEx study

2021 ◽  
pp. 135245852110483
Author(s):  
Brian M Sandroff ◽  
Robert W Motl ◽  
Maria Pia Amato ◽  
Giampaolo Brichetto ◽  
Jeremy Chataway ◽  
...  
Keyword(s):  
Physical Activity ◽  
Multiple Sclerosis ◽  
Cardiorespiratory Fitness ◽  
Vigorous Physical Activity ◽  
Verbal Learning ◽  
Progressive Multiple Sclerosis ◽  
Aerobic Exercise Training ◽  
California Verbal Learning Test ◽  
Z Scores ◽  
Learning Test

Background: Aerobic exercise training (physical activity for improving cardiorespiratory fitness) represents a promising approach for managing cognitive impairment in multiple sclerosis (MS). However, there is limited evidence that levels of physical activity and fitness are associated with cognition in progressive MS. Objective: We examined associations among cardiorespiratory fitness, moderate-to-vigorous physical activity (MVPA), and cognitive performance in a large, international progressive MS sample. Methods: Two hundred forty European and North American persons with progressive MS underwent cardiorespiratory fitness measurement on a recumbent stepper, wore an ActiGraph GT3X + accelerometer for 7 days for measuring MVPA, and underwent the Brief International Cognitive Assessment in MS. Results: Cardiorespiratory fitness was not significantly correlated with Symbol Digit Modalities Test (SDMT; r = −0.01; r = −0.04), California Verbal Learning Test-II (CVLT-II; r = 0.05; r = 0.05), or Brief Visuospatial Memory Test–Revised (BVMT-R; r = −0.14; r = −0.14) z-scores controlling for age, sex, and education. MVPA and SDMT ( r = 0.05), CVLT-II ( r = −0.07), and BVMT-R ( r = 0.01) z-scores were not significantly correlated. Conclusion: Cardiorespiratory fitness and MVPA were not associated with cognition in this large progressive MS sample, yet these outcomes represent critical manipulation checks for documenting the success of the CogEx trial. This highlights the importance of examining other exercise-related mechanisms-of-action for improving cognition in progressive MS.

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.

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 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 A validation study for remote testing of cognitive function in multiple sclerosis

2020 ◽  
pp. 135245852093738
Author(s):  
Lisa F Barcellos ◽  
Mary Horton ◽  
Xiaorong Shao ◽  
Kalliope H Bellesis ◽  
Terrence Chinn ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Function ◽  
Cognitive Assessment ◽  
Verbal Learning ◽  
California Verbal Learning Test ◽  
Validity And Reliability ◽  
Remote Testing ◽  
Remote Assessment ◽  
Learning Test ◽  
Test Retest Reliability

Objectives: Determine the validity and reliability of a remote, technician-guided cognitive assessment for multiple sclerosis (MS), incorporating the Symbol Digit Modalities Test (SDMT) and the California Verbal Learning Test, Second Edition (CVLT-II). Methods: In 100 patients, we compared conventional in-person testing to remote, web-assisted assessments, and in 36 patients, we assessed test–retest reliability using two equivalent, alternative forms. Results: In-person and remote-administered SDMT ( r = 0.85) and CVLT-II ( r = 0.71) results were very similar. Reliability was adequate and alternative forms of SDMT ( r = 0.92) and CVLT-II ( r = 0.81) produced similar results. Conclusions: Findings indicate remote assessment can provide valid, reliable measures of cognitive function in MS.

