Hospital Universitari Germans Trias i Pujol
Neuroscience

Author Of 2 Presentations

Disease Modifying Therapies – Mechanism of Action Poster Presentation

P0313 - Dimethyl fumarate-induced changes in lymphocyte subpopulations could identify "NEDA" patients (ID 1433)

Presentation Number
P0313
Presentation Topic
Disease Modifying Therapies – Mechanism of Action

Abstract

Background

The optimal response to dimethyl fumarate (DMF) is mediated by a shift to antiinflammatory and immunoregulatory profile. In a preliminary study of 22 patients with multiple sclerosis (MS) followed for 12 months, we observed that, at 3 months of treatment, patients with "No evidence of disease activity (NEDA)" had a decrease in the Th1-like Th17 effector memory subpopulation.

Objectives

To analyze the long-term effect of DMF on the lymphocyte subpopulations of MS patients and its relationship with the activity of the disease.

Methods

Ongoing longitudinal prospective study in MS patients undergoing DMF treatment. A panel of T and B lymphocyte subpopulations in peripheral blood is analyzed by flow cytometry. Patients with a complete follow-up of more than 1 year are classified as: NEDA, MEDA (minimal clinical or radiological activity) or EDA.

Results

To date, 48 patients have been analyzed. After a 2.66 (1-5) years follow-up, we find 39.6% in NEDA, 25% in MEDA, and 16.7% in EDA.

The changes induced on the subpopulations (increase T [CD4 and CD8] and B naïve, and decrease T central memory (CM) and effector memory (EfM), and B memory) remain stable in the long term (> 2 years), being most prominent in NEDA patients. In these, lower percentages of Th1 CM and EfM pre-treatment (p = 0.009, p = 0.002), as well as of Th1, Th17 and Th1-like Th17 CM (p <0.001, p = 0.002, p = 0.012) and Th1 and Th17 EfM (p <0.001, p = 0.034) during the first 12 months of treatment are found. MEDA patients appear to behave like EDA patients in changes in Th1/Th17/Th1-like Th17.

Conclusions

The changes induced by DMF on the lymphocyte subpopulations remain stable over time. NEDA patients have an immunophenotype that seems to identify them. Immunomonitoring detects the true biological effect of the treatments.

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Neuropsychology and Cognition Poster Presentation

P0820 - Phase II trial of cognitive rehabilitation in patients with multiple sclerosis: preliminary results (ID 847)

Abstract

Background

Around 50% of patients with multiple sclerosis (MS) present a decline in cognitive behavior that impacts negatively on their autonomy, social and working skills. The benefits of cognitive rehabilitation on cognition and brain plasticity are not well understood due to methodological limitations of most studies, such the use of an inappropriate control group or the small number of patients included.

Objectives

To study the efficacy on attention, processing speed and working memory of a cognitive training program in patients with MS.

Methods

Multi-center, phase II, double-blind and randomized clinical trial to a treatment group (upward intensity training) or control group (low intensity static training). Patients were assessed using Rao's battery before and after 12 weeks of online training with the Guttmann, NeuroPersonalTrainer® (GNPT). The main objective was to demonstrate an improvement in attention and working memory tests (Pasat Auditory Serial Addition Test, PASAT, and Symbol Digit Modalities Test, SDMT) in the treatment group.

Results

The recruitment is still active. In an interim analysis on May 2020, 61 patients had been evaluated, of whom 35 fulfilled the inclusion criteria, and 23 had completed the follow-up period (age 48.8±7.4, disease duration 19.2±9.3 years). Ten patients had been assigned to the treatment group and 13 to the control group. The treatment group showed a significant reduction in z-scores of attention and working memory tests (z-score=-1.68±0.90 at baseline and -1.26±1.05 at follow up) compared to the control group (-1.78±0.63 at baseline and -1.45±1.06 at follow up), p corrected=0.003, and a trend for verbal memory (treatment group z-score -2.19±1.14 and -1.61±1.68 and sham group z-score -1.38±1.32 and -1.34±1.5 at baseline and follow up respectively, corrected p=0.074). There were no significant changes in other cognitive domains (verbal, visual, and fluency memory).

Conclusions

This preliminary analysis shows that intensive rehabilitation focused on attention, information processing speed and working memory can improve these cognitive functions.

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Presenter Of 1 Presentation

Disease Modifying Therapies – Mechanism of Action Poster Presentation

P0313 - Dimethyl fumarate-induced changes in lymphocyte subpopulations could identify "NEDA" patients (ID 1433)

Presentation Number
P0313
Presentation Topic
Disease Modifying Therapies – Mechanism of Action

Abstract

Background

The optimal response to dimethyl fumarate (DMF) is mediated by a shift to antiinflammatory and immunoregulatory profile. In a preliminary study of 22 patients with multiple sclerosis (MS) followed for 12 months, we observed that, at 3 months of treatment, patients with "No evidence of disease activity (NEDA)" had a decrease in the Th1-like Th17 effector memory subpopulation.

Objectives

To analyze the long-term effect of DMF on the lymphocyte subpopulations of MS patients and its relationship with the activity of the disease.

Methods

Ongoing longitudinal prospective study in MS patients undergoing DMF treatment. A panel of T and B lymphocyte subpopulations in peripheral blood is analyzed by flow cytometry. Patients with a complete follow-up of more than 1 year are classified as: NEDA, MEDA (minimal clinical or radiological activity) or EDA.

Results

To date, 48 patients have been analyzed. After a 2.66 (1-5) years follow-up, we find 39.6% in NEDA, 25% in MEDA, and 16.7% in EDA.

The changes induced on the subpopulations (increase T [CD4 and CD8] and B naïve, and decrease T central memory (CM) and effector memory (EfM), and B memory) remain stable in the long term (> 2 years), being most prominent in NEDA patients. In these, lower percentages of Th1 CM and EfM pre-treatment (p = 0.009, p = 0.002), as well as of Th1, Th17 and Th1-like Th17 CM (p <0.001, p = 0.002, p = 0.012) and Th1 and Th17 EfM (p <0.001, p = 0.034) during the first 12 months of treatment are found. MEDA patients appear to behave like EDA patients in changes in Th1/Th17/Th1-like Th17.

Conclusions

The changes induced by DMF on the lymphocyte subpopulations remain stable over time. NEDA patients have an immunophenotype that seems to identify them. Immunomonitoring detects the true biological effect of the treatments.

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