Multiple Sclerosis Cognition Abstracts - 1

  1. Nicotine-induced Limbic Cortical activation in the human Brain: a functional MRI study
    Am J Psychiatry 1998 Aug;155(8):1009-15

  2. The NeuroPsychiatry of Multiple Sclerosis
    Int J Psychiatry Med 1995;25(2):123-30

  3. MRI correlates of NeuroPsychological Impairment in Multiple Sclerosis
    J NeuroPsychiatry Clin NeuroSci 1992 Spring;4(2):152-8

  4. NeuroPsychological assessment in R/R Multiple Sclerosis and mild functional impairment: correlation with MRI
    J Neurol NeuroSurg Psychiatry 1990 Feb;53(2):142-5

  5. Brain MRI correlates of Cognitive Impairment in Multiple Sclerosis
    J Neurol Sci 1993 Apr;115 Suppl:S66-73

  6. NeuroPsychology and Multiple Sclerosis: diagnostic and rehabilitative approaches
    J Neurol Sci 1993 Apr;115 Suppl:S51-4

  7. NeuroPsychological assessment in Multiple Sclerosis: a follow-up study with MRI
    J Neurol 1991 Oct;238(7):395-400

  8. Serial NeuroPsychological assessment and MRI analysis in MS
    Arch Neurol 1997 Aug;54(8):1018-25

  9. MRI and Cognitive functioning in Multiple Sclerosis
    J Neurol 1987 Dec;235(2):86-9

  10. Brain MRI Correlates Of Cognitive Impairment In Primary and S/P Multiple Sclerosis
    J Neurol Sci 1995 Oct;132(2):222-7

  11. Memory and learning disturbances in Multiple Sclerosis - MRI lesions and NeuroPsychological correlation
    Eur J Radiol 1991 Nov-Dec;13(3):220-4

  12. NeuroPsychological assessment in MS: Clinical, NeuroPhysiological and NeuroRadiological relationships
    Acta Neurol Scand 1992 Aug;86(2):124-8


Nicotine-Induced Limbic Cortical Activation In The Human Brain: A functional MRI Study

Stein EA, Pankiewicz J, Harsch HH, Cho JK, Fuller SA, Hoffmann RG, Hawkins M, Rao SM, Bandettini PA, Bloom AS
Am J Psychiatry 1998 Aug;155(8):1009-15
Medical College of Wisconsin, Dept of Psychiatry, Biophysics Research Institute, Milwaukee 53226, USA
PMID# 9699686; UI# 98363266

Nicotine is a highly addictive substance, and cigarette smoking is a major cause of premature death among humans. Little is known about the NeuroPharmacology and sites of action of Nicotine in the human Brain.

Such knowledge might help in the development of new behavioral and pharmacological therapies to aid in treating Nicotine dependence and to improve smoking cessation success rates.

Functional Magnetic Resonance Imaging, a real-time imaging technique, was used to determine the acute CNS effects of IntraVenous Nicotine in 16 active cigarette smokers.

An injection of saline followed by injections of three doses of Nicotine (0.75, 1.50, and 2.25 mg/70 kg of weight) were each administered IntraVenously over 1-minute periods.

In an ascending, cumulative-dosing paradigm while whole Brain gradient-echo, echo-planar images were acquired every 6 seconds during consecutive 20-minute trials.

Nicotine induced a dose-dependent increase in several behavioral parameters, including feelings of "rush" and "high" and drug liking.

Nicotine also induced a dose-dependent increase in Neuronal activity in a distributed system of Brain regions, including the Nucleus Accumbens, Amygdala, Cingulate, and Frontal Lobes.

Activation in these structures is consistent with Nicotine's behavior-arousing and behavior-reinforcing properties in humans.

The identified Brain regions have been previously shown to participate in the reinforcing, mood-elevating, and Cognitive properties of other abused drugs such as Cocaine, Amphetamine, and Opiates.

Suggesting that Nicotine acts similarly in the human Brain to produce its reinforcing and dependence properties.


The NeuroPsychiatry Of Multiple Sclerosis

Mendez MF
Int J Psychiatry Med 1995;25(2):123-30
VA Medical Center West, Neurobehavior Unit, Los Angeles, USA
PMID# 7591490; UI# 96000523

This article examines the Cognitive and Psychiatric features of Multiple Sclerosis. MS can manifest as a NeuroPsychiatric disturbance even in the absence of physical disabilities.

Two MS patients with predominant behavioral symptoms are described, and the literature is reviewed.

The first patient had an InterHemispheric Disconnection Syndrome, and the second patient had Cognitive fatigue and Depression.

Other patients have Slowed Information Processing Speed, Memory Retrieval Difficulty, Frontal-Executive Dysfunction, and VisuoSpatial Difficulty.

MS results in specific Cognitive deficits and Mood Disorders.

