Innovations In Clinical Neuroscience

HOTTOP Multiple Sclerosis DEC 2017

A peer-reviewed, evidence-based journal for clinicians in the field of neuroscience

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13 Hot Topics in Multiple Sclerosis [December 2017] M E E T I N G H I G H L I G H T S RELATIONSHIP BETWEEN COGNITION AND MULTIPLE SCLEROSIS Detection of cognitive decline in MS using BICAMS: Is there substantial value in applying the full battery? The Brief International Cognitive Assessment for MS (BICAMS) was introduced to streamline cognitive testing results for patients with multiple sclerosis (MS) worldwide. While the battery, which includes three individual tests, only takes about 20 minutes to administer, researchers sought to determine if similar results could be extracted if patients instead took just one or two of the tests. The study included 1,380 patients, and after they all took the BICAMS, 41.7 percent were deemed cognitively impaired. Researchers found that the combination of Symbol Digits Modalities Test (SDMT) and the Brief Visuospatial Memory Test (BVMTR), as well as the combination of the Verbal Learning Memory Test (VLMT) and BVMTR, had "significantly higher consistency" with the overall battery compared to the combination of the SDMT and VLMT. The BVMTR was the strongest individual test, while the VLMT was the weakest. Overall, the investigators concluded that the combination SDMT and BVMTR was just as reliable as taking the entire BICAMS and would be less time consuming. * Access the abstract online Cognitive impairment in MS: are white matter lesions the main driver? While cognitive impairment (CI) is a frequent symptom of multiple sclerosis (MS), it doesn't often occur until later in the disease process. This study, which was presented at the 7th Joint ACTRIMS- ECTRIMS meeting in Paris, aimed to measure whether white matter lesions (WMLs) were the main factor in CI. The study included 69 patients who had CI and 612 who did not have CI, as measured by the Multiple Sclerosis Inventory of Cognition (MUSIC) test. Researchers found higher WML and decreased cortical gray matter (GM) for patients with MS with CI. However, after correction for the Expanded Disability Status Scale (EDSS), only WML explained CI independently. * Access the abstract online OTHER TOPICS IN MULTIPLE SCLEROSIS The impact of depression and anxiety symptoms on information processing speed in MS and other immune-mediated inflammatory diseases. At the 7th Joint ACTRIMS- ECTRIMS meeting in October, researchers presented on the effects that anxiety and depression (self-reported) had on information processing speed in multiple sclerosis (MS) and other immune- mediated inflammatory diseases (IMIDs). There were 255 patients with MS in the study, and they all completed the Symbol Digit Modalities Test (SDMT), Weschler Test of Adult Reading (WTAR), and the Hospital Anxiety and Depression Scale (HADS). A significantly higher percentage of patients with MS suffered from impairment compared to the other disease groups (irritable bowel disease and rheumatoid arthritis). Current symptoms of anxiety and depression impacted processing speed in patients with MS, but the values were not significant after controlling for Expanded Disability Status Scale (EDSS) scores. Regardless, the authors recommend continued research on how depression and anxiety affect information processing speed in IMDs. * Access the abstract online Aging is accelerating central atrophy in MS patients. While brain volume loss is a natural occurrence as people surpass age 60, lateral ventricular volume (LVV) enlargement accelerates in patients with multiple sclerosis (MS) once the disease process begins. Researchers at the 7th Joint ACTRIMS-ECTRIMS meeting in Paris, France, studied how LVV enlargement affects patients with MS. The study included 2,104 patients with MS and 350 healthy individuals (HI). They used the Neurological Software Tool for REliable Atrophy Measurement (NeuroSTREAM) to measure LVV values in 8,858 brain scans. Based on first magnetic resonance imaging (MRI) results, all age groups of patients with MS had higher LVV levels compared to the HI group. The percent LVV change for the 20 to 59 years of age groups was 3.6 percent, and it was 6.9 percent in the 60–79 years of age groups. The decade with the highest percent LVV change was the 70–79 years of age group, which was 8.2 percent. The authors concluded that the aging effect does indeed impact LVV enlargement in patients with MS. * Access the abstract online

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