Cognitive impairment in multiple sclerosis: An exploratory analysis of environmental and lifestyle risk factors

English version

Autoři: Maria Pia Amato ^aff001; Elio Prestipino ^aff001; Angelo Bellinvia ^aff001; Claudia Niccolai ^aff001; Lorenzo Razzolini ^aff001; Luisa Pastò ^aff003; Roberto Fratangelo ^aff001; Laura Tudisco ^aff001; Mattia Fonderico ^aff001; Paolo Luca Mattiolo ^aff001; Benedetta Goretti ^aff001; Giovanni Bosco Zimatore ^aff004; Nunzia Alessandra Losignore ^aff004; Emilio Portaccio ^aff005; Francesco Lolli ^aff001
Působiště autorů: Department NEUROFARBA, Section of Neurosciences, University of Florence, Florence, Italy ^aff001; IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy ^aff002; SOD Neurological Rehabilitation, Careggi University Hospital, Florence, Italy ^aff003; Operative Unit of Neurology, Dimiccoli General Hospital, Barletta, Italy ^aff004; SOC Neurology, San Giovanni di Dio Hospital, Florence, Italy ^aff005
Vyšlo v časopise: PLoS ONE 14(10)
Kategorie: Research Article
prolekare.web.journal.doi_sk: https://doi.org/10.1371/journal.pone.0222929

Souhrn

Background

Many potentially modifiable risk factors for MS are investigated. It is not known, however, if these factors also apply to MS-related cognitive impairment (CI), a frequent consequence of MS.

Objective

The aim of our study was to assess risk factors for CI in MS patients, focusing on environmental exposures, lifestyle and comorbidities.

Methods

We included MS patients referring to MS Centers in Florence and Barletta between 2014 and 2017. Neuropsychological performance was assessed through the Rao’s battery and Stroop test, cognitive reserve (premorbid intelligence quotient–IQ) was evaluated using the National Adult Reading Test (NART). Potential risk factors were investigated through a semi-structured questionnaire.

Results

150 patients were included. CI was detected in 45 (30%) subjects and was associated with older age (p<0.005), older age at MS onset (p = 0.016), higher EDSS score (p<0.005), progressive disease course (p = 0.048) and lower premorbid IQ score (p<0.005). As for risk factors, CI was related with lower physical activity in childhood-adolescence (p<0.005). In women, hormonal therapy resulted to be protective against CI (p = 0.041). However, in the multivariable analysis, the only significant predictors of CI were older age (p<0.05; OR 1.06, 95% CI 1.02–1.10) and lower premorbid IQ (p<0.05; OR 0.93, 95% CI: 0.88–0.98). Removing IQ from the model, CI was associated with higher EDSS (p = 0.030; OR 1.25, 95% CI 1.02–1.53) and, marginally, previous physical activity (p = 0.066; OR 0.49, 95% CI: 0.23–1.05)

Conclusions

Our findings suggest that physical activity in childhood-adolescence could be a contributor to cognitive reserve building, thus representing a potential protective factors for MS-related CI susceptible to preventive strategies.

Klíčová slova:

Physical activity – Cognitive impairment – Cannabis – Medical risk factors – Neuropsychological testing – Neuropsychology – Multiple sclerosis – Hormonal therapy

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