Category Ranking
98%
Total Visits
921
Avg Visit Duration
2 minutes
Citations
20
Article Abstract
Background: High-efficacy disease-modifying therapies (HETs) have substantially improved multiple sclerosis (MS) management, yet ongoing cognitive decline remains a concern. This study aims to assess Symbol Digit Modalities Test (SDMT) changes in patients with stable relapsing-remitting MS (RRMS) treated with HETs and to evaluate the role of baseline MRI biomarkers as predictors of SDMT changes.
Methods: Consecutive patients with RRMS treated with HETs underwent clinical, SDMT and MRI assessment at baseline with SDMT and clinical re-evaluation after 24 months. Patients presenting relapses or MRI activity (new T2 and/or gadolinium-enhancing lesions) during follow-up were excluded. Cognitive changes were defined using the 90% CI regression-based reliable change index methodology accounting for sex, age, education and baseline score. Baseline MRI examination included three-dimensional-sagittal Fluid Attenuated Inversion Recovery (FLAIR), T1-Magnetization Prepared - RApid Gradient Echo (T1-MPRAGE) and quantitative susceptibility mapping (QSM) for paramagnetic rim lesions (PRLs) and QSM-isointense lesions (ISO) assessment. Univariate and multivariable regression analyses were performed to predict SDMT changes.
Results: 90 patients (mean age: 40.3 years, median Expanded Disability Status Scale: 2.0) were included. PRLs were present in 46 (51.1%) patients. After 24 months, 13 (14.4%) patients showed SDMT decline and 8 (8.9%) showed improvement. At multivariable analyses, PRLs were associated with higher risk of SDMT decline (β: 2.70, p: 0.02, OR: 14.82) while higher ISO lesion volumes were weakly associated with SDMT improvement (β: 0.07, p: 0.01, OR: 1.07).
Conclusions: SDMT decline and improvement are detectable in patients with RRMS without clinical or MRI activity over 2 years. PRLs seem to predict SDMT decline in MS, underscoring the critical role of compartmentalised chronic inflammation in disease progression.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1136/jnnp-2024-335144 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Acute effects of neuromuscular electrical stimulation on lactate, IGF-1 and cognition in chronic spinal cord injury: A pilot randomized cross-over study.
J Spinal Cord Med
September 2025
Department of Health Promotion and Rehabilitation, Lithuanian Sports University, Kaunas, Lithuania.
Introduction: Individuals with spinal cord injuries (SCI) exhibit an accelerated age-related cognitive decline compared to healthy individuals, even after adjusting for mood factors and concomitant traumatic brain injury. We hypothesized that neuromuscular electrical stimulation (NMES) on hamstring and gluteal muscles may induce a dose-dependent increase in lactate and insulin-like growth factor-1 (IGF-1) which is hypothesized to be associated with a temporary enhancement of cognitive performance.
Methods: Twenty-two individuals with chronic SCI participated in a randomized cross-over study, receiving NMES on one of both visits.
Correlation of Neurodegenerative Biomarkers and Functional Outcome in Patients with Relapsing-Remitting Multiple Sclerosis.
Neurol Int
August 2025
Department of Neurology and Neurosurgery, Riga East University Hospital, LV-1038 Riga, Latvia.
: Multiple sclerosis (MS) is a chronic autoimmune, inflammatory, and neurodegenerative central nervous system disease. Neurodegeneration plays a central role in long-term disease progression. : This cross-sectional study examined the relationship between neurodegenerative biomarkers, namely plasma neurofilament light chain (pNfL) levels and MRI-derived brain volume measurements, and clinical outcomes in 49 patients with relapsing-remitting multiple sclerosis (RRMS).
View Article and Find Full Text PDFInvestigating the association between choroid plexus volume and the pathogenesis of Parkinson's disease.
Parkinsonism Relat Disord
August 2025
Department of Neurology, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China. Electronic address:
Background And Objective: Parkinson's disease (PD) involves motor and cognitive impairments, with recent evidence suggesting that changes in choroid plexus volume (CPV) may contribute to disease progression by affecting protein accumulation in the brain. This study aims to assess the relationship between CPV and PD symptoms, and explore its potential as a biomarker for tracking disease progression.
Methods: Data from 236 newly diagnosed, untreated PD patients and 47 healthy controls were retrospectively obtained from a large (n = 412) longitudinal study of patients.
Association of Physical Exercise With Structural Brain Changes and Cognitive Decline in Patients With Early Parkinson Disease.
Neurology
September 2025
Unidad de Trastornos del Movimiento, Servicio de Neurología, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Spain.
Background And Objectives: Accumulating evidence suggests that physical activity is associated with a better clinical and cognitive course in Parkinson disease (PD), yet whether these effects are subserved by structural brain alterations are largely unexplored. The aim of this study was to investigate whether regular physical activity associates with a reduced longitudinal rate of neurodegeneration and slower cognitive decline in PD.
Methods: In this longitudinal, observational cohort study, we used data from the Parkinson's Progression Markers Initiative.
Background: Atrial fibrillation (AF) is associated with aging and increased risk of stroke and dementia. We examined the association between incident AF and cognitive trajectories in older adults using longitudinal data from the ASPirin in Reducing Events in the Elderly (ASPREE) study.
Methods: ASPREE was a multi-center randomized, double-blind, placebo-controlled trial of low-dose (100 mg) aspirin in healthy older adults.