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Bioengineering
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Cognitive Impairment in Multiple Sclerosis
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Cognitive Impairment in Multiple Sclerosis

A special issue of Bioengineering (ISSN 2306-5354). This special issue belongs to the section "Biomedical Engineering and Biomaterials".

Deadline for manuscript submissions: closed (31 January 2024) | Viewed by 10971

Special Issue Editors

Dr. Elisabetta Signoriello

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Guest Editor
Department of Advanced Medical and Surgical Sciences, 2nd Division of Neurology, Center for Rare Diseases and Inter University Center for Research in Neurosciences, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy
Interests: multiple sclerosis; biomarkers; DMTs; progression; cognitive impairment
Special Issues, Collections and Topics in MDPI journals
Dr. Cinzia Coppola

E-Mail Website
Guest Editor
Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy
Interests: cognitive impairment; dementia; cognitive functions; genetics and epigenetics
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Cognitive impairment in multiple sclerosis (MS) has an important impact on the global functioning of the patients. It is recognized from the onset of the disease, also in pediatric form, and the alteration of attention, language, visual–spatial and spatial memory are the items mostly involved. The frequency and severity of cognitive impairment increase over time and have a negative impact on the patient’s life. It was demonstrated also that MS patients, caused by cognitive impairment, achieve lower educational levels and have higher unemployment rates. Many studies have attempted to evaluate possible pathogenetic mechanisms underlying cognitive impairment, and most focused primarily on gray matter atrophy and lesion load. This Special Issue aims to deepen this symptom of disease, from the pathogenesis to clinical evaluations and possible therapeutic strategies.

Dr. Elisabetta Signoriello
Dr. Cinzia Coppola
Guest Editors

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Keywords

  • multiple sclerosis
  • neuroinflammation
  • cognitive functions
  • neurodegeneration
  • cognitive impairment

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Published Papers (4 papers)

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Research

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10 pages, 1547 KiB  
Article
Making Visible the Invisible: Automatically Measured Global and Regional Brain Volume Is Associated with Cognitive Impairment and Fatigue in Multiple Sclerosis
by Stefano Ziccardi, Francesca Benedetta Pizzini, Maddalena Guandalini, Agnese Tamanti, Cecilia Cristofori and Massimiliano Calabrese
Bioengineering 2023, 10(1), 41; https://doi.org/10.3390/bioengineering10010041 - 29 Dec 2022
Cited by 6 | Viewed by 2422
Abstract
In multiple sclerosis (MS), the transition from relapsing-remitting to the secondary-progressive phase is characterized by a progression independent of relapse activity (PIRA), resulting in physical disability accumulation and invisible symptoms, i.e., fatigue and cognitive impairment (CI). These symptoms are related to neurodegenerative processes [...] Read more.
In multiple sclerosis (MS), the transition from relapsing-remitting to the secondary-progressive phase is characterized by a progression independent of relapse activity (PIRA), resulting in physical disability accumulation and invisible symptoms, i.e., fatigue and cognitive impairment (CI). These symptoms are related to neurodegenerative processes and have been correlated with MRI measures of brain atrophy only at a group level; however, the application in clinical practice of atrophy-based measurements for single-patient evaluation is yet to be fully investigated. In the present study, we aimed to evaluate the association between brain atrophy, measured with easy-to-use automatic software, and the “invisible” MS symptoms of cognition and fatigue. A total of 69 MS patients were included in the study; cognitive impairment and fatigue (FSS) (in addition to neurological disability, EDSS) were assessed and correlated with brain volumes calculated using the automated software QyScore® which is validated for single-patient use in the clinical setting. Results showed that the cognitive status was accurately reflected by measures of atrophy, with a sensitivity of up to 90%. CI patients showed a lower volume compared to cognitively normal patients in the whole brain (p = 0.017), gray matter (p = 0.042), insula (p = 0.035), cerebellum (p = 0.008), and limbic lobe (p = 0.049). FSS was associated with temporal lobe (r = −0.37, p = 0.013) and insular (r = −0.36, p = 0.019) volumes. The volumes of the same regions were also associated with EDSS. The global/regional atrophy results, assessed with automatic and easy-to-use software, correlated with cognitive and fatigue symptoms, thus supporting the clinical application in routine patient management. Full article
(This article belongs to the Special Issue Cognitive Impairment in Multiple Sclerosis)
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Review

