scholarly journals Clinical predictors to cognitive impairment in multiple sclerosis patients

2021 ◽  
Vol 57 (1) ◽  
Author(s):  
Haidy Elshebawy ◽  
Ebtesam Mohamed Fahmy ◽  
Nervana Mohamed Elfayoumy ◽  
Ahmed Mohamed Abdelalim ◽  
Rania Shehata Ismail
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
Cognitive Dysfunction ◽  
Educational Level ◽  
Disease Duration ◽  
Immunosuppressive Treatment ◽  
Clinical Predictors ◽  
Physical Handicap ◽  
Frequent Relapses ◽  
Multiple Sclerosis Patients

Abstract Background Cognitive dysfunction is increasingly recognized in multiple sclerosis, even in the early phase of the disease. Multiple sclerosis patients with even mild cognitive deficits may experience greater difficulties in social contact and daily activities, irrespective of physical handicap. This study aimed to estimate clinical predictors of cognitive dysfunction in a sample of Egyptian people with MS. Results Significant worse performance in assessed cognitive scales was observed in people with MS as compared to controls. This was related to low educational level, long disease duration, initial cerebellar and motor attacks, progressive course, frequent relapses, and immunosuppressive medications. Cognitive assessment scales were significantly negatively correlated with disability measured by Expanded Disability Status Scale (EDSS) scores. Conclusion Predictors of cognitive impairment in people with MS were low educational level, longer disease duration, type of initial attack, frequent relapses, progressive form, higher clinical disability, and immunosuppressive treatment.

Cognitive Function in Patients with Multiple Sclerosis: Impairment and Treatment

2004 ◽  
Vol 6 (1) ◽  
pp. 9-22 ◽  
Author(s):  
Stephen M. Rao
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
Cognitive Dysfunction ◽  
Disease Duration ◽  
Cognitive Domains ◽  
Neuropsychological Dysfunction ◽  
Visuospatial Abilities ◽  
Assessment And Treatment ◽  
Neurologic Disability ◽  
History Of

Cognitive impairment is common in multiple sclerosis (MS), with up to 65% of patients exhibiting some type of neuropsychological dysfunction. The cognitive domains most affected by MS are learning and memory, attention, information processing, visuospatial abilities, and executive functioning. It is difficult to detect cognitive dysfunction in patients with MS during routine neurologic examinations because conventional measures of neurologic disability are not sensitive enough to detect cognitive impairment. Furthermore, cognitive dysfunction is only weakly correlated with the type of MS, disease duration, or physical disability. However, brain imaging studies show that a relatively strong correlation exists between cognitive dysfunction and overall lesion burden and brain atrophy in MS. This paper reviews the natural history of cognitive dysfunction, areas of cognition affected, the correlation between MRI measures and cognitive dysfunction, issues related to neuropsychological assessment, and treatment of cognitive impairment with disease-modifying MS drugs.

scholarly journals Cognitive Impairment in Relapsing-Remitting Multiple Sclerosis Patients with Very Mild Clinical Disability

2017 ◽  
Vol 2017 ◽  
pp. 1-10 ◽  
Author(s):  
S. Migliore ◽  
A. Ghazaryan ◽  
I. Simonelli ◽  
P. Pasqualetti ◽  
F. Squitieri ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
Executive Functions ◽  
Cognitive Dysfunction ◽  
Cognitive Functions ◽  
Verbal Memory ◽  
Visual Memory ◽  
Clinical Stage ◽  
Relapsing Remitting ◽  
Multiple Sclerosis Patients

Cognitive dysfunction affects 40–65% of multiple sclerosis (MS) patients and can occur in the early stages of the disease. This study aimed to explore cognitive functions by means of the Italian version of the minimal assessment of cognitive function in MS (MACFIMS) in relapsing-remitting MS (RRMS) patients with very mild clinical disability to identify the primarily involved cognitive functions. Ninety-two consecutive RRMS patients with Expanded Disability Status Scale (EDSS) scores ≤ 2.5 and forty-two healthy controls (HC) were investigated. Our results show that 51.1% of MS patients have cognitive dysfunction compared to HC. An impairment of verbal and visual memory, working memory, and executive functions was found in the RRMS group. After subgrouping RRMS by EDSS, group 1 (EDSS ≤ 1.5) showed involvement of verbal memory and executive functions; moreover, group 2 (2 ≤ EDSS ≤ 2.5) patients were also impaired in information processing speed and visual memory. Our results show that utilizing a comprehensive neuropsychological assessment, approximately half of MS patients with very mild physical disability exhibit cognitive impairment with a primary involvement of prefrontal cognitive functions. Detecting impairment of executive functions at an early clinical stage of disease could be useful to promptly enroll MS patients in targeted rehabilitation.

The unique impact of changes in normal appearing brain tissue on cognitive dysfunction in secondary progressive multiple sclerosis patients

2004 ◽  
Vol 10 (6) ◽  
pp. 626-629 ◽  
Author(s):  
Darcy Cox ◽  
Daniel Pelletier ◽  
Claude Genain ◽  
Sharmila Majumdar ◽  
Ying Lu ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
Cognitive Functioning ◽  
Brain Tissue ◽  
Cognitive Dysfunction ◽  
Progressive Multiple Sclerosis ◽  
Resonance Spectroscopy ◽  
Lesion Load ◽  
T1 And T2 ◽  
Multiple Sclerosis Patients

