Contributions
Abstract: EP1582
Type: ePoster
Abstract Category: Pathology and pathogenesis of MS - 24 Neuropsychology
Background: Cerebellar motor symptoms mean poor prognosis in MS and have been associated with a specific cognitive profile. A few studies have reported further dysfunction in the domains of reduced information processing speed (IPS), impairments in visuospatial functions and verbal fluency deficits associated with cerebellar damage. The cerebellum can encode models of sensory stimuli, providing mental representations of the world used to plan motor actions. Motor planning may be a key factor in the disability that cerebellar involvement imposes.
Aim: To explore how the cognitive profile of those with cerebellar motor symptoms (RR-MSc) differs from those without cerebellar symptoms (RR-MSnc), and how this relates to motor function and motor planning.
Method: RR-MSc allocation was based on the NARCOMS tremor and coordination scale (≥4). 21 HC
(10 males, x̅ age: 37.1), 21 RR-MSnc (6 males, x̅ age: 39.8) and 14 RR-MSc (7 males, x̅ age: 40.6) completed BICAMS (CVLT-II, SDMT, BVMT-R), PASAT3, and word list generation (WLG). We computed a cognitive impairment index (CII), and designated “widespread cognitive impairment” (x̅- (>1.5SD) on three or more tests). The 9-hole peg-test (9-HPT, as a sensorimotor control) and grooved pegboard test (GPT, more motor planning demands) were subtracted to compute a motor planning index (MPI).
Results: One-way ANCOVAs, covarying premorbid IQ revealed differences: SDMT (F(3,52) = 7.81, p < .001), CVLT-II (F(3,52) = 3.42, p = .0024), BVMT-R (F(3,52) = 2.93, p = .0042), PASAT3 (F(3,52) = 12.89, p < .001), CII (F(53,2) = 8.85, p < .001), 9HPT(F(3,52) = 20.04, p < .001), GPT (F(3,52) = 20.15, p = .001), MPI (F(3,52) = 16.75, p = < .001). No differences were found for WLG (F(3,52) = 2.55, p = .07). SDMT, GPT, 9HPT and MPI were the only tests to differentiate RR-MSnc and HC, and all tests differentiated RR-MSnc and RR-MSc other than WLG (not significant) and BVMT-R (just HC from RR-MSc). CII differed significantly between RR-MSc and all groups, but not between RR-MSnc and HC. RR-MSc showed significantly greater CII. Frequency of widespread cognitive impairment was 4.8% for HC, 28.6% for RR-MSnc and 57.1% for RR-MSc.
Conclusion: RR-MSc had more significant and widespread impairments than RR-MSnc, specifically with IPS, visual/verbal memory, and motor planning and function. These findings have clinical implications for those with cerebellar symptoms. MPI has potential as a clinical and research measure of motor planning.
Disclosure:
JH: none
KA: Consultancy from Merck; sponsored educational activities from TEVA, Biogen, Novartis, Merck and Sanofi Genzyme
KP: Holds a grant of the Baasch-Medicus-Foundation and has received travel support from Novartis Switzerland unrelated to this work.
DL: Consultancy from Novartis, Bayer, TEVA, Biogen, Merck; Speaker bureau for Almirall, TEVA, Biogen, Novartis, Bayer, Excemed; Research grants from Novartis, Biogen, Bayer. All are paid into DL's university.
Abstract: EP1582
Type: ePoster
Abstract Category: Pathology and pathogenesis of MS - 24 Neuropsychology
Background: Cerebellar motor symptoms mean poor prognosis in MS and have been associated with a specific cognitive profile. A few studies have reported further dysfunction in the domains of reduced information processing speed (IPS), impairments in visuospatial functions and verbal fluency deficits associated with cerebellar damage. The cerebellum can encode models of sensory stimuli, providing mental representations of the world used to plan motor actions. Motor planning may be a key factor in the disability that cerebellar involvement imposes.
Aim: To explore how the cognitive profile of those with cerebellar motor symptoms (RR-MSc) differs from those without cerebellar symptoms (RR-MSnc), and how this relates to motor function and motor planning.
Method: RR-MSc allocation was based on the NARCOMS tremor and coordination scale (≥4). 21 HC
(10 males, x̅ age: 37.1), 21 RR-MSnc (6 males, x̅ age: 39.8) and 14 RR-MSc (7 males, x̅ age: 40.6) completed BICAMS (CVLT-II, SDMT, BVMT-R), PASAT3, and word list generation (WLG). We computed a cognitive impairment index (CII), and designated “widespread cognitive impairment” (x̅- (>1.5SD) on three or more tests). The 9-hole peg-test (9-HPT, as a sensorimotor control) and grooved pegboard test (GPT, more motor planning demands) were subtracted to compute a motor planning index (MPI).
Results: One-way ANCOVAs, covarying premorbid IQ revealed differences: SDMT (F(3,52) = 7.81, p < .001), CVLT-II (F(3,52) = 3.42, p = .0024), BVMT-R (F(3,52) = 2.93, p = .0042), PASAT3 (F(3,52) = 12.89, p < .001), CII (F(53,2) = 8.85, p < .001), 9HPT(F(3,52) = 20.04, p < .001), GPT (F(3,52) = 20.15, p = .001), MPI (F(3,52) = 16.75, p = < .001). No differences were found for WLG (F(3,52) = 2.55, p = .07). SDMT, GPT, 9HPT and MPI were the only tests to differentiate RR-MSnc and HC, and all tests differentiated RR-MSnc and RR-MSc other than WLG (not significant) and BVMT-R (just HC from RR-MSc). CII differed significantly between RR-MSc and all groups, but not between RR-MSnc and HC. RR-MSc showed significantly greater CII. Frequency of widespread cognitive impairment was 4.8% for HC, 28.6% for RR-MSnc and 57.1% for RR-MSc.
Conclusion: RR-MSc had more significant and widespread impairments than RR-MSnc, specifically with IPS, visual/verbal memory, and motor planning and function. These findings have clinical implications for those with cerebellar symptoms. MPI has potential as a clinical and research measure of motor planning.
Disclosure:
JH: none
KA: Consultancy from Merck; sponsored educational activities from TEVA, Biogen, Novartis, Merck and Sanofi Genzyme
KP: Holds a grant of the Baasch-Medicus-Foundation and has received travel support from Novartis Switzerland unrelated to this work.
DL: Consultancy from Novartis, Bayer, TEVA, Biogen, Merck; Speaker bureau for Almirall, TEVA, Biogen, Novartis, Bayer, Excemed; Research grants from Novartis, Biogen, Bayer. All are paid into DL's university.