Poster No:
169
Submission Type:
Abstract Submission
Authors:
Shu Umezawa1, Yuki Matsumoto2, Yasuko Tatewaki3, Naohiro Sakamoto2, Naoki Yamamoto2, Naoya Yamazaki2, Chihiro Namatame2, Hirohiko Ono2, Kimihiko Kaneko2, Yoshiki Takai2, Hiroshi Kuroda4, Kazuo Fujihara4, Tatsuro Misu2, Yasuyuki Taki3, Masashi Aoki2
Institutions:
1Department of Neurology, Graduate School of Medicine, Tohoku University, Sendai, Miyagi, 2Department of Neurology, Tohoku University Hospital, Sendai, Miyagi, 3Department of Aging Research and Geriatric Medicine, Tohoku University Hospital, Sendai, Miyagi, 4Department of Multiple Sclerosis Therapeutics, Fukushima Medical University, Fukushima, Fukushima
First Author:
Shu Umezawa
Department of Neurology, Graduate School of Medicine, Tohoku University
Sendai, Miyagi
Co-Author(s):
Yuki Matsumoto
Department of Neurology, Tohoku University Hospital
Sendai, Miyagi
Yasuko Tatewaki
Department of Aging Research and Geriatric Medicine, Tohoku University Hospital
Sendai, Miyagi
Naohiro Sakamoto
Department of Neurology, Tohoku University Hospital
Sendai, Miyagi
Naoki Yamamoto
Department of Neurology, Tohoku University Hospital
Sendai, Miyagi
Naoya Yamazaki
Department of Neurology, Tohoku University Hospital
Sendai, Miyagi
Chihiro Namatame
Department of Neurology, Tohoku University Hospital
Sendai, Miyagi
Hirohiko Ono
Department of Neurology, Tohoku University Hospital
Sendai, Miyagi
Kimihiko Kaneko
Department of Neurology, Tohoku University Hospital
Sendai, Miyagi
Yoshiki Takai
Department of Neurology, Tohoku University Hospital
Sendai, Miyagi
Hiroshi Kuroda
Department of Multiple Sclerosis Therapeutics, Fukushima Medical University
Fukushima, Fukushima
Kazuo Fujihara
Department of Multiple Sclerosis Therapeutics, Fukushima Medical University
Fukushima, Fukushima
Tatsuro Misu
Department of Neurology, Tohoku University Hospital
Sendai, Miyagi
Yasuyuki Taki
Department of Aging Research and Geriatric Medicine, Tohoku University Hospital
Sendai, Miyagi
Masashi Aoki
Department of Neurology, Tohoku University Hospital
Sendai, Miyagi
Introduction:
The information processing speed (IPS) test, such as the Symbol-Digit Modalities Test (SDMT), is a brief cognitive test widely used to assess IPS. It is also included in the Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS), one of the major cognitive batteries for patients with multiple sclerosis (MS). These assessments often aid neurologists in selecting treatment strategies for MS patients. Many psychological and functional magnetic resonance imaging studies previously suggested that the task involves various cognitive functions, including working memory (WM) and decision-making (DM). Consequently, the conventional IPS test scores are considered to reflect the composites of these cognitive functions, and they cannot separately evaluate multiple functions related to the test. Here, we examined our patients using the conventional IPS test and an electrically-presented IPS test program we developed (information processing acceleration test, or IPAT). IPAT is designed to measure IPS for each single symbol presented in a trial. We compared IPAT performance with the conventional IPS test to validate its effectiveness. From the time-series IPS data collected, we estimated coefficients reflecting WM and DM and their associations with cerebral cortical atrophy.
Methods:
In this preliminary study, ten patients with relapsing-remitting MS participated. Each patient was assessed using both the conventional IPS test and IPAT. Structural brain MRI data were acquired within a month of the cognitive assessment. We compared the accomplishment scores of IPAT with those of the conventional IPS tests to ensure IPAT validity. Subsequently, we calculated IPS, which is the inverse of each reaction time for every single trial that the patients took for the stimulus presented. A nonlinear regression model was applied to these time-series IPS data, and we estimated two coefficients: one indicative of corrected IPS in the plateau phase (p) and another representing IPS acceleration rate (a). The patients' T1-weighted brain images underwent preprocessing with the sMRIPrep pipeline before analyzed with FreeSurfer (6.0.0) for surface-based morphometry. The association between the coefficients and cortical atrophy was examined using a multiple regression model.
Results:
The conventional IPS accomplishment score correlated linearly with those obtained from IPAT. Analysis of the time-series IPS data from IPAT revealed an initial adaptive phase with increased IPS, followed by a plateau phase where IPS stayed at the level. The nonlinear regression analysis estimated curves that closely fit with the observed IPS patterns. Notably, the coefficients p for the corrected IPS in the plateau were significantly correlated with cortical thickness in the right suborbital sulci. Moreover, the coefficients a for IPS acceleration rate showed significant correlations with regions in the left parahippocampal gyrus and the right superior parietal gyrus (p<0.05).
Conclusions:
The conventional IPS test serves as a helpful tool for roughly grasping the declined IPS of patients with MS, but the score is composed of multiple functions. In our preliminary study, the IPAT program, developed by our team, effectively assesses IPS comparably to the conventional test. Furthermore, we were able to decompose the observed time-series IPS into two distinctive phases: an adaptive phase marked by accelerating IPS and a subsequent plateau phase. We extracted coefficients representing these phases linked with WM and DM functions, respectively. These two coefficients were associated with cortical atrophy in the regions known to play roles in these cognitive functions. After accumulating data from MS patients at various stages longitudinally, we hope to use the IPAT for a more detailed evaluation of cognitive functions to support clinical decision-making for treatment.
Disorders of the Nervous System:
Neurodegenerative/ Late Life (eg. Parkinson’s, Alzheimer’s) 1
Higher Cognitive Functions:
Executive Function, Cognitive Control and Decision Making 2
Learning and Memory:
Working Memory
Keywords:
Demyelinating
STRUCTURAL MRI
1|2Indicates the priority used for review
Provide references using author date format
Benedict, R. H. B. (2020). 'Cognitive impairment in multiple sclerosis: clinical management, MRI, and therapeutic avenues', The Lancet. Neurology, 19(10), 860–871