Abstract Details

Title Reappraisal of Old Assumptions: Patient-Reported Memory (But Not Objective Memory) is Linked to Hippocampal Volume in Early Multiple Sclerosis

Topic Multiple Sclerosis

Presentation(s) P1 - Poster Session 1 (12:00 PM-1:00 PM)

Poster/Presentation
Number 9-001

Objective To re-assess longstanding assumptions in research and clinical practice that objective performance on memory tests is more valid than subjective memory in early multiple sclerosis (MS) by examining differential links to hippocampal and hippocampal subfield volumes.

Background Patients with early MS frequently report memory problems, but objective memory test results are often normal. Faced with this disconnect between subjective and objective memory, researchers and clinicians tend to believe objective performance over subjective report. However, subjective memory may be more sensitive than objective measures to early, more subtle disease-related hippocampal changes.

Design/Methods Persons with early MS (n=185; ≤5 years diagnosed) reported subjective memory via questionnaire and completed standardized objective memory tests. Normalized volumes of hippocampus and hippocampal subfields were derived from 3D 3.0T MRIs. We assessed correlations between memory (subjective, objective) and hippocampal volumes among patients in partially-adjusted (age, sex) and fully-adjusted (age, sex, mood, IQ) models. For context, healthy controls completed questionnaires (n=150), objective tests (n=50), and MRIs (n=35).

Results Lower hippocampal volumes (total, subfields) were linked to worse subjective memory across models, with links to CA1, subiculum, and molecular layer withstanding multiple comparisons corrections. Links between hippocampal volumes and objective memory were weaker, and none withstood multiple comparisons corrections. Findings were maintained even among patients with mood symptoms. Patients reported worse subjective memory than controls, and patients with the worst subjective memory (highest tertile) had lower hippocampal volume than controls. This was not found for objective memory.

Conclusions It is assumed in research and clinical practice that objective test performance is more valid than patient-reported cognition. In contrast, links between lower hippocampal volume and worse subjective (but not objective) memory support validity of patients’ perspectives on their own function, particularly early in disease when symptoms may be subtle but nonetheless impactful. Findings warrant reappraisal of memory processes and memory assessment in MS.

Authors/Disclosures
Lisa Glukhovsky, PhD (Mount Sinai Hospital) PRESENTER	No disclosure on file
Rachel Brandstadter, MD (University of Pennsylvania)	Dr. Brandstadter has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Alexion.
Victoria Leavitt, PhD, FAAN (Columbia University Irving Medical Center)	Dr. Leavitt has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Leavitt has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Novartis. The institution of Dr. Leavitt has received research support from National Institutes of Health. The institution of Dr. Leavitt has received research support from National Multiple Sclerosis Society. The institution of Dr. Leavitt has received research support from Department of Defense. Dr. Leavitt has received intellectual property interests from a discovery or technology relating to health care.
Stephen Krieger, MD, FAAN (Mount Sinai Dept of Neurology)	Dr. Krieger has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Biogen. Dr. Krieger has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for EMD Serono. Dr. Krieger has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Genentech. Dr. Krieger has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Dr. Krieger has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for TG Therapeutics. Dr. Krieger has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Sanofi. Dr. Krieger has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Cycle. The institution of Dr. Krieger has received research support from Novartis. The institution of Dr. Krieger has received research support from Bristol Myers Squibb. The institution of Dr. Krieger has received research support from Biogen. The institution of Dr. Krieger has received research support from Sanofi.
Korhan Buyukturkoglu, PhD (Columbia University)	Dr. Buyukturkoglu has nothing to disclose.
Michelle Fabian, MD, FAAN (Mount Sinai Hospital)	Dr. Fabian has nothing to disclose.
Ilana B. Katz Sand, MD (Corinne Goldsmith Dickinson Center for MS)	The institution of Dr. Katz Sand has received research support from National Multiple Sclerosis Society. The institution of Dr. Katz Sand has received research support from Hirschl Foundation. The institution of Dr. Katz Sand has received research support from National Institutes of Health. Dr. Katz Sand has received personal compensation in the range of $500-$4,999 for serving as a Conference presenter with American Academy of Neurology.
Sylvia Klineova, MD (Icahn School of Medicine At Mount Sinai)	Dr. Klineova has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Amgen. Dr. Klineova has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for TG Therapeutics. Dr. Klineova has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Biogen. Dr. Klineova has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Alexion.
Claire Riley, MD, FAAN	Dr. Riley has received personal compensation for serving as an employee of AstraZeneca. Dr. Riley has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genentech. Dr. Riley has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for EMD Serono. Dr. Riley has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for TG Therapeutics. Dr. Riley has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Horizon. Dr. Riley has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Riley has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Amgen. Dr. Riley has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Immunic AG. Dr. Riley has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Cabaletta Bio. Dr. Riley has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Bristol Myers Squibb. Dr. Riley has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Riley has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for TG Therapeutics.
Fred D. Lublin, MD, FAAN (Icahn School of Medicine At Mount Sinai)	Dr. Lublin has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Roche/Genentech. Dr. Lublin has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen. Dr. Lublin has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Neurogene. Dr. Lublin has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Dr. Lublin has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Medimmune/Viela Bio/Horizon. Dr. Lublin has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Receptos/Celgene/BMS. Dr. Lublin has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Immunic. Dr. Lublin has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Labcorp. Dr. Lublin has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Neuralight. Dr. Lublin has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Entelexo. Dr. Lublin has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Janssen. Dr. Lublin has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Avotres. Dr. Lublin has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Sanofi. Dr. Lublin has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Biogen. Dr. Lublin has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for EMD Serono. Dr. Lublin has received personal compensation in the range of $100,000-$499,999 for serving as an Expert Witness for Multiple entities. Dr. Lublin has stock in Avotres. Dr. Lublin has stock in Neuralight. The institution of Dr. Lublin has received research support from Brainstorm. The institution of Dr. Lublin has received research support from biogen. The institution of Dr. Lublin has received research support from NIH.
Aaron E. Miller, MD, FAAN (Mt Sinai School Of Med)	Dr. Miller has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Accordant Health Services (Caremark). Dr. Miller has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Corevitas (formerly known as Corrona). Dr. Miller has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for MAPI=Pharma. Dr. Miller has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Viatris (Mylan). Dr. Miller has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Guidepoint Global. Dr. Miller has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Gerson Lehrman Group. Dr. Miller has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Biogen Idec. Dr. Miller has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Alexion. Dr. Miller has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Amgen (Horizon Therapeutics). Dr. Miller has received personal compensation in the range of $50,000-$99,999 for serving as an Expert Witness for Sterne Kessler. Dr. Miller has received publishing royalties from a publication relating to health care.
James F. Sumowski (Icahn School of Medicine At Mount Sinai)	Mr. Sumowski has nothing to disclose.