scholarly journals Longitudinal Stability of Cognition in Early-Phase Relapsing-Remitting Multiple Sclerosis

2018 ◽  
Vol 20 (4) ◽  
pp. 173-179 ◽  
Author(s):  
Roxana M. Barbu ◽  
Jason A. Berard ◽  
Louise M. Gresham ◽  
Lisa A.S. Walker
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
Executive Functions ◽  
Early Phase ◽  
Cognitive Reserve ◽  
Cognitive Change ◽  
Disease Stage ◽  
Cognitive Domains ◽  
Relapsing Remitting ◽  
Over Time

Abstract Background: Up to 70% of people with multiple sclerosis (MS) experience cognitive impairment. Some remain cognitively intact despite advanced disease. Cognitive reserve (CR) theory postulates that individuals with higher levels of intellectual enrichment can tolerate more pathology than others before exhibiting cognitive impairment. Methods: Thirty-two individuals with early-phase relapsing-remitting MS with mild physical disability and disease duration less than 10 years and 32 controls were recruited. At baseline and after 3 years, participants completed neuropsychological tests evaluating several cognitive domains. The CR was assessed via a cognitive reserve index (CRI) using educational levels and North American Adult Reading Test scores. Change in cognition was assessed using a reliable change index. Results: At baseline, people with MS performed worse than controls on visual memory. There were no significant group differences on information processing speed, learning, language, and executive functions. Most cognitive domains showed no change over time, and CRI was not a significant predictor in the regression model. Conclusions: People with MS performed worse on memory tasks at baseline compared with controls. Cognitive change differed between people with MS and controls in executive functions. Although people with MS and controls improved over time, beyond practice effects, people with MS improved less than controls. Overall, no cognitive deterioration was noted over time, and CR did not predict change in cognition. Sample homogeneity in terms of disease stage and CR may explain these findings.

MRI techniques and cognitive impairment in the early phase of relapsing-remitting multiple sclerosis

2001 ◽  
Vol 43 (4) ◽  
pp. 272-278 ◽  
Author(s):  
R. Zivadinov ◽  
R. De Masi ◽  
D. Nasuelli ◽  
L. Monti Bragadin ◽  
M. Ukmar ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
Early Phase ◽  
Relapsing Remitting ◽  
Remitting Multiple Sclerosis ◽  
Relapsing Remitting Multiple Sclerosis

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.

scholarly journals Cognitive impairment and depression in patients with relapsing–remitting multiple sclerosis depending on age and neuroimaging findings

2021 ◽  
Vol 57 (1) ◽  
Author(s):  
Oksana O. Kopchak ◽  
Tetiana A. Odintsova
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
Corpus Callosum ◽  
Executive Functions ◽  
Frontal Lobe ◽  
Abstract Thinking ◽  
Visual Spatial ◽  
Relapsing Remitting ◽  
Remitting Multiple Sclerosis ◽  
Relapsing Remitting Multiple Sclerosis

Abstract Background Multiple sclerosis is an insidious, disabling, both physically and mentally, demyelinating disease of the central nervous system. This work aims to evaluate relationships between cognitive impairment in separate domains, depression and their correspondence with MRI-findings, as well as the influence on each other’s manifestations, in patients with relapsing–remitting multiple sclerosis. Results Visual–spatial/executive functions and memory domains suffered more frequently than others in the study subjects under 40 years; in patients over 40 years old memory, visual–spatial/executive functions and abstract thinking impairment prevailed the most. Such cognitive domains as memory, language, abstract thinking, visual–spatial and executive functions were impacted in both groups of patients even without the apparent cognitive decline according to MoCA scale. Presence of depression impacted language and attention more prominently than the rest of the domains only in participants younger 40 years. According to the MRI, frontal lobe, corpus callosum and periventricular area were affected more often compared to other brain regions in case of cognitive impairment; meanwhile, combined lesions of frontal lobe and corpus callosum, fronto-temporal region were associated with depression. Conclusion Cognitive impairment and depression are one of the common, yet disabling and socially disrupting manifestations of MS. Quite frequently such complaints are neglected or considered as parts of comorbidities. At the same time cognitive impairment can be amplified by depression, especially in patients under 40 years.

scholarly journals Cognitive impairments in relapsing-remitting multiple sclerosis: a meta-analysis

2008 ◽  
Vol 14 (9) ◽  
pp. 1250-1261 ◽  
Author(s):  
RS Prakash ◽  
EM Snook ◽  
JM Lewis ◽  
RW Motl ◽  
AF Kramer
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
Meta Analysis ◽  
Memory And Learning ◽  
Motor Functioning ◽  
Cognitive Domains ◽  
Relapsing Remitting ◽  
Remitting Multiple Sclerosis ◽  
And Gender ◽  
Relapsing Remitting Multiple Sclerosis

