Chronic Progressive Multiple Sclerosis

Rao, Stephen M.; Glatt, Sander L.; Hammeke, Thomas A.; McQuillen, Michael P.; Khatri, B. O.; Rhodes, Ann Marie; Pollard, Susan

doi:10.1001/archneur.1985.04060070068018

Cited by 131 publications

(7 citation statements)

References 23 publications

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“…The remaining cognitive functions were stable over time and unaffected by disability. Many cross-sectional studies concerning the relationship between physical disability and cognitive decline have reported contradictory results [5, 46] and failed to show any correlation between disability and cognition [51, 60, 61]. However, some longitudinal studies have, similarly to our study, yielded an association between physical disability and cognitive decline [23, 27].…”

Section: Discussionsupporting

confidence: 60%

Selective Decline in Information Processing in Subgroups of Multiple Sclerosis: An 8-Year Longitudinal Study

Bergendal¹,

Fredrikson²,

Almkvist

2007

Eur Neurol

130

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Multiple sclerosis (MS) is an inflammatory and degenerative disease of the central nervous system (CNS) that causes white matter and cortical lesions over many years. The CNS is selectively affected by the disease with a great variety of symptoms between patients. In this study, we describe the impact on various aspects of cognition over an 8-year follow-up period in 31 consecutive MS patients subgrouped as relapsing remitting (RR) MS, secondary progressive (SP) MS, and primary progressive (PP) MS. Results showed a differential pattern of cognitive decline already at baseline in speed of information processing. During the follow-up, a pronounced decline occurred in speed of information processing, finger-motor speed, copying geometrical designs, episodic memory, and visuospatial short-term memory. A striking difference was observed between a marked decline in visual reaction time, whereas no significant change was seen in auditory reaction time. In contrast, there was no time-related decline in verbal abilities. However, an initial marked cognitive impairment predicted further cognitive decline over the 8-year follow-up. Information-processing tests were found to be an especially strong predictor of long-term cognitive decline. In addition, high EDSS score at follow-up was associated with decline in information processes. Results also showed that SP-MS patients deteriorated significantly more than the other two groups, particularly in visual compared to auditory information processing. To conclude, cognitive decline appeared particularly in SP-MS patients and in visual information processing.

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Section: Discussionsupporting

confidence: 60%

Selective Decline in Information Processing in Subgroups of Multiple Sclerosis: An 8-Year Longitudinal Study

Bergendal¹,

Fredrikson²,

Almkvist

2007

Eur Neurol

130

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“…In MS, early work in the late 1980s showed that cognitive impairment is correlated with lesion burden and ventricle enlargement. 58,59 The next decade witnessed the advent of many MRI metrics including spectroscopy, diffusion, whole brain atrophy, and gray versus white matter volume. Two early studies 44,60 used linear regression with multiple MRI measures to determine the most robust predictor of cognitive impairment and in both studies MRI accounted for most variance in SDMT, the strongest predictor being central atrophy (r = 0.70 or 0.71), as measured by ventricle enlargement.…”

Section: Review Objectivementioning

confidence: 99%

Validity of the Symbol Digit Modalities Test as a cognition performance outcome measure for multiple sclerosis

et al. 2017

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Cognitive and motor performance measures are commonly employed in multiple sclerosis (MS) research, particularly when the purpose is to determine the efficacy of treatment. The increasing focus of new therapies on slowing progression or reversing neurological disability makes the utilization of sensitive, reproducible, and valid measures essential. Processing speed is a basic elemental cognitive function that likely influences downstream processes such as memory. The Multiple Sclerosis Outcome Assessments Consortium (MSOAC) includes representatives from advocacy organizations, Food and Drug Administration (FDA), European Medicines Agency (EMA), National Institute of Neurological Disorders and Stroke (NINDS), academic institutions, and industry partners along with persons living with MS. Among the MSOAC goals is acceptance and qualification by regulators of performance outcomes that are highly reliable and valid, practical, cost-effective, and meaningful to persons with MS. A critical step for these neuroperformance metrics is elucidation of clinically relevant benchmarks, well-defined degrees of disability, and gradients of change that are deemed clinically meaningful. This topical review provides an overview of research on one particular cognitive measure, the Symbol Digit Modalities Test (SDMT), recognized as being particularly sensitive to slowed processing of information that is commonly seen in MS. The research in MS clearly supports the reliability and validity of this test and recently has supported a responder definition of SDMT change approximating 4 points or 10% in magnitude.

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“…Selective atrophy of the hippocampus has been described in relapsing-remitting multiple sclerosis (RRMS) [11], and this has been found to correlate with performance in tests of verbal learning/recall in MS patients [11], [12]. Atrophy of the thalamus occurs in MS [13], [14], and shows a significant relationship to cognitive performance when measured directly or indirectly [15], [16], [17], [18]. Mammillary body atrophy has also been identified in MS [19], but the cognitive relevance of this finding has not, to our knowledge, been tested.…”

Section: Introductionmentioning

confidence: 99%

Extra-Hippocampal Subcortical Limbic Involvement Predicts Episodic Recall Performance in Multiple Sclerosis

et al. 2012

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BackgroundEpisodic memory impairment is a common but poorly-understood phenomenon in multiple sclerosis (MS). We aim to establish the relative contributions of reduced integrity of components of the extended hippocampal-diencephalic system to memory performance in MS patients using quantitative neuroimaging.Methodology/Principal Findings34 patients with relapsing-remitting MS and 24 healthy age-matched controls underwent 3 T MRI including diffusion tensor imaging and 3-D T1-weighted volume acquisition. Manual fornix regions-of-interest were used to derive fornix fractional anisotropy (FA). Normalized hippocampal, mammillary body and thalamic volumes were derived by manual segmentation. MS subjects underwent visual recall, verbal recall, verbal recognition and verbal fluency assessment. Significant differences between MS patients and controls were found for fornix FA (0.38 vs. 0.46, means adjusted for age and fornix volume, P<.0005) and mammillary body volumes (age-adjusted means 0.114 ml vs. 0.126 ml, P<.023). Multivariate regression analysis identified fornix FA and mammillary bodies as predictor of visual recall (R2 = .31, P = .003, P = .006), and thalamic volume as predictive of verbal recall (R2 = .37, P<.0005). No limbic measures predicted verbal recognition or verbal fluency.Conclusions/SignificanceThese findings indicate that structural and ultrastructural alterations in subcortical limbic components beyond the hippocampus predict performance of episodic recall in MS patients with mild memory dysfunction.

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Chronic Progressive Multiple Sclerosis

Cited by 131 publications

References 23 publications

Selective Decline in Information Processing in Subgroups of Multiple Sclerosis: An 8-Year Longitudinal Study

Selective Decline in Information Processing in Subgroups of Multiple Sclerosis: An 8-Year Longitudinal Study

Validity of the Symbol Digit Modalities Test as a cognition performance outcome measure for multiple sclerosis

Extra-Hippocampal Subcortical Limbic Involvement Predicts Episodic Recall Performance in Multiple Sclerosis

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