These two patients had organic mental disorders from Cerebral DeMyelination particularly affecting the Corpus Callosum.

Our patients have NeuroPsychiatric symptoms from extensive DeMyelination of PreFrontal-SubCortical circuits. Evaluation and management strategies are discussed.


Magnetic Resonance Imaging Correlates Of NeuroPsychological Impairment In Multiple Sclerosis

Huber SJ, Bornstein RA, Rammohan KW, Christy JA, Chakeres DW, McGhee RB
J NeuroPsychiatry Clin NeuroSci 1992 Spring;4(2):152-8
Univ of Kansas Medical Center, Dept of Neurology, Kansas City 66103
PMID# 1627976; UI# 92330496

The authors examined whether specific NeuroPsychological abnormalities in Multiple Sclerosis (MS) are associated with focal lesion areas detected by MRI.

Lesion area, regardless of distribution, correlated with performance on the vast majority of NeuroPsychological procedures.

No significant difference appeared between groups with normal/mild and moderate overall Cognitive Impairment on any of the MRI measures.

However, patients with severe Cognitive Impairment had greater lesion area, regardless of location, and had significant atrophy of the Corpus Callosum compared with the other two groups.

These results suggest that severe atrophy of the Corpus Callosum reflects global disease and provides a relatively focal morphological marker of severe Cognitive Impairment in MS.


NeuroPsychological Assessment In Relapsing/Remitting Multiple Sclerosis And Mild Functional Impairment: Correlation With Magnetic Resonance Imaging

Anzola GP, Bevilacqua L, Cappa SF, Capra R, Faglia L, Farina E, Frisoni G, Mariani C, Pasolini MP, Vignolo LA
J Neurol NeuroSurg Psychiatry 1990 Feb;53(2):142-5
Clinica Neurologica dell'Universita di Brescia, Italy
PMID# 2313301; UI# 90188423

Forty one moderately impaired patients with clinically confirmed Multiple Sclerosis (MS) and a Relapsing/Remitting course were submitted to a NeuroPsychological battery and Magnetic Resonance Imaging (MRI) to correlate the NeuroPsychological performances with the degree of Cerebral DeMyelination.

The NeuroPsychological results were indicative of a very mild overall impairment. The patients were subdivided into two groups (extensive PeriVentricular DeMyelination or discrete lesions on MRI) and the results of NeuroPsychological tests compared.

Patients with extensive PeriVentricular DeMyelination had an inferior performance on Concept Formation, Non-Verbal Reasoning and Verbal Memory tests.

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    J Neurol NeuroSurg Psychiatry 1991 Aug;54(8):757


Brain Magnetic Resonance Imaging Correlates Of Cognitive Impairment In Multiple Sclerosis

Comi G, Filippi M, Martinelli V, Sirabian G, Visciani A, Campi A, Mammi S, Rovaris M, Canal N
J Neurol Sci 1993 Apr;115 Suppl:S66-73
Univ of Milan, Multiple Sclerosis Center, Ospedale S. Raffaele, Italy
PMID# 8340796; UI# 93340689

We evaluated the correlations between Cognitive Impairment, clinical and Brain Magnetic Resonance Imaging (MRI) findings in 100 patients with Multiple Sclerosis (MS).

The performance on one or more NeuroPsychological tests was abnormal in 47% of the 64 patients who completed the entire NeuroPsychological battery; the Cognitive Impairment was mild in 14 (22%) and severe in 16 (25%).

Performance on any single NeuroPsychological test was unrelated to clinical parameters (age, duration of the disease, disability).

The NeuroPsychological performance of Relapsing/Remitting patients was better than in patients with a Chronic/Progressive disease.

The mean scores for almost all the NeuroPsychological tests were significantly lower in patients with severe Ventricular dilatation and Corpus Callosum atrophy than in patients in whom these structures were little affected.

Mean scores for WMS, performance Intelligence Quotient (IQ), total IQ and Token Test (TT) were also significantly correlated with the widening of Cortical Sulci and total lesional scores.

Our data support the contention that the involvement of pathways that are critical for a given Cognitive process.

As well as the progression of the Axonal degeneration and Sclerosis seem to play important roles in the PathoPhysiology of Cognitive Dysfunction in MS.


NeuroPsychology And Multiple Sclerosis: Diagnostic And Rehabilitative Approaches

Prosiegel M, Michael C
J Neurol Sci 1993 Apr;115 Suppl:S51-4
Neurologisches Krankenhaus Munchen, Germany
PMID# 8340793; UI# 93340686

The frequency of Cognitive deficits in Multiple Sclerosis (MS) patients is rather high and the estimates vary between 43% and 72% depending on the patient samples studied as well as on the methods of Cognitive assessment.

