Clinical Unit of Neurology, Department of Medicine, Surgery and Health Sciences, Cattinara University Hospital ASUGI, University of Trieste

Author Of 2 Presentations

Neuropsychology and Cognition Late Breaking Abstracts

LB1261 - Resting-state neural activity, cognitive functioning and reserve in relapsing-remitting multiple sclerosis: a microstates EEG study. (ID 2157)

Speakers
Presentation Number
LB1261
Presentation Topic
Neuropsychology and Cognition

Abstract

Background

In multiple sclerosis (MS) the prevalence of cognitive impairment (CI) ranges 40–65%. Besides, high level of cognitive reserve (CR) is strongly associated with better cognitive functioning in patients with MS (PwMS). How the cognitive performance and the CR level in PwMS can be associated to the fluctuations of spontaneous EEG is not completely understood.

Objectives

To compare scalp voltage maps (microstates) during resting between PwMS and healthy controls (HCs) and to investigate how the temporal parameters of microstates and the level of CR can predict the cognitive performance.

Methods

50 relapsing-remitting multiple sclerosis (RRMS) patients and 25 HCs, matched for age and sex, were enrolled. For PwMS, we administrated the Brief International Cognitive Assessment (BICAMS) and the Cognitive Reserve Index questionnaire (CRIq). All participants underwent to 15-min of high-density EEG recording (256ch), closed-eyes. EEG data were filtered 1-40Hz, ICA-corrected for artifacts and downsampled to 256Hz. Microstates analysis identified a set of voltage maps representing the EEG activity for all participants that were fitted on the corrected-EEGs to quantify: global explained variance (GEV), mean duration (MD), time coverage (TC) and occurrence (Frequ). Repeated Two-Way ANOVA (Bonferroni comparisons) was used to compare groups and microstates; stepwise multiple linear regression was performed to study the cognitive performance in correlation to the microstates and level of CR; alpha=0.05.

Results

24% of PwMS had CI and 34% reported a low level of CR. Microstates analysis found 4 maps in both groups and PwMS showed a significant increase in Map-A (GEV/TC/Frequ) and Map-B (GEV), while Map-C (MD) and Map-D (MD/TC) were significantly decreased with respect to HCs. Multiple linear regression analysis showed two strong predicted models (p<0.001), respectively, for Brief Visual-Spatial Memory Test (BVMT) and Symbol Digit Memory Test (SDMT). BVMT was predicted by GEV of Map-C improved by CRI_L, reaching 44% of explained variance. SDMT was predicted by Frequ of Map-A and CRI_Edu.

Conclusions

Microstate analysis reveled altered fluctuations of EEG topographies in RRMS patients with low disability and at the first stage of disease. In particular, Map-C (salience network) and leisure as well as Map-A (auditory processing) and education, respectively, predicted BVMR and SDMT scores.

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Symptom Management Poster Presentation

P1086 - Botulinum toxin injections in multiple sclerosis versus post-stroke spasticity (ID 1888)

Speakers
Presentation Number
P1086
Presentation Topic
Symptom Management

Abstract

Background

Botulinum toxin (BTX) is an effective and safe treatment for spasticity both in multiple sclerosis (MS) and post-stroke spasticity (PSS).

Objectives

The aim of our single-centre retrospective study was to compare the sites of injection and the dosages of BTX used for the treatment of spasticity in MS and PSS.

Methods

We enrolled 33 patients with MS and 55 patients with PSS that were treated with BTX in our outpatient spasticity clinic. Clinical and demographic data were collected. Total BTX dosage, upper and lower limb dosage, pattern of injected muscles, and their respective dosage were recorded. We performed a statistical analysis to compare BTX treatment dosage in the two conditions and to investigate any predictor of total BTX dosage.

Results

MS patients received a significant lower total BTX dosage compared to PSS (p<0.001): they were treated with lower BTX dosage in the lower limbs (p=0.005), but not in the upper limbs (p=0.30). Patients with MS were rarely injected in the upper limbs. Proximal upper limbs muscles were more frequently injected in MS, while patients with PSS were more frequently treated in distal muscles (fingers). In the lower limbs MS patients were more frequently injected in adductor muscles and rectus femoris while PSS patients were treated in soleus and tibialis posterior. EDSS was the only variable correlated to total BTX dosage (rho=0.399, p=0.021).

Conclusions

In our experience, MS spasticity requires a lower BTX dosage than PSS. This observation could be explained both by a different pattern of muscles affected by spasticity in these two diseases and also by different clinical management (e.g. the need of maintaining a greater residual function in MS, especially in lower limbs).

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