Associations of the Lifestyle for Brain Health Index With Structural Brain Changes and Cognition: Results From the Maastricht Study

Background and Objectives:Observational research has shown that a substantial proportion of all dementia cases worldwide is attributable to modifiable risk factors. Dementia risk scores might be useful to identify high-risk individuals and monitor treatment adherence. The objective of this study was to investigate whether a dementia risk score, the LIfestyle for BRAin health (LIBRA) index, is associated with MRI markers and cognitive functioning/impairment in the general population.Methods:Cross-sectional data was used from the observational population-based cohort of The Maastricht Study.. The weighted compound score of LIBRA (including twelve dementia risk and protective factors, e.g. hypertension, physical inactivity) was calculated, with higher scores indicating higher dementia risk. Standardized volumes of white matter, grey matter, CSF (as proxy for general brain atrophy), white matter hyperintensities, and presence of cerebral small vessel disease were derived from 3T MRI. Cognitive functioning was tested in three domains: memory, information processing speed, and executive function and attention. Values ≤1.5 SD below the average were defined as cognitive impairment. Multiple regression analyses and structural equation modelling were used, adjusted for age, sex, education, intracranial volume and type-2 diabetes.Results:Participants (n=4,164; mean age 59y; 49.7% men) with higher LIBRA scores (mean=1.19, range=-2.7 to +9.2), denoting higher dementia risk, had higher volumes of white matter hyperintensities (β=0.051, p=.002), and lower scores on information processing speed (β=-0.067, p=.001) and executive function and attention (β=-0.065, p=.004). Only in men, associations between LIBRA and volumes of grey matter (β=-0.093, p<.001), CSF (β=0.104, p<.001) and memory (β=-0.054, p=.026) were found. White matter hyperintensities and CSF volume partly mediated the association between LIBRA and cognition.Discussion:Higher health- and lifestyle-based dementia risk is associated with markers of general brain atrophy, cerebrovascular pathology and worse cognition, suggesting that LIBRA meaningfully summarizes individual lifestyle-related brain health. Improving LIBRA factors on an individual level might improve population brain health. Sex differences in lifestyle-related pathology and cognition need to be further explored.Classification of Evidence:This study provides Class II evidence that higher LIBRA scores are significantly associated with lower scores on some cognitive domains and a higher risk of cognitive impairment.

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

The Egyptian Journal of Neurology Psychiatry and Neurosurgery ◽

10.1186/s41983-021-00351-y ◽

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.

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

10.21203/rs.3.rs-725383/v1 ◽

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.

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The relation of depression with structural brain abnormalities and cognitive functioning: the Maastricht study

Psychological Medicine ◽

10.1017/s0033291721000222 ◽

2021 ◽

pp. 1-10

Author(s):

Anouk F. J. Geraets ◽

Miranda T. Schram ◽

Jacobus F. A. Jansen ◽

Annemarie Koster ◽

Pieter C. Dagnelie ◽

...

Keyword(s):

Type 2 Diabetes ◽

Cognitive Impairment ◽

Information Processing ◽

White Matter ◽

Executive Functioning ◽

Cognitive Functioning ◽

Processing Speed ◽

Brain Atrophy ◽

Information Processing Speed

Abstract Background Individuals with depression often experience widespread and persistent cognitive deficits, which might be due to brain atrophy and cerebral small vessel disease (CSVD). We therefore studied the associations between depression, markers of brain atrophy and CSVD, and cognitive functioning. Methods We used cross-sectional data from the population-based Maastricht study (n = 4734; mean age 59.1 ± 8.6 years, 50.2% women), which focuses on type 2 diabetes. A current episode of major depressive disorder (MDD, n = 151) was assessed by the Mini-International Neuropsychiatric Interview. Volumes of cerebral spinal fluid, white matter, gray matter and white matter hyperintensities, presence of lacunar infarcts and cerebral microbleeds, and total CSVD burden were assessed by 3 T magnetic resonance imaging. Multiple linear and logistic regression analyses tested the associations between MDD, brain markers and cognitive functioning in memory, information processing speed, and executive functioning & attention, and presence of cognitive impairment. Structural equation modeling was used to test mediation. Results In fully adjusted models, MDD was associated with lower scores in information processing speed [mean difference = −0.18(−0.28;−0.08)], executive functioning & attention [mean difference = −0.13(−0.25;−0.02)], and with higher odds of cognitive impairment [odds ratio (OR) = 1.60(1.06;2.40)]. MDD was associated with CSVD in participants without type 2 diabetes [OR = 1.65(1.06;2.56)], but CSVD or other markers of brain atrophy or CSVD did not mediate the association with cognitive functioning. Conclusions MDD is associated with more impaired information processing speed and executive functioning & attention, and overall cognitive impairment. Furthermore, MDD was associated with CSVD in participants without type 2 diabetes, but this association did not explain an impaired cognitive profile.

