Abstract Details

Title Clinical and Conventional MRI Predictors of Cognitive Rehabilitation Efficacy in Multiple Sclerosis

Topic Multiple Sclerosis

Presentation(s) P5 - Poster Session 5 (5:30 PM-6:30 PM)

Poster/Presentation
Number 15-033

Objective

To identify baseline clinical factors and conventional MRI measures of neuropathology which predict patient response to cognitive rehabilitation in multiple sclerosis (MS).

Background Efficacy of restorative cognitive rehabilitation is highly variable for people with MS. Baseline clinical and conventional MRI characteristics are widely available and may help predict patient responsiveness to treatment and improve individualized patient care.

Design/Methods

We recruited 51 PwMS (35 relapsing-remitting, 16 progressive) for a 12-week restorative cognitive rehabilitation program. Subjects were recruited from a cohort with MRI previously collected for a larger study. Baseline and follow-up assessment included standard tests of cognition and clinical questionnaires. Treatment efficacy was measured according to improvement on the Symbol Digit Modalities Test (SDMT). We applied forward stepwise selection using baseline clinical predictors, including age, sex, EDSS, fatigue, depression, personality, disease course, and education, to predict this response to treatment. A separate, analogous analysis was applied to investigate MRI predictors of treatment efficacy, and included lateral ventricular volume (LVV), gray matter volume (GMV), and T2 lesion volume (T2LV).

Results Disease course (relapsing remitting vs progressive) was retained in the final model predicting treatment efficacy (β=-0.336,p=0.026). The relapsing-remitting subgroup showed a mean improvement of 4.4±6.5 raw points (p<0.0001), while there was no significant change in the progressive MS group performance on SDMT (0.3±4.7 points,p=0.835). As well, baseline GMV was retained in the final MRI model, predicting treatment efficacy (β=0.367,p=0.014). People with relapsing-remitting MS had significantly greater GMV (750.3ml) relative to those with progressive MS (710.7ml, t=2.75, p=0.009).

Conclusions The presently used form of restorative cognitive rehabilitation is more likely to benefit individuals with relapsing-remitting MS rather than those with progressive MS. This difference may be explained by group differences in GMV. Future studies should aim to compare different forms of rehabilitation to predict the best treatment option for each individual patient.

Authors/Disclosures
Tom Fuchs (Buffalo Neuroimaging Analysis Center) PRESENTER	Mr. Fuchs has nothing to disclose.
Ralph H. Benedict, PhD (University At Buffalo)	Dr. Benedict has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Roche. Dr. Benedict has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Sanofi. Dr. Benedict has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Bristol Meyers Squibb. Dr. Benedict has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Immunic Therapeutics. Dr. Benedict has received intellectual property interests from a discovery or technology relating to health care.
	No disclosure on file
Leigh E. Charvet, PhD (NYU Langone)	Dr. Charvet has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Johnson & Johnson. Dr. Charvet has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Springer Healthcare. Dr. Charvet has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for YBrain. Dr. Charvet has stock in Johnson&Johnson.
Michael Shaw	Mr. Shaw has nothing to disclose.
Alexander Bartnik	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
Faizan Yasin (WVU Neurology)	No disclosure on file
	No disclosure on file
	No disclosure on file
Robert Zivadinov, MD, PhD, FAAN (Buffalo Neuroimaging Analysis Center)	The institution of Dr. Zivadinov has received personal compensation in the range of $500-$4,999 for serving as a Consultant for BMS. The institution of Dr. Zivadinov has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Omnicuris. The institution of Dr. Zivadinov has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Myrobalan. Dr. Zivadinov has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Sanofi. Dr. Zivadinov has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for EMD Serono. Dr. Zivadinov has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Bristol Myers Squibb. The institution of Dr. Zivadinov has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Biogen.
Michael G. Dwyer III, MD, PhD (Buffalo Neurological Analysis Center)	Dr. Dwyer has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Bristol Myers Squibb. Dr. Dwyer has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Keystone Heart, Ltd. Dr. Dwyer has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Novartis. The institution of Dr. Dwyer has received research support from Novartis. The institution of Dr. Dwyer has received research support from Keystone Heart, Ltd. The institution of Dr. Dwyer has received research support from Bristol Myers Squibb. The institution of Dr. Dwyer has received research support from Roche.

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