Cognitive impairment in clinically isolated syndrome: a systematic review

Abstract

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.

Cognitive impairment is correlated with reduced quality of life in patients with clinically isolated syndrome

“…Some recent studies have shown that CIS patients may present mild cognitive impairment, especially in processing speed and executive functions [4][5][6] . Depression and anxiety have also been found in patients with CIS but their precise prevalence in this population is still unknown [6][7][8][9] . Quality of life has been studied in patients with multiple sclerosis (MS) but there are no previous studies evaluating quality of life in patients with CIS.…”

“…Considering that CIS is associated with cognitive dysfunction, depression and anxiety, it is possible that it can affect quality of life in patients with CIS. However, quality of life in patients with CIS is still poorly understood 6,9,[13][14][15] . The present study aimed to evaluate the quality of life of patients with CIS and to evaluate potential determinants of quality of life such as cognition, depression and anxiety in patients with CIS.…”

Cognition in relapsing-remitting multiple sclerosis : consequences may be relative to working memory and not processing speed

“…When stringent criteria are implemented, approximately 30% of CIS patients experience some form of cognitive impairment (Potagas et al, 2008;Zipoli et al, 2010). This conclusion is in line with a systematic review by Anhoque et al (2010) stating that cognitive impairment in CIS seems to be less frequent and intense than in definite MS.…”

“…In other work examining cognition early in the disease course, impairment has been reported to occur in 25-57%) of patients with probable MS or clinically isolated syndrome (CIS; Achiron & Barak, 2003;Feuillet et al, 2007;Potagas et al, 2008;Zipoli et al, 2010). CIS is the first episode of a demyelinating and inflammatory disease of the central nervous system and a proportion of CIS patients will later be diagnosed with definite MS (Anhoque, Domingues, Teixeira, & Domingues, 2010). The wide variability in prevalence of cognitive impairments across samples of patients with CIS is likely due to the different neuropsychological tests and criteria for defining impairment employed between the studies.…”

Anxiety and depressive symptoms in clinically isolated syndrome and multiple sclerosis

“…It was shown that the presence of such psychiatric comorbidities has a great impact in general health status and quality of life of MS patients [9][10][11] . However, little is known about these neuropsychiatric comorbidities in patients with CIS 12 . Some studies have found that neuropsychiatric symptoms in MS are related with the degree of functional disability and with disease duration 13,14 .…”