Late-onset multiple sclerosis presenting with cognitive dysfunction and severe cortical/infratentorial atrophy

Calabrese, Massimiliano; Gajofatto, Alberto; Gobbin, Francesca; Turri, Giulia; Richelli, Silvia; Matinella, Angela; Oliboni, Eugenio; Benedetti, Maria Donata; Monaco, Salvatore

doi:10.1177/1352458514542363

Cited by 28 publications

(13 citation statements)

References 37 publications

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“…Our data confirm the limited ability of conventional MRI to discriminate between RRMS patients with and without benign course, with the exception of a greater proportion of n‐BMS subjects showing infratentorial lesions at baseline MRI scan, a finding with a well‐recognized negative prognostic relevance in MS . Our group recently observed in a separate series of patients with MS that brain stem involvement could be a relevant feature of cases with prominent cognitive impairment . Previous MRI studies have related cognitive impairment in BMS to the presence of cortical and subcortical brain damage .…”

Section: Discussionsupporting

confidence: 85%

Benign multiple sclerosis: physical and cognitive impairment follow distinct evolutions

et al. 2015

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Section: Discussionsupporting

confidence: 85%

Benign multiple sclerosis: physical and cognitive impairment follow distinct evolutions

et al. 2015

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“…To do so, we assessed patients with MS at illness onset and compared their data with data from healthy adolescents and healthy young adults. We hold that the present pattern of results might be of practical importance, as until now, to the best of our knowledge, neurocognitive assessments to detect neurocognitive impairments, [30][31][32][33] and imaging techniques to assess a cortical atrophy, [34][35][36][37][38] taken from a larger data set and sample, as already largely described elsewhere (Gerber et al, 23 ).…”

Section: Introductionmentioning

confidence: 75%

During early to mid adolescence, moderate to vigorous physical activity is associated with restoring sleep, psychological functioning, mental toughness and male gender

Brand

Kalak

Gerber

et al. 2016

Journal of Sports Sciences

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Numerous studies showed that regular physical activity (PA) is associated with both favourable and restorative sleep and improved psychological functioning (PF). However, there is little research on the topic covering the early to mid-adolescence period. Moreover, curiosity and exploratory behaviour (CEB) and mental toughness (MT) as a result of PA remains thus far uninvestigated, as do possible gender differences. The aim of the present study was to explore the associations between PA, subjective sleep (sS), PF, CEB, and MT during early to mid-adolescence. A total of 1361 participants (mean age = 13.37 years; range: 11-16 years; 51.2% female) took part in the study. They completed questionnaires covering PA, sS, PF, CEB, and MT. Greater PA was related to improved PF, better sS, and increased CEB and MT. Compared to male participants, females reported less PA, poorer sS, and had lower PF and MT scores. The present pattern of results suggests that during early and mid-adolescence greater PA was associated with more favourable sS and better PF, including CEB and MT, and that female participants reported lower scores in PA, sS, and PF. Accordingly, if PA has a favourable impact on sleep and psychological functioning, then data suggest that sports participation should be more tailored to increase motivation among female adolescents.

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“…Pathology in this area could impact performance for visual scanning of several targets as during the TMT. Executive dysfunction affects predominantly later stages and/or progressive forms (Brissart et al, 2013, Calabrese et al, 2015a, Ruet et al, 2013). In our cohort, lower WCST scores correlated with longer q-T 2 * in the right medial prefrontal cortex, and in parietal areas including precuneus.…”

Section: Discussionmentioning

confidence: 99%

The association between intra- and juxta-cortical pathology and cognitive impairment in multiple sclerosis by quantitative T 2 * mapping at 7 T MRI

Louapre

Govindarajan

Giannì

et al. 2016

NeuroImage: Clinical

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Using quantitative T2* at 7 Tesla (T) magnetic resonance imaging, we investigated whether impairment in selective cognitive functions in multiple sclerosis (MS) can be explained by pathology in specific areas and/or layers of the cortex.Thirty-one MS patients underwent neuropsychological evaluation, acquisition of 7 T multi-echo T2* gradient-echo sequences, and 3 T anatomical images for cortical surfaces reconstruction. Seventeen age-matched healthy subjects served as controls.Cortical T2* maps were sampled at various depths throughout the cortex and juxtacortex. Relation between T2*, neuropsychological scores and a cognitive index (CI), calculated from a principal component analysis on the whole battery, was tested by a general linear model.Cognitive impairment correlated with T2* increase, independently from white matter lesions and cortical thickness, in cortical areas highly relevant for cognition belonging to the default-mode network (p < 0.05 corrected). Dysfunction in different cognitive functions correlated with longer T2* in selective cortical regions, most of which showed longer T2* relative to controls. For most tests, this association was strongest in deeper cortical layers. Executive dysfunction, however, was mainly related with pathology in juxtameningeal cortex. T2* explained up to 20% of the variance of the CI, independently of conventional imaging metrics (adjusted-R2: 52–67%, p < 5.10− 4).Location of pathology across the cortical width and mantle showed selective correlation with impairment in differing cognitive domains. These findings may guide studies at lower field strength designed to develop surrogate markers of cognitive impairment in MS.

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Late-onset multiple sclerosis presenting with cognitive dysfunction and severe cortical/infratentorial atrophy

Cited by 28 publications

References 37 publications

Benign multiple sclerosis: physical and cognitive impairment follow distinct evolutions

Benign multiple sclerosis: physical and cognitive impairment follow distinct evolutions

During early to mid adolescence, moderate to vigorous physical activity is associated with restoring sleep, psychological functioning, mental toughness and male gender

The association between intra- and juxta-cortical pathology and cognitive impairment in multiple sclerosis by quantitative T 2 * mapping at 7 T MRI

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