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NeuroSci
Special Issues
Cognitive Impairment and Neuropsychiatric Dysfunctions in Multiple Sclerosis
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Cognitive Impairment and Neuropsychiatric Dysfunctions in Multiple Sclerosis

A special issue of NeuroSci (ISSN 2673-4087).

Deadline for manuscript submissions: closed (31 July 2022) | Viewed by 26116

Special Issue Editor

Dr. Ugo Nocentini

E-Mail Website
Guest Editor
1. Fondazione Santa Lucia IRCCS, 00179 Rome, Italy
2. Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
Interests: neurorehabilitation; neuropsychology; cognitive assessment; multiple sclerosis (cognition in MS); social cognition; disability assessment
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleague,

Cognitive deficits have been reported in 45%–70% of patients with multiple sclerosis (MS). Like other symptoms of MS, cognitive deficits are highly variable. Slowed information processing and memory and learning dysfunction are regarded as the most frequent cognitive deficits in MS. Both white and gray matter damages have been suggested to contribute to cognitive impairments in MS. In addition to cognitive impairments, neuropsychiatric symptoms are observed in MS, the most common being alterations in mood state, which have multidimensional effects on patients’ quality of life. Consequently, attention should be paid to cognitive impairment and neuropsychiatric dysfunctions in multiple sclerosis, which this Special Issue aims to address.

The scope of this Special Issue includes, but is not limited to, the following:

  • Historical background;
  • Cognitive impairment in MS: last developments and future prospects;
  • Neuropsychiatric dysfunctions in MS;
  • Personality, behavior and MS;
  • Neuroimaging of cognitive impairment and neuropsychiatric dysfunctions in MS;
  • Neurochemistry of cognitive impairment and neuropsychiatric dysfunctions in MS;
  • Non-pharmacological treatments of cognitive impairment in MS.

Dr. Ugo Nocentini
Guest Editor

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Published Papers (6 papers)

