Novel fMRI working memory paradigm accurately detects cognitive impairment in multiple sclerosis

Nelson, Flavia; Akhtar, Mohammad A; Zúñiga, Edward; Pérez, Carlos A.; Hasan, Khader M.; Wilken, Jeffrey; Wolinsky, Jerry S.; Narayana, Ponnada A.; Steinberg, Joel L.

doi:10.1177/1352458516666186

Cited by 10 publications

(8 citation statements)

References 38 publications

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“…Finally, we would like to highlight advances of fMRI and cognitive research in MS [78], although there has been some controversies about the real meaning of fMRI results, it seems that early changes can be seen, even in cognitively preserved patients, including higher recruitment of non-related areas, such as supplementary motor cortex during working memory tasks [113] or by changes in activity properties of regions highly related to cognitive functions, as centrality measures of the default mode network [114], changes that may be used as a biomarker for neurocognitive rehabilitation [115] especially, resting state fMRI [116,117,118].…”

Section: Neural Basis Of Cognitive Impairment In Msmentioning

confidence: 99%

Assessment and Impact of Cognitive Impairment in Multiple Sclerosis: An Overview

2019

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Cognitive impairment affects 40–60% of patients with multiple sclerosis. It may be present early in the course of the disease and has an impact on a patient’s employability, social interactions, and quality of life. In the last three decades, an increasing interest in diagnosis and management of cognitive impairment has arisen. Neuropsychological assessment and neuroimaging studies focusing on cognitive impairment are now being incorporated as primary outcomes in clinical trials. However, there are still key uncertainties concerning the underlying mechanisms of damage, neural basis, sensitivity and validity of neuropsychological tests, and efficacy of pharmacological and non-pharmacological interventions. The present article aimed to present an overview of the assessment, neural correlates, and impact of cognitive impairment in multiple sclerosis.

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Section: Neural Basis Of Cognitive Impairment In Msmentioning

confidence: 99%

Assessment and Impact of Cognitive Impairment in Multiple Sclerosis: An Overview

2019

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“…Several previous studies have shown reorganization of the brain in patients with MS across systems, with an emphasis on the motor (Zeller & Classen, ), visual (Toosy et al ., ; Korsholm et al ., ; Jenkins et al ., ; Gallo et al ., ) and cognitive (Helekar et al ., ; Hulst et al ., ; Nelson et al ., ) domains. Reorganization within the motor system in the remitting phase of MS has mostly been demonstrated by means of functional magnetic resonance imaging (fMRI).…”

Section: Introductionmentioning

confidence: 99%

Altered motor plasticity in an acute relapse of multiple sclerosis

Wirsching

Buttmann

Odorfer

et al. 2018

Eur J of Neuroscience

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In relapsing-remitting MS (RRMS), the symptoms of a clinical relapse subside over time. Neuroplasticity is believed to play an important compensatory role. In this study, we assessed excitability-decreasing plasticity during an acute relapse of MS and 12 weeks afterwards. Motor plasticity was examined in 19 patients with clinically isolated syndrome or RRMS during a steroid-treated relapse (t1) and 12 weeks afterwards (t2) using paired-associative stimulation (PAS10). This method combines repetitive electric nerve stimulation with transcranial magnetic stimulation of the contralateral motor cortex to model long-term synaptic depression in the human cortex. Additionally, 19 age-matched healthy controls were assessed. Motor-evoked potentials of the abductor pollicis brevis muscle were recorded before and after intervention. Clinical disability was assessed by the multiple sclerosis functional composite and the subscore of the nine-hole peg test taken as a measure of hand function. The effect of PAS10 was significantly different between controls and patients; at t1, but not at t2, baseline-normalized postinterventional amplitudes were significantly higher in patients (106 [IQR 98-137] % post10-15 and 111 [IQR 88-133] % post20-25) compared to controls (92 [IQR 85-111] % and 90 [IQR 75-102] %). Additional exploratory analysis indicated a potentially excitability-enhancing effect of PAS10 in patients as opposed to controls. Significant clinical improvement between t1 and t2 was not correlated with PAS10 effects. Our results indicate an alteration of PAS10-induced synaptic plasticity during relapse, presumably reflecting a polarity shift due to metaplastic processes within the motor cortex. Further studies will need to elucidate the functional significance of such changes for the clinical course of MS.

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“…In a recent fMRI study (Nelson et al, 2017), reduced activation of prefrontal cortex was observed in cognitively impaired MS patients on a working memory task compared to MS patients who were cognitively intact.…”

Section: Neuroimagingmentioning

confidence: 91%

Neuropsychology of Multiple Sclerosis: Looking Back and Moving Forward

Benedict

DeLuca

Enzinger

et al. 2017

J Int Neuropsychol Soc

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The neuropsychological aspects of multiple sclerosis (MS) have evolved over the past three decades. What was once thought to be a rare occurrence, cognitive dysfunction is now viewed as one of the most disabling symptoms of the disease, with devastating effects on patients' quality of life. This selective review will highlight major innovations and scientific discoveries in the areas of neuropathology, neuroimaging, diagnosis, and treatment that pertain to our understanding of the neuropsychological aspects of MS. Specifically, we focus on the recent discovery that MS produces pathogical lesions of gray matter (GM) that have consequences for cognitive functions. Methods for imaging these GM lesions in MS are discussed along with multimodal imaging studies that integrate structural and functional imaging methods to provide a better understanding of the relationship between cognitive test performance and functional reserve. Innovations in the screening and comprehensive assessment of cognitive disorders are presented along with recent research that examines cognitive dysfunction in pediatric MS. Results of innovative outcome studies in cognitive rehabilitation are discussed. Finally, we highlight trends for potential future innovations over the next decade. (JINS, 2017, 23, 832-842)

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Novel fMRI working memory paradigm accurately detects cognitive impairment in multiple sclerosis

Cited by 10 publications

References 38 publications

Assessment and Impact of Cognitive Impairment in Multiple Sclerosis: An Overview

Assessment and Impact of Cognitive Impairment in Multiple Sclerosis: An Overview

Altered motor plasticity in an acute relapse of multiple sclerosis

Neuropsychology of Multiple Sclerosis: Looking Back and Moving Forward

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