Cognitive impairment starts early in MS

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Objective: This study assessed whether abnormalities on functional magnetic resonance imaging (fMRI) are related to cognitive function in people at presentation with clinically isolated syndrome (CIS) suggestive of MS. 

fMRI is a tool that allows investigators to assess the functioning of specific regions of the brain by assessing the blood flow to that region; the more active a region the greater the blood flow, the less active a region the less the blood flow. 
Methods: 18 people with CIS and 15 healthy controls performed an adapted fMRI version of the Paced Auditory Serial Addition Test (PASAT); a cognitive test. According to their PASAT performance, CIS patients were divided into two groups: 10 with a low PASAT performance were considered to be ‘cognitively impaired’ (CI) and 8 were defined as ‘cognitively preserved’ (CP). Between-group differences in the patterns of brain activations and effective connectivity were assessed. 
Results: During PASAT, compared to HCs, CIS patients showed increased activation of several areas of the brain. 
When CIS’ers were analyzed, the CI group had a more significant activation than HCs and CP CIS’ers.
Conclusions: During performance of the PASAT, CIS’ers showed abnormalities in the patterns of brain function and connectivity related to the level of their cognitive impairment as measured by the PASAT test.
“More reason to treat early and to consider aggressive treatment strategies; cognition is a very valuable function that is not captured with our current outcome measures.”

“This study supports other findings in the field; in other words this data is reproducible (the most important principle in science) and consistent with other findings in the field (an important second principle of scientific discovery).”

“Reproducibility & Consistency with other findings!”
Additional reading: fMRI, PASAT
Other relevant posts on this blog:

31 Jul 2011
“Some studies have shown that DMTs, which reduce the burden of disease, also slow the rate at which cognition is affected in MS’ers. Unfortunately, not all trials have collected relevant outcome data on cognition.” 

19 Jul 2011
We use the test to assess the impact of treatments on cognition. The test is part of a battery of tests that form the MS functional composite or MSFC. The MSFC is another measure we use to assess disability progression 

06 Jul 2011
I would like to add to the discussion another source of valuable information on the subject of cognition difficulties and MS and this is a new page I just finished working for my web site 

About the author

Prof G

Professor of Neurology, Barts & The London. MS & Preventive Neurology thinker, blogger, runner, vegetable gardener, husband, father, cook and wine & food lover.

2 comments

  • This would be an interesting test to do pre and post CCSVI treatment. My cognitive abilities have improved greatly since venoplasty. The Edinbugh Clinic are doing a repeat PASAT at 6 months, but not with fMRI.

  • Cognition is especially important in pediatric MS where the child still has so much basic learning to acquire.

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