University of Genoa
Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa and Ospedale Policlinico San Martino, Genova Italy.

Author Of 2 Presentations

Neuropsychology and Cognition Poster Presentation

LB1171 - Embracing resilience in Multiple Sclerosis: a new perspective from COVID-19 pandemic. (ID 1742)

Speakers
Presentation Number
LB1171
Presentation Topic
Neuropsychology and Cognition

Abstract

Background

Coronavirus Disease 2019 (COVID-19), a severe acute respiratory syndrome due to Coronavirus 2 (SARS-CoV-2) infection, determined cross-sectional social and emotive consequences, representing an unprecedented social experiment. Past epidemiological experiences and recent studies dealing with COVID-19 pandemic and healthy population already showed the deep albeit heterogeneous psychological repercussions of pandemics. Nevertheless, little is known about the relationship between COVID-19 outbreak and patients with chronic diseases, Multiple Sclerosis (MS) in particular, and about the possible strategies for boosting resilience, a well-known protective and buffering instrument helping in facing the challenges of life.

Objectives

To assess the changes in mental distress during COVID-19 outbreak in patients with MS (pw-MS) and to identify predictive factors that could help in developing resilience and facing COVID-19 pandemic.

Methods

We enrolled 106 pw-MS (69 relapsing-remitting, 20 secondary-progressive and 17 primary-progressive) who had undergone neuropsychological assessment before outbreak (between January the 1st 2019 and March the 1st 2020): patients were previously tested with Brief International Cognitive Assessment for MS (BICAMS), Hospital Anxiety and Depression Scale (HADS) and patient-reported MS Neuropsychological Screening Questionnaire (MSNQ-P). All patients were asked to fulfill an online survey comprehensive of sociodemographic information (e.g. marital and employment status), HADS self-rating Scale, MSNQ-P Questionnaire and finally Connor-Davidson Resilience self-rating Scale (CD-RISC 25), in order to evaluate resilience. Statistical analyses (repeated-measures ANCOVA) were performed using SPSS 23.

Results

Even if no significant changes in HADS and MSNQ-P scores were detected during COVID-19 pandemic in our population, pre-existing lower HADS and MSNQ-P scores were found to be significantly (p<0.0001) and independently associated with a better resilience attitude; conversely, no demographic, disease- and treatment-related elements resulted predictive neither of anxiety, depression and perceived cognitive status nor of better resilient behaviour

Conclusions

Our study confirms the fundamental role of anxiety diagnosis and of neuropsychological evaluation in pw-MS, outlining its compelling role in predicting a resilient and positive response in case of pervasive commitment and the necessity of a comprehensive care for pw-MS.

Collapse
Reproductive Aspects and Pregnancy Poster Presentation

P1134 - Recovery of menstrual cycle in women with multiple sclerosis treated with autologous haematopoietic stem cell transplantation. (ID 1633)

Speakers
Presentation Number
P1134
Presentation Topic
Reproductive Aspects and Pregnancy

Abstract

Background

Autologous haematopoietic stem cell transplantation (aHSCT) is increasingly taken into consideration as a treatment strategy for patients with aggressive multiple sclerosis (MS). The chemotherapies used in the conditioning regimens for aHSCT are known to be responsible of amenorrhea in fertile women. Therefore, concerns on successful family planning in women with aggressive MS treated with aHSCT might rise.

Objectives

To assess fertility outcomes in women treated with aHSCT for aggressive MS considering different conditioning regimens.

Methods

We collected disease- and treatment-related characteristics from consecutive women with MS treated with aHSCT at the Italian MS centers of Genoa, Barletta and Cagliari. ANCOVA analyses and binary logistic regression were performed to assess the effects of baseline characteristics on fertility outcomes.

Results

We included 38 women [25(67%) with relapsing-remitting MS] with a mean age at aHSCT of 31.7(±6.7) years and a mean disease duration of 10.9(±6.0) years. Mean age of menarche was 12.3(±1.9) years. 31(82%) patients underwent transplant with a myeloablative cconditioning regimen while 7(18%) patients were transplanted with a low-intensity lymphoablative regimen. 26(68.4%) patients recovered menstrual cycle after a mean time of 5.7(5.2) months. Among these, 10(38%) patients had irregular periods (<21days;>35days apart) and 11(42%) had changes in the menstrual flow. Patients who recovered menstrual cycle were younger at the time of transplant (28.8vs37.7 years;p<0.0001) and had lower EDSS scores 1 year before aHSCT (4.7vs5.8;p=0.024). No significant differences were noted in terms of clinical phenotypes, age of menarche, body mass index, number of previous therapies, previous exposure to cyclophosphamide, mitoxantrone and the conditioning regimen used within aHSCT. A younger age was independently associated with a higher probability of recovery of menstrual cycle (OR=0.78;p=0.006). 3/27 patients (11%) with ≤35 years had persistent amenorrhea after aHSCT. We recorded 4 pregnancy after aHSCT (3 uncomplicated pregnancies and 1 spontaneous abortion). One patient repeatedly tried to conceive, both naturally and artificially, without success.

Conclusions

Younger age is independently associated with the recovery of menstrual cycle in women with MS treated with aHSCT, which is obtained in 89% of women under 35 years old. The use of a myeloablative conditioning regimen doesn’t seem to be associated with worse fertility outcomes.

