Correlates of cognitive dysfunction in multiple sclerosis

Heesen, Christoph; Schulz, Karl‐Heinz; Fiehler, Jens; Mark, Ute; Otte, Christian; Jung, Roman; Poettgen, Jana; Krieger, Thorsten; Gold, Stefan M.

doi:10.1016/j.bbi.2010.05.006

Cited by 99 publications

(87 citation statements)

References 55 publications

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“…Four of these studies also examined the relationships between global or regional brain atrophy and cognitive measures but found no associations 2, 24, 25, 26. Other studies did not find associations between MRI and cognitive measures presumably due to the small sample size and heterogeneity of studied cohorts 17, 19, 20, 21…”

Section: Discussionmentioning

confidence: 99%

Cognitive clinico‐radiological paradox in early stages of multiple sclerosis

Uher

Krásenský

Sobíšek

et al. 2017

Ann Clin Transl Neurol

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ObjectiveTo investigate whether the strength of the association between magnetic resonance imaging (MRI) metrics and cognitive outcomes differs between various multiple sclerosis subpopulations.MethodsA total of 1052 patients were included in this large cross‐sectional study. Brain MRI (T1 and T2 lesion volume and brain parenchymal fraction) and neuropsychological assessment (Brief International Cognitive Assessment for Multiple Sclerosis and Paced Auditory Serial Addition Test) were performed.ResultsWeak correlations between cognitive domains and MRI measures were observed in younger patients (age≤30 years; absolute Spearman's rho = 0.05–0.21), with short disease duration (<2 years; rho = 0.01–0.21), low Expanded Disability Status Scale [EDSS] (≤1.5; rho = 0.08–0.18), low T2 lesion volume (lowest quartile; <0.59 mL; rho = 0.01–0.20), and high brain parenchymal fraction (highest quartile; >86.66; rho = 0.01–0.16). Stronger correlations between cognitive domains and MRI measures were observed in older patients (age>50 years; rho = 0.24–0.50), with longer disease duration (>15 years; rho = 0.26–0.53), higher EDSS (≥5.0; rho = 0.23–0.39), greater T2 lesion volume (highest quartile; >5.33 mL; rho = 0.16–0.32), and lower brain parenchymal fraction (lowest quartile; <83.71; rho = 0.13–0.46). The majority of these observed results were confirmed by significant interactions (P ≤ 0.01) using continuous variables.InterpretationThe association between structural brain damage and functional cognitive impairment is substantially weaker in multiple sclerosis patients with a low disease burden. Therefore, disease stage should be taken into consideration when interpreting associations between structural and cognitive measures in clinical trials, research studies, and clinical practice.

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Section: Discussionmentioning

confidence: 99%

Cognitive clinico‐radiological paradox in early stages of multiple sclerosis

Uher

Krásenský

Sobíšek

et al. 2017

Ann Clin Transl Neurol

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“…15,31,32 MS-related cognitive dysfunction could be a function of fatigue, central inflammation, neurodegeneration, neuroendocrine dysregulation, and/or depression. 33 This study is the first to document moderate correlations between measurements of fatigue and cognitive function at baseline and during natalizumab treatment. The associations between measurements of fatigue and cognitive function observed in this study further support linkage between the two MS symptoms, but the specific interactions and causality remain unclear.…”

Section: Discussionmentioning

confidence: 99%

Changes in Fatigue and Cognition in Patients with Relapsing Forms of Multiple Sclerosis Treated with Natalizumab

Wilken¹,

Kane²,

Sullivan³

et al. 2013

International Journal of MS Care

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“…81 Suicide rates are also higher in this population, 82 and depressive symptoms tend to increase as MS progresses. 83 Adults with MS who have depression exhibit less apathy and social withdrawal than other depressed patients, instead showing increased irritability, worry, and discouragement. 84 Furthermore, other features of MS such as fatigue and concentration difficulties may resemble depressive symptoms, making differential diagnosis more challenging.…”

Section: Summary Of Cognitive Functioningmentioning

confidence: 99%

Neuropsychological correlates of multiple sclerosis across the lifespan

et al. 2015

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Neurobiology of pediatric and adult MSThe few pathological studies of pediatric MS suggest that it shares many features with the adult disease. As in adult MS, myelin and axonal damage have also been found in normal-appearing intrahemispheric, interhemispheric, and projection white matter tracts. 9 Despite some remyelination after an attack, over time neurological functioning is permanently decreased due to irreversible axonal injury, depletion of oligodendrocytes, and gliosis. 10 Notably, a recent study has suggested that the extent of acute axonal damage in early active demyelinating lesions is increased by 50% in pediatric patients as compared to adults. 11 This finding may provide some explanation for the often observed severe onset in pediatric MS. Neuropsychological correlates of multiple sclerosis across the lifespanJulia Nunan-Saah, Selvi R Paulraj, Emmanuelle Waubant, Lauren B Krupp and Rowena G Gomez Abstract: Multiple sclerosis can adversely affect cognitive functioning whether the disease has an adult or pediatric onset. The research thus far suggests that pediatric MS shares many features with adult MS but is also unique in several respects. One particular characteristic of pediatric MS is that, while physical disability develops more slowly as compared with adult patients, the impact of cognitive deficits in children may be more substantial as they are in a period of life during which they acquire many skills that are needed to transition into independently functioning adults. Our review takes a lifespan approach to MS, comparing and contrasting the neuropsychology (i.e., cognitive, psychological, and psychosocial factors) of these two populations. Understanding how MS manifests across the lifespan has important implications for tailoring assessment and treatment for individuals with MS as they transition from childhood to adulthood, and later life.

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Correlates of cognitive dysfunction in multiple sclerosis

Cited by 99 publications

References 55 publications

Cognitive clinico‐radiological paradox in early stages of multiple sclerosis

Cognitive clinico‐radiological paradox in early stages of multiple sclerosis

Changes in Fatigue and Cognition in Patients with Relapsing Forms of Multiple Sclerosis Treated with Natalizumab

Neuropsychological correlates of multiple sclerosis across the lifespan

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