Cognitive Impairment in Early-Onset Multiple Sclerosis

Amato, Maria Pia; Ponziani, Giuseppina; Pracucci, Giovanni; Bracco, Laura; Siracusa, G.; Amaducci, L.

doi:10.1001/archneur.1995.00540260072019

Cited by 313 publications

(49 citation statements)

References 41 publications

(3 reference statements)

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“…In contrast to cognitive decline in certain domains, there was no decline in verbal short-term memory, as well as verbal learning and retention, which represents a second main finding. Some other studies have found normal short-term memory in MS patients [21, 45, 46]. However, the intact episodic memory encoding and retrieval in the current study are in disagreement with the majority of earlier findings showing that MS patients have difficulties with both acquisition and retrieval [47,48,49,50,51,52,53].…”

Section: Discussioncontrasting

confidence: 99%

“…For instance, Jennekens-Schinkel et al [20] noticed that although MS patients were more cognitively impaired than healthy subjects in the beginning of the study, 75% of them did not show any further cognitive decline at the end of the follow-up period. In a 4-year follow-up study, Amato et al [21] found that patients with recent onset of MS had initial deficits in verbal memory and abstract reasoning, however these patients generally did not worsen, although problems with word fluency and verbal comprehension occurred. Similar results have been reported in several studies [22, 23].…”

Section: Introductionmentioning

confidence: 99%

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Selective Decline in Information Processing in Subgroups of Multiple Sclerosis: An 8-Year Longitudinal Study

Bergendal¹,

Fredrikson²,

Almkvist

2007

Eur Neurol

128

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Multiple sclerosis (MS) is an inflammatory and degenerative disease of the central nervous system (CNS) that causes white matter and cortical lesions over many years. The CNS is selectively affected by the disease with a great variety of symptoms between patients. In this study, we describe the impact on various aspects of cognition over an 8-year follow-up period in 31 consecutive MS patients subgrouped as relapsing remitting (RR) MS, secondary progressive (SP) MS, and primary progressive (PP) MS. Results showed a differential pattern of cognitive decline already at baseline in speed of information processing. During the follow-up, a pronounced decline occurred in speed of information processing, finger-motor speed, copying geometrical designs, episodic memory, and visuospatial short-term memory. A striking difference was observed between a marked decline in visual reaction time, whereas no significant change was seen in auditory reaction time. In contrast, there was no time-related decline in verbal abilities. However, an initial marked cognitive impairment predicted further cognitive decline over the 8-year follow-up. Information-processing tests were found to be an especially strong predictor of long-term cognitive decline. In addition, high EDSS score at follow-up was associated with decline in information processes. Results also showed that SP-MS patients deteriorated significantly more than the other two groups, particularly in visual compared to auditory information processing. To conclude, cognitive decline appeared particularly in SP-MS patients and in visual information processing.

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Section: Discussioncontrasting

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Selective Decline in Information Processing in Subgroups of Multiple Sclerosis: An 8-Year Longitudinal Study

Bergendal¹,

Fredrikson²,

Almkvist

2007

Eur Neurol

128

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“…Language impairment has not been frequently reported in MS patients, even if an impairment in the Token Test has been already signalled [22]. In this respect, one can speculate that the deficit evidenced in the Token Test could reflect a combination of perceptual, attentional and memory impairments.…”

Section: Discussionmentioning

confidence: 99%

Patterns of Cognitive Impairment in Secondary Progressive Stable Phase of Multiple Sclerosis: Correlations with MRI Findings

et al. 2001

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Cognitive impairment is commonly described in multiple sclerosis (MS), but conflicting results have been reported about its pattern by previous studies focused on heterogeneous patient groups. The aim of this study was to investigate the cognitive skills of a homogeneous group of secondary progressive MS patients, and to examine the relationship of this impairment to MRI parameters. Forty-four MS patients underwent a series of neuropsychological tests devised to explore the main cognitive domains, and T1- and T2-weighted brain MRI. Results showed the presence of deficits of attention, memory, planning abilities, problem-solving and conceptual reasoning (frontal functions) in a subgroup of MS patients. Correlations between the performance in some ‘frontal’ tests and the extent of frontal lobe MRI lesional area were present, but rather unspecific, the same performance being also correlated with the nonfrontal lesional area. These findings suggest that in MS, overall macroscopic and microscopic brain damage is more important than the corresponding focal brain disease, even in determining deficits of selective cognitive domains.