Collapse

Presenter Of 2 Presentations

Neuropsychology and Cognition Poster Presentation

LB1171 - Embracing resilience in Multiple Sclerosis: a new perspective from COVID-19 pandemic. (ID 1742)

Speakers
Presentation Number
LB1171
Presentation Topic
Neuropsychology and Cognition

Abstract

Background

Coronavirus Disease 2019 (COVID-19), a severe acute respiratory syndrome due to Coronavirus 2 (SARS-CoV-2) infection, determined cross-sectional social and emotive consequences, representing an unprecedented social experiment. Past epidemiological experiences and recent studies dealing with COVID-19 pandemic and healthy population already showed the deep albeit heterogeneous psychological repercussions of pandemics. Nevertheless, little is known about the relationship between COVID-19 outbreak and patients with chronic diseases, Multiple Sclerosis (MS) in particular, and about the possible strategies for boosting resilience, a well-known protective and buffering instrument helping in facing the challenges of life.

Objectives

To assess the changes in mental distress during COVID-19 outbreak in patients with MS (pw-MS) and to identify predictive factors that could help in developing resilience and facing COVID-19 pandemic.

Methods

We enrolled 106 pw-MS (69 relapsing-remitting, 20 secondary-progressive and 17 primary-progressive) who had undergone neuropsychological assessment before outbreak (between January the 1st 2019 and March the 1st 2020): patients were previously tested with Brief International Cognitive Assessment for MS (BICAMS), Hospital Anxiety and Depression Scale (HADS) and patient-reported MS Neuropsychological Screening Questionnaire (MSNQ-P). All patients were asked to fulfill an online survey comprehensive of sociodemographic information (e.g. marital and employment status), HADS self-rating Scale, MSNQ-P Questionnaire and finally Connor-Davidson Resilience self-rating Scale (CD-RISC 25), in order to evaluate resilience. Statistical analyses (repeated-measures ANCOVA) were performed using SPSS 23.

Results

Even if no significant changes in HADS and MSNQ-P scores were detected during COVID-19 pandemic in our population, pre-existing lower HADS and MSNQ-P scores were found to be significantly (p<0.0001) and independently associated with a better resilience attitude; conversely, no demographic, disease- and treatment-related elements resulted predictive neither of anxiety, depression and perceived cognitive status nor of better resilient behaviour

Conclusions

Our study confirms the fundamental role of anxiety diagnosis and of neuropsychological evaluation in pw-MS, outlining its compelling role in predicting a resilient and positive response in case of pervasive commitment and the necessity of a comprehensive care for pw-MS.

Collapse
Reproductive Aspects and Pregnancy Poster Presentation

P1134 - Recovery of menstrual cycle in women with multiple sclerosis treated with autologous haematopoietic stem cell transplantation. (ID 1633)

Speakers
Presentation Number
P1134
Presentation Topic
Reproductive Aspects and Pregnancy

Abstract

Background

Autologous haematopoietic stem cell transplantation (aHSCT) is increasingly taken into consideration as a treatment strategy for patients with aggressive multiple sclerosis (MS). The chemotherapies used in the conditioning regimens for aHSCT are known to be responsible of amenorrhea in fertile women. Therefore, concerns on successful family planning in women with aggressive MS treated with aHSCT might rise.

Objectives

To assess fertility outcomes in women treated with aHSCT for aggressive MS considering different conditioning regimens.

Methods

We collected disease- and treatment-related characteristics from consecutive women with MS treated with aHSCT at the Italian MS centers of Genoa, Barletta and Cagliari. ANCOVA analyses and binary logistic regression were performed to assess the effects of baseline characteristics on fertility outcomes.

Results

We included 38 women [25(67%) with relapsing-remitting MS] with a mean age at aHSCT of 31.7(±6.7) years and a mean disease duration of 10.9(±6.0) years. Mean age of menarche was 12.3(±1.9) years. 31(82%) patients underwent transplant with a myeloablative cconditioning regimen while 7(18%) patients were transplanted with a low-intensity lymphoablative regimen. 26(68.4%) patients recovered menstrual cycle after a mean time of 5.7(5.2) months. Among these, 10(38%) patients had irregular periods (<21days;>35days apart) and 11(42%) had changes in the menstrual flow. Patients who recovered menstrual cycle were younger at the time of transplant (28.8vs37.7 years;p<0.0001) and had lower EDSS scores 1 year before aHSCT (4.7vs5.8;p=0.024). No significant differences were noted in terms of clinical phenotypes, age of menarche, body mass index, number of previous therapies, previous exposure to cyclophosphamide, mitoxantrone and the conditioning regimen used within aHSCT. A younger age was independently associated with a higher probability of recovery of menstrual cycle (OR=0.78;p=0.006). 3/27 patients (11%) with ≤35 years had persistent amenorrhea after aHSCT. We recorded 4 pregnancy after aHSCT (3 uncomplicated pregnancies and 1 spontaneous abortion). One patient repeatedly tried to conceive, both naturally and artificially, without success.

Conclusions

Younger age is independently associated with the recovery of menstrual cycle in women with MS treated with aHSCT, which is obtained in 89% of women under 35 years old. The use of a myeloablative conditioning regimen doesn’t seem to be associated with worse fertility outcomes.

Collapse