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CC BY-NC-ND 4.0 · Arq Neuropsiquiatr 2021; 79(08): 666-675
DOI: 10.1590/0004-282X-anp-2020-0162
Article

Regional brain atrophy is related to social cognition impairment in multiple sclerosis

La atrofia cerebral regional se relaciona con el deterioro de la cognición social en sclerosis múltiple
Tomas P. Labbe 
1   Universidad de Santiago de Chile, Escuela de Medicina, Santiago, Chile.
2   Pontificia Universidad Católica de Chile, Interdisciplinary Center of Neurosciences, Santiago, Chile.
,
Cristian Montalba 
3   Pontificia Universidad Católica de Chile, Biomedical Imaging Center, Santiago, Chile.
,
Mariana Zurita 
3   Pontificia Universidad Católica de Chile, Biomedical Imaging Center, Santiago, Chile.
,
Ethel Leslie Ciampi 
4   Pontificia Universidad Católica de Chile, Neurology Department, School of Medicine, Santiago, Chile.
,
Juan Pablo Cruz 
5   Pontificia Universidad Católica de Chile, Radiology Department, School of Medicine, Santiago, Chile.
,
Macarena Vasquez 
4   Pontificia Universidad Católica de Chile, Neurology Department, School of Medicine, Santiago, Chile.
,
Sergio Uribe 
3   Pontificia Universidad Católica de Chile, Biomedical Imaging Center, Santiago, Chile.
5   Pontificia Universidad Católica de Chile, Radiology Department, School of Medicine, Santiago, Chile.
6   Millenium Nucleus for Cardiovascular Magnetic Resonance, Santiago, Chile.
,
Nicolás Crossley 
7   Pontificia Universidad Católica de Chile, Interdisciplinary Center of Neurosciences, Santiago, Chile.
8   Pontificia Universidad Católica de Chile, Psychiatry Department, School of Medicine, Santiago, Chile.
,
Claudia Cárcamo 
4   Pontificia Universidad Católica de Chile, Neurology Department, School of Medicine, Santiago, Chile.
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ABSTRACT

Background: Multiple sclerosis exhibits specific neuropathological phenomena driving to both global and regional brain atrophy. At the clinical level, the disease is related to functional decline in cognitive domains as the working memory, processing speed, and verbal fluency. However, the compromise of social-cognitive abilities has concentrated some interest in recent years despite the available evidence suggesting the risk of disorganization in social life. Recent studies have used the MiniSEA test to assess the compromise of social cognition and have found relevant relationships with memory and executive functions, as well as with the level of global and regional brain atrophy. Objective: The present article aimed to identify structural changes related to socio-cognitive performance in a sample of patients with relapsing-remitting multiple sclerosis. Methods: 68 relapsing-remitting multiple sclerosis Chilean patients and 50 healthy control subjects underwent MRI scans and neuropsychological evaluation including social-cognition tasks. Total brain, white matter, and gray matter volumes were estimated. Also, voxel-based morphometry was applied to evaluate regional structural changes. Results: Patients exhibited lower scores in all neuropsychological tests. Social cognition exhibited a significant decrease in this group mostly related to the declining social perception. Normalized brain volume and white matter volume were significantly decreased when compared to healthy subjects. The regional brain atrophy analysis showed that changes in the insular cortex and medial frontal cortices are significantly related to the variability of social-cognitive performance among patients. Conclusions: In the present study, social cognition was only correlated with the deterioration of verbal fluency, despite the fact that previous studies have reported its link with memory and executive functions. The identification of specific structural correlates supports the comprehension of this phenomenon as an independent source of cognitive disability in these patients.

RESUMEN

Antecedentes: La esclerosis múltiple presenta fenómenos neuropatológicos específicos que conducen a la atrofia cerebral global y regional. A nivel clínico, la enfermedad está relacionada con el deterioro funcional de los dominios cognitivos como la memoria de trabajo, la velocidad de procesamiento y la fluidez verbal. Sin embargo, el compromiso de las habilidades socio-cognitivas ha concentrado cierto interés en los últimos años debido a la evidencia disponible que sugiere el riesgo de desorganización en la vida social. Estudios recientes han utilizado la prueba MiniSEA para evaluar el compromiso de la cognición social y han encontrado relaciones relevantes con la memoria y funciones ejecutiva, así como con el nivel de atrofia cerebral global y regional. Objetivo: El presente artículo tiene como objetivo identificar cambios estructurales relacionados con el rendimiento sociocognitivo en una muestra de pacientes con esclerosis múltiple recurrente-remitente. Métodos: 68 pacientes Chilenos con esclerosis múltiple recurrente-remitente y 50 sujetos de control sanos se sometieron a resonancias magnéticas y evaluación neuropsicológica, incluidas las tareas de cognición social. Se estimaron los volúmenes cerebrales totales, de materia blanca y materia gris. Además, se aplicó la morfometría basada en vóxel para evaluar los cambios estructurales regionales. Resultados: Los pacientes muestran puntuaciones más bajas en todas las pruebas neuropsicológicas. La cognición social exhibe una disminución significativa en este grupo principalmente relacionada con la disminución de la percepción social. El volumen normalizado del cerebro y el volumen de la materia blanca disminuyeron significativamente en comparación con los sujetos sanos. El análisis regional de atrofia cerebral mostró que los cambios en la corteza insular y la corteza frontal medial están significativamente relacionados con la variabilidad del rendimiento sociocognitivo entre los pacientes. Conclusiones: En el presente estudio, la cognición social sólo se correlacionó con el deterioro de la fluencia verbal, a pesar de que estudios previos han reportado su vinculación con la memoria y funciones ejecutivas. La identificación de correlatos estructurales específicos apoya la comprensión de este fenómeno como una fuente independiente de discapacidad cognitiva en estos pacientes.

Keywords:

Multiple Sclerosis - Social Cognition - Theory of Mind - Social Perception - Brain Atrophy

Palabras clave:

Esclerosis Múltiple - Cognición Social - Teoría de la Mente - Percepción Social - Atrofia Cerebral

Authors’ contributions:

TL, EC, CC: conceived of the presented idea; TL: wrote the manuscript with support from NK, CC; JPC, MV, SU: helped supervise the project; TL, MZ, CM carried out the experiments.




Publication History

Received: 15 April 2020

Accepted: 22 November 2020

Article published online:
01 June 2023

© 2021. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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