Evolving relationship between respiratory functions &amp; impairment in sleep and cognition in patients with multiple sclerosis

Hashim, Noha A.; Ismail, Nagwan A.; Emad, Engy M.

doi:10.1016/j.msard.2020.102514

Cited by 9 publications

(7 citation statements)

References 53 publications

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“…Indeed in 146 patients with MS with mean EDSS score of 4.11 (SD 2.39), lower MIP and MEP correlated with lower BICAMS score. 28 However, we did not find any association between fatigue and cognitive impairment here, but the severe disability of our patients may blur this association.…”

Section: Discussioncontrasting

confidence: 63%

“…Moreover, as highlighted in introduction, diagnosing diaphragm dysfunction is challenging in light of the neurological disability related to MS. Another French study 27 28 However, we did not find any association between fatigue and cognitive impairment here, but the severe disability of our patients may blur this association.…”

Section: Diaphragm Dysfunction In Mscontrasting

confidence: 71%

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Clinical correlates of respiratory disorders in patients with severe multiple sclerosis: A cross-sectional cohort

Maillart,

Redolfi,

Louapre

et al. 2024

Mult Scler

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Background: Respiratory disorders remain incompletely described in multiple sclerosis (MS), even though they are a frequent cause of death. Methods: The objective was to describe respiratory disorders in MS patients with Expanded Disability Status Score (EDSS) ⩾ 6.5. Diaphragm dysfunction was defined by at least two of the seven criteria: clinical signs, inspiratory recruitment of neck muscles during wakefulness, reduced upright vital capacity (VC) < 80%, upright-to-supine VC ⩾ 15% of upright VC, decrease in Maximal Inspiratory Pressure < 60%, phasic activation of inspiratory neck muscles during sleep, and opposition of thoracic and abdominal movements during sleep. Cough weakness was defined by a peak cough flow < 270 L/min and/or need for cough assist. Sleep apnea syndrome was defined by an apnea–hypopnea index ⩾ 15. Results: Notably, 71 MS patients were included: median age 54 [48, 61] years; median disease duration 21.4 [16.0, 31.4] years. Of these, 52 patients had one or more respiratory disorders; diaphragm dysfunction was the most frequent ( n = 34). Patients with diaphragm dysfunction and cough weakness were more disabled. The fatigue score and the cognitive evaluations did not differ between the groups. Five patients required non-invasive ventilation. Conclusion: Respiratory disorders are frequent in severe MS, mostly diaphragm dysfunction. Of interest, instrumental interventions are available to address these disorders.

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Section: Discussioncontrasting

confidence: 63%

Section: Diaphragm Dysfunction In Mscontrasting

confidence: 71%

Clinical correlates of respiratory disorders in patients with severe multiple sclerosis: A cross-sectional cohort

Maillart,

Redolfi,

Louapre

et al. 2024

Mult Scler

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“…It is not yet clear whether the cognitive function directly affects physical performance, and it is speculated that older people with low cognitive function may have less understanding, processing of information and execution of the test, which demands attention, balance, agility and gait speed 27 , 29 . Similarly, impaired respiratory muscle function was also associated with lower cognitive function, suggesting a potential link between respiratory muscle strength and cognition in older adults 30 . These findings hold potential clinical utility in facilitating the screening and identification of cognitive decline in older women, utilizing simple physical tests that can be administered even before the onset of dementia.…”

Section: Discussionmentioning

confidence: 97%

Cognitive function is associated with performance in time up and go test and with leptin blood levels in community-dwelling older women

