scholarly journals Cognitive processing speed in multiple sclerosis clinical practice: association with patient‐reported outcomes, employment and magnetic resonance imaging metrics

2020 ◽  
Vol 27 (7) ◽  
pp. 1238-1249 ◽  
Author(s):  
G. Macaron ◽  
L. E. Baldassari ◽  
K. Nakamura ◽  
S. M. Rao ◽  
M. P. McGinley ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Multiple Sclerosis ◽  
Clinical Practice ◽  
Magnetic Resonance ◽  
Cognitive Processing ◽  
Processing Speed ◽  
Patient Reported Outcomes ◽  
Resonance Imaging ◽  
Patient Reported ◽  
Cognitive Processing Speed

scholarly journals Information Processing and Magnetic Resonance Imaging Indices of Brain Pathology in Multiple Sclerosis

2012 ◽  
Vol 14 (2) ◽  
pp. 84-91 ◽  
Author(s):  
Antonina Omisade ◽  
John D. Fisk ◽  
Raymond M. Klein ◽  
Matthias Schmidt ◽  
Sultan Darvesh ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Multiple Sclerosis ◽  
Magnetic Resonance ◽  
Cognitive Processing ◽  
Processing Speed ◽  
Clinical Test ◽  
Brain Pathology ◽  
Resonance Imaging ◽  
Cognitive Changes ◽  
Cognitive Processing Speed

Accumulation of central nervous system (CNS) pathology affects cognitive processing speed and efficiency and is thought to underlie attentional and executive deficits in multiple sclerosis (MS). Most clinical neuropsychological tests are multifactorial and are limited in their sensitivity to specific cognitive processes. This may, in part, account for the low to moderate correlations between clinical test results and magnetic resonance imaging (MRI) indices of brain pathology. We compared the ability of a clinical and an experimental test of cognitive processing speed to differentiate domain-specific cognitive changes in MS, and examined relations between test performance and MRI measures of brain pathology. Twelve MS patients and 12 controls completed the Paced Auditory Serial Addition Test (PASAT) and the Attention Networks Test–Interactions (ANT-I), a computerized response latency task. Subjects also had MRI scans that included T1, T2, and fluid-attenuated inversion recovery (FLAIR) sequences that provided global and localized volumetric measures. Patients made more errors on the PASAT and were slower on the ANT-I. The ANT-I also revealed specific deficits in response inhibition. In addition, ANT-I performance was associated with changes in a number of MRI measures, which was not the case for the PASAT. Reaction time paradigms that manipulate within-task demands on distinct cognitive functions may provide meaningful markers of brain disease burden in MS.

Multiple Sclerosis and Cognitive Impairment

2021 ◽  
pp. 39-41
Author(s):  
Cristina Valencia-Sanchez ◽  
Jonathan L. Carter
Keyword(s):  
Magnetic Resonance Imaging ◽  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
Information Processing ◽  
Magnetic Resonance ◽  
Processing Speed ◽  
Rehabilitation Program ◽  
Resonance Imaging ◽  
The Past ◽  
Demyelinating Lesions

A 60-year-old woman with a history of multiple sclerosis was evaluated for cognitive concerns. At age 30 years she had an episode of optic neuritis, followed by an episode of bilateral lower extremity numbness at age 35 years. In the following years, she had at least 6 further multiple sclerosis relapses, the last one approximately 3 years before the current presentation. She was initially treated with interferon, but she did not tolerate it. She had been taking glatiramer acetate for the past 3 years. She had noticed progressive deterioration of her gait for the past 3 years, having to use a cane on occasions. Magnetic resonance imaging of the brain showed multiple demyelinating lesions), and magnetic resonance imaging of the cervical spine showed 1 small demyelinating lesion at C6. Vitamin B12 level and thyroid function were normal. Comprehensive neuropsychological testing showed multidomain cognitive impairment, mainly impairment of speed of information processing, spatial discrimination skills, and attention/concentration. The patient’s multiple sclerosis phenotype was consistent with secondary progressive multiple sclerosis. Her cognitive impairment profile, mainly affecting information processing speed and disinhibition suggestive of frontal dysfunction, was consistent with multiple sclerosis. The patient began a cognitive rehabilitation program, and learning and memory aids were recommended. Lifestyle changes were also recommended, including weight loss and physical exercise. She was given recommendations for sleep hygiene and began taking gabapentin for neuropathic pain and restless legs. Cognitive impairment is common in patients with multiple sclerosis. Slowed cognitive processing speed and episodic memory decline are the most common cognitive deficits in MS, with additional difficulties in executive function, verbal fluency, and visuospatial analysis.

