Contributions
Abstract: P1098
Type: Poster
Abstract Category: Pathology and pathogenesis of MS - 24 Neuropsychology
Background: Persons with MS report word finding problems, but we do not have adequate tools to assess this specific deficit. For instance, the verbal fluency task used to evaluate MS patients (Controlled Oral Word Association Test, COWAT) is confounded by speed (i.e., quickly name words starting with F). We developed the Test of Naming Efficiency (TONE) to precisely assess word finding deficits. We compare TONE versus COWAT to patient report of naming deficits and neuroanatomical correlates on MRI.
Methods: One hundred persons with early MS (18 CIS, 82 RRMS; < 5 years diagnosed) completed the TONE, which requires rapid naming of common objects. A control task of rapid visual recognition is subtracted from the first task to isolate naming time. Patients also completed the COWAT, a patient-reported assessment of word finding problems from never (0) to very often (4), and underwent 3.0T 3D T1 MRIs. FreeSurfer derived cortical thickness of left and right frontal, parietal, temporal, occipital, and cingulate regions, and normalized volumes of total brain, total grey, total white, and subcortical structures.
Results: Patient-reported word finding deficit was linked to longer (worse) TONE naming time (r=.301, p=.002), but was unrelated to COWAT (r=-.107, p=.291). Separate stepwise regressions (entry p=.01, removal p=.05, controlling for age, sex) revealed that only left parietal cortical thickness independently predicted TONE (rp=-.389, p< .001) and patient-report (rp=-.279, p=.005). Moreover, the link between left parietal thickness and patient-report was mediated by TONE (Sobel z=1.97, p=.049). In contrast, thalamic volume was the only independent predictor of COWAT (rp=.428, p< .001).
Conclusions: Word finding deficits are among the most common cognitive complaints of MS patients, but deficits are often overlooked due to inadequate measurement. The TONE is the first test of word finding to isolate naming ability by eliminating speed as a confounder. We validated this task with patient-report and MRI, and showed that TONE performance is the behavioral expression of the link between cortical thickness in left hemisphere language areas and patient-report. These findings suggest that language deficits in MS are not the result of subcortical dysfunction or generalized cerebral atrophy, but display a role for cortical grey matter. Ability to quantify naming deficits in MS will highlight this prevalent deficit and motivate research on word finding treatments.
Disclosure:
Rachel Brandstadter: nothing to disclose
Michelle Fabian: nothing to disclose
Stephen Krieger has received compensation for consulting and advisory board work with Acorda Therapeutics Inc.; Bayer; Biogen; EMD Serono (Merck & Co., Inc.); Genentech; Genzyme; Mallinckrodt; Novartis; and Teva Pharmaceutical Industries Ltd. and has given non-promotional lectures with Biogen.
Victoria M. Leavitt: nothing to disclose
Christina Lewis: nothing to disclose
Gabrielle Pelle: nothing to disclose
James F. Sumowski: nothing to disclose
Abstract: P1098
Type: Poster
Abstract Category: Pathology and pathogenesis of MS - 24 Neuropsychology
Background: Persons with MS report word finding problems, but we do not have adequate tools to assess this specific deficit. For instance, the verbal fluency task used to evaluate MS patients (Controlled Oral Word Association Test, COWAT) is confounded by speed (i.e., quickly name words starting with F). We developed the Test of Naming Efficiency (TONE) to precisely assess word finding deficits. We compare TONE versus COWAT to patient report of naming deficits and neuroanatomical correlates on MRI.
Methods: One hundred persons with early MS (18 CIS, 82 RRMS; < 5 years diagnosed) completed the TONE, which requires rapid naming of common objects. A control task of rapid visual recognition is subtracted from the first task to isolate naming time. Patients also completed the COWAT, a patient-reported assessment of word finding problems from never (0) to very often (4), and underwent 3.0T 3D T1 MRIs. FreeSurfer derived cortical thickness of left and right frontal, parietal, temporal, occipital, and cingulate regions, and normalized volumes of total brain, total grey, total white, and subcortical structures.
Results: Patient-reported word finding deficit was linked to longer (worse) TONE naming time (r=.301, p=.002), but was unrelated to COWAT (r=-.107, p=.291). Separate stepwise regressions (entry p=.01, removal p=.05, controlling for age, sex) revealed that only left parietal cortical thickness independently predicted TONE (rp=-.389, p< .001) and patient-report (rp=-.279, p=.005). Moreover, the link between left parietal thickness and patient-report was mediated by TONE (Sobel z=1.97, p=.049). In contrast, thalamic volume was the only independent predictor of COWAT (rp=.428, p< .001).
Conclusions: Word finding deficits are among the most common cognitive complaints of MS patients, but deficits are often overlooked due to inadequate measurement. The TONE is the first test of word finding to isolate naming ability by eliminating speed as a confounder. We validated this task with patient-report and MRI, and showed that TONE performance is the behavioral expression of the link between cortical thickness in left hemisphere language areas and patient-report. These findings suggest that language deficits in MS are not the result of subcortical dysfunction or generalized cerebral atrophy, but display a role for cortical grey matter. Ability to quantify naming deficits in MS will highlight this prevalent deficit and motivate research on word finding treatments.
Disclosure:
Rachel Brandstadter: nothing to disclose
Michelle Fabian: nothing to disclose
Stephen Krieger has received compensation for consulting and advisory board work with Acorda Therapeutics Inc.; Bayer; Biogen; EMD Serono (Merck & Co., Inc.); Genentech; Genzyme; Mallinckrodt; Novartis; and Teva Pharmaceutical Industries Ltd. and has given non-promotional lectures with Biogen.
Victoria M. Leavitt: nothing to disclose
Christina Lewis: nothing to disclose
Gabrielle Pelle: nothing to disclose
James F. Sumowski: nothing to disclose