Association between smoking and cognitive impairment in multiple sclerosis

Abstract

PurposeAlthough smoking is known to cause various symptoms in multiple sclerosis (MS) patients, there have been no reports regarding the relationship between smoking and cognitive impairment in MS. Studying the effects of cigarette smoking in MS patients is imperative as there is a high prevalence of cognitive impairment in MS patients. In this study we examined the potentially deleterious effects of heavy smoking on mentation of patients with MS.Patients and methodsMS patients receiving care at the Neurology Clinic at Bezmialem Vakıf University, between the ages of 18–65 years who have at least graduated elementary school were included in the study. The Brief Repeatable Battery of Neuropsychological Tests (BRB-N) is a commonly used method to assess cognitive function in MS patients and was utilized in our study. Patients that smoked for at least 10 pack-years were considered heavy smokers.ResultsAll the patients were stratified into two groups: heavy smokers (n=20) and nonsmokers (n=24). For heavy smokers, their cognitive functioning was more impaired than that of nonsmokers (P=0.04, χ2=4.227). For patients with cognitive impairment, 78.9% of the Paced Auditory Serial Addition Test and 63.2% of the Symbol Digit Modalities Test scores were found to be lower.ConclusionPrevious reports have suggested that smoking increases the frequency of relapse among individuals with relapsing-remitting MS and accelerates disease progression in patients with progressive MS. According to the results of our study, heavy smokers had increased cognitive impairment when compared to nonsmokers. Extensive studies are necessary to further elucidate the relationship between smoking and cognitive impairment in MS patients.

Role of Smoking in the Pathogenesis of Multiple Sclerosis: A Review Article

“…Smoking affects the cognitive functions of MS patients [29,30]. The prevalence of cognitive deficits in patients with MS ranges from 40% to 70% [29].…”

“…Memory is most often affected, and the number of patients that experience memory and learning problems is between 40% and 60% [31]. Cognitive deficits may occur depending on the size and location of the focal area of demyelination in the CNS [30]. Studies have reported that male MS patients have more significant cognitive impairments than females, but in recent research, it was found that sex is not associated with cognitive impairment [32,33].…”

Brain health: time matters in multiple sclerosis

“…Cigarette smoking is associated with decreased brain volume in people with MS (Kappus et al, 2016), as well as with higher relapse rates (B. et al, 2010), increased disability progression (Pittas et al, 2009;B. et al, 2010), increased cognitive impairment (Ozcan et al, 2014) and reduced survival (Jick et al, 2015) compared with not smoking. Additionally, smokers with CIS are nearly twice as likely as non-smokers with CIS to develop further inflammatory lesions and, thus, MS (Di Pauli et al, 2008).…”

Clinical and cognitive implications of cerebrospinal fluid oligoclonal bands in multiple sclerosis patients

“…The common pattern includes deficits in information processing speed, attention, working memory and episodic memory processes, whereas impaired spatial processing, verbal fluency and executive functions have been described to a lesser extent [18,19]. Cognitive impairment has recently been studied in smoker MS patients, and due to advanced neuroimaging techniques, expanding and speeding our decision on early treatment [20,21]. To our knowledge, only a short communication evaluated OCB and cognitive functions in four MS patients [22], despite the fact that MS-related characteristics, such as ''brain atrophy'' and ''cognitive features'', are considered in the efficacy profile of the first-and second-line disease-modifying treatments [23].…”