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32 pages, 805 KiB  
Review
Cognitive Impairment in Multiple Sclerosis
by Kenneth Maiese
Bioengineering 2023, 10(7), 871; https://doi.org/10.3390/bioengineering10070871 - 23 Jul 2023
Cited by 10 | Viewed by 4332
Abstract
Almost three million individuals suffer from multiple sclerosis (MS) throughout the world, a demyelinating disease in the nervous system with increased prevalence over the last five decades, and is now being recognized as one significant etiology of cognitive loss and dementia. Presently, disease [...] Read more.
Almost three million individuals suffer from multiple sclerosis (MS) throughout the world, a demyelinating disease in the nervous system with increased prevalence over the last five decades, and is now being recognized as one significant etiology of cognitive loss and dementia. Presently, disease modifying therapies can limit the rate of relapse and potentially reduce brain volume loss in patients with MS, but unfortunately cannot prevent disease progression or the onset of cognitive disability. Innovative strategies are therefore required to address areas of inflammation, immune cell activation, and cell survival that involve novel pathways of programmed cell death, mammalian forkhead transcription factors (FoxOs), the mechanistic target of rapamycin (mTOR), AMP activated protein kinase (AMPK), the silent mating type information regulation 2 homolog 1 (Saccharomyces cerevisiae) (SIRT1), and associated pathways with the apolipoprotein E (APOE-ε4) gene and severe acute respiratory syndrome coronavirus (SARS-CoV-2). These pathways are intertwined at multiple levels and can involve metabolic oversight with cellular metabolism dependent upon nicotinamide adenine dinucleotide (NAD+). Insight into the mechanisms of these pathways can provide new avenues of discovery for the therapeutic treatment of dementia and loss in cognition that occurs during MS. Full article
(This article belongs to the Special Issue Cognitive Impairment in Multiple Sclerosis)
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18 pages, 698 KiB  
Review
Current Status of Oral Disease-Modifying Treatment Effects on Cognitive Outcomes in Multiple Sclerosis: A Scoping Review
by Vincenzo Carlomagno, Massimiliano Mirabella and Matteo Lucchini
Bioengineering 2023, 10(7), 848; https://doi.org/10.3390/bioengineering10070848 - 18 Jul 2023
Cited by 2 | Viewed by 1769
Abstract
Introduction. Cognitive impairment represents one of the most hidden and disabling clinical aspects of multiple sclerosis (MS). In this regard, the major challenges are represented by the need for a comprehensive and standardised cognitive evaluation of each patient, both at disease onset and [...] Read more.
Introduction. Cognitive impairment represents one of the most hidden and disabling clinical aspects of multiple sclerosis (MS). In this regard, the major challenges are represented by the need for a comprehensive and standardised cognitive evaluation of each patient, both at disease onset and during follow-up, and by the lack of clear-cut data on the effects of treatments. In the present review, we summarize the current evidence on the effects of the available oral disease-modifying treatments (DMTs) on cognitive outcome measures. Materials and Methods. In this systematised review, we extract all the studies that reported longitudinally acquired cognitive outcome data on oral DMTs in MS patients. Results. We found 29 studies that evaluated at least one oral DMT, including observational studies, randomised controlled trials, and their extension studies. Most of the studies (n = 20) evaluated sphingosine-1-phosphate (S1P) modulators, while we found seven studies on dimethyl fumarate, six on teriflunomide, and one on cladribine. The most frequently used cognitive outcome measures were SDMT and PASAT. Most of the studies reported substantial stability or mild improvement in cognitive outcomes in a short-time follow-up (duration of most studies ≤2 years). A few studies also reported MRI measures of brain atrophy. Conclusion. Cognitive outcomes were evaluated only in a minority of prospective studies on oral DMTs in MS patients with variable findings. More solid and numerous data are present for the S1P modulators. A standardised cognitive evaluation remains a yet unmet need to better clarify the possible positive effect of oral DMTs on cognition. Full article
(This article belongs to the Special Issue Cognitive Impairment in Multiple Sclerosis)
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Other

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10 pages, 479 KiB  
Brief Report
Evaluating Cognitive-Motor Interference in Multiple Sclerosis: A Technology-Based Approach
by Jessica Podda, Ludovico Pedullà, Giampaolo Brichetto and Andrea Tacchino
Bioengineering 2024, 11(3), 277; https://doi.org/10.3390/bioengineering11030277 - 14 Mar 2024
Viewed by 1324
Abstract
Background: People with multiple sclerosis (PwMS) frequently present both cognitive and motor impairments, so it is reasonable to assume they may have difficulties in executing dual-tasks (DT). The aim of the present study is to identify novel technology-based parameters to assess cognitive-motor interference [...] Read more.
Background: People with multiple sclerosis (PwMS) frequently present both cognitive and motor impairments, so it is reasonable to assume they may have difficulties in executing dual-tasks (DT). The aim of the present study is to identify novel technology-based parameters to assess cognitive-motor interference (CMI) in PwMS. In particular, we focused on the definition of dual-task cost (DTC) measures using wearable and portable tools such as insoles and mobile apps. Methods: All participants underwent a verbal fluency task (cognitive single-task, ST), a motor ST of walking, and a combination of these tasks (DT). Number of words uttered in the cognitive ST and steps recorded by insoles were used to calculate the motor and cognitive DTC. Results: The number of steps strongly correlated with the walked meters for both single- (r = 0.88, p < 0.05) and dual- (r = 0.91, p < 0.05) tasks. Motor but not cognitive performances significantly worsened during DT. Over the cognitive ST and DT, the number of pronounced words progressively decreased, probably due to the activation of different cognitive processes. Cognitive efforts could be the cause of cognitive task prioritization. Conclusions: Our findings promote the use of low-cost devices to assess CMI easily in the clinical context and to detect ecologically valid DT impairments. Full article
(This article belongs to the Special Issue Cognitive Impairment in Multiple Sclerosis)
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