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Review

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14 pages, 316 KiB  
Review
Focus or Neglect on Cognitive Impairment Following the History of Multiple Sclerosis
by Ugo Nocentini
NeuroSci 2023, 4(1), 65-78; https://doi.org/10.3390/neurosci4010008 - 15 Feb 2023
Cited by 1 | Viewed by 2379
Abstract
Cognitive disorders are now considered an integral part of the picture of multiple sclerosis. If we trace the history of the accounts of this disease, from the early descriptions by Jean-Martin Charcot, the first to provide systematic characteristics of multiple sclerosis, to present-day [...] Read more.
Cognitive disorders are now considered an integral part of the picture of multiple sclerosis. If we trace the history of the accounts of this disease, from the early descriptions by Jean-Martin Charcot, the first to provide systematic characteristics of multiple sclerosis, to present-day accounts, reports of cognitive disturbances have demonstrated an alternating trend. Cognitive disturbances were identified in the beginning, quite clearly for the times. Then, for a long time, they were considered infrequent or attributed to other factors. Finally, since the 1980s, cognitive disturbances have been the subject of increasingly in-depth studies, and are currently assumed to be a very important consequence of multiple sclerosis. In this work, the history of the description of cognitive disorders of multiple sclerosis will be retraced by analyzing the possible reasons for the differences in attention they have received over time. It emerged from the analysis that, as in the case of other pathologies, various factors have influenced how cognitive disorders have been taken into consideration. Some of these factors are inherent to the very nature of the cognitive impairments present in multiple sclerosis; others are linked to historical periods, or to the different ways of approaching the analysis of the phenomena caused by a disease. The reflections made on these topics should, among other things, increase our awareness of how scientific investigation is invariably placed in the historical context in which it is carried out. Full article
(This article belongs to the Special Issue Cognitive Impairment and Neuropsychiatric Dysfunctions in Multiple Sclerosis)
10 pages, 560 KiB  
Review
Cognitive Impairment in Multiple Sclerosis: An Update on Assessment and Management
by Emilio Portaccio and Maria Pia Amato
NeuroSci 2022, 3(4), 667-676; https://doi.org/10.3390/neurosci3040048 - 22 Nov 2022
Cited by 24 | Viewed by 9251
Abstract
Cognitive impairment (CI) is a core feature of multiple sclerosis (MS) and affects up to 65% of patients in every phase of the disease, having a deep impact on all aspects of patients’ lives. Cognitive functions most frequently involved include information processing speed, [...] Read more.
Cognitive impairment (CI) is a core feature of multiple sclerosis (MS) and affects up to 65% of patients in every phase of the disease, having a deep impact on all aspects of patients’ lives. Cognitive functions most frequently involved include information processing speed, learning and memory, visuospatial abilities, and executive function. The precise pathogenetic mechanisms underpinning CI in MS are still largely unknown, but are deemed to be mainly related to pathological changes in lesioned and normal-appearing white matter, specific neuronal grey matter structures, and immunological alterations, with particular impact on synaptic transmission and plasticity. Moreover, much research is needed on therapeutic strategies. Small to moderate efficacy has been reported for disease-modifying therapies, particularly high-efficacy drugs, and symptomatic therapies (dalfampridine), while the strongest benefit emerged after cognitive training. The present narrative review provides a concise, updated overview of more recent evidence on the prevalence, profile, pathogenetic mechanisms, and treatment of CI in people with MS. CI should be screened on a regular basis as part of routine clinical assessments, and brief tools are now widely available (such as the Symbol Digit Modalities Test). The main goal of cognitive assessment in MS is the prompt implementation of preventive and treatment interventions. Full article
(This article belongs to the Special Issue Cognitive Impairment and Neuropsychiatric Dysfunctions in Multiple Sclerosis)
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11 pages, 665 KiB  
Review
Cognitive Relapse in Multiple Sclerosis: New Findings and Directions for Future Research
by Zachary L. Weinstock and Ralph H. B. Benedict
NeuroSci 2022, 3(3), 510-520; https://doi.org/10.3390/neurosci3030036 - 26 Aug 2022
Cited by 3 | Viewed by 3005
Abstract
Multiple sclerosis (MS) is a chronic inflammatory, demyelinating disease of the central nervous system, often presenting with brain atrophy and cognitive impairment (CI). In the relapsing–remitting phenotype, cognitive performance is increasingly recognized to decline acutely during MS relapse, with varying degrees of recovery [...] Read more.
Multiple sclerosis (MS) is a chronic inflammatory, demyelinating disease of the central nervous system, often presenting with brain atrophy and cognitive impairment (CI). In the relapsing–remitting phenotype, cognitive performance is increasingly recognized to decline acutely during MS relapse, with varying degrees of recovery afterwards. Therefore, CI in MS may result from incomplete recovery from episodes of so-called “cognitive relapse”, gradual neurodegeneration, or both. Among a variety of validated measures of cognitive performance, the Symbol Digit Modalities Test (SDMT) represents the most sensitive measure of cognitive decline and is easily translated to clinical practice. In fact, cognitive relapse identified using the SDMT has been reported in clinically relapsing cohorts as well as in individuals with no other neurological signs, suggesting that routine cognitive assessment may be necessary to fully appreciate the extent of a patient’s disease activity. The aim of this narrative review is as follows: (1) to provide the historical context for neuropsychological assessment in MS, (2) to provide a summation of key studies describing the cognitive relapse phenomenon, and (3) to discuss current gaps in our knowledge and highlight avenues for future research. Full article
(This article belongs to the Special Issue Cognitive Impairment and Neuropsychiatric Dysfunctions in Multiple Sclerosis)
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18 pages, 712 KiB  
Review
Non-Pharmacological Treatments of Cognitive Impairment in Multiple Sclerosis: A Review
by Michela Bossa, Nicola Manocchio and Ornella Argento
NeuroSci 2022, 3(3), 476-493; https://doi.org/10.3390/neurosci3030034 - 22 Aug 2022
Cited by 4 | Viewed by 3434
Abstract
Cognitive impairment (CI) represents a common symptom in patients suffering from multiple sclerosis (MS), which can affect every stage of the disease course. Recent studies seem to support cognitive rehabilitation (CR) for minimizing the CI consequences. We reviewed the currently available evidence on [...] Read more.
Cognitive impairment (CI) represents a common symptom in patients suffering from multiple sclerosis (MS), which can affect every stage of the disease course. Recent studies seem to support cognitive rehabilitation (CR) for minimizing the CI consequences. We reviewed the currently available evidence on the non-pharmacological approaches to CI, with the aim of giving an overview of the treatments used worldwide, from the traditional methods to the most recent techniques. A search of the literature was conducted on PubMed (articles in English performed in the last five years on humans). A total of 37 articles met our eligibility criteria after screening titles, abstracts and full-text and were divided into three main groups: in-presence interventions; studies performed via tele-rehabilitation and miscellaneous. Despite the great heterogeneity of the intervention and assessment methods, the evidence suggests that a non-pharmacological approach can improve MS-related CI. Cognitive rehabilitation seems effective and well established, as well as the use of computerized CR having the benefit of being even more appealing. Limited conclusions can be drawn on group CR due to the small number of studies focused on this kind of intervention. Some of the innovative approaches (virtual reality, EEG-based neurofeedback, brain stimulation, exercise, diet modification) may play a role in future studies and should be deeply explored. Full article
(This article belongs to the Special Issue Cognitive Impairment and Neuropsychiatric Dysfunctions in Multiple Sclerosis)
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14 pages, 320 KiB  
Review
Developing the Rationale for Including Virtual Reality in Cognitive Rehabilitation and Exercise Training Approaches for Managing Cognitive Dysfunction in MS
by Carly L. A. Wender, John DeLuca and Brian M. Sandroff
NeuroSci 2022, 3(2), 200-213; https://doi.org/10.3390/neurosci3020015 - 3 Apr 2022
Cited by 3 | Viewed by 4226
Abstract
Cognitive impairment is a common and detrimental consequence of multiple sclerosis (MS) and current rehabilitation methods are insufficient. Cognitive rehabilitation (CR) and exercise training (ET) are the most promising behavioral approaches to mitigate cognitive deficits, but effects are small and do not effectively [...] Read more.
Cognitive impairment is a common and detrimental consequence of multiple sclerosis (MS) and current rehabilitation methods are insufficient. Cognitive rehabilitation (CR) and exercise training (ET) are the most promising behavioral approaches to mitigate cognitive deficits, but effects are small and do not effectively translate to improvements in everyday function. This article presents a conceptual framework supporting the use of virtual reality (VR) as an ideal, common adjuvant traditional CR and ET in MS. VR could strengthen the effects of CR and ET by increasing sensory input and promoting multisensory integration and processing during rehabilitation. For ET specifically, VR can also help incorporate components of CR into exercise sessions. In addition, VR can enhance the transfer of cognitive improvements to everyday functioning by providing a more ecologically valid training environment. There is a clear interest in adding VR to traditional rehabilitation techniques for neurological populations, a stronger body of evidence of this unique approach is needed in MS. Finally, to better understand how to best utilize VR in rehabilitation for cognitive deficits in MS, more systematic research is needed to better understand the mechanism(s) of action of VR with CR and ET. Full article
(This article belongs to the Special Issue Cognitive Impairment and Neuropsychiatric Dysfunctions in Multiple Sclerosis)

