Cognitive phenotypes in patients with relapsing-remitting multiple sclerosis with different disease duration, applying the international classification of cognitive disorders in MS (IC-CoDiMS).

Objective: Cognitive impairment is experienced by 40-70% of multiple sclerosis patients, with information processing speed and memory most affected. Until now, cognitive results classified patients as impaired and not impaired. With this dichotomous approach, it is difficult to identify, in a heterogeneous group of patients with cognitive impairment, which cognitive domain(s) are most altered. This study aims to identify cognitive phenotypes in a clinical cohort of adult patients with Relapsing-Remitting Multiple Sclerosis (RRMS) using the International Classification of Cognitive Disorders in MS (IC-CoDiMS) and to characterize their clinical features. Methods: Three hundred patients with RRMS underwent neuropsychological assessment with the Brief Repeatable Battery of Neuropsychological Tests (BRBN-T) and the Brief International Cognitive Multiple Sclerosis (BICAMS). Results: In our cohort, the mean age was 41.38 [11.48 SD] years, and 205 [68.3%] were women. At the -1 SD threshold, 49% were cognitively intact, 25% had uni-domain impairment, 17% had bi-domain impairment, and 9% had multi-domain impairment. Processing speed was the most frequent single-domain impairment, followed by memory and verbal fluency. At the -1.5 SD threshold, 74.7% were cognitively intact, 17% had uni-domain impairment, 6% had bi-domain impairment, had bi-domain impairment, and 3.0% had multi-domain impairment. Memory was the most frequent single-domain impairment, followed by processing speed and verbal fluency. Conclusions: This study corroborates the importance of determining cognitive phenotypes through taxonomy (IC-CoDiMS). In addition, it contributes to improving the classification of cognitive phenotypes in patients with RRMS to enhance the development of more effective treatments and cognitive interventions.

Cognitive impairment in multiple sclerosis phenotypes: Neuropsychological assessment in a portuguese sample.

BACKGROUND: Cognitive impairment affects 40-65% of MS patients, encompassing all disease stages and types of clinical courses. This estimation is based on different instruments used and population normative data. OBJECTIVE: This study aims to assess the cognitive function in a hospital-based cohort of Portuguese MS patients, to allow estimating the prevalence of cognitive impairment in different phenotypes. METHODS: Three hundred and thirteen patients with Multiple Sclerosis (MS) underwent neuropsychological assessment with the brief repeatable battery of neuropsychological tests (BRBN-T) and the brief international cognitive assessment for multiple sclerosis (BICAMS). RESULTS: Differences were observed in the cognitive impairment profile of different disease phenotypes and of the different disease severity stages. RRMS patients performed better in the cognitive test of the BRBN-T and BICAMS than those with progressive disease phenotypes. Relationships between cognitive impairment and disability and professional status were relevant. Although similarities could be observed in the cognitive profile of the MS phenotypes, with predominant involvement of verbal memory, verbal fluency, and information processing speed, the latter was found to be more frequent as the disease progressed. CONCLUSION: This study contributes to improve knowledge about the cognitive profile of the different MS phenotypes and understand the cognitive characteristics of Portuguese patients.

Real-Time Psychophysiological and Writing Correlates of Expressive Writing.

Concealing memories and emotions associated with a traumatic event seems to have negative effects on health. Re-enacting those events through writing is an opportunity to disclose such memories and emotions, and especially for emotion regulation. To study this, 57 university students were randomly assigned to one of two groups. They either completed an expressive writing or a neutral writing task. Real-time writing and psychophysiological data were recorded throughout the experiment to examine writing dynamics associated with emotion regulation and its psychophysiological correlates (electrodermal activity and electrocardiography measures). The results showed that the expressive group (EG) paused for longer than the control group (CG) denoting a positive and medium effect size ( η p 2 = .10 ) . Furthermore, during and after writing, the EG showed a higher low frequency/high frequency ratio than the CG, evidencing a positive and large effect size ( η p 2 = .22 ) . These real-time findings are interpreted as signs of emotion regulation happening during writing.

Multiplex quantitative assays indicate a need for reevaluating reported small-molecule TrkB agonists.

