INS NYC 2024 Program

Poster	Poster Session 09 Program Schedule 02/16/2024 03:30 pm - 04:45 pm Room: Shubert Complex (Posters 1-60) Poster Session 09: Epilepsy \| Oncology \| MS \| Infectious Disease Final Abstract #32 Paired Associate Learning is More Sensitive to Memory Changes than Traditional Memory Tasks in Persons with MS Emily Dvorak, Teachers College, Columbia University, New York, United States James Sumowski, Icahn School of Medicine at Mount Sinai, New York, United States Category: Multiple Sclerosis/ALS/Demyelinating Disorders Keyword 1: memory complaints Keyword 2: multiple sclerosis Objective: Memory decline is common in persons with multiple sclerosis (MS). Patients often report memory concerns early in disease despite normal objective performance on commonly used memory tasks (e.g., word list learning). In these cases, there is a tendency for researchers and clinicians to afford greater weight to objective performance rather than subject complaints. Alternatively, it may be that traditional memory measures are not sufficiently sensitive to subtle but problematic memory decline in persons with early MS. Indeed, research in aging indicates that subjective memory changes precede decline on objective tasks, and a recent study in MS showed that subjective memory concerns are associated with hippocampal atrophy despite normal objective memory. Among memory assessment paradigms, paired associate learning is likely more sensitive to hippocampal dysfunction. Here, we investigated whether paired associate learning is more sensitive to subjective memory complaints and hippocampal volume loss than more commonly used assessments in early MS. Participants and Methods: Data were analyzed from 165 persons with relapse-onset MS (66.7% female) within the RADIEMS cohort study for baseline (Y0) and three-year follow-up (Y3). Baseline characteristics: aged 20-50 years (34.2±7.5), median (IQR) 2.0 (1.0, 3.5) years diagnosed. At both time points, participants completed the Perceived Deficits Questionnaire (PDQ) to capture subjective cognitive concerns; the ten memory complaint items were summed to derive a total subjective memory score (higher scores indicate increased concern). Objective verbal and nonverbal memory was assessed with two traditional tasks typical of MS consensus cognitive batteries (Selective Reminding Test, SRT; Brief Visuospatial Memory Test, Revised, BVMT-R) and two paired associate learning tasks (Verbal Paired Associate Learning, VPAL; CANTAB Paired Associate Learning, PAL). Normalized hippocampal volume (nHV) was derived at Y0 and Y3 from 3.0T T1-weighted MR images processed with FIRST (FSL) and adjusted for intracranial volume using the volume scaling factor (SIENAX). Correlations investigated relationships between objective memory performance on the four tasks and a) subjective memory concerns and b) nHV at baseline and follow-up. Results: At Y0, paired associate learning correlated with subjective memory (VPAL, r= -0.23, p=0.003; PAL, r= -0.23, p=0.003); traditional memory tasks were not reliably related (SRT, r= -0.13, p > 0.10; BVMT-R, r= -0.13, p>0.10). At Y3, paired associate learning was again related to subjective memory (VPAL, r=-0.22, p=0.005; PAL (r=-0.24, p=0.002); unlike at Y0, traditional memory metrics were related to subjective memory at Y3 (SRT, r=-0.35, p<0.001; BVMT-R, r=0.-21, p=0.007). Likewise, at Y0, performance on paired associate learning (r=0.21, p=0.010) but not traditional tasks (r=0.16, p>0.05) was related to nHV, but both paired associate learning (r=0.23, p=0.006) and traditional tasks (r=0.23, p=0.006) were related to nHV at Y3. Conclusions: Results suggest that paired associate learning is more sensitive to early memory decline, including both subjective memory complaints and hippocampal changes, than traditional memory assessments in persons with MS. These findings highlight the need to re-evaluate the objective metrics commonly used to assess memory changes early in disease. Utilizing sufficiently sensitive objective memory measures has important implications for intervention.

Poster

02/16/2024
03:30 pm - 04:45 pm
Room: Shubert Complex (Posters 1-60)

Poster Session 09: Epilepsy | Oncology | MS | Infectious Disease

Final Abstract #32

Paired Associate Learning is More Sensitive to Memory Changes than Traditional Memory Tasks in Persons with MS

Emily Dvorak, Teachers College, Columbia University, New York, United States
James Sumowski, Icahn School of Medicine at Mount Sinai, New York, United States

Category: Multiple Sclerosis/ALS/Demyelinating Disorders

Keyword 1: memory complaints
Keyword 2: multiple sclerosis

Objective:

Memory decline is common in persons with multiple sclerosis (MS). Patients often report memory concerns early in disease despite normal objective performance on commonly used memory tasks (e.g., word list learning). In these cases, there is a tendency for researchers and clinicians to afford greater weight to objective performance rather than subject complaints. Alternatively, it may be that traditional memory measures are not sufficiently sensitive to subtle but problematic memory decline in persons with early MS. Indeed, research in aging indicates that subjective memory changes precede decline on objective tasks, and a recent study in MS showed that subjective memory concerns are associated with hippocampal atrophy despite normal objective memory. Among memory assessment paradigms, paired associate learning is likely more sensitive to hippocampal dysfunction. Here, we investigated whether paired associate learning is more sensitive to subjective memory complaints and hippocampal volume loss than more commonly used assessments in early MS.

Participants and Methods:

Data were analyzed from 165 persons with relapse-onset MS (66.7% female) within the RADIEMS cohort study for baseline (Y0) and three-year follow-up (Y3). Baseline characteristics: aged 20-50 years (34.2±7.5), median (IQR) 2.0 (1.0, 3.5) years diagnosed. At both time points, participants completed the Perceived Deficits Questionnaire (PDQ) to capture subjective cognitive concerns; the ten memory complaint items were summed to derive a total subjective memory score (higher scores indicate increased concern). Objective verbal and nonverbal memory was assessed with two traditional tasks typical of MS consensus cognitive batteries (Selective Reminding Test, SRT; Brief Visuospatial Memory Test, Revised, BVMT-R) and two paired associate learning tasks (Verbal Paired Associate Learning, VPAL; CANTAB Paired Associate Learning, PAL). Normalized hippocampal volume (nHV) was derived at Y0 and Y3 from 3.0T T1-weighted MR images processed with FIRST (FSL) and adjusted for intracranial volume using the volume scaling factor (SIENAX). Correlations investigated relationships between objective memory performance on the four tasks and a) subjective memory concerns and b) nHV at baseline and follow-up.

Results:

At Y0, paired associate learning correlated with subjective memory (VPAL, r= -0.23, p=0.003; PAL, r= -0.23, p=0.003); traditional memory tasks were not reliably related (SRT, r= -0.13, p > 0.10; BVMT-R, r= -0.13, p>0.10). At Y3, paired associate learning was again related to subjective memory (VPAL, r=-0.22, p=0.005; PAL (r=-0.24, p=0.002); unlike at Y0, traditional memory metrics were related to subjective memory at Y3 (SRT, r=-0.35, p<0.001; BVMT-R, r=0.-21, p=0.007). Likewise, at Y0, performance on paired associate learning (r=0.21, p=0.010) but not traditional tasks (r=0.16, p>0.05) was related to nHV, but both paired associate learning (r=0.23, p=0.006) and traditional tasks (r=0.23, p=0.006) were related to nHV at Y3.

Conclusions:

Results suggest that paired associate learning is more sensitive to early memory decline, including both subjective memory complaints and hippocampal changes, than traditional memory assessments in persons with MS. These findings highlight the need to re-evaluate the objective metrics commonly used to assess memory changes early in disease. Utilizing sufficiently sensitive objective memory measures has important implications for intervention.