Contributions
Abstract: P294
Type: Poster
Abstract Category: Clinical aspects of MS - Paediatric MS
Background: Cognitive impairment occurs in only 30% of paediatric MS patients, despite a high lesion volume and reduction in age-expected brain volumes. The current study aims to identify whether patients who are cognitively preserved demonstrate compensatory recruitment, using a working memory task as a representative cognitive measure.
Method: Twenty-four patients with paediatric-onset MS were recruited and screened for cognitive impairment using a test battery based on the Brief Neuropsychological Battery for Children. Twenty patients were considered cognitively intact (performance < 1.5 SD below normative data on < 2 tests) and were included (mean age = 18.7 ± 2.8; 15 female) and matched for age and sex with 20 healthy controls (HCs).
Participants completed a working memory task (Alphaspan) while undergoing functional magnetic resonance imaging on a 3T scanner. Participants were asked to study a set of letter strings and then to either maintain the letter set (low executive demand (ED)) or to manipulate the letters into alphabetical order (high ED). Only correct trials were analyzed.
Results: MS patients did not differ from HCs with respect to accuracy on the task, however, a 0.21s slower response time was observed in MS patients, collapsing across task conditions, t(38) = 2.15,
p = 0.038.
Areas demonstrating significant change in activation across the maintain and manipulate conditions were flagged as regions of interest for group comparisons. MS patients showed greater activation than HCs in the right middle frontal and left medial frontal gyri on the maintenance condition (p < 0.05). A trend was observed between higher activation in these two regions and poorer accuracy scores for the maintenance condition in MS patients (r = -0.32, p = 0.083; r = -0.37, p = 0.056, respectively). Activation in these regions was higher in the manipulation than in the maintain condition, but did not differ between groups at this task level.
Conclusion: Increased activation in the right middle and left medial frontal gyri occur for MS patients and HCs as a task becomes more challenging. MS patients had greater activation of these regions relative to HCs during the maintenance task, potentially reflecting compensatory processes required for storage of information. Findings suggest that compensatory recruitment may be more apparent in conditions typically requiring lower ED, with a possible ceiling effect as greater executive control is required for a task.
Disclosure:
Ms. Barlow-Krelina has nothing to disclose.
Dr. Turner has nothing to disclose.
Ms. Lysenko has nothing to disclose.
Dr. Akbar has nothing to disclose.
Dr. Banwell serves as a consultant to Novartis, and as an advisor for clinical trials for Biogen Idec, Sanofi, and Tevaneuroscience.
Dr. Yeh has received a speaker´s honorarium from Novartis.
Dr. Till has has nothing to disclose.
This project was funded by the Scottish Rite Charitable Foundation.
Abstract: P294
Type: Poster
Abstract Category: Clinical aspects of MS - Paediatric MS
Background: Cognitive impairment occurs in only 30% of paediatric MS patients, despite a high lesion volume and reduction in age-expected brain volumes. The current study aims to identify whether patients who are cognitively preserved demonstrate compensatory recruitment, using a working memory task as a representative cognitive measure.
Method: Twenty-four patients with paediatric-onset MS were recruited and screened for cognitive impairment using a test battery based on the Brief Neuropsychological Battery for Children. Twenty patients were considered cognitively intact (performance < 1.5 SD below normative data on < 2 tests) and were included (mean age = 18.7 ± 2.8; 15 female) and matched for age and sex with 20 healthy controls (HCs).
Participants completed a working memory task (Alphaspan) while undergoing functional magnetic resonance imaging on a 3T scanner. Participants were asked to study a set of letter strings and then to either maintain the letter set (low executive demand (ED)) or to manipulate the letters into alphabetical order (high ED). Only correct trials were analyzed.
Results: MS patients did not differ from HCs with respect to accuracy on the task, however, a 0.21s slower response time was observed in MS patients, collapsing across task conditions, t(38) = 2.15,
p = 0.038.
Areas demonstrating significant change in activation across the maintain and manipulate conditions were flagged as regions of interest for group comparisons. MS patients showed greater activation than HCs in the right middle frontal and left medial frontal gyri on the maintenance condition (p < 0.05). A trend was observed between higher activation in these two regions and poorer accuracy scores for the maintenance condition in MS patients (r = -0.32, p = 0.083; r = -0.37, p = 0.056, respectively). Activation in these regions was higher in the manipulation than in the maintain condition, but did not differ between groups at this task level.
Conclusion: Increased activation in the right middle and left medial frontal gyri occur for MS patients and HCs as a task becomes more challenging. MS patients had greater activation of these regions relative to HCs during the maintenance task, potentially reflecting compensatory processes required for storage of information. Findings suggest that compensatory recruitment may be more apparent in conditions typically requiring lower ED, with a possible ceiling effect as greater executive control is required for a task.
Disclosure:
Ms. Barlow-Krelina has nothing to disclose.
Dr. Turner has nothing to disclose.
Ms. Lysenko has nothing to disclose.
Dr. Akbar has nothing to disclose.
Dr. Banwell serves as a consultant to Novartis, and as an advisor for clinical trials for Biogen Idec, Sanofi, and Tevaneuroscience.
Dr. Yeh has received a speaker´s honorarium from Novartis.
Dr. Till has has nothing to disclose.
This project was funded by the Scottish Rite Charitable Foundation.