Benign multiple sclerosis: aspects of cognition and neuroimaging

Abstract

The existence of a benign multiple sclerosis (BMS) form is a controversial subject. Recent studies of these patients reveal different levels of cognitive impairment, despite the apparent preservation of motor function. The objective of this study was to review and analyze a number of publications that discuss the general aspects of this disease form, such as the definition criteria, prevalence, and clinical and neuroimaging markers. A systematic review of published data on BMS up to October 2015 was performed. Thirty-one published articles were analyzed. The estimated frequency of BMS varied between 6% and 73%. Cognitive impairment was recognized as affecting 17% to 47% of the subjects and presented significant correlation with neuroimaging, such as brain atrophy, increased lesion volume in T2 magnetic resonance assay, and regional grey matter atrophy. The current criteria overestimated the frequency of BMS and, for that reason, this highlights the importance of validating the diagnostic methods practiced.

Neurodegeneration in Multiple Sclerosis: Symptoms of Silent Progression, Biomarkers and Neuroprotective Therapy—Kynurenines Are Important Players

“…Nearly ¾ of “benign” MS patients show signs of fatigue and almost half of them have depressive symptoms [ 55 ]. Studies differ, but up to 47% of the “benign” patients have some degree of CI with detailed evaluations [ 56 ]. These data—combined with the earlier reviewed data on PIRA and PIRMA—clearly show that there is no such thing as “benign” MS, just symptoms of silent progression and neurodegeneration that are not routinely assessed.…”

Avaliação da destreza manual de pessoas com esclerose múltipla usando o nine hole peg test

“…Mota, R. F. O., Leon, P. A. P., Oliveira, P. C. A., Xavier, T. G. M., Leal, N. P. R., Souza, L. F. Avaliação da destreza manual de pessoas com esclerose múltipla usando o nine hole peg test A neuroplasticidade caracteriza-se como a capacidade do cérebro lesionado de adequar-se e moldar-se a algum estímulo, agindo em dada área afetada ou parte responsável por realizar determinada ação que tenha sido prejudicada diante das lesões. A estimulação ocorre a partir de testes específicos que, em sua maioria, são internacionais, mas validados no Brasil, com orientação clara e objetiva para o paciente e profissional (6,7,8) .…”

The epidemiology of multiple sclerosis

“…This was an important reason (among others) that initialized the search for other signs and symptoms of MS that may not be incorporated into the EDSS system but can be prevalent during the first, seemingly inactive phase of the disease. Evaluations discovered that among benign patients, fatigue is as prevalent, as in other courses; that approximately 50% of these patients exhibit signs of cognitive dysfunction; that a grand proportion of "benign" patients are burdened by depression, anxiety or other psychiatric conditions, which are not yet routinely examined and followed-up (Amato et al, 2006a;Correale et al, 2012;Sayao et al, 2007;Ton et al, 2017). These information may propose, that the activity in this group seems low because the disease does not manifest in the somatic symptoms of MS, yet in the psychopathological domains.…”