Objective: The purpose of this study was to examine the relationships between cognitive functioning, whole brain magnetic transfer ratio (MTR) imaging, supratentorial 1H-magnetic resonance spectroscopy imaging (1HMRSI), and conventional T1 and T2 imaging in a homogenous sample of SPMS patients. Methods: Nineteen patients underwent a single 90-min imaging session that obtained T1-and T2-weighted images and MTR. 1HMRSI was obtained on 14 of these patients. Patients underwent a neuropsychological battery, which was used to create an integrated measure of cognitive impairment. Cognitive impairment was the dependent variable in two hierarchical multiple regression analyses in which T2 lesion load, T1 lesion load, and MTR or NAA/Cr were entered sequentially. Results: MTR was significantly related to cognitive functioning (ΔR2= 0.22, P= 0.02) after accounting for T2 lesion load (ΔR2=0.33, P= 0.01) and T1 lesion load (ΔR2= 0.00, P=0.98). NAA/Cr was not significantly related to cognitive functioning. Conclusions: Cognitive dysfunction may act as a clinical marker of normal appearing brain tissue pathology in multiple sclerosis.

The relationship between total and regional corpus callosum atrophy, cognitive impairment and fatigue in multiple sclerosis patients

2013 ◽  
Vol 20 (3) ◽  
pp. 356-364 ◽  
Author(s):  
Özgür Yaldizli ◽  
Iris-Katharina Penner ◽  
Karl Frontzek ◽  
Yvonne Naegelin ◽  
Michael Amann ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
Corpus Callosum ◽  
Disease Duration ◽  
Brain Magnetic Resonance Imaging ◽  
Lesion Volume ◽  
Poor Outcome ◽  
Edss Score ◽  
Multiple Sclerosis Patients ◽  
The Relationship

Objective: The objective of this paper is to investigate the relationship between total and regional corpus callosum (CC) atrophy, neuropsychological test performance and fatigue in multiple sclerosis (MS) patients. Methods: We conducted a cross-sectional study in 113 MS patients: mean age 48±11 years, 75/113 women, 84/113 relapsing–remitting MS, mean disease duration 21±9 years, mean Expanded Disability Status Scale (EDSS) score 3.2±1.7. All patients underwent brain magnetic resonance imaging, standardised neurological assessment and comprehensive cognitive testing including assessments for fatigue and depression. Total and regional CC atrophy was assessed using the corpus callosum index (CCI). Results: CCI correlated more strongly with T2- and T1-lesion volume and whole brain volume than with disease duration or EDSS score. CCI correlated strongly with the verbal fluency test (VFT), Symbol Digit Modalities Test (SDMT) and Paced Auditory Serial Addition Test (PASAT). Multivariate regression analysis revealed that atrophy of the posterior CC segment was significantly associated with poor outcome in the PASAT, VFT and SDMT. In contrast, atrophy of the anterior CC segment was significantly associated with fatigue severity and poor outcome in the long-term memory test. Conclusions: Atrophy of the CC is associated with cognitive impairment and fatigue. Regional CCI results indicate that these associations are partially spatially segregated.

Interferon gamma production in blood lymphocytes correlates with disability score in multiple sclerosis patients

2000 ◽  
Vol 6 (1) ◽  
pp. 19-23 ◽  
Author(s):  
H F Petereit ◽  
N Richter ◽  
R Pukrop ◽  
S Bamborschke
Keyword(s):  
Multiple Sclerosis ◽  
Interferon Gamma ◽  
Disease Duration ◽  
Immunosuppressive Treatment ◽  
Unexpected Finding ◽  
Disability Score ◽  
Blood Lymphocytes ◽  
Variation Range ◽  
Wide Scatter ◽  
Multiple Sclerosis Patients

The proinflammatory cytokine interferon gamma (IFG) is elevated in body fluids of multiple sclerosis patients but its variation range is broad. The reason for this wide scatter of IFG production is not yet known. We looked for the relation between clinical parameters such as disability, exacerbation frequency, disease duration, course of the disease and IFG producing blood lymphocytes. Forty-one consecutive, clinically stable multiple sclerosis patients with primary relapsing course of the disease and without immunomodulatory or immunosuppressive treatment in the last 3 months were investigated for IFG in blood lymphocytes by flow cytometry. A significant positive correlation between IFG production and disability (r = 0.45, P50.01, Spearman's rho coefficient) was found. Pathophysiological implications and therapeutical relevance of this unexpected finding are discussed.

scholarly journals Evaluation of the effects of group psychotherapy on cognitive function in patients with multiple sclerosis with cognitive dysfunction and depression

2015 ◽  
Vol 73 (2) ◽  
pp. 90-95 ◽  
Author(s):  
Emine Bilgi ◽  
Hasan Hüseyin Özdemir ◽  
Ayhan Bingol ◽  
Serpil Bulut
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
Cognitive Function ◽  
Group Psychotherapy ◽  
Cognitive Dysfunction ◽  
Beck Depression Inventory ◽  
Neuropsychological Tests ◽  
Depression Severity ◽  
Group Members ◽  
Repeatable Battery

Objective This study will evaluate how decreasing depression severity via group psychotherapy affects the cognitive function of patients with multiple sclerosis (MS) who are also diagnosed with depression and cognitive dysfunction. Method MS patients completed the Brief Repeatable Battery of Neuropsychological Tests and Beck Depression Inventory (BDI). The group members diagnosed with depression and cognitive dysfunction underwent group psychotherapy for 3 months. Upon completion of psychotherapy, both tests were readministered. Results Depression and cognitive dysfunction were comorbid in 15 (13.9%) of patients. Although improvement was detected at the end of the 3-month group psychotherapy intervention, it was limited to the BDI and the Paced Auditory Test. Conclusion Group psychotherapy might decrease cognitive impairment in MS patients.

Sign in / Sign up

Export Citation Format

Share Document