The Effect of Cognitive Rehabilitation on Peripheral Blood B Cell Distribution and Specific Gene Expression Levels in MS patients

INTRODUCTION: Multiple Sclerosis (MS) is an autoimmune, demyelinating, and neurological disorder of the central nervous system (CNS). For years, cellular immunity is thought to be the possible potential mechanism in the immunopathogenesis of the disease; however, nowadays, studies show that humoral immunity has a major part and also plays an important role. Neuropsychological tests in known to detect mild, moderate, or severe cognitive impairments that occur in patients, particularly memory and executive functions are affected. Studies showed that computer-assisted cognitive rehabilitation (CCR) studies that are performed with special software improve memory functions and change the levels of memory proteins, neurotrophic factors, and neurotransmitters in the peripheral blood.
METHODS: Patients with MS (n=18) who are included in the study participated in the CCR for 6 months, and blood samples were gathered at the beginning and after the neuro-rehabilitation stage of the study. Flow cytometry is used to immunophenotype the PBMCs. The expression level of B cell-associated genes that were detected by another microarray study was determined by a real-time polymerase chain reaction. The immunophenotype and gene expression levels of the patients and 20 healthy volunteers, from whom only peripheral blood samples were taken, were compared.
RESULTS: After the CCR, non-significant increased natural killer cells were observed. Regulatory B cell percentages were increased following the rehabilitation period, which differed only from healthy donors. The significantly increased transforming growth factor-beta and ATPase Na+/K+ Transporting Subunit Beta 3 gene expressions after rehabilitation was evaluated as a shift of cell activity toward immunosuppression.
DISCUSSION AND CONCLUSION: The findings suggest that treatment methods, such as cognitive rehabilitation, that are not based on biological foundations may also have molecular and cellular effects. This supports its role in the regression of inflammation and clinical progression.