Despite the great impact of Cognitive dysfunction on several aspects of the quality of life, the importance of accurate assessment and rehabilitation of NeuroPsychological deficits in MS patients has long been ignored.

In this article, we first describe tests for the assessment of impairments, disabilities and handicaps.

We emphasize that after screening with brief assessment instruments, detailed testing of the basic target deficits is mandatory for the planning of special Cognitive training programs.

Second, the correlation of certain Cognitive deficit patterns with important Magnetic Resonance Imaging (MRI) variables such as total lesion area, size of the Corpus Callosum and specific lesion location is outlined in detail.

Third, some recommendations are made with regard to general rehabilitation principles such as restitution, compensation and adaptation as well as for special rehabilitation techniques including Cognitive retraining of basic deficits and/or training of activities of daily living.

Finally, we emphasize that there is a need for the development of tailor-made NeuroPsychological rehabilitation techniques for MS patients.

Which take into account the course and stage of the disease as well as the specific psychosocial problems of the individual patient.


NeuroPsychological Assessment In Multiple Sclerosis: A Follow-Up Study With MRI

Mariani C, Farina E, Cappa SF, Anzola GP, Faglia L, Bevilacqua L, Capra R, Mattioli F, Vignolo LA
J Neurol 1991 Oct;238(7):395-400
Istituto di Clinica Neurologica, Univ of Milan, Italy
PMID# 1960544; UI# 92071737

Nineteen moderately impaired patients with clinically definite Multiple Sclerosis and an initially Relapsing/Remitting course were included in a NeuroPsychological and Magnetic Resonance Imaging (MRI) follow-up study.

The average test/re-test interval was about 2 years. The NeuroPsychological findings were indicative of a very mild overall impairment; the patients, as a group, showed no evidence of Cognitive deterioration in the follow-up period.

A numerical estimation of the severity of Cerebral DeMyelination shown by MRI did not indicate a significant change. No correlation between Cognitive performance variations and MRI changes was found.


Serial NeuroPsychological Assessment And Magnetic Resonance Imaging Analysis In Multiple Sclerosis

Hohol MJ, Guttmann CR, Orav J, Mackin GA, Kikinis R, Khoury SJ, Jolesz FA, Weiner HL
Arch Neurol 1997 Aug;54(8):1018-25
Brigham and Women's Hospital, Center for Neurologic Diseases, Boston, MA 02115, USA
PMID# 9267977; UI# 97411864

To assess the correlation between Cognitive Dysfunction and disease burden in Multiple Sclerosis (MS) during a 1-year period.

The Brief, Repeatable Battery of NeuroPsychological Tests in Multiple Sclerosis was performed at entrance and 1 year.

Patients underwent at least 20 Proton Density (range, 20-24) and T2-weighted axial Magnetic Resonance Imaging (MRI) Brain scans except for stable patients who were scanned monthly.

Magnetic Resonance Imaging was evaluated using computer-automated, 3-dimensional volumetric analysis.

Setting & Participants
A research clinic of a university hospital. Forty-four patients with MS of the following disease categories:

  1. Relapsing/Remitting (14)
  2. Relapsing/Remitting/Progressive (12)
  3. Chronic/Progressive (13)
  4. Stable (5)

Main Outcome Measures
The relationships between scores on the Brief, Repeatable Battery of NeuroPsychological Tests in Multiple Sclerosis and 2 MRI measures (total lesion volume and Brain to IntraCranial cavity volume ratio) were assessed using linear regression.

These MRI measures were also compared with Cognitive status at 1 year using analysis of variance.

Overall, there was no decline in mean Cognitive test performance during 1 year.

Significant correlations were found between baseline NeuroPsychological test scores of NonVerbal Memory, Information-Processing Speed, and Attention and both MRI measures.

Patients with Chronic/Progressive MS demonstrated the strongest correlations. At 1 year, change in information-processing speed and attention correlated with change in total lesion volume.

The mean increase in total lesion volume was 5.7 mL for 4 patients whose Cognitive status worsened compared with 0.4 mL for 19 patients who improved and 0.5 mL for 21 patients who remained stable.

During a 1-year period mean Cognitive performance did not worsen.

Automated volumetric MRI measures of total lesion volume and Brain to IntraCranial cavity volume ratio correlated with NeuroPsychological performance.

Especially in patients with Chronic/Progressive MS. Worsening MRI lesion burden correlated with Cognitive decline.


Magnetic Resonance Imaging And Cognitive Functioning In Multiple Sclerosis

Medaer R, Nelissen E, Appel B, Swerts M, Geutjens J, Callaert H
J Neurol 1987 Dec;235(2):86-9
Multiple Sclerosis and Rehabilitation Clinic, Overpelt, Belgium
PMID# 3430196; UI# 88117612

The relationship between Cognitive Impairment in Multiple Sclerosis and Brain lesions seen on Magnetic Resonance Imaging (MRI) was studied.

