Cognitive Dysfunction in Early-Onset Multiple Sclerosis

Amato, Maria Pia; Ponziani, Giuseppina; Siracusa, G.; Sorbi, Sandro

doi:10.1001/archneur.58.10.1602

Cited by 597 publications

(497 citation statements)

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“…While white matter lesion load accounts only for some cognitive deficits in MS, this type of disorders can be better explained through pathological processes affecting gray matter, which are revealed in very early stages of the disease [140][141][142]. A significant positive correlation was established between neocortical volume and cognitive damage in patients with RRMS [143], as the gray matter atrophy occurring faster than white matter atrophy and, as recent research indicates, probably playing a central role in the emerging and deepening of cognitive deficits [144].…”

Section: Discussionmentioning

confidence: 99%

Social Cognition Impairments in Patients with Multiple Sclerosis and Comparison with Imaging Studies, Disease Duration and Grade of Disability

Ignatova¹,

Todorova²,

Surchev³

2016

Trending Topics in Multiple Sclerosis

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Cognitive impairments in multiple sclerosis (MS) are heterogeneous and their rate varies between 43% and 70%. A less studied aspect of cognition is social cognition, which is not a uniform theoretical construct. It includes emotion perception, prosody, empathy, theory of mind (ToM) and assessment of mood. In addition to progressive physical disability, social cognitive impairments are a reason for job loss in 24-80% of patients with MS, increased divorce rate, dissolution of partnerships and social communication difficulties.Social cognitive impairments are the result of disruptions in the mentalization network at the neuroanatomical, neurochemical and/or genetic level, which can lead to malfunctions in the dopaminergic-serotoninergic system and to compromising the development of neuroanatomical targets within the network. The wide dissemination of demyelinating lesions and cortical thinning typical of patients with MS often lead to anatomic and functional disorders of the above-mentioned specific brain structures. A correlation has been established among specific cortical areas involved in emotion identification from facial expression (right and left fusiform face area, frontal eye), emotion processing (right entorhinal cortex) and socially relevant information (left temporal pole). The most active brain region involved in social cognitive processing is the medal frontal cortex (MFC), which is described as the brain's social cognitive center. During performance of various sociocognitive tasks for mental state attribution, common areas of increased activation in the medial prefrontal gyrus and the temporoparietal junctions are registered bilaterally, while the area of the medial prefrontal cortex (the paracingulate cortex) is the only region uniquely activated by the performance of ToM.Most MRI studies of patients with MS found a correlation between the cognitive and/or affective disorders, on the one hand, and lesion localization, total lesion load, or cerebral atrophy, on the other. A significant correlation was also reported between © 2016 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.abnormal activities in specific cortical zones on fMRI, on the one hand, and clinical manifestation, conventional MRI findings and behavioral changes, on the other. Altered patterns of brain activity were found in all clinical phenotypes of MS, including when cognitive abilities were intact and/or restored, social cognitive dysfunction in MS actually affects all stages of the disease and all types of clinical course. The cortical plastic changes are a dynamic phenomenon that can be modulated by external factors. This phenomenon would facilitate the mapping of individual strategies for adequate treatment and rehabilitation of each patient.

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Section: Discussionmentioning

confidence: 99%

Social Cognition Impairments in Patients with Multiple Sclerosis and Comparison with Imaging Studies, Disease Duration and Grade of Disability

Ignatova¹,

Todorova²,

Surchev³

2016

Trending Topics in Multiple Sclerosis

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“…Peyser et al claimed in their 1980 study that there is an association between cognitive involvement and duration of disease and cognitive impairment is one of the late stage symptoms of the disease (27). However, in later studies, cognitive involvement was shown to occur in very early stages of the disease (28,29). Amato et al showed in MS patients they had been monitoring for 10 years that cognitive impairment rate was around 56%, and the impairment was affected by factors including form of disease, late age, and physical disability (29).…”

Section: Discussionmentioning

confidence: 99%

Multipl Sklerozlu Hastalarda Depresyon ve Kognitif Fonksiyon Bozukluğu Sıklığının Belirlenmesi

Bilgi¹,

Özdemir²,

Bulut³

2013

Tnd

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Re cei ved/Ge lifl Ta ri hi: 13.11.2012 Ac cep ted/Ka bul Ta ri hi: 23.01.2013 Özet Amaç: Multipl skleroz (MS), mobilite ve fonksiyonel aktivitelerde değişik derecelerde özürlülüğe yol açan, kişinin sosyal ve meslek hayatında kısıtlamalara neden olarak ileri düzeyde engellilik yaratan ve yaşam kalitesini bozan bir hastalıktır. Hastaların büyük bir kısmında depresyon gözlenmektedir. Ayrıca kognitif fonksiyonlarda da bozulma (KFB) meydana gelmektedir. Bu çalışmanın amacı, MS'li hastalarda depresyon ve KFB sıklığını belirlemektir. Bulgular: Çalışmaya katılan 108 MS olgusunun; %69,4'ü (n=75) kadın, %30,6'sı (n=33) erkektir. Hastaların %19,5'inde (n=21) depresyon, %41,7'sinde (n=45) ise KFB tespit edilmiştir. Hastaların %13,9'unda (n=15) ise hem depresyon ve hem de KFB gözlenmiştir. Ge reç ve Sum maryObjective: Multiple sclerosis (MS) not only leads to different levels of disabilities in mobility and functional activities, but also creates severe disability and impairs the quality of life by limiting the patient's social and occupational life. Most MS patients experience depression. In addition, cognitive dysfunction is also present. In this study we aimed to determine the frequency of depression and cognitive dysfunction in MS patients. Ma te ri al and Met hod:One hundred and eight patients diagnosed with MS were evaluated. was by using Brief Re sults: Of the 108 MS subjects who participated in the study, 69.4% (n=75) were female, while 30.6% (n=33) were male. Depression was detected in 19.5% (n=21) of the patients, and cognitive dysfunction was found in 41.7% (n=45). Depression and cognitive dysfunction were detected simultaneously in 13.9% (n=15) of the patients.Dis cus si on: Depression and cognitive dysfunction are not rare in patients with MS. A multidisciplinary approach is needed to treat the patients diagnosed with MS.

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“…Foruten motoriske symptomer med bevegelsesinnskrenkning, spastisitet og koordinasjonssvikt, forekommer vannlatingsplager (urgeinkontinens og urinretensjon), avføringsplager (obstipasjon og fekal inkontinens), seksuell dysfunksjon, nevralgiske smerter, depresjon og utmattelse (fatigue) hyppig (3). Inntil 70 % utvikler kognitive symptomer, hyppigst i form av vansker med hukommelse, kompleks oppmerksomhet, prosesseringshastighet og eksekutive funksjoner (4,5).…”

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