Contributions
Abstract: P391
Type: Poster Sessions
Abstract Category: Clinical aspects of MS - Clinical assessment tools
Background: Cerebellum has a main role in various sensory-motor networks and in cognitive-behavioural processes in patients with Multiple Sclerosis (MS), with a wide-range negative impact on their lives.
Aim: To investigate the association between cerebellar white (WM) and grey matter (GM) lesion burden and cognitive dysfunctions, fatigue and depression at MS diagnosis.
Methods: Fourty-five consecutive patients (F/M: 2.4; age 33.91±9.9 years; disease duration -DD- < 5 years) with relapsing remitting MS were enrolled. Clinical evaluation included: EDSS, Brief Repeatable Battery of Neuropsychological Tests (BRB-NT), Delis-Kaplan Executive Function System Sorting Test (D-KEFS ST), MS Neuropsychological Questionnaire (MSNQ), Fatigue Severity Scale (FSS), Beck Depression Inventory (BDI-II) and Brain 3T MRI, which included 3D T1, 3D FLAIR, 3D DIR and 2D PSIR. MRI analysis was achieved on 3DT1 using SUIT atlas, calculating lesion number and volume by manual segmentation (ITK-SNAP).
Results: Evidence of cognitive dysfunction was documented by BRB-NT and/or D-KEFS SR in 26.6% patients. Cognitively impaired (CI) patients showed a significant decrease in mental performance in almost all items of BRB-T (p< 0.02) and in D-KEFS SR (p< 0.004). No difference between CI and cognitive normal (CN) patients was observed regarding age, sex, DD and EDSS. CI patients had significantly more cerebellar GM lesions than CN (p=0.04). Cognitive dysfunctions observed by BRB-NT were associated with cerebellar GM lesion number (r=0.42, p< 0.05) and volume (r=0.33, p< 0,05). The more frequently compromised tests were SDMT and SRT-D. No correlation was found between cerebellar and supratentorial GM lesion load both on DIR (r=0.08 p>0.5) and PSIR (r=0.29, p>0.05). Moderate inverse correlations were observed between cerebellar pathology and MSNQ (r= -0.44, p< 0.05), FSS score (r=-0.66, p< 0.05), and BDI-II score (r=-0.67, p< 0.05). While only weak correlations were found between supratentorial WM and GM lesions number and volume and MSNQ (< -0.33, p< 0.05) and FSS (< -0.33, p< 0.05), no correlation was found between BDI-II and supratentorial lesions.
Conclusions: Our findings suggest that cerebellar pathology has an early and significant negative impact on cognitive functions in MS. The negative association with fatigue and emotional changes seems to indicate that these functions are not significantly influenced by cerebellar pathology in the early disease phases
Disclosure: Lazzarotto A: nothing to disclose.
Favaretto A: has received honoraria from Teva, Sanofi-Genzyme, Biogen, Merck-Serono, Almirall, Novartis.
Franciotta S has nothing to disclose.
Zywicki S has nothing to disclose.
Riccardi A has received honoraria from Novartis, Biogen, Teva and Merck Serono, she has been consultant for Biogen.
Ermani M has nothing to disclose.
Poggiali D has nothing to disclose.
Anglani MG has received honoraria from Biogen.
Causin F has nothing to disclose.
Gallo P has received honoraria from Bayer Schering, Biogen Idec/Elan, Merck Serono, Novartis, Sanofi-Aventis and Teva, and has been a consultant for Bayer Schering, Biogen Idec, Genzyme, Merck Serono and Novartis, and has received research support from Bayer, Biogen Idec/Elan, Merk Serono, Genzyme and Teva, and has received research grants from the University of Padova, Veneto Region of Italy, the Italian Association for Multiple Sclerosis, the Italian Ministry of Public Health.
Abstract: P391
Type: Poster Sessions
Abstract Category: Clinical aspects of MS - Clinical assessment tools
Background: Cerebellum has a main role in various sensory-motor networks and in cognitive-behavioural processes in patients with Multiple Sclerosis (MS), with a wide-range negative impact on their lives.
Aim: To investigate the association between cerebellar white (WM) and grey matter (GM) lesion burden and cognitive dysfunctions, fatigue and depression at MS diagnosis.
Methods: Fourty-five consecutive patients (F/M: 2.4; age 33.91±9.9 years; disease duration -DD- < 5 years) with relapsing remitting MS were enrolled. Clinical evaluation included: EDSS, Brief Repeatable Battery of Neuropsychological Tests (BRB-NT), Delis-Kaplan Executive Function System Sorting Test (D-KEFS ST), MS Neuropsychological Questionnaire (MSNQ), Fatigue Severity Scale (FSS), Beck Depression Inventory (BDI-II) and Brain 3T MRI, which included 3D T1, 3D FLAIR, 3D DIR and 2D PSIR. MRI analysis was achieved on 3DT1 using SUIT atlas, calculating lesion number and volume by manual segmentation (ITK-SNAP).
Results: Evidence of cognitive dysfunction was documented by BRB-NT and/or D-KEFS SR in 26.6% patients. Cognitively impaired (CI) patients showed a significant decrease in mental performance in almost all items of BRB-T (p< 0.02) and in D-KEFS SR (p< 0.004). No difference between CI and cognitive normal (CN) patients was observed regarding age, sex, DD and EDSS. CI patients had significantly more cerebellar GM lesions than CN (p=0.04). Cognitive dysfunctions observed by BRB-NT were associated with cerebellar GM lesion number (r=0.42, p< 0.05) and volume (r=0.33, p< 0,05). The more frequently compromised tests were SDMT and SRT-D. No correlation was found between cerebellar and supratentorial GM lesion load both on DIR (r=0.08 p>0.5) and PSIR (r=0.29, p>0.05). Moderate inverse correlations were observed between cerebellar pathology and MSNQ (r= -0.44, p< 0.05), FSS score (r=-0.66, p< 0.05), and BDI-II score (r=-0.67, p< 0.05). While only weak correlations were found between supratentorial WM and GM lesions number and volume and MSNQ (< -0.33, p< 0.05) and FSS (< -0.33, p< 0.05), no correlation was found between BDI-II and supratentorial lesions.
Conclusions: Our findings suggest that cerebellar pathology has an early and significant negative impact on cognitive functions in MS. The negative association with fatigue and emotional changes seems to indicate that these functions are not significantly influenced by cerebellar pathology in the early disease phases
Disclosure: Lazzarotto A: nothing to disclose.
Favaretto A: has received honoraria from Teva, Sanofi-Genzyme, Biogen, Merck-Serono, Almirall, Novartis.
Franciotta S has nothing to disclose.
Zywicki S has nothing to disclose.
Riccardi A has received honoraria from Novartis, Biogen, Teva and Merck Serono, she has been consultant for Biogen.
Ermani M has nothing to disclose.
Poggiali D has nothing to disclose.
Anglani MG has received honoraria from Biogen.
Causin F has nothing to disclose.
Gallo P has received honoraria from Bayer Schering, Biogen Idec/Elan, Merck Serono, Novartis, Sanofi-Aventis and Teva, and has been a consultant for Bayer Schering, Biogen Idec, Genzyme, Merck Serono and Novartis, and has received research support from Bayer, Biogen Idec/Elan, Merk Serono, Genzyme and Teva, and has received research grants from the University of Padova, Veneto Region of Italy, the Italian Association for Multiple Sclerosis, the Italian Ministry of Public Health.