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Cognitive rehabilitation effects on grey matter volume and Go-NoGo activity in progressive multiple sclerosis: results from the CogEx trial.
Rocca, Maria A; Valsasina, Paola; Romanò, Francesco; Tedone, Nicolò; Amato, Maria Pia; Brichetto, Giampaolo; Boccia, Vincenzo Daniele; Chataway, Jeremy; Chiaravalloti, Nancy D; Cutter, Gary; Dalgas, Ulrik; DeLuca, John; Farrell, Rachel A; Feys, Peter; Freeman, Jennifer; Inglese, Matilde; Meza, Cecilia; Motl, Robert W; Salter, Amber; Sandroff, Brian M; Feinstein, Anthony; Filippi, Massimo.
  • Rocca MA; Neuroimaging Research Unit, Division of Neuroscience, IRCCS Ospedale San Raffaele, Milan, Italy rocca.mara@hsr.it.
  • Valsasina P; Neurology Unit, IRCCS Ospedale San Raffaele, Milan, Italy.
  • Romanò F; Vita-Salute San Raffaele University, Milan, Italy.
  • Tedone N; Neuroimaging Research Unit, Division of Neuroscience, IRCCS Ospedale San Raffaele, Milan, Italy.
  • Amato MP; Neuroimaging Research Unit, Division of Neuroscience, IRCCS Ospedale San Raffaele, Milan, Italy.
  • Brichetto G; Neuroimaging Research Unit, Division of Neuroscience, IRCCS Ospedale San Raffaele, Milan, Italy.
  • Boccia VD; Department NEUROFARBA, Section Neurosciences, University of Florence, Florence, Italy.
  • Chataway J; IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy.
  • Chiaravalloti ND; Scientific Research Area, Italian Multiple Sclerosis Foundation (FISM), Genoa, Italy.
  • Cutter G; AISM Rehabilitation Service, Italian Multiple Sclerosis Society, Genoa, Italy.
  • Dalgas U; Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, and Center of Excellence for Biomedical Research, University of Genoa, Genoa, Italy.
  • DeLuca J; Queen Square Multiple Sclerosis Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, UK.
  • Farrell RA; National Institute for Health Research, University College London Hospitals, Biomedical Research Centre, London, UK.
  • Feys P; Kessler Foundation, West Orange, NJ, USA.
  • Freeman J; Department of Physical Medicine & Rehabilitation, Rutgers New Jersey Medical School, Newark, New Jersey, USA.
  • Inglese M; Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL, USA.
  • Meza C; Exercise Biology, Department of Public Health, Aarhus University, Aarhus, Denmark.
  • Motl RW; Kessler Foundation, West Orange, NJ, USA.
  • Salter A; Department of Physical Medicine & Rehabilitation, Rutgers New Jersey Medical School, Newark, New Jersey, USA.
  • Sandroff BM; Queen Square Multiple Sclerosis Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, UK.
  • Feinstein A; REVAL, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium.
  • Filippi M; University MS Center, Hasselt University, Pelt, Belgium.
J Neurol Neurosurg Psychiatry ; 2024 May 16.
Article en En | MEDLINE | ID: mdl-38754979
ABSTRACT

BACKGROUND:

Research on cognitive rehabilitation (CR) and aerobic exercise (EX) to improve cognition in progressive multiple sclerosis (PMS) remains limited. CogEx trial investigated the effectiveness of CR and EX in PMS here, we present MRI substudy volumetric and task-related functional MRI (fMRI) findings.

METHODS:

Participants were randomised to 'CR plus EX', 'CR plus sham EX (EX-S)', 'EX plus sham CR (CR-S)' and 'CR-S plus EX-S' and attended 12-week intervention. All subjects performed physical/cognitive assessments at baseline, week 12 and 6 months post intervention (month 9). All MRI substudy participants underwent volumetric MRI and fMRI (Go-NoGo task).

RESULTS:

104 PMS enrolled at four sites participated in the CogEx MRI substudy; 84 (81%) had valid volumetric MRI and valid fMRI. Week 12/month 9 cognitive performances did not differ among interventions; however, 25-62% of the patients showed Symbol Digit Modalities Test improvements. Normalised cortical grey matter volume (NcGMV) changes at week 12 versus baseline were heterogeneous among interventions (p=0.05); this was mainly driven by increased NcGMV in 'CR plus EX-S' (p=0.02). Groups performing CR (ie, 'CR plus EX' and 'CR plus EX-S') exhibited increased NcGMV over time, especially in the frontal (p=0.01), parietal (p=0.04) and temporal (p=0.04) lobes, while those performing CR-S exhibited NcGMV decrease (p=0.008). In CR groups, increased NcGMV (r=0.36, p=0.01) at week 12 versus baseline correlated with increased California Verbal Learning Test (CVLT)-II scores. 'CR plus EX-S' patients exhibited Go-NoGo activity increase (p<0.05, corrected) at week 12 versus baseline in bilateral insula.

CONCLUSIONS:

In PMS, CR modulated grey matter (GM) volume and insular activity. The association of GM and CVLT-II changes suggests GM plasticity contributes to cognitive improvements. TRIAL REGISTRATION NUMBER NCT03679468.
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Texto completo: 1 Banco de datos: MEDLINE Idioma: En Año: 2024 Tipo del documento: Article
Texto completo
Imprimir
XML
PubMed Links
Search on Google

Texto completo: 1 Banco de datos: MEDLINE Idioma: En Año: 2024 Tipo del documento: Article