There is debate in the literature regarding the magnitude, nature, and influence of cognitive impairment in individuals with relapsing-remitting multiple sclerosis (RRMS). Therefore, we conducted a meta-analysis that quantified the overall magnitude of cognitive impairment in individuals with RRMS and identified the domains of cognition and clinical/demographic variables that were moderators of the overall effect. We included 57 studies with 3891 participants that yielded a total of 755 effect sizes. Overall, there was a moderate decline in cognitive functioning in individuals with RRMS compared with healthy controls. Larger effects were observed in cognitive domains of motor functioning, mood status and memory and learning. Regarding demographic and clinical variables, age and gender were moderators of cognitive impairment in all cognitive domains, whereas neurological disability and disease duration primarily moderated performance on tasks assessing memory and learning.

scholarly journals Short Report: Prevalence of Cognitive Impairment in Newly Diagnosed Relapsing-Remitting Multiple Sclerosis

2018 ◽  
Vol 20 (4) ◽  
pp. 153-157 ◽  
Author(s):  
Giulia DiGiuseppe ◽  
Mervin Blair ◽  
Sarah A. Morrow
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
Processing Speed ◽  
Clinical Population ◽  
Clinical Event ◽  
Routine Practice ◽  
Short Report ◽  
Newly Diagnosed ◽  
Mood Symptoms ◽  
Relapsing Remitting

Abstract Background: Cognitive impairment is common in multiple sclerosis (MS) and can manifest early in the disease process, sometimes as early as the first demyelinating event. However, the frequency of cognitive impairment in a newly diagnosed MS population has not been evaluated comprehensively in a clinical population. We sought to examine the prevalence of cognitive impairment in relapsing-remitting MS (RRMS) within a year of diagnosis in a clinic where cognitive testing at diagnosis is part of routine practice. Methods: A retrospective medical record review of persons with RRMS assessed in a cognitive MS clinic identified 107 patients assessed by the Minimal Assessment of Cognitive Function in Multiple Sclerosis battery within 1 year of a confirmed RRMS diagnosis. Results: The cohort was predominantly female (n = 82 [76.6%]) and white (n = 93 [86.9%]). Only 36 patients (33.6%) were diagnosed as having RRMS based on a second clinical event. Processing speed was the most frequently impaired domain (n = 38 [35.5%]). Only 37 patients (34.6%) were within normal limits on all cognitive domains. Regarding mood symptoms, 25 patients (23.4%) were positive for depressive symptoms; 59 (55.1%), for anxiety. Severe fatigue was correlated with a lower score on the Symbol Digit Modalities Test (SDMT) (r = −0.380, P < .001), and higher depressive scores were correlated with lower performance on the SDMT (r = −0.397, P < .001) and the Paced Auditory Serial Addition Test (r = −0.254, P = .009). Conclusions: Cognitive impairment, specifically processing speed, and mood symptoms are frequently present in persons with newly diagnosed RRMS.

scholarly journals Monitoring cognitive change in multiple sclerosis using a computerized cognitive battery

2018 ◽  
Vol 4 (4) ◽  
pp. 205521731881551 ◽  
Author(s):  
L De Meijer ◽  
D Merlo ◽  
O Skibina ◽  
EJ Grobbee ◽  
J Gale ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Change ◽  
Progressive Multiple Sclerosis ◽  
Healthy Controls ◽  
Relapsing Remitting ◽  
Remitting Multiple Sclerosis ◽  
Serial Addition ◽  
Multiple Sclerosis Patients ◽  
Relapsing Remitting Multiple Sclerosis ◽  
Cognitive Monitoring

Background Cognitive monitoring that can detect short-term change in multiple sclerosis is challenging. Computerized cognitive batteries such as the CogState Brief Battery can rapidly assess commonly affected cognitive domains. Objectives The purpose of this study was to establish the acceptability and sensitivity of the CogState Brief Battery in multiple sclerosis patients compared to controls. We compared the sensitivity of the CogState Brief Battery to that of the Paced Auditory Serial Addition Test over 12 months. Methods Demographics, Expanded Disability Status Scale scores, depression and anxiety scores were compared with CogState Brief Battery and Paced Auditory Serial Addition Test performances of 51 patients with relapsing–remitting multiple sclerosis, 19 with secondary progressive multiple sclerosis and 40 healthy controls. Longitudinal data in 37 relapsing–remitting multiple sclerosis patients were evaluated using linear mixed models. Results Both the CogState Brief Battery and the Paced Auditory Serial Addition Test discriminated between multiple sclerosis and healthy controls at baseline ( p<0.001). CogState Brief Battery tasks were more acceptable and caused less anxiety than the Paced Auditory Serial Addition Test ( p<0.001). In relapsing–remitting multiple sclerosis patients, reaction time slowed over 12 months ( p<0.001) for the CogState Brief Battery Detection (mean change –34.23 ms) and Identification (–25.31 ms) tasks. Paced Auditory Serial Addition Test scores did not change over this time. Conclusions The CogState Brief Battery is highly acceptable and better able to detect cognitive change than the Paced Auditory Serial Addition Test. The CogState Brief Battery could potentially be used as a practical cognitive monitoring tool in the multiple sclerosis clinic setting.

