Depression and cognitive function in early multiple sclerosis: Multitasking is more sensitive than traditional assessments

Glukhovsky, Lisa; Kurz, Daniel; Brandstadter, Rachel; Leavitt, Victoria M.; Krieger, Stephen; Fabian, Michelle; Sand, Ilana Katz; Klineova, Sylvia; Riley, Claire; Lublin, Fred; Miller, Aaron; Sumowski, James F.

doi:10.1177/1352458520958359

Cited by 12 publications

(11 citation statements)

References 33 publications

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“…For instance, word-finding and multitasking difficulties are especially prevalent among PwMS and often a subjective complaint not easily identified by standard consensus batteries. 26,27 Refining and incorporating tests which assess these common yet functionally-specific deficits (e.g. rapid automatized naming) may be necessary for comprehensive examination.…”

Section: Discussionmentioning

confidence: 99%

Staging and stratifying cognitive dysfunction in multiple sclerosis

et al. 2021

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Background: The sequence in which cognitive domains become impaired in multiple sclerosis (MS) is yet to be formally demonstrated. It is unclear whether processing speed dysfunction temporally precedes other cognitive impairments, such as memory and executive function. Objective: Determine the order in which different cognitive domains become impaired in MS and validate these findings using clinical and vocational outcomes. Methods: In a longitudinal sample of 1073 MS patients and 306 healthy controls, we measured performance on multiple, consensus-standard, neurocognitive tests. We used an event-based staging approach to model the sequence in which cognitive domains become impaired. Linear and logistic mixed-effects models were used to explore associations between stages of impairment, neurological disability, and employment status. Results: Our model suggested that the order of impairments was as follows: processing speed, visual learning, verbal learning, working memory/attention, and executive function. Stage of cognitive impairment predicted greater neurological disability, β = 0.16, SE = 0.02, p < 0.001, and probability of unemployment, β = 1.14, SE = 0.001, p < 0.001. Conclusion: This is the first study to introduce a cognitive staging and stratification system for MS. Findings underscore the importance of using the Symbol Digit Modalities Test in routine screening for cognitive impairment and memory testing to assess patients later in disease evolution.

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Section: Discussionmentioning

confidence: 99%

Staging and stratifying cognitive dysfunction in multiple sclerosis

et al. 2021

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“…While depression is prevalent in MS, 163 there is mixed evidence on its relationship with cognitive functioning. Ten studies did not find an association between performance and level of depressive symptom severity, 29 , 34 , 37 , 46 , 83 , 85 , 113 , 124 , 135 , 141 while 14 studies found a negative impact, 16 , 18 , 22 , 30 , 44 , 45 , 69 , 70 , 74 , 98 , 105 , 107 , 125 , 142 such as higher levels of depression among persons with cognitive impairment or worse performance on verbal fluency, aspects of executive functioning, multitasking, working memory, and processing speed tasks. There is also mixed evidence with quality of life and cognition, with two studies not finding a relationship 82 , 115 and four studies noting a significant association.…”

Section: Resultsmentioning

confidence: 96%

Identifying Early Neuropsychological Indicators of Cognitive Involvement in Multiple Sclerosis

Gromisch

Dhari

2021

NDT

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Multiple sclerosis (MS) is a debilitating disease of the central nervous system that is most commonly seen in early to middle adulthood, although it can be diagnosed during childhood or later in life. While cognitive impairment can become more prevalent and severe as the disease progresses, signs of cognitive involvement can be apparent in the early stages of the disease. In this review, we discuss the prevalence and types of cognitive impairment seen in early MS, including the specific measures used to identify them, as well as the challenges in characterizing their frequency and progression. In addition to examining the progression of early cognitive involvement over time, we explore the clinical factors associated with early cognitive involvement, including demographics, level of physical disability, disease modifying therapy use, vocational status, and psychological and physical symptoms. Given the prevalence and functional impact these impairments can have for persons with MS, considerations for clinicians are provided, such as the role of early cognitive screenings and the importance of comprehensive neuropsychological assessments.

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“…We utilized two executive control paradigms: Stroop Color-Word Test e-14 and Decision Speed Dual-Task. 9 Each paradigm has a speeded executive control task and a speeded non-executive comparison task; the latter is used to isolate executive control from non-executive task demands (i.e. cognitive speed).…”

Section: Methodsmentioning

confidence: 99%

Depression symptoms and cognition in multiple sclerosis: Longitudinal evidence of a specific link to executive control

Anderson,

Fitzgerald,

Murrough

et al. 2023

Mult Scler

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Background: Depression symptoms are prevalent in multiple sclerosis (MS) and associated with poorer cognition in cross-sectional studies; it is unknown whether changes in depression symptoms track with cognitive changes longitudinally. Objective: Investigate whether changes in depression symptoms correspond with cognitive changes over time in MS, and identify specific cognitive functions related to depression symptoms. Method: Persons with early relapse-onset MS ( n = 165) completed a depression questionnaire (Beck Depression Inventory FastScreen) and tests of cognitive speed, executive control, and memory at baseline and 3-year follow-up. One-way ANOVAs assessed differences in cognitive change across participants with worsened, stable, or improved depression symptoms from baseline to year 3. Results: Change in depression symptoms was related to change in executive control ( p = 0.001, ηp2 = 0.08; worsened mood with worsened executive control; improved mood with improved executive control), even when adjusting for cognitive speed ( p = 0.002, ηp2 = 0.08). There were no links to cognitive speed ( p = 0.826) or memory ( p = 0.243). Regarding individual depression symptoms, executive control was related to loss of pleasure and suicidal thoughts. Conclusions: Executive control tracks with depression symptoms, raising hope that management of mood may improve executive control. The specific link between executive control and anhedonia implicates dysfunctional reward processing as a key component of MS depression.

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Depression and cognitive function in early multiple sclerosis: Multitasking is more sensitive than traditional assessments

Cited by 12 publications

References 33 publications

Staging and stratifying cognitive dysfunction in multiple sclerosis

Staging and stratifying cognitive dysfunction in multiple sclerosis

Identifying Early Neuropsychological Indicators of Cognitive Involvement in Multiple Sclerosis

Depression symptoms and cognition in multiple sclerosis: Longitudinal evidence of a specific link to executive control

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