Abstract Details

Title Cognitive Signatures of Depression and Anxiety in Multiple Sclerosis

Topic Multiple Sclerosis

Presentation(s) S6 - MS and CNS Inflammatory Disease: Clinical Considerations I (2:17 PM-2:28 PM)

Poster/Presentation
Number 008

Background Neuropsychiatric comorbidities are common in MS, with much higher prevalence than the general population: anxiety, 21.9%, depression, 23.7% (Marrie et al 2015). Cognitive decline is also common in persons with MS; however, distinct relationships of depression and anxiety to cognition are not well understood.

Objective To examine relationships of elevated depression and anxiety to cognition across multiple domains in persons with multiple sclerosis (MS).

Design/Methods 70 MS patients participated: 54 female (74%); age= 40.7±11.1 years; IQ=112±10; education= 16.1±1.7 years; disease duration 7.6±6.9 years. We measured depression (Beck Depression Inventory-II), anxiety (measured as high neuroticism, NEO Five Factor Inventory), and cognition across domains [Symbol Digit Modalities Test; Digit Span forward+back; Stroop Color Word Test (word, color, color-word trials); verbal fluency (FAS, animals), Selective Reminding Test, (learning & delayed recall); Brief Visuospatial Memory Test, (learning & delayed recall)]. Latent variables of cognition were derived using PCA, yielding 4 variables: language, verbal memory, attention/working memory, and nonverbal memory. Defining high anxiety as a neuroticism score of T≥65 yielded groups of high (n=10) and low (n=60) anxiety; high depression defined as BDI≥20 yielded groups of high (n=35) and low (n=35) depression. MANCOVAs controlling for age, sex, education and IQ evaluated cognitive differences between anxiety / depression subgroups.

Results Whereas the high anxiety group (compared to low) performed worse only in verbal memory [F(1,70)=5.773 p=.019], high depression group (compared to low) performed worse only in attention/working memory [F(1,70)= 10.853, p=.002]. In a subsample of 48 patients with imaging, we found higher depression to be associated with larger right amygdala volume (r=.383, p=.010), consistent with a chronic stress model describing increased amygdala volume due as the result of increased dendritic arborization (Lupien et al 2009).

Conclusions

Depression and anxiety have distinct neural signatures. This finding may facilitate clinical decision making and development of targeted treatment for cognition in MS.

Authors/Disclosures
Victoria Leavitt, PhD, FAAN (Columbia University Irving Medical Center) PRESENTER	Dr. Leavitt has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Leavitt has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Novartis. The institution of Dr. Leavitt has received research support from National Institutes of Health. The institution of Dr. Leavitt has received research support from National Multiple Sclerosis Society. The institution of Dr. Leavitt has received research support from Department of Defense. Dr. Leavitt has received intellectual property interests from a discovery or technology relating to health care.
	No disclosure on file
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.

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