University of Verona
Department of Neurosciences, Biomedicine and Movement

Author Of 2 Presentations

Neuropsychology and Cognition Late Breaking Abstracts

LB1209 - A tablet-based videogame for capturing slowing processing speed in multiple sclerosis patients: a pilot study (ID 2064)

Speakers
Presentation Number
LB1209
Presentation Topic
Neuropsychology and Cognition

Abstract

Background

Slowing information processing speed (IPS) is a biomarker of neuronal damage in patients with MS (pwMS). Computerized tools allow testing different cognitive load conditions that might reveal initial IPS inefficiencies before the appearance of formal cognitive impairment (CI) as assessed with paper-and-pencil neuropsychological tests.

Objectives

To further explore the feasibility of computerizes tools, we developed a tablet-based videogame for quickly and efficiently measuring IPS in pwMS without formal CI with the aim to assess its specificity and sensitivity in testing IPS in different cognitive load conditions in pwMS as compared to healthy controls (HC).

Methods

Forty-five pwMS (age:36.8±9.3; edu:13.9±3.1; F=33) without CI and 20 matched HC (age:34.4±12.3; edu:17.5±2.5; F=7) underwent 3 videogame levels of increasing cognitive load. Reaction times (RTs) and accuracy were recorded and subjected to mixed-repeated ANOVAs. PwMS also underwent neuropsychological tests of IPS, attention, executive functioning (EF), and memory; correlation analyses between RTs of each level and the neuropsychological tests were performed.

Results

Significant differences between pwMS and HC were found as a function of increasing cognitive load conditions, on both RTs (p<.001) and accuracy (p<.001), with pwMS being on average significantly slower (p=.003) and less accurate (p=.004) than HC. Significant correlations between RTs of each level and composite score of IPS-attention (level 1: p=.006; level 2: p=.009; level 3: p=.002) and EF (level 1: p=.03; level 2: p=.002; level 3: p=.002), but not memory (all ps>.12), were found.

Conclusions

Measuring IPS efficiency in pwMS with computerized tools (i.e., videogame) could be useful in both screening and monitoring disease progression and response to therapies within a telemedicine perspective. The inverse relationship between increasing cognitive load and slowing IPS efficiency might be related either to over-recruitment or dysfunction of neural networks (i.e., neural plasticity) which may induce cognitive inefficiency even before the appearance of formal CI.

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Neuropsychology and Cognition Late Breaking Abstracts

LB1210 - Cerebrospinal fluid inflammatory profile of cognitive dysfunction in newly diagnosed multiple sclerosis patients (ID 2066)

Speakers
Presentation Number
LB1210
Presentation Topic
Neuropsychology and Cognition

Abstract

Background

Increased cerebrospinal fluid (CSF) expression of proinflammatory cytokines (IFNG, TNF, IL2, and IL22) and molecules related to sustained B-cell activity and lymphoid-neogenesis (CXCL13, CXCL10, LTa, IL6, and IL10) was found associated to increase cortical grey matter (GM) pathology and more active and severe disease outcome either in naive MS patients or in post-mortem MS cases. Cognitive impairment (CI) is one of the main features of GM damage in MS and can be early observed in newly diagnosed MS patients.

Objectives

To investigate whether a potential link between CSF inflammatory profile and CI exists in newly diagnosed MS patients.

Methods

Sixty-nine, treatment-naïve MS patients (54 F, age=37.3±11.6 ys; education=14.4±3.5 years) underwent an extended battery of neuropsychological tests (median time between LP and neuropsychological assessment: 1 month) and the protein analysis of the levels of 57 inflammatory mediators by using customized immune-assay multiplex Bio-Plex X200. MS patients were classified into three groups (Cognitively Normal: CN; mild CI: mCI; severe CI: sCI) according to the number of neuropsychological tests below the cut-off (5th percentile).

Results

Increased CSF levels of CXCL13 were detected in sCI (mean=29.6pg/ml±SD=59.3) compared to both CN (5.5±9.6) and mCI (6.7±6.3) patients. Furthermore, in mCI compared to CN patients were found higher levels of CHI3L1 (mCI: 5431.7±31942.7; CN: 32743.6±18050.9), CX3CL1 (mCI: 550.7±402.2; CN: 311.7±146.1), IL8 (mCI: 116.5±128.6; CN: 43.1±30.5), CCL3 (mCI: 8.8±7.7; CN: 4.7±2.7), CCL19 (mCI: 164.5±117.0; CN: 83.8±93.4), sTNFr2 (mCI: 1017.9±761.3; CN: 550.1±366.6), and CCL8 (mCI: 590.4±1097.6; CN: 97.4±194.5). Finally, in sCI compared to CN patients were found higher levels of IL22 (sCI: 46.5±43.7; CN: 17.1±15.2), IL35 (sCI: 330.0±214.2; CN: 192.1±133.2), IL12 (sCI: 31.0±37.1; CN: 9.6±11.9), and LIGHT (sCI: 291.3±519.3; CN: 61.6±100.1). In particular, significant correlations were found between the cytokines-chemokines and tests of memory, attention/executive functions, and information processing speed. No significant difference in the CSF Nf-L level was found among the three groups (p=.96).

Conclusions

The presence of CI might be reflected by increased CSF levels of inflammatory mediators. In particular, we found a specific molecular pattern discriminating CN (innate immunity) from mCI and sCI (B-cell chemotaxis and activity). These results demonstrate, for the first time, that specific intrathecal inflammatory milieu might possibly contribute to the MS-related cognitive impairment since the early phases of MS disease.

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