Brain-derived neurotrophic factor (BDNF) and its receptor, tropomyosin-related kinase B (TrkB), have emerged as key regulators of brain plasticity and represent disease-modifying targets for several brain disorders, including Alzheimer's disease and major depressive disorder. Because of poor pharmacokinetic properties of BDNF, the interest in small-molecule TrkB agonists and modulators is high. Several compounds have been reported to act as TrkB agonists, and their increasing use in various nervous system disorder models creates the perception that these are reliable probes. To examine key pharmacological parameters of these compounds in detail, we have developed and optimized a series of complementary quantitative assays that measure TrkB receptor activation, TrkB-dependent downstream signaling, and gene expression in different cellular contexts. Although BDNF and other neurotrophic factors elicited robust and dose-dependent receptor activation and downstream signaling, we were unable to reproduce these activities using the reported small-molecule TrkB agonists. Our findings indicate that experimental results obtained with these compounds must be carefully interpreted and highlight the challenge of developing reliable pharmacological activators of this key molecular target.

Deconstructing the Iboga Alkaloid Skeleton: Potentiation of FGF2-induced Glial Cell Line-Derived Neurotrophic Factor Release by a Novel Compound.

Modulation of growth factor signaling pathways in the brain represents a new experimental approach to treating neuropsychiatric disorders such as depression, anxiety, and addiction. Neurotrophins and growth factors exert synaptic, neuronal, and circuit level effects on a wide temporal range, which suggests a possibility of rapid and lasting therapeutic effects. Consequently, identification of small molecules that can either enhance the release of growth factors or potentiate their respective pathways will provide a drug-like alternative to direct neurotrophin administration or viral gene delivery and thus represents an important frontier in chemical biology and drug design. Glial cell line-derived neurotrophic factor (GDNF), in particular, has been implicated in marked reduction of alcohol consumption in rodent addiction models, and the natural product ibogaine, a substance used traditionally in ritualistic ceremonies, has been suggested to increase the synthesis and release of GDNF in the dopaminergic system in rats. In this report, we describe a novel iboga analog, XL-008, created by unraveling the medium size ring of the ibogamine skeleton, and its ability to induce release of GDNF in C6 glioma cells. Additionally, XL-008 potentiates the release of GDNF induced by fibroblast growth factor 2 (FGF2), another neurotrophin implicated in major depressive disorder, increasing potency more than 2-fold (from 7.85 ± 2.59 ng/mL to 3.31 ± 0.98 ng/mL) and efficacy more than 3-fold. The GDNF release by both XL-008 and the FGF2/XL-008 mixture was found to be mediated through the MEK and PI3K signaling pathways but not through PLCγ in C6 glioma cells.

C-H bonds as ubiquitous functionality: a general approach to complex arylated pyrazoles via sequential regioselective C-arylation and N-alkylation enabled by SEM-group transposition.

Pyrazoles are important azole heteroarenes frequently found in pharmaceuticals and protein ligands, and there has been a growing interest in new synthetic methods for their preparation. We report the first catalytic intermolecular C-H arylation of pyrazoles, namely SEM-protected pyrazoles and N-alkylpyrazoles, which lays the foundation for a new approach to the synthesis of complex arylated pyrazoles, where new arene rings are directly attached to predetermined positions of the heteroarene nucleus ("topologically obvious synthesis"). Through a systematic search, we identified a palladium-pivalate catalytic system as the most effective protocol and mapped the reactivity of all three C-H bonds of the pyrazole (C-5 > C-4 >> C-3). To circumvent the low reactivity of the C-3 position, we developed a "SEM switch", which transposes the SEM-protecting group from one nitrogen to the other in one step, and in the process transforms the unreactive C-3 position to the reactive C-5 position. The SEM switch thus enables sequential arylation of C-5 and C-3 position, providing rapid access to protected or free 3,4,5-triarylpyrazoles (the C-4 arene ring is readily introduced by bromination and Suzuki coupling). Furthermore, N-alkylation of SEM-protected pyrazoles allows for regioselective introduction of the amine substituent, addressing the low regioselectivity of N-alkylation of pyrazoles lacking sufficient steric bias. Thus, the catalytic C-H arylation combined with the protecting group transposition and N-alkylation provides a rapid route to fully substituted pyrazoles with complete regiocontrol of all substituents. The particular strength of this strategy is the ability to commence the synthesis from either the parent pyrazole or practically any pyrazole intermediate.