Yuan Yang1, Dengji Pan1, Zhenxiang Gong1, Jiahui Tang1, Zehui Li1, Fengfei Ding2, Mao Liu3, Min Zhang4. 1. Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jie Fang Avenue 1095, 430030, Wuhan, Hubei, PR China. 2. Department of Pharmacology, School of Basic Medical Sciences, Fudan University, Shanghai, China. 3. Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jie Fang Avenue 1095, 430030, Wuhan, Hubei, PR China. liumao1987@gmail.com. 4. Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jie Fang Avenue 1095, 430030, Wuhan, Hubei, PR China. zhang_min_3464@126.com.
Abstract
BACKGROUND: ALS patients have changed peripheral immunity. It is unknown whether peripheral immunity is related to cognitive dysfunction in ALS patients. OBJECTIVE: To explore the relationship between the peripheral blood lymphocyte subsets and the cognitive status in ALS patients. METHODS: Among 81 ALS patients, we compared the demographic, clinical, and peripheral levels of total T lymphocyte, CD4+ T lymphocyte, CD8+ T lymphocyte, B lymphocyte, and NK cell between those with cognitive impairment (ALS-ci) and those without (ALS-nci). The cognitive status was evaluated via the Chinese version of the Edinburgh cognitive and behavioral screen (ECAS). Significant predictors of cognitive impairment in univariate logistic regression analysis were further examined using multivariate logistic regression analysis. RESULTS: 39.5% of all ALS patients had cognitive impairment. The ALS-ci group had shorter education time, older age at both symptom onset and testing, longer disease duration, and lower levels of peripheral total, CD4+, and CD8+ T lymphocyte and B lymphocyte than the ALS-nci group. Frequency of behavioral impairment did not differ between the two groups. While parameters with significant differences identified by group comparison were also significant predictors of cognitive impairment in univariate logistic regression analysis except the level of B lymphocyte, only older age at testing, education time less than 9 years, and lower level of CD4+ T lymphocyte remained significant in multivariate logistic regression analysis. The predictive model combining these three parameters had an area under the receiver operating characteristic curve value of 0.842 with a sensitivity of 90.6% and a specificity of 67.3%. CONCLUSION: In Chinese ALS patients, blood CD4+ T lymphocyte might help evaluate cognitive impairment along with age and education level.
BACKGROUND:ALSpatients have changed peripheral immunity. It is unknown whether peripheral immunity is related to cognitive dysfunction in ALSpatients. OBJECTIVE: To explore the relationship between the peripheral blood lymphocyte subsets and the cognitive status in ALSpatients. METHODS: Among 81 ALSpatients, we compared the demographic, clinical, and peripheral levels of total T lymphocyte, CD4+ T lymphocyte, CD8+ T lymphocyte, B lymphocyte, and NK cell between those with cognitive impairment (ALS-ci) and those without (ALS-nci). The cognitive status was evaluated via the Chinese version of the Edinburgh cognitive and behavioral screen (ECAS). Significant predictors of cognitive impairment in univariate logistic regression analysis were further examined using multivariate logistic regression analysis. RESULTS: 39.5% of all ALSpatients had cognitive impairment. The ALS-ci group had shorter education time, older age at both symptom onset and testing, longer disease duration, and lower levels of peripheral total, CD4+, and CD8+ T lymphocyte and B lymphocyte than the ALS-nci group. Frequency of behavioral impairment did not differ between the two groups. While parameters with significant differences identified by group comparison were also significant predictors of cognitive impairment in univariate logistic regression analysis except the level of B lymphocyte, only older age at testing, education time less than 9 years, and lower level of CD4+ T lymphocyte remained significant in multivariate logistic regression analysis. The predictive model combining these three parameters had an area under the receiver operating characteristic curve value of 0.842 with a sensitivity of 90.6% and a specificity of 67.3%. CONCLUSION: In Chinese ALSpatients, blood CD4+ T lymphocyte might help evaluate cognitive impairment along with age and education level.
Authors: Michael J Strong; Sharon Abrahams; Laura H Goldstein; Susan Woolley; Paula Mclaughlin; Julie Snowden; Eneida Mioshi; Angie Roberts-South; Michael Benatar; Tibor HortobáGyi; Jeffrey Rosenfeld; Vincenzo Silani; Paul G Ince; Martin R Turner Journal: Amyotroph Lateral Scler Frontotemporal Degener Date: 2017-01-05 Impact factor: 4.092
Authors: Benjamin J Murdock; Tingting Zhou; Samy R Kashlan; Roderick J Little; Stephen A Goutman; Eva L Feldman Journal: JAMA Neurol Date: 2017-12-01 Impact factor: 18.302
Authors: Michael P Gustafson; Nathan P Staff; Svetlana Bornschlegl; Greg W Butler; Mary L Maas; Mohamed Kazamel; Adeel Zubair; Dennis A Gastineau; Anthony J Windebank; Allan B Dietz Journal: PLoS One Date: 2017-07-25 Impact factor: 3.240