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Brain Sciences
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Cognitive Involvement in Multiple Sclerosis
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Cognitive Involvement in Multiple Sclerosis

A special issue of Brain Sciences (ISSN 2076-3425). This special issue belongs to the section "Neuropsychology".

Deadline for manuscript submissions: closed (15 October 2021) | Viewed by 31280

Special Issue Editor

Prof. Roberta Lanzillo

E-Mail Website
Guest Editor
Department of NSRO, Federico II University, 80131 Naples, Italy
Interests: imaging; neuroscience; neurodegeneration; neurological diseases; neurology; multiple sclerosis; demyelinating diseases
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Research on cognitive involvement in multiple sclerosis (MS) is steadily evolving, with different aspects regarding assessment, correlations with clinical evolution and other possible biomarkers, neuroimaging and rehabilitation.

Early cognitive impairment has been recognized as a negative prognostic marker in MS, but we still need to standardize and apply it in clinical practice cognitive evaluation.

The aim of this Special Issue is to focus on cognitive assessment methods in MS, the impact of cognitive impairment on disease evolution, the correlations with other recognized markers of disease (neuroimages, OCT, neurofilaments, etc.), and cognitive rehabilitation, both in adult and in paediatric onset MS.

Dr. Roberta Lanzillo
Guest Editor

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Keywords

  • multiple sclerosis
  • cognitive involvement
  • cognitive assessment
  • prognostic markers
  • biomarkers
  • neuroimaging
  • cognitive rehabilitation
  • disease evolution
  • OCT
  • neurofilaments
  • pediatric multiple sclerosis

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Published Papers (8 papers)

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Editorial

Jump to: Research, Review

4 pages, 949 KiB  
Editorial
Editorial to Special Issue “Cognitive Involvement in Multiple Sclerosis”
by Roberta Lanzillo
Brain Sci. 2022, 12(5), 561; https://doi.org/10.3390/brainsci12050561 - 27 Apr 2022
Cited by 1 | Viewed by 1415
Abstract
Multiple sclerosis (MS) is a multifaceted and complex disorder that mainly affects young adults, impacting their work and social abilities [...] Full article
(This article belongs to the Special Issue Cognitive Involvement in Multiple Sclerosis)
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Research

