Comorbidity effect on processing speed test and MRI measures in multiple sclerosis patients

Abbatemarco, Justin R.; Ontaneda, Daniel; Nakamura, Kunio; Husak, Scott; Wang, Zhini; Alshehri, Ebtesam; Bermel, Robert; Conway, Devon

doi:10.1016/j.msard.2020.102593

Cited by 6 publications

(9 citation statements)

References 35 publications

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“…The largest cross-sectional study to date, which included 6,409 from the MS-PATHS study, found that the presence of two or more vascular comorbidities was associated with lower whole brain and gray matter volumes ( 17 ). However, another MS-PATHS study including some of these participants, but based at a single center, found that while depression was associated with lower whole brain and gray matter volumes, hyperlipidemia was associated with higher whole brain volumes for unclear reasons ( 14 ). In the general population vascular comorbidities are also reportedly associated with differences in brain structure.…”

Section: Discussionmentioning

confidence: 99%

“…They are associated with outcomes such as relapses, disability progression and lower quality of life ( 12 , 13 ). More recent studies suggest that hypertension and diabetes are also associated with reduced cognitive function in domains such as processing speed, verbal learning and visual memory for persons with MS ( 14 – 16 ). However, findings have varied across studies, possibly reflecting differences in study populations, comorbidity measurement and cognitive tests employed.…”

Section: Introductionmentioning

confidence: 99%

“…However, findings have varied across studies, possibly reflecting differences in study populations, comorbidity measurement and cognitive tests employed. Although findings are inconsistent as to the magnitude of the effect and the specific comorbidities involved ( 14 , 17 – 19 ), vascular comorbidities have been associated with macrostructural brain changes such as lower brain volumes in people with MS. In the general population widespread changes in white matter microstructure are known to be associated with vascular risk factors; mean diffusivity (MD) appears to be more sensitive to these effects than FA or mean kurtosis ( 20 , 21 ).…”

Section: Introductionmentioning

confidence: 99%

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Effects of Vascular Comorbidity on Cognition in Multiple Sclerosis Are Partially Mediated by Changes in Brain Structure

et al. 2022

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ObjectiveVascular comorbidities are associated with reduced cognitive performance and with changes in brain structure in people with multiple sclerosis (MS). Understanding causal pathways is necessary to support the design of interventions to mitigate the impacts of comorbidities, and to monitor their effectiveness. We assessed the inter-relationships among vascular comorbidity, cognition and brain structure in people with MS.MethodsAdults with neurologist-confirmed MS reported comorbidities, and underwent assessment of their blood pressure, HbA1c, and cognitive functioning (i.e., Symbol Digit Modalities Test, California Verbal Learning Test, Brief Visuospatial Memory Test-Revised, and verbal fluency). Test scores were converted to age-, sex-, and education-adjusted z-scores. Whole brain magnetic resonance imaging (MRI) was completed, from which measures of thalamic and hippocampal volumes, and mean diffusivity of gray matter and normal-appearing white matter were converted to age and sex-adjusted z-scores. Canonical correlation analysis was used to identify linear combinations of cognitive measures (cognitive variate) and MRI measures (MRI variate) that accounted for the most correlation between the cognitive and MRI measures. Regression analyses were used to test whether MRI measures mediated the relationships between the number of vascular comorbidities and cognition measures.ResultsOf 105 participants, most were women (84.8%) with a mean (SD) age of 51.8 (12.8) years and age of symptom onset of 29.4 (10.5) years. Vascular comorbidity was common, with 35.2% of participants reporting one, 15.2% reporting two, and 8.6% reporting three or more. Canonical correlation analysis of the cognitive and MRI variables identified one pair of variates (Pillai's trace = 0.45, p = 0.0035). The biggest contributors to the cognitive variate were the SDMT and CVLT-II, and to the MRI variate were gray matter MD and thalamic volume. The correlation between cognitive and MRI variates was 0.50; these variates were used in regression analyses. On regression analysis, vascular comorbidity was associated with the MRI variate, and with the cognitive variate. After adjusting for the MRI variate, vascular comorbidity was not associated with the cognitive variate.ConclusionVascular comorbidity is associated with lower cognitive function in people with MS and this association is partially mediated via changes in brain macrostructure and microstructure.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Effects of Vascular Comorbidity on Cognition in Multiple Sclerosis Are Partially Mediated by Changes in Brain Structure

et al. 2022

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“…1 Like other MS manifestations, the severity of cognitive impairment varies widely between patients and is influenced by several disease-related variables, comorbidities, and health behaviors. 2,3 Information processing speed is one of the earliest and most frequently affected cognitive domains in MS patients, and it predicts dysfunction in other cognitive domains. 4 Moreover, reduced processing speed correlates with global and regional brain atrophy, physical disability, and disease progression.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The impact of cigarette smoking on cognitive processing speed and brain atrophy in multiple sclerosis

et al. 2023

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Background: Smoking is associated with an increased risk of multiple sclerosis (MS) and disability worsening. The relationship between smoking, cognitive processing speed, and brain atrophy remains uncertain. Objective: To quantify the impact of smoking on processing speed and brain volume in MS and to explore the longitudinal relationship between smoking and changes in processing speed. Methods: A retrospective study of MS patients who completed the processing speed test (PST) between September 2015 and March 2020. Demographics, disease characteristics, smoking history, and quantitative magnetic resonance imaging (MRI) were collected. Cross-sectional associations between smoking, PST performance, whole-brain fraction (WBF), gray matter fraction (GMF), and thalamic fraction (TF) were assessed using multivariable linear regression. The longitudinal relationship between smoking and PST performance was assessed by linear mixed modeling. Results: The analysis included 5536 subjects of whom 1314 had quantitative MRI within 90 days of PST assessment. Current smokers had lower PST scores than never smokers at baseline, and this difference persisted over time. Smoking was associated with reduced GMF but not with WBF or TF. Conclusion: Smoking has an adverse relationship with cognition and GMF. Although causality is not demonstrated, these observations support the importance of smoking cessation counseling in MS management.

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Association of socioeconomic disadvantage and neighborhood disparities with clinical outcomes in multiple sclerosis patients

Abbatemarco

Carlson

Ontaneda

et al. 2022

Multiple Sclerosis and Related Disorders

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Comorbidity effect on processing speed test and MRI measures in multiple sclerosis patients

Cited by 6 publications

References 35 publications

Effects of Vascular Comorbidity on Cognition in Multiple Sclerosis Are Partially Mediated by Changes in Brain Structure

Effects of Vascular Comorbidity on Cognition in Multiple Sclerosis Are Partially Mediated by Changes in Brain Structure

The impact of cigarette smoking on cognitive processing speed and brain atrophy in multiple sclerosis

Association of socioeconomic disadvantage and neighborhood disparities with clinical outcomes in multiple sclerosis patients

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