Investigation of changes in memory protein expression levels of MS patients due to cognitive rehabilitation

Multiple Sclerosis (MS) is a progressive, inflammatory, demyelinating, neurodegenerative and autoimmune disease of the central nervous system. Although the cause is unknown, especially T lymphocyte activation and T and B lymphocytes' interactions play a role in immunopathogenesis. It is known that mild, moderate or severe cognitive degradation can be detected in patients with neuropsychological tests, and memory and executive functions are especially affected. Computer-assisted cognitive rehabilitation (CCR) studies performed with special software are known to improve memory functions and change the memory protein, neurotrophic factor and neurotransmitter levels in peripheral blood. 45 MS patients and 28 healthy volunteers were included in the study to evaluate the effects of CCR on cognitive functions and immune system. Patients were included in the rehabilitation for 6 months and blood samples were collected before the study and after rehabilitation. Immune system cells were determined from peripheral blood mononuclear cell (PBMC) samples by flow cytometry. The validation of the genes determined by Microarray study was done by real-time PCR analysis. A large panel was applied to the volunteers for the evaluation of cognitive and motor functions. In patients, cognitive and motor functions were found to decrease in verbal and visual memory. While the improvement in executive functions was observed after rehabilitation, there was no modifying effect on verbal and visual memory and motor functions. There was no significant increase in NK cells after rehabilitation. The effect of rehabilitation was not determined between non-effector B cell subgroups. Regulatory B-cell (Breg) subgroup was found to be increased after rehabilitation and it was found to be different from only healthy group. A significant increase in TGFB and ATP1B3 gene expression after rehabilitation can be interpreted as the shift of cell activity to the direction of immune suppression. However, no correlation was found between the percentages of B cell subgroups, neuropsychological test scores, and gene expression levels. These findings suggest that treatment methods that do not rely on biological basis such as cognitive rehabilitation may have molecular and cellular effects. This supports the views that inflammation and clinical progression may lead to regression.