Jump to: Editorial, Review

11 pages, 792 KiB  
Article
Serum Vitamin D as a Marker of Impaired Information Processing Speed and Early Disability in Multiple Sclerosis Patients
by Eleonora Virgilio, Domizia Vecchio, Ilaria Crespi, Paolo Barbero, Beatrice Caloni, Paola Naldi, Roberto Cantello, Umberto Dianzani and Cristoforo Comi
Brain Sci. 2021, 11(11), 1521; https://doi.org/10.3390/brainsci11111521 - 17 Nov 2021
Cited by 14 | Viewed by 3526
Abstract
Slowed information processing speed (IPS) is the hallmark and first cognitive domain to be altered in multiple sclerosis (MS) patients. Insufficient serum vitamin D was previously associated with disease development, relapses, and progression, but little is reported on cognition. However, vitamin D and [...] Read more.
Slowed information processing speed (IPS) is the hallmark and first cognitive domain to be altered in multiple sclerosis (MS) patients. Insufficient serum vitamin D was previously associated with disease development, relapses, and progression, but little is reported on cognition. However, vitamin D and cognitive impairment (CI) in other neurodegenerative diseases have already been linked. We explored the possible correlation between vitamin D and IPS at diagnosis and early disability at last follow-up in 81 MS patients. At diagnosis, we collected vitamin D levels and performed a Symbol Digit Modalities Test (SDMT). Raw scores were adjusted for age, gender, and educational level. Early disability was evaluated with MS severity score (MSSS) and age-related MSSS (ARMSS). A total of 71 patients (86.58%) showed hypovitaminosis D (19.71 ± 8.76 ng/mL) and 18 patients (21.95%) had CI. Patients with CI showed severe hypovitaminosis D (p = 0.004). No patients with sufficient vitamin D levels had CI. We found a positive correlation between vitamin D levels at diagnosis and (1) SDMT raw and z-score that persisted after correction for sunlight exposure and MRI baseline characteristics, and (2) EDSS, MSSS, and ARMSS after a mean 2 year follow-up. Low vitamin D levels may affect both cognition and early disability in newly diagnosed MS patients. Full article
(This article belongs to the Special Issue Cognitive Involvement in Multiple Sclerosis)
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8 pages, 447 KiB  
Article
A Retrospective Exploratory Analysis on Cardiovascular Risk and Cognitive Dysfunction in Multiple Sclerosis
by Antonio Reia, Martina Petruzzo, Fabrizia Falco, Teresa Costabile, Matteo Conenna, Antonio Carotenuto, Maria Petracca, Giuseppe Servillo, Roberta Lanzillo, Vincenzo Brescia Morra and Marcello Moccia
Brain Sci. 2021, 11(4), 502; https://doi.org/10.3390/brainsci11040502 - 16 Apr 2021
Cited by 11 | Viewed by 2760
Abstract
Background. Cardiovascular comorbidities have been associated with cognitive decline in the general population. Objectives. To evaluate the associations between cardiovascular risk and neuropsychological performances in MS. Methods. This is a retrospective study, including 69 MS patients. For all patients, we calculated the Framingham [...] Read more.
Background. Cardiovascular comorbidities have been associated with cognitive decline in the general population. Objectives. To evaluate the associations between cardiovascular risk and neuropsychological performances in MS. Methods. This is a retrospective study, including 69 MS patients. For all patients, we calculated the Framingham risk score, which provides the 10-year probability of developing macrovascular disease, using age, sex, diabetes, smoking, systolic blood pressure, and cholesterol levels as input variables. Cognitive function was examined with the Brief International Cognitive Assessment for MS (BICAMS), including the Symbol Digit Modalities Test (SDMT), the California Verbal Learning Test-II (CVLT-II), and the Brief Visuospatial Memory Test-Revised (BVMT-R). Results. Each point increase of the Framingham risk score corresponded to 0.21 lower CVLT-II score. Looking at Framingham risk score components, male sex and higher total cholesterol levels corresponded to lower CVLT scores (Coeff = −8.54; 95%CI = −15.51, −1.57; and Coeff = −0.11; 95%CI = −0.20, −0.02, respectively). No associations were found between cardiovascular risk and SDMT or BVMT-R. Conclusions. In our exploratory analyses, cardiovascular risk was associated with verbal learning dysfunction in MS. Lifestyle and pharmacological interventions on cardiovascular risk factors should be considered carefully in the management of MS, given the possible effects on cognitive function. Full article
(This article belongs to the Special Issue Cognitive Involvement in Multiple Sclerosis)
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15 pages, 36795 KiB  
Article
Magnetoencephalography and High-Density Electroencephalography Study of Acoustic Event Related Potentials in Early Stage of Multiple Sclerosis: A Pilot Study on Cognitive Impairment and Fatigue
by Damiano Paolicelli, Alessia Manni, Antonio Iaffaldano, Giusy Tancredi, Katia Ricci, Eleonora Gentile, Rosa Gemma Viterbo, Silvia Giovanna Quitadamo, Marina de Tommaso and Maria Trojano
Brain Sci. 2021, 11(4), 481; https://doi.org/10.3390/brainsci11040481 - 9 Apr 2021
Cited by 9 | Viewed by 2949
Abstract
Cognitive impairment (CI) is a common and disabling symptom of Multiple Sclerosis (MS) with a negative impact on daily living. In this pilot study, we applied magnetoencephalography (MEG) and high density (hd) electroencephalography (EEG) study to evaluate acoustic P300 features in a cohort [...] Read more.