da Costa Teixeira,

Soares,

Lima

et al. 2024

Sci Rep

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Considering the challenge that cognitive dysfunction and dementia represent to health is imperative to prioritize early diagnosis strategies and explore the pathophysiological mechanisms. There is no consensus on specific markers and physical tests that indicate cognitive decline in older. The objective of this study was to evaluate a panel of inflammatory biomarkers and physical function and investigate their association with cognitive function in community-dwelling older women. Seventy-one participants were included in this study. Cognitive function was assessed by Mini Mental State Examination, muscle strength using dynamometer, body composition using Dual X-ray absorptiometry, respiratory muscle strength using manuvacuometer, and physical function using the Short Physical Performance Battery and Time Up and Go (TUG) tests. Blood samples were collected to analyze a panel of inflammatory biomarkers. The cognitive function was associated with TUG (β = − 0.48; 95%IC = − 0.54 to − 0.21; p < 0.001), inspiratory muscle strength (β = 0.30; 95%IC = 0.005–0.03; p = 0.009), and leptin concentrations (β = 0.32; 95% IC = 0.001–0.006; 0.007). Time spent on TUG test and leptin levels accounted for 27% of variability in cognitive function independent of age. Poorer physical function with leptin plasma levels is associated with decreased cognitive function in older women. These findings contribute to comprehension of pathophysiology underlying cognitive decline and informing the development of new approaches to prevent, diagnose, monitoring and treat cognitive decline in aging.

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“…Cross-sectional observations have revealed significant associations between respiratory muscle strength with MS-related disability, 5 perceived fatigue, 6 and cognition. 18 Lower aerobic fitness, slower walking speed, and cognitive processing speed prior to starting the exercise intervention were linked to larger improvements in these respective outcomes, indicating that persons with MS with poorer baseline performance experienced greater training benefits. 19 In summary, there is a gap in knowledge about the factors that may influence the positive outcome of IMT in the MS population.…”

Section: Introductionmentioning

confidence: 99%

“…The purpose of this study was to identify independent factors associated with improvements in inspiratory muscle strength following IMT using a resistive threshold device in PwAMS. In light of the paucity of relevant research, clinical characteristics of persons with MS that are commonly evaluated by clinicians and reported in the literature 5,6,[13][14][15][16][17][18][19] were considered as the potential predictors relating to the positive outcome following IMT.…”

Section: Introductionmentioning

confidence: 99%

Predictors of positive outcomes following resistive inspiratory muscle training in non-ambulatory persons with advanced multiple sclerosis

Huang

Doyle

Burnham

et al. 2022

Multiple Sclerosis Journal - Experimental, Translational and Cl

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Background Inspiratory muscle training (IMT) using a threshold device improves inspiratory muscle strength. What factors influence the IMT outcome has not been examined. Objective To identify predictors of the positive outcome following IMT in persons with advanced multiple sclerosis (PwAMS). Methods Inclusion criteria were non-ambulatory PwAMS, Expanded Disability Status Scale (EDSS) ≥6.5, age >18 years, no acute medical conditions, current non-smokers, and ability to consent. Participants ( n = 38) performed daily inspiratory exercises using a resistive threshold device for 10 weeks. Baseline measurements included age, sex, body mass index, year post multiple sclerosis diagnosis, comorbidities, EDSS, Modified Fatigue Impact Scale-5, and oral Symbol Digit Modality Test. The percentage of completed prescribed exercise trials (Trials%) during the 10-week intervention was calculated. Age- and sex-adjusted predicted values of maximum inspiratory pressure (MIP%pred) and maximum expiratory pressure (MEP%pred) were obtained before and after the 10-week intervention. Backward multivariable regression analyses for the primary outcome (MIP%pred) were conducted. Results After controlling for the initial MIP%pred, perceived fatigue at the baseline and Trial% were significant and independent predictors of MIP%pred after IMT. Conclusion Less fatigue at the baseline and higher adherence to the prescribed exercise repetitions were positive predictors of the positive outcome following IMT in PwAMS.

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Evolving relationship between respiratory functions & impairment in sleep and cognition in patients with multiple sclerosis

Cited by 9 publications

References 53 publications

Clinical correlates of respiratory disorders in patients with severe multiple sclerosis: A cross-sectional cohort

Clinical correlates of respiratory disorders in patients with severe multiple sclerosis: A cross-sectional cohort

Cognitive function is associated with performance in time up and go test and with leptin blood levels in community-dwelling older women

Predictors of positive outcomes following resistive inspiratory muscle training in non-ambulatory persons with advanced multiple sclerosis

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