Abstract Details

Title Cognitive Phenotypes in Multiple Sclerosis: Mapping the Spectrum of Impairment

Topic Aging, Dementia, and Behavioral Neurology

Presentation(s) S28 - Vascular and Other Non-Alzheimer’s Dementias (2:48 PM-3:00 PM)

Poster/Presentation
Number 010

Background Cognitive deficits in multiple sclerosis (MS) are common and heterogeneous, however available criteria rely on a dichotomous definition of impairment.

Objective To identify cognitive phenotypes in MS patients, and describe their demographic, clinical and structural MRI characteristics.

Design/Methods Two hundred and forty-three MS patients and 158 healthy controls underwent neuropsychological tests to assess memory, attention, and executive function. For each domain, mild impairment was defined as performing 1.5 standard deviations below the normative mean on two tests, while the threshold for significant impairment was 2 standard deviations. Patients were classified into cognitive phenotypes based on severity of the impairment (mild/significant) and number of domains affected (one/more).

Results Five cognitive phenotypes emerged: Preserved cognition (PC; 56%), Mild Single-Domain Impairment (DI; 15%), Mild Multi-DI (9%), Significant Single-DI (12%), Significant Multi-DI (8%). Compared with PC, patients with Mild Single-DI were older, had longer disease duration and higher T2-hyperintense lesion volume (LV; p≤0.02); patients with Mild Multi-DI were older had longer disease duration, higher disability, higher T2 LV and lower thalamic volume (p≤0.01); patients with Significant Single-DI had longer disease duration and lower gray matter cortical volume, thalamic, caudate, putamen and accumbens volumes (p≤0.04); and patients with Significant Multi-DI were older, had longer disease duration, higher disability and more extensive structural damage in all brain regions explored (p≤0.03), except white matter and amygdala volumes.

Conclusions We identified five cognitive phenotypes that represent a graded degree of impairment. These phenotypes were characterized by distinct demographic, clinical and MRI features, indicating potential variations in the neural substrates of dysfunction throughout disease stages.

Authors/Disclosures
Damiano Mistri, MSC (Università Vita-Salute San Raffaele) PRESENTER	Mr. Mistri has nothing to disclose.
Diana Biondi	No disclosure on file
Nicolò Tedone (San Raffaele hospital)	No disclosure on file
Carmen Vizzino	No disclosure on file
Elisabetta Pagani	No disclosure on file
Paolo Preziosa (Ospedale San Raffaele)	Mr. Preziosa has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Bristol Myers Squibb . Mr. Preziosa has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Sanofi Genzyme. Mr. Preziosa has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Novartis. Mr. Preziosa has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Roche. Mr. Preziosa has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Merck.
Maria A. Rocca (Neuroimaging Research Unit)	Maria Assunta Rocca has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen, Bristol Myers Squibb, Eli Lilly, Janssen, Roche. Maria Assunta Rocca has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for AstraZaneca, Biogen, Bristol Myers Squibb, Bromatech, Celgene, Genzyme, Horizon Therapeutics Italy, Merck Serono SpA, Novartis, Roche, Sanofi and Teva. The institution of Maria Assunta Rocca has received research support from MS Society of Canada, the Italian Ministry of Health, the Italian Ministry of University and Research, and Fondazione Italiana Sclerosi Multipla.
Massimo Filippi, MD, FAAN (Ospedale San Raffaele, Neuroimaging Research Unit)	Dr. Filippi has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Alexion, Almirall, Biogen, Merck, Novartis, Roche, Sanofi;. Dr. Filippi has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion, Biogen, Bristol-Myers Squibb, Merck, Novartis, Roche, Sanofi, Sanofi-Aventis, Sanofi- Genzyme, Takeda. Dr. Filippi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Bayer, Biogen, Celgene, Chiesi Italia SpA, Eli Lilly, Genzyme, Janssen, Merck-Serono, Neopharmed Gentili, Novartis, Novo Nordisk, Roche, Sanofi, Takeda, and TEVA. Dr. Filippi has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Springer Nature. The institution of Dr. Filippi has received research support from Biogen Idec, Merck-Serono, Novartis, Roche, the Italian Ministry of Health, the Italian Ministry of University and Research, and Fondazione Italiana Sclerosi Multipla.