Abstract
Multiple sclerosis (MS) is a chronic central nervous system disorder characterized by white matter inflammation, demyelination and neurodegeneration. Although cognitive dysfunction is a common manifestation, it may go unnoticed in recently-diagnosed patients. Prior studies suggest MS patients develop compensatory mechanisms potentially involving enhanced performance monitoring. Here we assessed the performance monitoring system in early-stage MS patients using the error-related negativity (ERN), an event-related brain potential (ERP) observed following behavioral errors. Twenty-seven early-stage MS patients and 31 controls were neuropsychologically assessed. Electroencephalography recordings were obtained while participants performed: a) a stop task and b) an auditory oddball task. Behavior and ERP measures were assessed. No differences in performance were found between groups in most neuropsychological tests or in behavior or ERP components in the auditory oddball task. However, the amplitude of the ERN associated with stop errors in the stop task was significantly higher in patients. ERN amplitude correlated positively with scores on the Expanded Disability Status Scale and the Multiple Sclerosis Severity Score, and negatively with the time since last relapse. Patients showed higher neuronal recruitment in tasks involving performance monitoring. Results suggest the development of compensatory brain mechanisms in early-stage MS and reflect the sensitivity of the ERN to detect these changes.
Highlights
Multiple sclerosis (MS) is a chronic, central nervous system (CNS) disorder characterized by white matter inflammation, demyelination and neurodegeneration [1]
To test whether the topographical distribution of the ERN differed between groups, we introduced the mean amplitude from 0 to a 100 ms post error into an ANOVA with electrode (19 levels) and group (MS vs. controls) as factors, and we searched for a significant interaction electrode x group as previously described [25].The ANOVA showed a significant effect of electrode, F(18,1008) = 3.35, p = 0.021, and a significant effect of group, [F(1,56) = 4.391, p = 0.041]
Using a behavioral stop-task associated with event-related brain potential (ERP) recordings, our results showed group differences in amplitude of the negative-going deflection (ERN) found in trials where subjects failed to inhibit their responses following a stop signal
Summary
Multiple sclerosis (MS) is a chronic, central nervous system (CNS) disorder characterized by white matter inflammation, demyelination and neurodegeneration [1]. Among the various clinical manifestations of MS, cognitive dysfunction is common, affecting around 50% of patients [2]. It significantly disrupts instrumental everyday activities, work, social interaction, and overall quality of life [3,4]. Achiron and Barak found that 19.4% of patients assessed shortly after the first neurological symptom failed one neuropsychological test and 34.3% failed two tests. This impairment had no effect on daily living activities [7]
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