Cognitive impairment (CI) is a common and disabling symptom of Multiple Sclerosis (MS) with a negative impact on daily living. In this pilot study, we applied magnetoencephalography (MEG) and high density (hd) electroencephalography (EEG) study to evaluate acoustic P300 features in a cohort of early MS. Sixteen MS patients (pwMS) and 19 healthy controls (HCs) matched for age and gender underwent an MEG-/(hd)-EEG-co-recording, using 306-channel Vectorview and 64 scalp electrodes. CI was assessed using Rao’s Brief Repeatable Battery (BRB). Moreover, we performed psychometric tests to assess depression and fatigue. In pwMS, we observed a slight latency prolongation of P300 peak compared to HCs, while P300 amplitude and scalp distribution were similar in the two groups. pwMS did not show an amplitude reduction and different scalp distribution of Event-Related Potentials (ERPs) and Event Related Fields (ERFs) related to an acoustic oddball paradigm. We found an inverse correlation between P300 amplitude and fatigue (r Spearman = −0.4; p = 0.019). In pwMS, phenomena of cortical adaptation to early dysfunction could preserve the cognitive performance of the P300 acoustic task, while the development of fatigue could prospectively lead to amplitude decline of P300, suggesting its possible role as a biomarker. Full article
(This article belongs to the Special Issue Cognitive Involvement in Multiple Sclerosis)
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12 pages, 2719 KiB  
Article
Gray Matter Morphometry Correlates with Attentional Efficiency in Young-Adult Multiple Sclerosis
by Sindhuja T. Govindarajan, Ruiqi Pan, Lauren Krupp, Leigh Charvet and Tim Q. Duong
Brain Sci. 2021, 11(1), 80; https://doi.org/10.3390/brainsci11010080 - 9 Jan 2021
Cited by 8 | Viewed by 4620
Abstract
Slowed processing on the alerting, orienting and executive control components of attention measured using the Attention Network Test-Interactions (ANT-I) have been widely reported in multiple sclerosis (MS). Despite the assumption that these components correspond to specific neuroanatomical networks in the brain, little is [...] Read more.
Slowed processing on the alerting, orienting and executive control components of attention measured using the Attention Network Test-Interactions (ANT-I) have been widely reported in multiple sclerosis (MS). Despite the assumption that these components correspond to specific neuroanatomical networks in the brain, little is known about gray matter changes that occur in MS and their association with ANT-I performance. We investigated vertex-wise cortical thickness changes and deep gray matter volumetric changes in young MS participants (N = 21, age range: 18–35) with pediatric or young-adult onset and mild disease severity. ANT-I scores and cortical thickness were not significantly different between MS participants and healthy volunteers (N = 19, age range: 18–35), but thalamic volumes were significantly lower in MS. Slowed reaction times on the alerting component in MS correlated significantly with reduced volume of the right pallidum in MS. Slowed reaction times on executive control component correlated significantly with reduced thickness in the frontal, parietal and visual cortical areas and with reduced volume of the left putamen in MS. These findings demonstrate associations between gray matter changes and attentional performance even in the absence of widespread atrophy or slowed attentional processes. Full article
(This article belongs to the Special Issue Cognitive Involvement in Multiple Sclerosis)
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12 pages, 1001 KiB  
Article
Visual-Attentional Load Unveils Slowed Processing Speed in Multiple Sclerosis Patients: A Pilot Study with a Tablet-Based Videogame
by Marco Pitteri, Caterina Dapor, Stefano Ziccardi, Maddalena Guandalini, Riccardo Meggiato and Massimiliano Calabrese
Brain Sci. 2020, 10(11), 871; https://doi.org/10.3390/brainsci10110871 - 18 Nov 2020
Cited by 6 | Viewed by 3882
Abstract
Slowing in information processing speed (IPS) is the key cognitive deficit in multiple sclerosis (MS). Testing IPS in different cognitive load conditions by using computerized tools might reveal initial IPS slowness underestimated by classic paper-and-pencil tests. To investigate the extent to which IPS [...] Read more.
Slowing in information processing speed (IPS) is the key cognitive deficit in multiple sclerosis (MS). Testing IPS in different cognitive load conditions by using computerized tools might reveal initial IPS slowness underestimated by classic paper-and-pencil tests. To investigate the extent to which IPS can be affected by increased task demands, we developed three tasks based on the manipulation of the visual-attentional load, delivered with a home-made, tablet-based videogame. Fifty-one patients with MS (pwMS), classified as having no cognitive impairment in classic paper-and-pencil tests, and 20 healthy controls (HC) underwent the videogame tasks; reaction times (RTs) and accuracy were recorded. A significant reduced performance of pwMS as compared with HC was found on the videogame tasks, with pwMS being on average slower and less accurate than HC. Furthermore, pwMS showed a significantly more pronounced decrement in accuracy as a function of the visual-attentional load, suggesting a higher susceptibility to increased task demands. Significant correlations among the Symbol Digit Modalities Test (SDMT) and the videogame mean RTs and accuracy were found, providing evidence for the concurrent validity of the videogame as a valid tool to test IPS in pwMS. The high potential that might derive from the adoption of computerized assessment tools in clinical practice should be taken into consideration and investigated further. Full article
(This article belongs to the Special Issue Cognitive Involvement in Multiple Sclerosis)
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Review