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Targeted cognitive game training enhances cognitive performance in multiple sclerosis patients treated with interferon beta 1-a

Journal of NeuroEngineering and Rehabilitation ◽

10.1186/s12984-021-00968-3 ◽

2021 ◽

Vol 18 (1) ◽

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 Background Prevention of cognitive decline in Multiple Sclerosis (MS) is of major importance. We explored the effect of a 6 months computerized game training program on cognitive performance in MS patients with mild cognitive impairment. Methods This was a single-center, randomized prospective study. We enrolled in this 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 by HappyNeuron (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. Results In 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. Conclusions Our 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.

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White matter hyperintensities mediate the association between blood-brain barrier leakage and information processing speed

Neurobiology of Aging ◽

10.1016/j.neurobiolaging.2019.09.017 ◽

2020 ◽

Vol 85 ◽

pp. 113-122 ◽

Cited By ~ 3

Author(s):

Whitney M. Freeze ◽

Heidi I.L. Jacobs ◽

Joost J. de Jong ◽

Inge C.M. Verheggen ◽

Ed H.B.M. Gronenschild ◽

...

Keyword(s):

Information Processing ◽

White Matter ◽

Blood Brain Barrier ◽

Processing Speed ◽

White Matter Hyperintensities ◽

Brain Barrier ◽

Information Processing Speed ◽

Blood Brain

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Cerebral small-vessel disease and decline in information processing speed, executive function and memory

Brain ◽

10.1093/brain/awh553 ◽

2005 ◽

Vol 128 (9) ◽

pp. 2034-2041 ◽

Cited By ~ 420

Author(s):

Niels D. Prins ◽

Ewoud J. van Dijk ◽

Tom den Heijer ◽

Sarah E. Vermeer ◽

Jellemer Jolles ◽

...

Keyword(s):

Information Processing ◽

Executive Function ◽

Processing Speed ◽

Small Vessel Disease ◽

Cerebral Small Vessel Disease ◽

Small Vessel ◽

Information Processing Speed ◽

Vessel Disease

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Reduced information processing speed as primum movens for cognitive decline in MS

Multiple Sclerosis Journal ◽

10.1177/1352458514537012 ◽

2014 ◽

Vol 21 (1) ◽

pp. 83-91 ◽

Cited By ~ 34

Author(s):

Jeroen Van Schependom ◽

Marie B D’hooghe ◽

Krista Cleynhens ◽

Mieke D’hooge ◽

Marie-Claire Haelewyck ◽

...

Keyword(s):

Cognitive Impairment ◽

Information Processing ◽

Processing Speed ◽

Time Course ◽

Age At Onset ◽

Memory Task ◽

Cognitive Domain ◽

Information Processing Speed ◽

Survival Curves ◽

Cross Sectional

Background: Cognitive impairment affects half of the multiple sclerosis (MS) patient population and is an important contributor to patients’ daily activities. Most cognitive impairment studies in MS are, however, cross-sectional or/and focused on the early disease stages. Objective: We aim to assess the time course of decline of different cognitive domains. Methods: We collected neuropsychological data on 514 MS patients to construct Kaplan-Meier survival curves of the tests included in the Neuropsychological Screening Battery for MS (NSBMS) and the Symbol Digit Modalities Test (SDMT). Cox-proportional hazard models were constructed to examine the influence of MS onset type, age at onset, gender, depression and level of education on the time course, expressed as age or disease. Results: Survival curves of tests focusing on information processing speed (IPS) declined significantly faster than tests with less specific demands of IPS. Median age for pathological decline was 56.2 years (95% CI: 54.4–58.2) on the SDMT and 63.9 years (95% CI: 60–66.9) on the CLTR, a memory task. Conclusion: In conclusion, IPS is the cognitive domain not only most widely affected by MS but it is also the first cognitive deficit to emerge in MS.

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