Table_1_Processing speed and memory test performance are associated with different brain region volumes in Veterans and others with progressive multiple sclerosis.pdf

BackgroundCognitive dysfunction and brain atrophy are both common in progressive multiple sclerosis (MS) but are seldom examined comprehensively in clinical trials. Antioxidant treatment may affect the neurodegeneration characteristic of progressive MS and slow its symptomatic and radiographic correlates.ObjectivesThis study aims to evaluate cross-sectional associations between cognitive battery components of the Brief International Cognitive Assessment for Multiple Sclerosis with whole and segmented brain volumes and to determine if associations differ between secondary progressive (SPMS) and primary progressive (PPMS) MS subtypes.DesignThe study was based on a baseline analysis from a multi-site randomized controlled trial of the antioxidant lipoic acid in veterans and other people with progressive MS (NCT03161028).MethodsCognitive batteries were conducted by trained research personnel. MRIs were processed at a central processing site for maximum harmonization. Semi-partial Pearson's adjustments evaluated associations between cognitive tests and MRI volumes. Regression analyses evaluated differences in association patterns between SPMS and PPMS cohorts.ResultsOf the 114 participants, 70% had SPMS. Veterans with MS made up 26% (n = 30) of the total sample and 73% had SPMS. Participants had a mean age of 59.2 and sd 8.5 years, and 54% of them were women, had a disease duration of 22.4 (sd 11.3) years, and had a median Expanded Disability Status Scale of 6.0 (with an interquartile range of 4.0–6.0, moderate disability). The Symbol Digit Modalities Test (processing speed) correlated with whole brain volume (R = 0.29, p = 0.01) and total white matter volume (R = 0.33, p < 0.01). Both the California Verbal Learning Test (verbal memory) and Brief Visuospatial Memory Test-Revised (visual memory) correlated with mean cortical thickness (R = 0.27, p = 0.02 and R = 0.35, p < 0.01, respectively). Correlation patterns were similar in subgroup analyses.ConclusionBrain volumes showed differing patterns of correlation across cognitive tasks in progressive MS. Similar results between SPMS and PPMS cohorts suggest combining progressive MS subtypes in studies involving cognition and brain atrophy in these populations. Longitudinal assessment will determine the therapeutic effects of lipoic acid on cognitive tasks, brain atrophy, and their associations.

背景认知功能障碍与脑萎缩在进展性多发性硬化症（MS）中均属常见，但在临床试验中却鲜有全面考察。抗氧化治疗可能影响进展性MS的神经退行性特征，并减缓其症状和影像学相关性。研究目的本项研究旨在评估国际多发性硬化症简明认知评估量表（BICAMS）的认知测试成分与全脑及分割脑体积之间的横断面关联，并确定这些关联在继发性进展性（SPMS）与原发性进展性（PPMS）MS亚型之间是否存在差异。研究设计本研究基于一项多中心随机对照试验的基线分析，该试验评估了抗氧化剂α-硫辛酸在退伍军人及其他进展性MS患者中的疗效（NCT03161028）。研究方法认知测试由经过培训的研究人员执行，MRI图像在中央处理中心进行处理，以确保最大程度的和谐。通过半部分Pearson调整评估认知测试与MRI体积之间的关联。回归分析用于评估SPMS与PPMS队列间关联模式的不同。研究结果在114名参与者中，70%患有SPMS。MS患者中，退伍军人占26%（n = 30），其中73%患有SPMS。参与者的平均年龄为59.2岁，标准差为8.5岁，其中54%为女性，疾病病程为22.4年（标准差11.3年），中位扩展残疾状态量表评分为6.0（四分位间距为4.0–6.0，中度残疾）。符号数字模式测试（处理速度）与全脑体积（R = 0.29，p = 0.01）和总白质体积（R = 0.33，p < 0.01）相关。加州语言学习测试（言语记忆）和简明视觉空间记忆测试修订版（视觉记忆）均与平均皮层厚度相关（R = 0.27，p = 0.02和R = 0.35，p < 0.01，分别）。亚组分析中，相关性模式相似。结论在进展性MS中，脑体积与认知任务的相关模式呈现出不同的特征。SPMS和PPMS队列间相似的结果表明，在涉及认知和脑萎缩的研究中，应结合进展性MS的亚型。纵向评估将确定α-硫辛酸对认知任务、脑萎缩及其关联的治疗效果。