Contributions
Abstract: EP1420
Type: Poster Sessions
Abstract Category: Clinical aspects of MS - Clinical assessment tools
Background: PwMS frequently experience cognitive impairment and fatigue as well as visual difficulty, all of which can be disabling. Cognitive impairment can result in disability distinct from physical disability. Disease activity is frequently evaluated by reported relapse rate, or identified changes in EDSS or MRI. None of these metrics is sufficient to quantify/track subtle but critical cognitive or visual impact/change in PwMS if not apparent to patient/examiner/MRI. We have previously reported a relationship between the number of cognitive domains impaired (#CDI) and increasing economically important disability (employment, driving, and fall risk) as well as measureable MRI volumetric changes. Cognitive impairment, as measured by individual cognitive domains, and cognitive fatigue have also both noted to track with Visual Evoked Potential Latency (VEP-L). However, individual cognitive domain scores might not reflect multi-domain cognitive network “efficiency” whereas # CDI and VEP-L together might reflect such a link that can be tracked concurrently in routine care. A potential relationship might explain “cognitive fatigue” on the basis of increasing “cognitive network failure”.
Objective: To explore the relationship between #CDI to VEP-L (unilaterally, and interocular latency difference).
Methods: PwMS completed standardized validated computerized cognitive testing and underwent VEP-L recording in the course of routine care. Spearman correlations were utilized to examine the relationship of VEP-L (continuous and categorical) with #CDI.
Results: 435 PwMS (age 45.7+/-10.4, 74% female). Sequential average prolongation of each eye (OD, OS) individual VEP-L tracked with an increasing # CDI (0-3+) with a significant Spearman's rank-order correlation (p< .001, p=.002) while Inter-Ocular VEP-L did not demonstrate a similar significant relationship.
Conclusion: The number of cognitive domains impaired is related to VEP-L but not to inter-ocular latency difference. Accumulation of CDI coupled with concomitant progressive increase in VEP-L might indicate that cognitive fatigue reflects increasing cognitive network failure as the basis for this “fatigue”. Multi-dimensional objective monitoring of disease impact/change in PwMS might provide earlier identification of increasing cognitive disability and cognitive fatigue.
Disclosure: (This study was not supported by outside funds):
MG- Research support (Biogen, EMD Serono, Novartis, Sanofi, Teva); speaker fees/consultant (Acorda, Amgen, Biogen, EMD Serono, Medtronic, Novartis, Sanofi, Saol Therapeutics, Teva).
JS- Nothing to disclose
MZ- Speaker fees (Acorda, Biogen, Genzyme and Teva)
BB- Speaker fees (Biogen, Genotech, Genzyme and Teva). MG: Research support (Biogen, EMD Serono, Novartis, Sanofi, Teva); speaker fees/consultant (Acorda, Amgen, Biogen, EMD Serono, Medtronic, Novartis, Sanofi, Saol Therapeutics, Teva).
MB: Nothing to disclose
LF- Nothing to disclose
DG- Nothing to disclose
CS- Nothing to disclose
JW- Nothing to disclose
GD- Employee at Neurotrax
Abstract: EP1420
Type: Poster Sessions
Abstract Category: Clinical aspects of MS - Clinical assessment tools
Background: PwMS frequently experience cognitive impairment and fatigue as well as visual difficulty, all of which can be disabling. Cognitive impairment can result in disability distinct from physical disability. Disease activity is frequently evaluated by reported relapse rate, or identified changes in EDSS or MRI. None of these metrics is sufficient to quantify/track subtle but critical cognitive or visual impact/change in PwMS if not apparent to patient/examiner/MRI. We have previously reported a relationship between the number of cognitive domains impaired (#CDI) and increasing economically important disability (employment, driving, and fall risk) as well as measureable MRI volumetric changes. Cognitive impairment, as measured by individual cognitive domains, and cognitive fatigue have also both noted to track with Visual Evoked Potential Latency (VEP-L). However, individual cognitive domain scores might not reflect multi-domain cognitive network “efficiency” whereas # CDI and VEP-L together might reflect such a link that can be tracked concurrently in routine care. A potential relationship might explain “cognitive fatigue” on the basis of increasing “cognitive network failure”.
Objective: To explore the relationship between #CDI to VEP-L (unilaterally, and interocular latency difference).
Methods: PwMS completed standardized validated computerized cognitive testing and underwent VEP-L recording in the course of routine care. Spearman correlations were utilized to examine the relationship of VEP-L (continuous and categorical) with #CDI.
Results: 435 PwMS (age 45.7+/-10.4, 74% female). Sequential average prolongation of each eye (OD, OS) individual VEP-L tracked with an increasing # CDI (0-3+) with a significant Spearman's rank-order correlation (p< .001, p=.002) while Inter-Ocular VEP-L did not demonstrate a similar significant relationship.
Conclusion: The number of cognitive domains impaired is related to VEP-L but not to inter-ocular latency difference. Accumulation of CDI coupled with concomitant progressive increase in VEP-L might indicate that cognitive fatigue reflects increasing cognitive network failure as the basis for this “fatigue”. Multi-dimensional objective monitoring of disease impact/change in PwMS might provide earlier identification of increasing cognitive disability and cognitive fatigue.
Disclosure: (This study was not supported by outside funds):
MG- Research support (Biogen, EMD Serono, Novartis, Sanofi, Teva); speaker fees/consultant (Acorda, Amgen, Biogen, EMD Serono, Medtronic, Novartis, Sanofi, Saol Therapeutics, Teva).
JS- Nothing to disclose
MZ- Speaker fees (Acorda, Biogen, Genzyme and Teva)
BB- Speaker fees (Biogen, Genotech, Genzyme and Teva). MG: Research support (Biogen, EMD Serono, Novartis, Sanofi, Teva); speaker fees/consultant (Acorda, Amgen, Biogen, EMD Serono, Medtronic, Novartis, Sanofi, Saol Therapeutics, Teva).
MB: Nothing to disclose
LF- Nothing to disclose
DG- Nothing to disclose
CS- Nothing to disclose
JW- Nothing to disclose
GD- Employee at Neurotrax