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Brief Computer-Based Information Processing Measures are Linked to White Matter Integrity in Pediatric-Onset Multiple
Elizabeth Bartlett1, Michael Shaw2, Colleen Schwarz3
1Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY.
Insights
Computer-administered cognitive tests effectively identify processing speed deficits in pediatric-onset multiple sclerosis (POMS). These deficits correlate with white matter integrity, specifically fractional anisotropy (FA), highlighting the link between brain structure and cognitive function in POMS.
Area of Science:
- Neuroscience
- Pediatric Neurology
- Radiology
Background:
- Pediatric-onset multiple sclerosis (POMS) presents unique clinical challenges in children and adolescents.
- Cognitive impairment is a significant issue in POMS, impacting quality of life.
- Understanding the neuroanatomical basis of cognitive deficits in POMS is crucial for effective management.
Purpose of the Study:
- To investigate the neuroanatomical correlates of cognitive deficits detected by screening batteries in POMS.
- To determine if computer-administered cognitive tests are sensitive to white matter changes in POMS.
Main Methods:
- Participants with POMS and age-matched healthy controls (HCs) underwent cognitive screening using Cogstate and BICAMS.
- Diffusion tensor imaging (DTI) was employed to assess fractional anisotropy (FA) in brain regions and white matter tracts.
- Statistical analyses correlated cognitive performance with FA measures.
Main Results:
- The Cogstate composite showed significant slowing in POMS patients compared to HCs (P = .004).
- Cogstate performance strongly correlated with regional FA (r = -.67 to -.82) and specifically with uncinate fasciculus FA (P = .002) in POMS.
- BICAMS did not significantly differentiate between POMS and HCs (P = .10), and its correlations with FA were weaker and not statistically significant after correction.
Conclusions:
- Computer-administered cognitive processing measures, like Cogstate, are sensitive to cognitive impairment in POMS.
- Cognitive deficits identified by these measures are closely associated with white matter integrity, particularly fractional anisotropy (FA).
- These findings underscore the importance of assessing processing speed and its relationship to white matter microstructure in pediatric MS.
Background And Purpose:
Pediatric-onset multiple sclerosis (POMS) is a demyelinating disorder with unique clinical challenges. A brief computer-administered cognitive screening battery measuring processing speed (Cogstate) and the Brief International Cognitive Assessment in MS (BICAMS) detect cognitive impairment in POMS. The neuroanatomic correlates of these deficits are incompletely understood. The purpose of this study is to define the neuroanatomic underpinnings of deficits identified with cognitive screening batteries in POMS.
Methods:
Participants with POMS and age-matched healthy controls (HCs) were screened with Cogstate and BICAMS. Diffusion tensor imaging assessed region-wise and tractography-based fractional anisotropy (FA).
Results:
The POMS (n = 15) and HC (n = 21) groups were matched on age (mean ages 17.9 ± 3.2 vs. 17.8 ± 3.3 years, respectively) and on an estimate of general intellectual functioning. The Cogstate composite revealed significant slowing in POMS relative to HCs (P = .004), but the BICAMS composite did not significantly distinguish the groups (P = .10). The Cogstate composite showed moderate-to-strong correlations with regional FA (r = -.67 to -.82) and significantly associated with uncinate fasciculus FA following multiple comparisons correction (P = .002) in POMS. However, the BICAMS composite measure showed only weak-to-moderate correlations with FA in POMS (r = -.19 to -.57), with none surviving multiple comparisons correction.
Conclusions:
Computer-administered measures of cognitive processing are particularly sensitive in POMS and are closely linked to white matter FA.
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