Examination of processing speed deficits in multiple sclerosis using functional magnetic resonance imaging

2009 ◽  
Vol 15 (3) ◽  
pp. 383-393 ◽  
Author(s):  
HELEN M. GENOVA ◽  
FRANK G. HILLARY ◽  
GLENN WYLIE ◽  
BART RYPMA ◽  
JOHN DELUCA
Keyword(s):  
Magnetic Resonance Imaging ◽  
Multiple Sclerosis ◽  
Magnetic Resonance ◽  
Functional Magnetic Resonance Imaging ◽  
Processing Speed ◽  
Anterior Cingulate ◽  
Precentral Gyrus ◽  
Functional Magnetic Resonance ◽  
Resonance Imaging ◽  
Group Processing

AbstractAlthough it is known that processing speed deficits are one of the primary cognitive impairments in multiple sclerosis (MS), the underlying neural mechanisms responsible for impaired processing speed remain undetermined. Using BOLD functional magnetic resonance imaging, the current study compared the brain activity of 16 individuals with MS to 17 healthy controls (HCs) during performance of a processing speed task, a modified version of the Symbol Digit Modalities Task. Although there were no differences in performance accuracy, the MS group was significantly slower than HCs. Although both groups showed similar activation involving the precentral gyrus and occipital cortex, the MS showed significantly less cerebral activity than HCs in bilateral frontal and parietal regions, similar to what has been reported in aging samples during speeded tasks. In the HC group, processing speed was mediated by frontal and parietal regions, as well as the cerebellum and thalamus. In the MS group, processing speed was mediated by insula, thalamus and anterior cingulate. It therefore appears that neural networks involved in processing speed differ between MS and HCs, and our findings are similar to what has been reported in aging, where damage to both white and gray matter is linked to processing speed impairments (JINS, 2009, 15, 383–393).

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.

Recovery of cognitive function after relapse in multiple sclerosis

2020 ◽  
Vol 27 (1) ◽  
pp. 71-78 ◽  
Author(s):  
Ralph HB Benedict ◽  
Jeta Pol ◽  
Faizan Yasin ◽  
David Hojnacki ◽  
Channa Kolb ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Processing ◽  
Verbal Memory ◽  
Patient Reported Outcomes ◽  
Patient Reported ◽  
Disability Status ◽  
Neurological Exam ◽  
Magnetic Resonance Imaging Mri ◽  
Cognitive Processing Speed

Background: Cognitive impairment is common in multiple sclerosis (MS) but its manifestation as acute disease activity is underappreciated. Objective: The aim of this study is to examine recovery after MS relapse on multiple tests of cognitive and motor function and explore correlates of change with Expanded Disability Status Scale (EDSS), magnetic resonance imaging (MRI), and cognitive reserve. Methods: Fifty relapsing group (RG) and matched stable participants were examined at baseline, during relapse, and at 3-month follow-up. Tests of cognitive processing speed (Symbol Digit Modalities Test (SDMT)) and consensus opinion measures of memory, ambulation, and manual dexterity were administered. All RG patients were treated with a 5-day course of Acthar Gel (5 mL/80 IU). Results: In RG patients, SDMT declined from 55.2 to 44.6 at relapse and recovered to 51.7, a slope differing from stable controls ( p = 0.001). A statistical trend ( p = 0.07) for the same effect was observed for verbal memory and was significant for ambulation ( p = 0.03). The Cerebral Function Score from the EDSS also changed in the RG and recovered incompletely relative to controls ( p = 0.006). Conclusion: These results replicate earlier reports of cognitive worsening during relapse in MS. Clinically meaningful improvements followed relapse on SDMT and ambulation. Cognitive decline during relapse can be appreciated on neurological exam but not patient-reported outcomes.

Sign in / Sign up

Export Citation Format

Share Document