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 #36 Fatigability on a Sustained Attention Task and Whole Brain White Matter Microstructure in Pediatric-Onset Multiple Sclerosis (POMS) Tracy Fabri, York University, Toronto, Canada Elisea De Somma, York University, Toronto, Canada Ritobrato Datta, Children’s Hospital of Philadelphia, Philadelphia, United States Eluen Yeh, The Hospital for Sick Children, Toronto, Canada Brenda Banwell, Children’s Hospital of Philadelphia, Philadelphia, United States Christine Till, York University, Toronto, Canada Category: Neurodegenerative Disorders Keyword 1: multiple sclerosis Keyword 2: fatigue Keyword 3: attention Objective: Cognitive fatigability, operationalized as variability in response time, may contribute to poorer accuracy in pediatric-onset multiple sclerosis (POMS). One factor that may increase fatigability involves disruptions to white matter integrity. The current study examined the association between whole brain white matter microstructure and measures of accuracy and fatigability in POMS. We hypothesized that reduced white matter integrity would contribute to reduced accuracy and greater variability in response time given that efficient processing is subserved by white matter. Participants and Methods: We compared 35 POMS participants (M_age=17.4±3.0 years; 24 female, average disease duration = 3.01±3.33 years) and 70 age- and sex-matched healthy controls (HCs) (M_age=18.4±4.9 years; 48 female) recruited from the Canadian Pediatric Demyelinating Disease Study. A subsample (i.e., 30 POMS, 51 HCs) had diffusion tensor imaging data available. The PedsQL-Multidimensional Fatigue Scale (PedsQL-MFS) was completed by participants and their parents. Severe fatigue was defined as scores falling two or more standard deviations from published norms. Fatigability was assessed using the abbreviated version of the Continuous Performance Test (CPT) from the Penn Computerized Neurocognitive Battery. Whole brain fractional anisotropy (FA) was used as a proxy of whole brain white matter microstructure. We used Fisher’s Exact Test to compare the proportion of POMS and HC participants endorsing severe fatigue as assessed by the PedsQL-MFS. We used multiple linear regressions to compare groups on CPT performance and whole brain FA, controlling for age and sex. We then examined associations between FA and CPT outcomes (i.e., accuracy, fatigability measured using individual standard deviation (ISD)) collapsing across and within groups using multiple linear regression, again controlling for age and sex. Results: POMS had poorer accuracy (p=.02) and greater fatigability (p=.01) relative to HCs on the CPT. Across the full sample, severe total fatigue was more commonly endorsed in the POMS group by both parents (45.5%) and patients (37.1%) relative to the HC group (13.3% and 11.1%, respectively, p<.01). Mean whole brain FA was significantly lower (p<.001) in POMS (0.19±0.00) relative to HCs (0.19±0.00). Accuracy was positively associated with whole brain FA for POMS patients (r=.41, p=.04) but was not significant among HCs (r=.22, p=.16). No statistically significant associations between fatigability and whole brain FA were observed by group, nor collapsing across groups (all p values >.05). Conclusions: Severe fatigue reported by patients and their parents is prevalent in POMS and is disproportionate to that reported by healthy peers and their parents. While POMS patients are more susceptible to reductions in accuracy and fatigability (i.e., greater response time variability) relative to healthy peers, whole brain white matter integrity measured using FA, only associates with accuracy in POMS. Future studies are needed to better understand factors that underly increased fatigability in POMS patients.

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 #36

Fatigability on a Sustained Attention Task and Whole Brain White Matter Microstructure in Pediatric-Onset Multiple Sclerosis (POMS)

Tracy Fabri, York University, Toronto, Canada
Elisea De Somma, York University, Toronto, Canada
Ritobrato Datta, Children’s Hospital of Philadelphia, Philadelphia, United States
Eluen Yeh, The Hospital for Sick Children, Toronto, Canada
Brenda Banwell, Children’s Hospital of Philadelphia, Philadelphia, United States
Christine Till, York University, Toronto, Canada

Category: Neurodegenerative Disorders

Keyword 1: multiple sclerosis
Keyword 2: fatigue
Keyword 3: attention

Objective:

Cognitive fatigability, operationalized as variability in response time, may contribute to poorer accuracy in pediatric-onset multiple sclerosis (POMS). One factor that may increase fatigability involves disruptions to white matter integrity. The current study examined the association between whole brain white matter microstructure and measures of accuracy and fatigability in POMS. We hypothesized that reduced white matter integrity would contribute to reduced accuracy and greater variability in response time given that efficient processing is subserved by white matter.

Participants and Methods:

We compared 35 POMS participants (M_age=17.4±3.0 years; 24 female, average disease duration = 3.01±3.33 years) and 70 age- and sex-matched healthy controls (HCs) (M_age=18.4±4.9 years; 48 female) recruited from the Canadian Pediatric Demyelinating Disease Study. A subsample (i.e., 30 POMS, 51 HCs) had diffusion tensor imaging data available. The PedsQL-Multidimensional Fatigue Scale (PedsQL-MFS) was completed by participants and their parents. Severe fatigue was defined as scores falling two or more standard deviations from published norms. Fatigability was assessed using the abbreviated version of the Continuous Performance Test (CPT) from the Penn Computerized Neurocognitive Battery. Whole brain fractional anisotropy (FA) was used as a proxy of whole brain white matter microstructure.

We used Fisher’s Exact Test to compare the proportion of POMS and HC participants endorsing severe fatigue as assessed by the PedsQL-MFS. We used multiple linear regressions to compare groups on CPT performance and whole brain FA, controlling for age and sex. We then examined associations between FA and CPT outcomes (i.e., accuracy, fatigability measured using individual standard deviation (ISD)) collapsing across and within groups using multiple linear regression, again controlling for age and sex.

Results:

POMS had poorer accuracy (p=.02) and greater fatigability (p=.01) relative to HCs on the CPT. Across the full sample, severe total fatigue was more commonly endorsed in the POMS group by both parents (45.5%) and patients (37.1%) relative to the HC group (13.3% and 11.1%, respectively, p<.01). Mean whole brain FA was significantly lower (p<.001) in POMS (0.19±0.00) relative to HCs (0.19±0.00). Accuracy was positively associated with whole brain FA for POMS patients (r=.41, p=.04) but was not significant among HCs (r=.22, p=.16). No statistically significant associations between fatigability and whole brain FA were observed by group, nor collapsing across groups (all p values >.05).

Conclusions:

Severe fatigue reported by patients and their parents is prevalent in POMS and is disproportionate to that reported by healthy peers and their parents. While POMS patients are more susceptible to reductions in accuracy and fatigability (i.e., greater response time variability) relative to healthy peers, whole brain white matter integrity measured using FA, only associates with accuracy in POMS. Future studies are needed to better understand factors that underly increased fatigability in POMS patients.