Depression and anxiety have been reported in patients with multiple sclerosis (MS) and in patients with clinically isolated syndrome (CIS). However, the precise mechanisms that lead to depressive and anxiety symptoms in these patients are still unclear. In this study we evaluated with the Beck Depression Inventory (BDI) and the Beck Anxiety Inventory (BAI) patients with MS and CIS and compared them to controls. We also correlated BDI and BAI scores with clinical parameters. Kruskall-Wallis followed by Dunn's Multiple Comparison Test, Chi-square and Spearman test were used. Patients with MS had higher depressive and anxiety scores than controls. The BDI and BAI scores of patients with CIS were not significantly different from controls. There was a positive correlation between BDI, BAI and EDSS. Our results corroborate the view that MS patients have higher depression and anxiety levels than control subjects. Anxiety and depressive symptoms also seem to progress according to the severity of the disease. Key words: clinically isolated syndrome, multiple sclerosis, anxiety, depression.Ansiedade e depressão em pacientes com síndrome clínica isolada e esclerose múltipla RESUMO A depressão e a ansiedade têm sido descritas em pacientes com esclerose múltipla (EM) e síndrome clinicamente isolada (CIS Conflict of interestThe authors report no conflicts of interest Multiple sclerosis (MS) is a chronic demyelinating central nervous system disease with time and space disseminated lesions. MS lesions usually have a relapsing remitting couse and affect periventricular region, optical nerves, and spinal cord 1 .

The pattern of cognitive abnormalities in multiple sclerosis (MS) has been extensively studied and well characterized. However, little is known about the cognitive involvement in patients with the clinically isolated syndrome (CIS).ObjectivesTo perform a systematic review of the results of the studies on cognitive dysfunction in CIS patients.MethodsCochrane, Lilacs, PubMed/Medline and SciELO databases were searched for studies involving patients with clinically isolated syndrome submitted to neuropsychological evaluation.ResultsSeven studies fulfilled the selection criteria adopted in this review. The pattern of cognitive abnormalities in CIS resembles that found in patients with MS and is characterized by attention deficit, reduced information processing speed and impaired working memory and executive functions. The frequency of cognitive impairment in CIS seems to be lower than in MS.ConclusionsCognition should be evaluated in patients with CIS. Future studies are required to evaluate the impact of cognitive abnormalities and to correlate them with axonal damage findings in patients with CIS.

Cognition, but not anxiety, depression and disability, was associated with reduced quality of life.

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Cognitive abnormalities have been extensively studied in Multiple Sclerosis (MS). However, little is known about the cognitive involvement in patients with Clinically Isolated Syndrome (CIS).ObjectiveThis study aimed to investigate cognitive impairment in patients with CIS compared with healthy subjects.Methods18 CIS patients and 18 controls were subjected to the Wechsler memory scale, Rey Auditory Verbal Learning, Rey Complex Figure, Paced Auditory Serial Addition, Digit Span, verbal fluency, Stroop color card test, D2, and Digit Symbol tests.ResultsCIS patients had significantly worse performance on the Paced Auditory Serial Addition Test (PASAT) 2 seconds (P=0.009) and on verbal fluency tests (P=0.0038) than controls.ConclusionCIS patients had worse cognitive performance than controls on neuropsychological tests evaluating executive functioning.