Brain atrophy and memory impairment in MS

How important is the observation of brain atrophy in MS? #MSBlog #MSResearch

Epub: Deluca et al. Memory impairment in multiple sclerosis is due to a core deficit in initial learning. J Neurol. 2013 Jul 6.

Background: MSers suffer memory impairment, but research on the nature of MS-related memory problems is mixed. Some have argued for a core deficit in retrieval, while others have identified deficient initial learning as the core deficit. 

Methods: These investigators used a selective reminding paradigm to determine whether deficient initial learning or delayed retrieval represents the primary memory deficit in 44 persons with MS. Brain atrophy was measured from high-resolution MRIs. Regression analyses examined the impact of brain atrophy on (a) initial learning and delayed retrieval separately, and then (b) delayed retrieval controlling for initial learning. 

Results: Brain atrophy was negatively associated with both initial learning and delayed retrieval (ps < 0.01), but brain atrophy was unrelated to retrieval when controlling for initial learning (p > 0.05). In addition, brain atrophy was associated with inefficient learning across initial acquisition trials, and brain atrophy was unrelated to delayed recall among MS subjects who successfully acquired the word list (although such learning frequently required many exposures). 

Conclusions: Taken together, memory deficits in MS are a result of deficits in initial learning; moreover, initial learning mediates the relationship between brain atrophy and subsequent retrieval, thereby supporting the core learning-deficit hypothesis of memory impairment in MS.

“Brain atrophy is associated with cognitive impairment in MS and may be the major determinant of this problem. What can we do about it? The good news for RRMSers is that the highly effective DMTs have an impact on brain atrophy. This is why we need to get the MS community to start asking questions about brain atrophy.”

05 Jul 2013
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“This study confirms what we already know from several other studies that MS is associated with progressive brain atrophy that begins early in the disease and is associated with disability progression. This is why it is important 
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Natalizumab may reduce cognitive changes and brain atrophy rate in relapsing-remitting multiple sclerosis: a prospective, non-randomized pilot study. Eur J Neurol. 2012 Oct 11. doi: 10.1111/j.1468-1331.2012.03882.x.
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Prof G

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

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