Causes, effects and connectivity changes in MS-related cognitive decline

Abstract

Cognitive decline is a frequent but undervalued aspect of multiple sclerosis (MS). Currently, it remains unclear what the strongest determinants of cognitive dysfunction are, with grey matter damage most directly related to cognitive impairment. Multi-parametric studies seem to indicate that individual factors of MS-pathology are highly interdependent causes of grey matter atrophy and permanent brain damage. They are associated with intermediate functional effects (e.g. in functional MRI) representing a balance between disconnection and (mal) adaptive connectivity changes. Therefore, a more comprehensive MRI approach is warranted, aiming to link structural changes with functional brain organization. To better understand the disconnection syndromes and cognitive decline in MS, this paper reviews the associations between MRI metrics and cognitive performance, by discussing the interactions between multiple facets of MS pathology as determinants of brain damage and how they affect network efficiency.

Cognitive impairment in an animal model of multiple sclerosis and its amelioration by glatiramer acetate

“…Indeed, cognitive deterioration strongly correlates with the demyelination, neuronal loss, cortical thinning and atrophy affecting the gray matter 1 , 9 . The cognitive domains affected during MS are mediated via largely distributed networks, including the prefrontal cortex, thalamus, basal ganglia, and hippocampus 2 , 6 , 10 – 13 , and many aspects of their associated pathologies still need to be investigated. Animal models can be useful to analyze specific cognitive deficits, their connection to tissue damage, and the ability to affect them by therapy.…”

A randomized controlled trial investigating the effects of a mediterranean-like diet in patients with multiple sclerosis-associated cognitive impairments and fatigue

“…MS-related impairment in cognitive function is an essential reason for the disability that could be attributed to brain tissue damage, indicators of its atrophy, and macroscopic MS lesions. 7 Genetic factors, age, and being male are of the most commonly recognized risk factors for cognitive dysfunction among these patients. 7 As mentioned, it is noteworthy that a decline in cognitive function could occur during the first years after disease onset even when the level of disability is not necessarily affected by disease progression.…”

“… 7 Genetic factors, age, and being male are of the most commonly recognized risk factors for cognitive dysfunction among these patients. 7 As mentioned, it is noteworthy that a decline in cognitive function could occur during the first years after disease onset even when the level of disability is not necessarily affected by disease progression. 5 , 6 Moreover, the mean duration of disease among studied groups in this trial was about 8 years, which might not be an appropriate time to prevent or attenuate impaired cognition in MS patients.…”

“… 5 , 6 Some of the suggested risk factors of cognitive impairment in MS patients include genetics, age, and the male gender. 7 However, it seems that there is no established and highly effective therapy to combat the cognitive decline of different disorders. In this regard, nonpharmacological options such as neuropsychological interventions and dietary modifications have been studied previously; however, their effectiveness is still under investigation.…”

Особливості Когнітивних Порушень У Хворих На Розсіяний Склероз

“…HLA DR15 є важливим фактором ризику розвитку РС, що, однак, не асоціюється з підвищеним ризиком виникнення когнітивного зниження. Генетичні варіації BDNF, особливо поліморфізм Val66Met, мають прямо пропорційне відношення до когнітивних змін при РС [7]. Згідно з даними B. Prokopova та співавт., зниження вмісту BDNF у плазмі за умови РС значно частіше відмічається в чоловіків порівняно з жінками при незначних і помірних когнітивних порушеннях і за відсутності фізичних проявів [8].…”