No evidence of disease activity in multiple sclerosis: Implications on cognition and brain atrophy

2015 ◽  
Vol 22 (1) ◽  
pp. 64-72 ◽  
Author(s):  
Alfredo Damasceno ◽  
Benito Pereira Damasceno ◽  
Fernando Cendes
Keyword(s):  
Multiple Sclerosis ◽  
Disease Activity ◽  
Brain Atrophy ◽  
Repeated Measures ◽  
Positive Impact ◽  
Cognitive Domains ◽  
Cortical Thinning ◽  
T2 Lesions ◽  
Relapsing Remitting ◽  
Volume Decrease

Background: The concept of no evidence of disease activity (NEDA) has emerged as an important outcome measure for multiple sclerosis (MS). However, it is not known if maintaining NEDA has a positive impact on cognition or brain atrophy. Objective: To evaluate NEDA status after two years, addressing its implications on cognition and brain atrophy. Methods: Forty-two relapsing–remitting MS patients and 30 controls underwent MRI (3T) and cognitive evaluation (BRB-N). Forty patients performed additional evaluations, after 12 and 24 months. NEDA was defined as the absence of clinical (relapses/disability progression) and MRI activity (new T2/gadolinium-enhancing lesions). Repeated measures and multivariate analyses were performed to assess the contribution of NEDA criteria to GM atrophy. Results: After two years, 30.8% of the cohort had NEDA. From these, 58.3% still had worsening in ⩾2 cognitive domains. Patients with MRI activity had more cortical thinning and slightly more thalamus volume decrease. Absence of new/enlarging T2 lesions was the only predictor of cortical thinning, subcortical GM and thalamic atrophy rates. Conclusions: NEDA status was achieved in a small proportion of our cohort, and did not preclude cognitive deterioration. Absence of MRI activity and especially of new/enlarging T2 lesions was associated with less cortical and subcortical GM atrophy.

The cognitive profile of behavioural variant FTD and its similarities with ALS: a systematic review and meta-analysis

2018 ◽  
Vol 89 (9) ◽  
pp. 995-1002 ◽  
Author(s):  
Emma Beeldman ◽  
Joost Raaphorst ◽  
Michelle Klein Twennaar ◽  
Rosanne Govaarts ◽  
Yolande A L Pijnenburg ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Social Cognition ◽  
Executive Functions ◽  
Verbal Memory ◽  
Cognitive Profile ◽  
Effect Sizes ◽  
Healthy Controls ◽  
Cognitive Profiles ◽  
Cognitive Domains ◽  
Visual Comparison

Approximately 30% of patients with amyotrophic lateral sclerosis (ALS) have cognitive impairment and 8%–14% fulfil the criteria for behavioural variant frontotemporal dementia (bv-FTD). The cognitive profiles of ALS and bv-FTD have been reported to be comparable, but this has never been systematically investigated. We aimed to determine the cognitive profile of bv-FTD and examine its similarities with that of ALS, to provide evidence for the existence of a cognitive disease continuum encompassing bv-FTD and ALS. We therefore systematically reviewed neuropsychological studies on bv-FTD patients and healthy volunteers. Neuropsychological tests were divided in 10 cognitive domains and effect sizes were calculated for all domains and compared with the cognitive profile of ALS by means of a visual comparison and a Pearson’s r correlation coefficient. We included 120 studies, totalling 2425 bv-FTD patients and 2798 healthy controls. All cognitive domains showed substantial effect sizes, indicating cognitive impairment in bv-FTD patients compared to healthy controls. The cognitive domains with the largest effect sizes were social cognition, verbal memory and fluency (1.77–1.53). The cognitive profiles of bv-FTD and ALS (10 cognitive domains, 1287 patients) showed similarities on visual comparison and a moderate correlation 0.58 (p=0.13). When social cognition, verbal memory, fluency, executive functions, language and visuoperception were considered, i.e. the cognitive profile of ALS, Pearson’s r was 0.73 (p=0.09), which raised to 0.92 (p=0.03), when language was excluded in this systematic analysis of patients with a non-language subtype of FTD. The cognitive profile of bv-FTD consists of deficits in social cognition, verbal memory, fluency and executive functions and shows similarities with the cognitive profile of ALS. These findings support a cognitive continuum encompassing ALS and bv-FTD.

Sign in / Sign up

Export Citation Format

Share Document