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Individuals with multiple sclerosis (MS) can have difficulty on tasks requiring social cognition, including Theory of Mind (ToM) and facial affect recognition. However, most research on social cognition in MS has focused on Relapsing–Remitting MS; less is known about deficits in individuals with progressive MS. This pilot study examined the social cognitive abilities of individuals with progressive MS on a dynamic social cognition task: The Awareness of Social Inference Test – Short Form (TASIT-S).
Methods:
Fifteen individuals with progressive MS and 17 healthy controls performed TASIT-S, which includes 3 subtests assessing facial affect recognition and ToM.
Results:
The MS group was impaired on all subtests of TASIT-S, including Emotion Evaluation, Social Inference – Minimal, and Social Inference – Enriched, which examine facial affect recognition and ToM. Deficits on TASIT-S were significantly correlated with several cognitive abilities including working memory, learning memory, and verbal IQ.
Conclusions:
Our findings suggest individuals with progressive MS were impaired across multiple social cognition domains as assessed by the TASIT-S. Furthermore, social cognitive abilities were related to cognitive abilities such as visuospatial memory and executive abilities. Results are discussed in terms of social cognition deficits in MS and how they relate to cognitive abilities.
As the prevalence and functional consequences of multiple sclerosis (MS)-related cognitive dysfunction became more widely recognized, several definitive trials of disease-modifying medications for relapsing remitting MS and progressive MS incorporated neuropsychological (NP) outcome measures. This chapter lists clinical trials designed to assess the efficacy of medications as symptomatic treatment for cognitive impairment. Several factors complicate the assessment of NP outcomes in MS trials, although none is insurmountable. With the recent development of functional magnetic resonance imaging (fMRI), it has been possible to image MS patients while they perform cognitive tests in the scanner. In general, these fMRI studies have demonstrated that, even when cognitive testing is comparable to healthy controls, MS patients exhibit a larger number of activated regions, an increase in MR signal change and spatial extent in regions also activated by controls, and a decrease in laterality indices.
This chapter summarizes interferon (IFN) biological effects, its possible mechanisms of action, and the key studies in clinically isolated syndromes (CIS), relapsing remitting multiple sclerosis (RRMS), and progressive MS. Measures of specific IFNβ-induced products, such as oligoadenylate synthetase (OAS), β-2 microglobulin, or neopterin, have been useful in pharmacodynamic studies to determine the magnitude and duration of the IFNβ-response, since serum levels of IFNβ are undetectable following injections. A consistent finding of follow-up studies from the three pivotal IFNβ RRMS trials and two CIS trials is that early treatment is beneficial compared with delayed treatment. IFNβ is partially effective in clinical trial groups. Since approval 18 years ago of the first IFNβ product for RRMS, treatment effects of β at all stages of MS have become fairly clear. The development of β for MS has illustrated many of the challenges in developing treatments for MS.
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