Correlation of Dementia, Neuropsychological and MRI Findings in Multiple Sclerosis

Tsolaki, Magda; Drevelegas, Antonios; Karachristianou, Stella; Kapinas, K.; Divanoglou, D.; Routsonis, K.

doi:10.1159/000106694

Cited by 25 publications

(21 citation statements)

References 19 publications

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“…Cerebral white matter (WM) has been a target for investigation, given the propensity of MS to affect WM. Studies performing quantification and mapping of macroscopic WM lesions have identified associations between lesion distribution and disability [3][4][5][6][7][8] , but fail to take into account widespread diffuse damage present in normal-appearing WM (NAWM). A technique which is sensitive to this damage 9,10 , diffusion tensor imaging (DTI), allows quantification of fractional anisotropy (FA), a marker of ultrastructural WM integrity that has been used for more than a decade to study both lesional and NAWM damage in MS [9][10][11][12][13][14] .…”

Section: Introductionmentioning

confidence: 99%

Functionally Relevant White Matter Degradation in Multiple Sclerosis: A Tract-based Spatial Meta-Analysis

Welton¹,

Kent²,

Constantinescu³

et al. 2015

Radiology

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(2015) Functionally relevant white matter degradation in multiple sclerosis: a tract-based spatial meta-analysis. Radiology, 275 (1). pp. 89-96. ISSN 152789-96. ISSN -1315 Access from the University of Nottingham repository: http://eprints.nottingham.ac.uk/38908/1/14-0925-clean.pdf Copyright and reuse:The Nottingham ePrints service makes this work by researchers of the University of Nottingham available open access under the following conditions. This article is made available under the University of Nottingham End User licence and may be reused according to the conditions of the licence. For more details see: http://eprints.nottingham.ac.uk/end_user_agreement.pdf A note on versions:The version presented here may differ from the published version or from the version of record. If you wish to cite this item you are advised to consult the publisher's version. Please see the repository url above for details on accessing the published version and note that access may require a subscription.For more information, please contact eprints@nottingham.ac.uk Advances in Knowledge:1. There are differential and only minimally-overlapping distributions of lower fractional anisotropy relating to clinical disability and cognitive impairment.Low anterior callosal and thalamic fractional anisotropy has specific importance to cognitive status, whereas low posterior callosal and deep parietal fractional anisotropy has specific importance to physical disability (uncorrected p<0.005, z>1, cluster extent≥10 voxels).2. Cerebral white matter degradation may be more relevant to cognitive than physical disability: 2.3 times as many voxels had a significantly lower fractional anisotropy in relation to cognition (753 voxels) than to physical disability (323 voxels) and the z-scores for those clusters were higher for cognition than for physical disability (2.532 and 1.701, respectively). Implications for Patient Care:1. Widespread white matter damage measured by diffusion tensor imaging occurs in multiple sclerosis; our meta-analysis reveals differential and only minimally-overlapping distributions of white matter damage relating to both cognitive and physical disability.Summary Statement: Our voxelwise meta-analysis of studies relating tract fractional anisotropy to cognitive and physical disability in multiple sclerosis reveals minimally-overlapping distributions and a possible greater relevance to cognition than to physical disability. Abstract PurposeTo identify statistical consensus between published studies for distribution and functional relevance of tract white matter degradation in multiple sclerosis (MS). Materials and MethodsBy systematically searching online databases, we identified tract-based spatial statistics (TBSS) studies which (1) compare fractional anisotropy (FA; a marker for white matter integrity) in MS patients to healthy controls, (2) correlate FA in MS patients with physical disability, or (3) correlate FA in MS patients with cognitive performance. We performed voxelwise meta-analyses using the Signed Differentia...

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Section: Introductionmentioning

confidence: 99%

Functionally Relevant White Matter Degradation in Multiple Sclerosis: A Tract-based Spatial Meta-Analysis

Welton¹,

Kent²,

Constantinescu³

et al. 2015

Radiology

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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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“…However, several potentially important aspects of the hand function remained unexplored. For example, the corpus callosum plays a major role in interhemispheric transfer and integration of sensorimotor information in bimanual movements (Seymour, Reuter-Lorenz, & Gazzaniga, 1994), and it appears to be affected frequently even in mildly involved MS patients (Mendez, 1995;Tsolaki et al, 1994). Therefore, it remains possible that the MS patients could reveal a noticeable deterioration in bimanual manipulation tasks.…”

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confidence: 99%

Impaired Object Manipulation in Mildly Involved Individuals with Multiple Sclerosis

Krishnan¹,

Freitas²,

Jarić³

2008

Motor Control

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We investigated hand function in mildly involved Multiple Sclerosis (MS) patients (N = 16; EDSS 1−5, 9-hole peg test 14−32 s) during static and dynamic manipulation tasks using an instrumented device. When compared with healthy controls (N = 16), the patients revealed impaired task performance regarding their ability to exert prescribed patterns of load force (L; force acting tangentially at the digits-object surface). Regarding the coordination of grip force (G; normal component) and L, the data only revealed elevated G/L ratio, although both the G and L coupling (maximum correlation coefficients and the time lags between them), and G modulation (gain and offset of G with respect to L) remained comparable in the two groups. Finally, most of the data suggested no MS-specific effects of switching from uni-to bimanual tasks, from available visual feedback to deprived feedback conditions. We conclude that the deterioration in the ability for precise control of external forces and overgripping could precede the decoupling of G and L and decreased G modulation in early phases of the disease. The results also suggest that the applied methodology could be sensitive enough to detect mild levels of impairment of hand function in MS and, possibly, other neurological diseases.Keywords hand function; grip; load; force coordination; coupling; task performanceThe main hand function is to grasp and manipulate objects and external supports. This function is essential for everyday life, and, consequently, an impaired hand function (e.g., associated with neurological diseases or injuries) could be an important obstacle to living an independent life. When an externally fixed (e.g., a handle providing external support) or a free-moving object (a cup of coffee, or a tool) is held with the opposing tips of the thumb and fingers, a load force (L) is applied tangentially to the surfaces in contact to move the object or exert a reaction force. The slippage of the object is countered by friction force originating from grip force (G) acting normally to the surface. A consistent finding throughout the literature has been that the changes in G and L appear to be highly coordinated. This coordination is based not only on an ability of the neural controlling mechanisms to assess the skin-object friction coefficient and, based on it, apply a relatively low safety margin [i.e., G slightly higher than necessary to prevent slippage; (Johansson & Westling, 1984)], but also to modulate G in parallel with L without any considerable time delays between them [i.e., using anticipatory mechanisms (Flanagan & Wing, 1995. The result appears to be a stable and relatively low grip-toload (G/L) ratio (Johansson, 1998), high coupling of G and L (as assessed by both high correlation coefficient and virtually no time lags between them [Blakemore, Goodbody, & Wolpert, 1998;Flanagan & Tresilian, 1994]), and a high level of modulation of G with respect to changes in L [i.e., high gain and low offset assessed through the slope and intercept, respectively, o...

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Correlation of Dementia, Neuropsychological and MRI Findings in Multiple Sclerosis

Cited by 25 publications

References 19 publications

Functionally Relevant White Matter Degradation in Multiple Sclerosis: A Tract-based Spatial Meta-Analysis

Functionally Relevant White Matter Degradation in Multiple Sclerosis: A Tract-based Spatial Meta-Analysis

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

Impaired Object Manipulation in Mildly Involved Individuals with Multiple Sclerosis

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