Olfactory Identification Predict Cognitive Impairment in Pediatric Onset Multiple Sclerosis

MedicalResearch.com Interview with:


Dr. Leigh Elkins Charvet

Leigh Elkins Charvet, PhD
Director of MS Research
Multiple Sclerosis Comprehensive Care Center
Associate Professor of Neurology
NYU Langone Medical Center
New York, NY 10016

MedicalResearch.com: What is the background for this study?

Dr. Charvet One of the goals of our work is to identify cognitive impairment at the earliest point that it occurs in multiple sclerosis (MS), and ultimately to predict those who are at greatest risk.  Olfactory impairment is a feature of neurodegenerative conditions such as Alzheimer’s and Parkinson’s disease and predicts cognitive decline.  Olfactory impairment has also been reported in adults with multiple sclerosis.  Our study, lead by Colleen Schwarz, measured olfactory identification and its link to cognitive performance in a subpopulation of those with earliest onset of MS—pediatric onset multiple sclerosis (POMS, referring to those with onset before the age of 18).

MedicalResearch.com: What are the main findings?

Dr. Charvet: We compared a consecutively-recruited pediatric onset multiple sclerosis sample (n=15) to healthy control participants (n=35) using the University of Pennsylvania Smell Identification Test (UPSIT)- a 40-item scratch and sniff test of olfactory identification.  We also administered the Symbol Digit Modalities Test or SDMT,  one of the most commonly used and sensitive measures for detection of cognitive impairment in MS.  For the POMS group, median Expanded Disability Status Scale  (EDSS) score was 1.0 and mean disease duration was 3.95 ± 0.96 years. The POMS group and the HC group were matched according to age (18.0±2.7 vs. 19.8±4.0 years, p=0.07), gender (53.3% female and 65.6% female, respectively) and reading level (standard score of 106 vs. 110, p=0.18). Using age- and gender-referenced normative data, the POMS group trended towards poorer UPSIT performance than the HC group (mean percentile of 14.9±14.9 vs. 24.6±23.4, p=0.09), while the groups did not differ in SDMT scores (mean z-score of 0.19±1.45 vs. -0.29±0.81, p=0.26).  Importantly, among the POMS participants, UPSIT percentile was significantly linked to SDMT performance (r=0.65, p=0.004) suggesting a link between these two areas of functioning. Also, the UPSIT better classified those with multiple sclerosis group than the SDMT.

MedicalResearch.com: What should clinicians and patients take away from your report?

Dr. Charvet: The UPSIT is an easily administered clinical tool and may have the potential to identify patients most at risk for cognitive involvement.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Dr. Charvet: Our finding warrants further study, both in a larger sample, and with more extensive measurement of cognitive functioning and clinical measures including neuroimaging to identify what may lead to poorer olfaction in multiple sclerosis.  We are particularly interested to follow our participants over time, to see if relatively poor olfactory functioning is a predictor for future cognitive decline.  This would help us understand whether this type of measurement could be used to identify those at greatest risk and as the best candidates for intervention to preserve cognitive functioning.


Olfactory Identification Deficits Predict Cognitive Impairment in Pediatric Onset Multiple Sclerosis (MS) (P1.379)

Colleen Schwarz3, Michael Shaw1, Roxane Javadi3, Lauren Krupp2 and Leigh Charvet2

Neurology April 5, 2016 vol. 86 no. 16 Supplement P1.379

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Last Updated on April 22, 2016 by Marie Benz MD FAAD