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Abstract Details

Executive Control of Attention Predicts Risk for Future Depression in Early Multiple Sclerosis
Multiple Sclerosis
S49 - MS Epidemiology and Risk Stratification (1:55 PM-2:06 PM)
006
Research has linked depression and executive function in multiple sclerosis (MS). Our longitudinal cohort study examines this relationship’s directionality/temporal order.
It is known that depression and executive function are linked in MS, but directionality of this relationship is unclear. We present a novel hypothesis in which poor executive control of attention may increase depression risk in MS.
The RADIEMS longitudinal cohort comprises 185 participants with MS (diagnosed <5 years), including comprehensive baseline cognitive/mood assessment and annual patient-reported outcomes. Baseline cognitive assessment included high-sensitivity screener (SDMT), attention/processing speed (Digit Span, Stroop, NIH-TB Pattern Comparison, Decision Speed), memory (SRT, BVMT-R, CANTAB PAL, Verbal-PAL), and a novel measure of executive control of attention requiring performing two tasks simultaneously (multitasking). Mental Health Inventory-3 (MHI-3) measured depression at baseline and at one year.  Stepwise regression predicted depression at year one with all cognitive predictors within the whole sample, then in a subsample of patients without baseline depression (MHI-3 >68), to assess whether baseline cognition predicts risk for future depression.
To date, 158/185 patients completed one-year surveys. Worse executive control of attention during multitasking was the only predictor of worse depression at one-year follow-up within the whole sample (r=.251, p=.001). Among the 121 patients without baseline depression, mood (depression) worsened over one year (p<.001), and this worsening depression over one year was predicted only by poorer executive control of attention at baseline (r=.196, p=.031).
The complex relationship of depression and executive function in MS is not understood well. Although poor mental health may lead to poor cognition, we present an alternative hypothesis in which poor executive control of attention secondary to disease increases depression risk. This may be due to difficulty controlling intrusive thoughts or depressive rumination. These findings have implications for treatment approaches to depression and executive dysfunction in MS (e.g., stimulants vs. antidepressants).
Authors/Disclosures
Lisa Glukhovsky, PhD (Mount Sinai Hospital)
PRESENTER 		No disclosure on file
Michelle Fabian, MD, FAAN (Mount Sinai Hospital) Dr. Fabian has nothing to disclose.
Ilana B. Katz Sand, MD (Corinne Goldsmith Dickinson Center for MS) The institution of Dr. Katz Sand has received research support from National Multiple Sclerosis Society. The institution of Dr. Katz Sand has received research support from Hirschl Foundation. The institution of Dr. Katz Sand has received research support from National Institutes of Health. Dr. Katz Sand has received personal compensation in the range of $500-$4,999 for serving as a Conference presenter with 好色先生.
Sylvia Klineova, MD (Icahn School of Medicine At Mount Sinai) Dr. Klineova has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Amgen. Dr. Klineova has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for TG Therapeutics. Dr. Klineova has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Biogen. Dr. Klineova has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Alexion.
Stephen Krieger, MD, FAAN (Mount Sinai Dept of Neurology) Dr. Krieger has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Biogen. Dr. Krieger has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for EMD Serono. Dr. Krieger has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Genentech. Dr. Krieger has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Novartis. Dr. Krieger has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for TG Therapeutics. Dr. Krieger has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Sanofi. Dr. Krieger has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for Expert Witness. The institution of Dr. Krieger has received research support from Novartis. The institution of Dr. Krieger has received research support from Bristol Myers Squibb. The institution of Dr. Krieger has received research support from Biogen.
Fred D. Lublin, MD, FAAN (Icahn School of Medicine At Mount Sinai) Dr. Lublin has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Roche/Genentech. Dr. Lublin has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen. Dr. Lublin has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Neurogene. Dr. Lublin has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Dr. Lublin has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Medimmune/Viela Bio/Horizon. Dr. Lublin has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Receptos/Celgene/BMS. Dr. Lublin has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Immunic. Dr. Lublin has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Labcorp. Dr. Lublin has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Neuralight. Dr. Lublin has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Entelexo. Dr. Lublin has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Janssen. Dr. Lublin has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Avotres. Dr. Lublin has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Sanofi. Dr. Lublin has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Biogen. Dr. Lublin has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for EMD Serono. Dr. Lublin has received personal compensation in the range of $100,000-$499,999 for serving as an Expert Witness for Multiple entities. Dr. Lublin has stock in Avotres. Dr. Lublin has stock in Neuralight. The institution of Dr. Lublin has received research support from Brainstorm. The institution of Dr. Lublin has received research support from biogen. The institution of Dr. Lublin has received research support from NIH.
Aaron E. Miller, MD, FAAN (Mt Sinai School Of Med) Dr. Miller has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Accordant Health Services (Caremark). Dr. Miller has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Corevitas (formerly known as Corrona). Dr. Miller has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for MAPI=Pharma. Dr. Miller has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Viatris (Mylan). Dr. Miller has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Guidepoint Global. Dr. Miller has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Gerson Lehrman Group. Dr. Miller has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Biogen Idec. Dr. Miller has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Alexion. Dr. Miller has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Amgen (Horizon Therapeutics). Dr. Miller has received personal compensation in the range of $50,000-$99,999 for serving as an Expert Witness for Sterne Kessler. Dr. Miller has received publishing royalties from a publication relating to health care.
Claire Riley, MD, FAAN (Columbia University Medical Center) Dr. Riley has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genentech. Dr. Riley has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for EMD Serono. Dr. Riley has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for TG Therapeutics. Dr. Riley has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Horizon. Dr. Riley has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Riley has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for TG Therapeutics. Dr. Riley has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Riley has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Amgen. Dr. Riley has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Immunic AG. Dr. Riley has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Cabaletta Bio. Dr. Riley has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Bristol Myers Squibb.
James F. Sumowski (Icahn School of Medicine At Mount Sinai) Mr. Sumowski has nothing to disclose.