Visuo-Cognitive Phenotypes in Early Multiple Sclerosis: A Multisystem Model of Visual Processing
Background: Cognitive impairment can emerge in the earliest stages of multiple sclerosis (MS), with heterogeneity in cognitive deficits often hindering symptom identification and management. Sensory–motor dysfunction, such as visual processing impairment, is also common in early disease and can impa...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2024-01-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/13/3/649 |
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| author | Hariklia Vagias Michelle L. Byrne Lyn Millist Owen White Meaghan Clough Joanne Fielding |
| author_facet | Hariklia Vagias Michelle L. Byrne Lyn Millist Owen White Meaghan Clough Joanne Fielding |
| author_sort | Hariklia Vagias |
| collection | DOAJ |
| description | Background: Cognitive impairment can emerge in the earliest stages of multiple sclerosis (MS), with heterogeneity in cognitive deficits often hindering symptom identification and management. Sensory–motor dysfunction, such as visual processing impairment, is also common in early disease and can impact neuropsychological task performance in MS. However, cognitive phenotype research in MS does not currently consider the relationship between early cognitive changes and visual processing impairment. Objectives: This study explored the relationship between cognition and visual processing in early MS by adopting a three-system model of afferent sensory, central cognitive and efferent ocular motor visual processing to identify distinct visuo-cognitive phenotypes. Methods: Patients with clinically isolated syndrome and relapsing–remitting MS underwent neuro-ophthalmic, ocular motor and neuropsychological evaluation to assess each visual processing system. The factor structure of ocular motor variables was examined using exploratory factor analysis, and phenotypes were identified using latent profile analysis. Results: Analyses revealed three ocular-motor constructs (cognitive control, cognitive processing speed and basic visual processing) and four visuo-cognitive phenotypes (early visual changes, efferent-cognitive, cognitive control and afferent-processing speed). While the efferent-cognitive phenotype was present in significantly older patients than was the early visual changes phenotype, there were no other demographic differences between phenotypes. The efferent-cognitive and cognitive control phenotypes had poorer performance on the Symbol Digit Modalities Test compared to that of other phenotypes; however, no other differences in performance were detected. Conclusion: Our findings suggest that distinct visual processing deficits in early MS may differentially impact cognition, which is not captured using standard neuropsychological evaluation. Further research may facilitate improved symptom identification and intervention in early disease. |
| first_indexed | 2024-03-08T03:54:28Z |
| format | Article |
| id | doaj.art-3cde97d1ac0b438ab5b465bcf08e14fb |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-08T03:54:28Z |
| publishDate | 2024-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-3cde97d1ac0b438ab5b465bcf08e14fb2024-02-09T15:15:25ZengMDPI AGJournal of Clinical Medicine2077-03832024-01-0113364910.3390/jcm13030649Visuo-Cognitive Phenotypes in Early Multiple Sclerosis: A Multisystem Model of Visual ProcessingHariklia Vagias0Michelle L. Byrne1Lyn Millist2Owen White3Meaghan Clough4Joanne Fielding5School of Psychological Sciences and the Turner Institute for Brain and Mental Health, Monash University, Melbourne 3800, AustraliaSchool of Psychological Sciences and the Turner Institute for Brain and Mental Health, Monash University, Melbourne 3800, AustraliaDepartment of Neuroscience, Alfred Hospital, Melbourne 3004, AustraliaDepartment of Neuroscience, Central Clinical School, Monash University, Melbourne 3004, AustraliaDepartment of Neuroscience, Central Clinical School, Monash University, Melbourne 3004, AustraliaDepartment of Neuroscience, Central Clinical School, Monash University, Melbourne 3004, AustraliaBackground: Cognitive impairment can emerge in the earliest stages of multiple sclerosis (MS), with heterogeneity in cognitive deficits often hindering symptom identification and management. Sensory–motor dysfunction, such as visual processing impairment, is also common in early disease and can impact neuropsychological task performance in MS. However, cognitive phenotype research in MS does not currently consider the relationship between early cognitive changes and visual processing impairment. Objectives: This study explored the relationship between cognition and visual processing in early MS by adopting a three-system model of afferent sensory, central cognitive and efferent ocular motor visual processing to identify distinct visuo-cognitive phenotypes. Methods: Patients with clinically isolated syndrome and relapsing–remitting MS underwent neuro-ophthalmic, ocular motor and neuropsychological evaluation to assess each visual processing system. The factor structure of ocular motor variables was examined using exploratory factor analysis, and phenotypes were identified using latent profile analysis. Results: Analyses revealed three ocular-motor constructs (cognitive control, cognitive processing speed and basic visual processing) and four visuo-cognitive phenotypes (early visual changes, efferent-cognitive, cognitive control and afferent-processing speed). While the efferent-cognitive phenotype was present in significantly older patients than was the early visual changes phenotype, there were no other demographic differences between phenotypes. The efferent-cognitive and cognitive control phenotypes had poorer performance on the Symbol Digit Modalities Test compared to that of other phenotypes; however, no other differences in performance were detected. Conclusion: Our findings suggest that distinct visual processing deficits in early MS may differentially impact cognition, which is not captured using standard neuropsychological evaluation. Further research may facilitate improved symptom identification and intervention in early disease.https://www.mdpi.com/2077-0383/13/3/649multiple sclerosisphenotypescognitionvisual processingvisuo-cognitive |
| spellingShingle | Hariklia Vagias Michelle L. Byrne Lyn Millist Owen White Meaghan Clough Joanne Fielding Visuo-Cognitive Phenotypes in Early Multiple Sclerosis: A Multisystem Model of Visual Processing Journal of Clinical Medicine multiple sclerosis phenotypes cognition visual processing visuo-cognitive |
| title | Visuo-Cognitive Phenotypes in Early Multiple Sclerosis: A Multisystem Model of Visual Processing |
| title_full | Visuo-Cognitive Phenotypes in Early Multiple Sclerosis: A Multisystem Model of Visual Processing |
| title_fullStr | Visuo-Cognitive Phenotypes in Early Multiple Sclerosis: A Multisystem Model of Visual Processing |
| title_full_unstemmed | Visuo-Cognitive Phenotypes in Early Multiple Sclerosis: A Multisystem Model of Visual Processing |
| title_short | Visuo-Cognitive Phenotypes in Early Multiple Sclerosis: A Multisystem Model of Visual Processing |
| title_sort | visuo cognitive phenotypes in early multiple sclerosis a multisystem model of visual processing |
| topic | multiple sclerosis phenotypes cognition visual processing visuo-cognitive |
| url | https://www.mdpi.com/2077-0383/13/3/649 |
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