Three groups of 11 patients with Multiple Sclerosis, matched for the variables of disability, duration of illness, age and sex, were included.

On the basis of NeuroPsychological testing, the groups were seen to differ in their level of Cognitive Impairment.

The first group showed no Cognitive Impairment, the second group a moderate, and the third group a serious Cognitive Impairment.

These differences between the groups were reflected by MRI, which revealed more abnormalities in the groups with Cognitive Impairment compared with the group with normal Cognitive function.

However, by MRI it was not possible to distinguish between the groups with moderate and that with serious Cognitive Impairment.


Brain MRI Correlates Of Cognitive Impairment In Primary and S/P Multiple Sclerosis

Comi G, Filippi M, Martinelli V, Campi A, Rodegher M, Alberoni M, Sirabian G, Canal N
J Neurol Sci 1995 Oct;132(2):222-7
Univ of Milan, Scientific Institute, Ospedale Dept of Neurology, San Raffaele, Italy
PMID# 8543952; UI# 96098615

Brain Magnetic Resonance Imaging (MRI) and an extensive battery of NeuroPsychological tests exploring Frontal functions, Short and Long-Term Memory, Visuo-Spatial skills, Attention and Language were applied to 14 patients with Primary/Progressive Multiple Sclerosis (PPMS) and 17 patients with Secondary/Progressive MS (SPMS).

Patients with PPMS and SPMS did not differ in degree of physical disability, but Cognitive deficits were found in 9/17 (53%) patients with SPMS and in only 1/14 (7%) of those with PPMS (p = 0.01).

Patients with SPMS had higher total (p = 0.004), PeriVentricular (p = 0.008) and Non-PeriVentricular (p = 0.04) MRI lesion loads than patients with PPMS.

In detail, patients with SPMS had greater involvement of Frontal (p = 0.05) and Occipital (p = 0.02) Horns, Trigones (p = 0.04), Third Ventricle (p = 0.03), Basal Ganglia (p = 0.02), Parietal (p = 0.02), Temporal (p = 0.004) and Occipital (p = 0.03) Lobes.

Patients with SPMS and NeuroPsychological deficits had higher Non-PeriVentricular lesion loads than patients with SPMS who did not have such deficits (p = 0.005).

Our results indicate that both NeuroPsychological and Brain MRI abnormalities are more extensive in patients with SPMS.

Since physical disability was similar for both groups, disability in PPMS may be predominantly due to Spinal Cord involvement.


Memory And Learning Disturbances In MS
MRI Lesions And NeuroPsychological Correlation

Izquierdo G, Campoy F Jr, Mir J, Gonzalez M, Martinez-Parra C
Eur J Radiol 1991 Nov-Dec;13(3):220-4
Hospital Universitario Virgen Macarena, Dept of Neurology, Sevilla, Spain
PMID# 1756751; UI# 92097572

Thirty-five patients with definite Multiple Sclerosis (MS) were studied. They underwent NeuroPsychological testing and Magnetic Resonance Imaging (MRI).

The MRI findings at different Brain areas levels were compared with the NeuroPsychological findings.

A quantitative system was used to measure MRI-MS lesions. In this series, a positive correlation was established between Memory and Learning disturbances measured by Battery 144, and the lesions measured by MRI (total, Hemispheric and, particularly, PeriVentricular lesions).

MRI can detect MS lesions, and this study shows that a correlation between MRI and NeuroPsychological findings is possible if quantitative methods are used to distinguish different MS involvement areas in relation to NeuroPsychological tasks.

These findings suggest that Hemispheric lesions in MS produce Cognitive disturbances and MRI could be a useful tool in predicting memory and learning impairment.


NeuroPsychological Assessment In MS: Clinical, NeuroPhysiological And NeuroRadiological Relationships

Maurelli M, Marchioni E, Cerretano R, Bosone D, Bergamaschi R, Citterio A, Martelli A, Sibilla L, Savoldi F
Acta Neurol Scand 1992 Aug;86(2):124-8
Neurological Institute C. Mondino, Univ of Pavia, Italy
PMID# 1414220; UI# 93034107

We assessed Cognitive performance and its relationship with clinical and anatomic disease severity in MS with mild to moderate handicap.

34 definite MS and 18 healthy subjects matched for age and education were submitted to a NeuroPsychological test battery.

Both groups were examined for Anxiety. MS patients underwent Magnetic Resonance Imaging examination.

MS performed worse than controls on all WAIS-P subtests and had Learning, Short- And Long-Term Verbal Memory Impairment.

Cognitive deficits were NOT related to abnormal Emotional States, but were found to be associated with Attentional Process and Information-Processing Speed Impairment.

Cognitive Impairment did not correlate with severity of physical disability.

The most Severe Memory Deficits were found in patients with extensive PeriVentricular damage.

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