Cognitive impairment

Sat, 01 Jan 2022 00:00:00 +0000

Cognitive impairment is an important and often under-recognised part of multiple sclerosis and related neurological disorders. A major aim of our work is to understand which cognitive domains are affected, how this evolves over time, and how it can be monitored more objectively.

Why this matters

Cognitive impairment has a substantial impact on quality of life, work participation, and daily functioning. Yet it remains difficult to capture efficiently in routine care and difficult to treat in a targeted way.

Characterising impairment

Our work has shown that information-processing speed occupies a central position in the clinical picture of cognitive dysfunction in multiple sclerosis, and that reduced performance in this domain can influence many broader cognitive outcomes.

Developing biomarkers

We develop multimodal biomarkers of cognitive impairment using:

neurophysiology, including P300-based markers
MRI-derived measures of structural damage
shape analysis of the corpus callosum
functional connectivity and dynamic-network analysis
blood and CSF biomarkers

For neurophysiological work specifically, see the Neurophysiology project page.

Clinical monitoring

A current focus is to make cognitive monitoring more scalable in the clinic, including app-based testing and image-based modelling approaches that can support longitudinal follow-up.

Treatment development

Because cognitive impairment remains difficult to treat, we are exploring new intervention strategies, including combined physical-cognitive training and non-invasive neuromodulation approaches.

See the Publications page for selected papers on cognitive impairment, cognitive decline, and multimodal biomarkers.

Neurophysiology

Sat, 01 Jan 2022 00:00:00 +0000

Because cognitive impairment is difficult to assess objectively, we study brain activity directly to understand how neurological disease alters large-scale brain function.

Brain dynamics

Modern neurophysiology increasingly goes beyond static connectivity analyses. We study transient brain states with distinct spatial, temporal, and spectral signatures, because these short-lived states offer a window on the timescales at which cognition unfolds.

Spectral analysis

Oscillatory activity, especially in the alpha range, has repeatedly been linked to cognitive impairment in multiple sclerosis. A central question in our work is how specific these associations are and which aspects of cognition they capture most strongly.

Excitation and inhibition

The 1/f spectral slope has been proposed as a marker of excitation-inhibition balance. We study how this measure changes under pharmacological manipulation and whether it can help explain variation in cognitive functioning in neurological disease.

Why this matters for biomarkers

By linking dynamic brain activity to cognition, we aim to build biomarkers that are closer to mechanism than conventional behavioural testing alone.

See the Publications page for selected work on MEG, transient brain states, oscillatory activity, and spectral slope measures.

MEG | Jeroen Van Schependom