Learning ability correlates with brain atrophy and disability progression in RRMS

ObjectiveTo assess the prognostic value of practice effect on Paced Auditory Serial Addition Test (PASAT) in multiple sclerosis.MethodsWe compared screening (day −14) and baseline (day 0) PASAT scores of 1009 patients from the FTY720 Research Evaluating Effects of Daily Oral therapy in Multiple Scle...

Celý popis

Uloženo v:
Podrobná bibliografie
Vydáno v:Journal of neurology, neurosurgery and psychiatry Ročník 90; číslo 1; s. 38 - 43
Hlavní autoři: Sormani, Maria Pia, De Stefano, Nicola, Giovannoni, Gavin, Langdon, Dawn, Piani-Meier, Daniela, Haering, Dieter A, Kappos, Ludwig, Tomic, Davorka
Médium: Journal Article
Jazyk:angličtina
Vydáno: England BMJ Publishing Group LTD 01.01.2019
BMJ Publishing Group
Edice:Research paper
Témata:
Adult
Aptitude
Atrophy
Brain - diagnostic imaging
Brain - pathology
Cognitive ability
Disease Progression
Female
Fingolimod Hydrochloride - therapeutic use
Humans
Immunosuppressive Agents - therapeutic use
Learning
Male
Middle Aged
Multiple Sclerosis
Multiple Sclerosis, Relapsing-Remitting - diagnostic imaging
Multiple Sclerosis, Relapsing-Remitting - drug therapy
Multiple Sclerosis, Relapsing-Remitting - physiopathology
Multiple Sclerosis, Relapsing-Remitting - psychology
Neurology
Randomized Controlled Trials as Topic
PASAT
disability progression
fingolimod
learning effect
multiple sclerosis
ISSN:0022-3050, 1468-330X, 1468-330X
On-line přístup:Získat plný text
Tagy: Přidat tag
Žádné tagy, Buďte první, kdo vytvoří štítek k tomuto záznamu!
Popis
Shrnutí:ObjectiveTo assess the prognostic value of practice effect on Paced Auditory Serial Addition Test (PASAT) in multiple sclerosis.MethodsWe compared screening (day −14) and baseline (day 0) PASAT scores of 1009 patients from the FTY720 Research Evaluating Effects of Daily Oral therapy in Multiple Sclerosis (FREEDOMS) trial. We grouped patients into high and low learners if their PASAT score change was above or below the median change in their screening PASAT quartile group. We used Wilcoxon test to compare baseline disease characteristics between high and low learners, and multiple regression models to assess the respective impact of learning ability, baseline normalised brain volume and treatment on brain volume loss and 6-month confirmed disability progression over 2 years.ResultsThe mean PASAT score at screening was 45.38, increasing on average by 3.18 from day −14 to day 0. High learners were younger (p=0.003), had lower Expanded Disability Status Scale score (p=0.031), higher brain volume (p<0.001) and lower T2 lesion volume (p=0.009) at baseline. Learning status was not significantly associated with disability progression (HR=0.953, p=0.779), when adjusting for baseline normalised brain volume, screening PASAT score and treatment arm. However, the effect of fingolimod on disability progression was more pronounced in high learners (HR=0.396, p<0.001) than in low learners (HR=0.798, p=0.351; p for interaction=0.05). Brain volume loss at month 24 tended to be higher in low learners (0.17%, p=0.058), after adjusting for the same covariates.ConclusionsShort-term practice effects on PASAT are related to brain volume, disease severity and age and have clinically meaningful prognostic implications. High learners benefited more from fingolimod treatment.
Bibliografie:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 14
content type line 23
ISSN:0022-3050
1468-330X
1468-330X
DOI:10.1136/jnnp-2018-319129