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“…melatonin levels [1][2][3][4][5][6]. The immune system is considered to play a crucial role connecting different health-and disease-related functions, and if aberrant leading to lesions which result in neurophysiological disabilities and neuropsychological dysfunction [7][8][9].…”

Section: Introductionmentioning

confidence: 99%

“…Those patients usually had long-standing disease, resulting in a wide range of cognitive and affective disturbances [1,10,12,13]. However, only few psychometric studies in patients with little or no disability have been carried out [2,3,7]. With respect to memory performance, disease duration of less than 2 years was already found to result in memory dysfunction including visual, verbal and shortterm memory despite neuroimmunomodulating therapies [7,10,12].…”

Section: Introductionmentioning

confidence: 99%

The Influence of Immunomodulation on Psycho-Neuroimmunological Functions in Benign Multiple Sclerosis

Haase

Tinnefeld²,

Faustmann³

2004

Neuroimmunomodulation

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Objectives: In multiple sclerosis (MS), several neuroimmunomodulatory effectors are known, including melatonin. They are able to influence disease-related neurophysiogical changes (disability or impaired vision) as well as neuropsychological performance (e.g. cognition and depression). In this study we assessed the relationship between immunomodulation on psycho-neuroimmunological functions in benign multiple sclerosis. Methods: We evaluated 26 young female patients with benign MS treated with/without immunomodulating therapies with regard to their physical disabilities (Expanded Disability Status Scale, EDSS), their visually evoked potentials (VEP), their plasma melatonin concentrations as well as their performance regarding emotional and cognitive tests and compared them with healthy matched controls. Results: Patients with MS showed deficits in cognitive and emotional functions compared to healthy controls, which were in accordance with their increase in EDSS over time. However, in contrast to untreated patients, patients receiving immunotherapy showed significantly increased dysfunction with respect to actual mood (p = 0.02) and a tendency to increased depression scores (p = 0.072). However, neither treatment subgroup had cognitive deficits. In untreated patients, melatonin levels correlated with reduced scores in the cognitive tests (p = 0.045) but not with depression or VEP latencies. Patients with long-standing MS (>10 years) showed a significant correlation (p = 0.01) to their increased depression scores and their melatonin levels, but no correlation with VEP or cognitive dysfunction, compared to patients with shorter disease duration (≤10 years). Conclusion: These results indicate that in MS all aspects of the psycho-neuroimmunological network can be affected. Despite the potential influence of immunomodulation on depression, no connection with melatonin representing the retinohypothalamic tract/pineal gland circuits could be detected. However, visual perception as well as visuoconstructive abilities were affected in MS patients. Neuropsychological tests in MS should concentrate on cognitive variables, which reflect the clinical status more accurately and may be used to monitor disease-modifying therapies.

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Cognitive Impairment in Early-Onset Multiple Sclerosis

Cited by 313 publications

References 41 publications

Selective Decline in Information Processing in Subgroups of Multiple Sclerosis: An 8-Year Longitudinal Study

Selective Decline in Information Processing in Subgroups of Multiple Sclerosis: An 8-Year Longitudinal Study

Patterns of Cognitive Impairment in Secondary Progressive Stable Phase of Multiple Sclerosis: Correlations with MRI Findings

The Influence of Immunomodulation on Psycho-Neuroimmunological Functions in Benign Multiple Sclerosis

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