Jelena Stojanovic-Radic’s research while affiliated with Rutgers New Jersey Medical School and other places

Cognitive Plasticity in Neurologic Disorders describes and specifies the cognitive impact of neuroplastic processes in key neurologic disorders and syndromes. It is set apart from previous works in this area by its emphasis on the changing quality of neurocognition, demonstrating that this dynamic nature emerges from the neuroplastic processes at work in both mild and severe states of brain disease or injury. This resource describes the ways neurological illness or trauma (or attempts to treat patients with such conditions) can trigger neuroplastic mechanisms in the brain, inducing cognitive reorganization and remapping of brain networks. Chapters show how the cognitive and behavioral presentation of the disorder mirrors the changing neurobiologic context, and displays the numerous techniques being employed (e.g. behavior and rehabilitation therapies, electrical stimulation, and computer/machine neuromodulation of brain signals) underlying the neurobiology in ways that facilitate adaptive plasticity and cognitive recovery. An important feature of the book involves characterizing the degree to which the mechanistic principles governing neuroplastic responses and cognitive reorganization in the brain have been elucidated, making clear that it is these principles which will allow us to further develop rational rehabilitative therapies, match patients to appropriate treatments, and even begin to predict clinical treatment outcomes.

Multiple sclerosis (MS) mostly affects young and middle-aged adults and is known to be associated with a host of factors involved in overall quality of life and well-being. The biopsychosocial model of disease takes into account the multifaceted nature of chronic illness and is commonly applied to MS. The present investigation examined the effectiveness of a 10-week psychoeducational MS wellness program that was developed on the basis of the biopsychosocial model and a wellness approach to treatment. The program consisted of 90-minute, weekly psychoeducational wellness group sessions aimed at improving quality of life by increasing awareness of the various social, intellectual, emotional, and spiritual factors that can affect the overall well-being of people living with MS. Fifty-four individuals with MS participated in the study (43 individuals who completed the wellness intervention and 11 individuals with MS who did not participate; "controls"). All participants completed a series of self-report questionnaires at baseline and at the 10-week follow-up, assessing depression, anxiety, perceived stress, cognitive complaints, pain, social support, and fatigue. Repeated-measures analysis revealed improvements in depression, anxiety, overall mental health, perceived stress, and pain in the treatment group compared with the control group. No significant differences were observed between the groups on measures assessing social support, cognitive complaints, and fatigue. The findings suggest that a psychoeducational wellness program is effective in improving the overall quality of life and well-being of individuals with MS.

The present study utilized functional near infrared spectroscopy (fNIRS) to detect neural activation differences in the orbitofrontal brain region between individuals with multiple sclerosis (MS) and healthy controls (HCs) during a working memory (WM) task. Thirteen individuals with MS and 12 HCs underwent fNIRS recording while performing the n-back WM task with four levels of difficulty (0-, 1-, 2-, and 3-back). Subjects were fitted with the fNIRS cap consisting of 30 'optodes' positioned over the forehead. The results revealed different patterns of brain activation in MS and HCs. The MS group showed an increase in brain activation, as measured by the concentration of oxygenated hemoglobin (oxyHb), in the left superior frontal gyrus (LSFG) at lower task difficulty levels (i.e. 1-back), followed by a decrease at higher task difficulty (2- and 3-back) as compared with the HC group. HC group achieved higher accuracy than the MS group on the lower task loads (i.e. 0- and 1-back), however there were no performance differences between the groups at the higher task loads (i.e. 2- and 3-back). Taken together, the results suggest that individuals with MS experience a task with the lower cognitive load as more difficult than the HC group, and the brain activation patterns observed during the task confirm some of the previous findings from functional magnetic resonance imaging (fMRI) studies. This study is the first to investigate brain activation by utilizing the method of fNIRS in MS during the performance of a cognitive task.

Post‐traumatic stress disorder (PTSD) is a chronic psychiatric disorder, with symptoms of hyperarousal, which can alter the biological stress response. Our objective was to determine whether possible increased sympathetic tone in veterans with PTSD affected cerebrovascular function due to altered autonomic control. To assess this we measured sympathetic activity from low frequency blood pressure (BP) and heart rate (HR) variability and cerebrovascular function during hyper/hypocapnia using transcranial Doppler in 29 Veterans (10 with PTSD). There was no difference in BP or cerebral flow velocity in the middle (MCA: 51±5 vs 53±3 cm/s) or anterior cerebral artery (ACA: 48±7 vs 49±3 cm/s). Examination of autonomic indicators found no difference in low frequency power in HR or BP variance. Similarly PTSD status did not affect cerebrovascular reactivity for either the MCA (2.2±0.1 vs 2.2±0.1 %/mmHg) or ACA (2.0±0.2 vs 2.3±0.2 %/mmHg). Surprisingly, regardless of PTSD status, all veterans had a blunted response to hypercapnia (MCA: 1.3±0.2; ACA: 1.3±0.2 %/mmHg) compared to hypocapnia (MCA: 2.8±0.2; ACA: 2.7±0.2 %/mmHg). In contrast to our hypothesis, we did not find increased sympathetic activity in PTSD or impaired cerebral blood flow regulation. One explanation for this finding is that our PTSD sample was not of the hyperarousal type. Since we anticipate that hyperarousal is associated with increased sympathetic outflow, if our subjects mainly had dissociative type PTSD, there could be no difference in autonomic function. The finding of impaired vasodilation to CO2 but not vasoconstriction in all Veterans may indicate impaired cerebral vascular function. Grant Funding Source : Supported by NIH R21DC009900 (Serrador) as well as the WRIISC and the Office of VA Public Health

The most common cognitive impairments in multiple sclerosis (MS) have been documented in specific domains, including new learning and memory, working memory, and information processing speed. However, little attempt has been made to increase our understanding of their relationship to one another. While recent studies have shown that processing speed impacts new learning and memory abilities in MS, the role of working memory in this relationship has received less attention. The present study examines the relative contribution of impaired working memory versus processing speed in new learning and memory functions in MS. Participants consisted of 51 individuals with clinically definite MS. Participants completed two measures of processing speed, two measures of working memory, and two measures of episodic memory. Data were analyzed via correlational and multiple regression analysis. Results indicate that the variance in new learning abilities in this sample was primarily associated with processing speed, with working memory exerting much less of an influence. Results are discussed in terms of the role of cognitive rehabilitation of new learning and memory abilities in persons with MS. This project was supported by Grants RG 3330A and MB003 from the National Multiple Sclerosis Society and the Kessler Foundation.