Other

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13 pages, 619 KiB  
Study Protocol
Study Protocol: Strategies and Techniques for the Rehabilitation of Cognitive and Motor Deficits in Patients with Multiple Sclerosis
by Ornella Argento, Chiara Piacentini, Michela Bossa, Carlo Caltagirone, Andrea Santamato, Vincenzo Saraceni and Ugo Nocentini
NeuroSci 2022, 3(3), 395-407; https://doi.org/10.3390/neurosci3030029 - 12 Jul 2022
Cited by 1 | Viewed by 2503
Abstract
MS clinical features vary between patients. In approximately 60% of cases, cognitive deficits are associated with motor disabilities, with consequences on both walking and maintaining balance and cognitive efficiency. Multimodal programs are very infrequent for MS patients and cognitive rehabilitation is not provided [...] Read more.
MS clinical features vary between patients. In approximately 60% of cases, cognitive deficits are associated with motor disabilities, with consequences on both walking and maintaining balance and cognitive efficiency. Multimodal programs are very infrequent for MS patients and cognitive rehabilitation is not provided by the Italian health system, which only favors access to motor rehabilitation. Dual-task studies showed how motor and cognitive skills are closely associated. Therefore, physiotherapy exercises may favor an indirect improvement in cognition. The aim of this study is to understand which rehabilitative approach may increase both cognitive and motor efficiency, avoiding the waste of time and resources. In this multi-site single-blind parallel controlled clinical trial, we will compare three rehabilitative approaches: cognitive training, motor training and combined cognitive–motor training. We also aim to evaluate: whether self-perception and objective improvement correspond; the impact of each rehabilitation program on patients’ QoL, mood and self-perception; and long-term effects. A total of 60 patients will be randomly assigned to one of the three treatments for two 45-min sessions/week for 12 weeks. All participants will undergo a complete cognitive, motor, clinical assessment together with mood, self-perception, and QoL questionnaires before, immediately after and 6 months after the training period. Full article
(This article belongs to the Special Issue Cognitive Impairment and Neuropsychiatric Dysfunctions in Multiple Sclerosis)
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