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19 pages, 327 KiB  
Review
Cognitive Issues in Pediatric Multiple Sclerosis
by Emilio Portaccio, Ermelinda De Meo, Angelo Bellinvia and Maria Pia Amato
Brain Sci. 2021, 11(4), 442; https://doi.org/10.3390/brainsci11040442 - 30 Mar 2021
Cited by 29 | Viewed by 3669
Abstract
Multiple sclerosis (MS) is one of the leading causes of disability in young adults. The onset of MS during developmental age makes pediatric patients particularly susceptible to cognitive impairment, resulting from both disease-related damage and failure of age-expected brain growth. Despite different test [...] Read more.
Multiple sclerosis (MS) is one of the leading causes of disability in young adults. The onset of MS during developmental age makes pediatric patients particularly susceptible to cognitive impairment, resulting from both disease-related damage and failure of age-expected brain growth. Despite different test batteries and definitions, cognitive impairment has been consistently reported in approximately one-third of pediatric patients with MS. However, the lack of a uniform definition of cognitive impairment and the adoption of different test batteries have led to divergent results in terms of cognitive domains more frequently affected across the cohorts explored. This heterogeneity has hampered large international collaborative studies. Moreover, research aimed at the identification of risk factors (e.g., demographic, clinical, and radiological features) or protective factors (e.g., cognitive reserve, leisure activities) for cognitive decline is still scanty. Mood disorders, such as depression and anxiety, can be detected in these patients alongside cognitive decline or in isolation, and can negatively affect quality of life scores as well as academic performances. By using MRI, cognitive impairment was attributed to damage to specific brain compartments as well as to abnormal network activation patterns. However, multimodal MRI studies are still needed in order to assess the contribution of each MRI metric to cognitive impairment. Importantly, longitudinal studies have recently demonstrated failure of age-expected brain growth and of white matter (WM) and gray matter (GM) maturation plays a relevant role in determining cognitive dysfunction, in addition to MS-related direct damage. Whether these growth retardations might result in specific cognitive profiles according to the age at disease onset has not been studied, yet. A better characterization of cognitive profiles in pediatric MS patients, as well as the definition of neuroanatomical substrates of cognitive impairment and their longitudinal evolution are needed to develop efficient therapeutic strategies against cognitive impairment in this patient population. Full article
(This article belongs to the Special Issue Cognitive Involvement in Multiple Sclerosis)
18 pages, 2683 KiB  
Review
Neuroimaging Correlates of Cognitive Dysfunction in Adults with Multiple Sclerosis
by Maria Petracca, Giuseppe Pontillo, Marcello Moccia, Antonio Carotenuto, Sirio Cocozza, Roberta Lanzillo, Arturo Brunetti and Vincenzo Brescia Morra
Brain Sci. 2021, 11(3), 346; https://doi.org/10.3390/brainsci11030346 - 9 Mar 2021
Cited by 28 | Viewed by 7352
Abstract
Cognitive impairment is a frequent and meaningful symptom in multiple sclerosis (MS), caused by the accrual of brain structural damage only partially counteracted by effective functional reorganization. As both these aspects can be successfully investigated through the application of advanced neuroimaging, here, we [...] Read more.
Cognitive impairment is a frequent and meaningful symptom in multiple sclerosis (MS), caused by the accrual of brain structural damage only partially counteracted by effective functional reorganization. As both these aspects can be successfully investigated through the application of advanced neuroimaging, here, we offer an up-to-date overview of the latest findings on structural, functional and metabolic correlates of cognitive impairment in adults with MS, focusing on the mechanisms sustaining damage accrual and on the identification of useful imaging markers of cognitive decline. Full article
(This article belongs to the Special Issue Cognitive Involvement in Multiple Sclerosis)
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