Validity of the California Verbal Learning Test–II in Multiple Sclerosis

2010 ◽  
Vol 24 (2) ◽  
pp. 189-202 ◽  
Author(s):  
Shane Stegen ◽  
Igor Stepanov ◽  
Diane Cookfair ◽  
Eben Schwartz ◽  
David Hojnacki ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Verbal Learning ◽  
California Verbal Learning Test ◽  
Learning Test

Decreased hippocampal volume, indirectly measured, is associated with depressive symptoms and consolidation deficits in multiple sclerosis

2011 ◽  
Vol 17 (9) ◽  
pp. 1088-1097 ◽  
Author(s):  
Gevrey Kiy ◽  
Pia Lehmann ◽  
Horst K Hahn ◽  
Paul Eling ◽  
Andreas Kastrup ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Memory Performance ◽  
Verbal Learning ◽  
Hippocampal Volume ◽  
Depressive Mood ◽  
California Verbal Learning Test ◽  
Hippocampal Atrophy ◽  
Indirect Measure ◽  
Temporal Horn ◽  
Learning Test

Background: The human hippocampus plays a role in episodic memory and depression. Recently, it has been shown, using manual tracings, that the hippocampus is smaller in volume in MS patients compared with healthy controls, and that, at least for depression, hippocampal atrophy correlates with symptom severity. Methods: Because manual tracing of the hippocampus is time consuming, we used a semi-automatic procedure for temporal horn volumetry in 72 multiple sclerosis (MS) patients and 16 control subjects as an indirect measure of hippocampal volume. We analysed memory performance with the California Verbal Learning Test (using separate indices for encoding, consolidation and retrieval) and depressive mood with the Beck’s Depression Inventory (distinguishing between psychic and somatic aspects). Results: MS patients had significantly larger temporal horn volumes and volume correlated with psychic symptoms of depressive mood. Temporal horn volume was also associated with consolidation, in particular in the most impaired group. Conclusions: Temporal horn volume can be measured relatively easily and appears to correlate with two major clinical problems in MS patients: memory performance and depressive mood. The link between temporal horn volume, consolidation and depression may be hippocampal atrophy, as suggested by their adjacent neuroanatomical localization, and by the similarity in functional loss following impairment of these two structures.

scholarly journals Cardiorespiratory fitness and moderate-to-vigorous physical activity in older adults with multiple sclerosis

2021 ◽  
Vol 7 (4) ◽  
pp. 205521732110575
Author(s):  
Robert W Motl ◽  
Jessica F Baird
Keyword(s):  
Physical Activity ◽  
Multiple Sclerosis ◽  
Older Adults ◽  
Cardiorespiratory Fitness ◽  
Vigorous Physical Activity ◽  
Well Being ◽  
Cardiopulmonary Exercise Test ◽  
Group Differences ◽  
Healthy Controls ◽  
Large Correlation

Background Cardiorespiratory fitness (VO2peak) may be a modifiable indicator of health status and well-being in older adults with multiple sclerosis. Purpose We examined differences in VO2peak and moderate-to-vigorous physical activity between older adults with multiple sclerosis and healthy controls, and whether moderate-to-vigorous physical activity accounted for group differences in VO2peak. Methods Older adults with multiple sclerosis ( n = 31) and healthy controls ( n = 29) completed a cardiopulmonary exercise test and wore an accelerometer for measuring moderate-to-vigorous physical activity. The data were analyzed using the Baron and Kenny approach for examining moderate-to-vigorous physical activity as a mediator of group differences in VO2peak. Results The multiple sclerosis group had significantly lower VO2peak and moderate-to-vigorous physical activity than healthy controls. VO2peak had a large correlation with moderate-to-vigorous physical activity ( r = .59). Group initially explained 8% of the variance in VO2peak ( β  =  −0.29). The inclusion of moderate-to-vigorous physical activity accounted for an additional 27% of the variance in VO2peak, but only moderate-to-vigorous physical activity ( β  =  0.57) was a statistically significant correlate of VO2peak. The effect of Group was attenuated and non-significant with the addition of moderate-to-vigorous physical activity in Step 2 (Group β Step 1  =  −0.29, Group β Step 2  =  −0.05). Conclusions Our results provide initial support for targeting moderate-to-vigorous physical activity as an approach for improving VO2peak in older adults with multiple sclerosis.

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.

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