The correlation between circulating inflammatory, oxidative stress, and neurotrophic factors level with the cognitive outcomes in multiple sclerosis patients.

Abstract

Changes in the levels of circulating markers of inflammation, oxidative stress, and neurotrophic factors might be a good candidate for the prediction of cognitive impairment in multiple sclerosis (MS). Here, the correlation between the mentioned circulating markers with the Cambridge neuropsychological test automated battery (CANTAB) task outcomes was determined in MS patients. The CANTAB (paired-associate learning (PAL), reaction time (RTI), rapid visual information processing (RVP), and spatial working memory tasks (SWM)) was completed by the patients. Accordingly, the serum levels of interferon-γ (INF-γ), C-reactive protein (CRP), ciliary neurotrophic factor (CNTF), glial cell line-derived neurotrophic factor (GDNF), and brain-derived neurotrophic factor (BDNF), malondialdehyde (MDA), total antioxidant capacity (TAC), and the acetylcholine esterase (AChE) activity were measured. Cognitive impairment status and the correlation between the circulating factors with the CANTAB outcomes were determined. The cognitively impaired (CI) patients appropriately differentiated from not cognitively impaired (NCI) ones using the CANTAB tasks. The serum levels of MDA, TAC, CRP, INF-γ, and GDNF correlated with the cognitive scores in MS patients (p < 0.05). After adjusting for age, sex, disease duration, and disability levels (covariates in a regression model), the MDA, INF-γ, and GDNF factors levels were statistically different between CI and NCI groups (p < 0.05). The mentioned markers might predict the cognitive impairment progress and be used as an index of its detection, in addition to neuropsychological assessments, in MS patients.