Mental change as an early feature of multiple sclerosis

Young, Alice; Saunders, John; Ponsford, J. R.

doi:10.1136/jnnp.39.10.1008

Cited by 81 publications

(13 citation statements)

References 18 publications

(17 reference statements)

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“…As already described, [34][35][36] we confirmed that cognitive dysfunction can be detected in some patients even in the incipient phase of MS. 13 As the disease progresses, the number of patients with cognitive defects tends to increase. The proportion of patients who were cognitively impaired at the end of our study was 56%, a finding consistent with results of previous cross-sectional surveys.…”

Section: Commentsupporting

confidence: 92%

Cognitive Dysfunction in Early-Onset Multiple Sclerosis

Amato¹,

Ponziani²,

Siracusa³

et al. 2001

Arch Neurol

596

416

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Section: Commentsupporting

confidence: 92%

Cognitive Dysfunction in Early-Onset Multiple Sclerosis

Amato¹,

Ponziani²,

Siracusa³

et al. 2001

Arch Neurol

596

416

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“…This has been widely disputed in recent years particularly that advancement of neuroimaging reduced the possibility of such misdiagnosis. However, conversion symptoms can complicate multiple sclerosis and in some cases be the presenting symptom [62]. For example, the author saw a 25-year old female that presented with 2 days' history of hysterical behaviour but had a completely normal neurological examination.…”

Section: Conversion Symptomsmentioning

confidence: 98%

Clinical characteristics of cortical multiple sclerosis

Zarei

2006

Journal of the Neurological Sciences

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“…Longitudinal evidence for2 and against34 progressive cognitive decline has been reported with considerable individual variation. 5 Cross sectional studies have either not documented deterioration' or noted it to be mild7 and have not contributed to clarifying the problem. What all these studies have in common, however, is a failure to take into account a host ofpotentially confounding variables-namely, selection bias, whether the course is relapsing-remitting or chronic-progressive,8 and clinical exacerbation,9 which have all been shown to influence cognition.…”

Section: Gresses'mentioning

confidence: 99%

Clinically isolated lesions of the type seen in multiple sclerosis: a cognitive, psychiatric, and MRI follow up study.

Feinstein

Kartsounis

Miller

et al. 1992

Journal of Neurology, Neurosurgery & Psychiatry

178

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There is a dearth of longitudinal studies on psychometric and psychiatric change in multiple sclerosis (MS) particularly on the evolution of these abnormalities early in the disease process. A 41 year follow up study documenting magnetic resonance imaging (MRI), psychometric, and psychiatric abnormalities was undertaken in a group of 48 patients with clinically isolated lesions-for example, optic neuritis-which are frequently the harbinger of MS. At follow up about half the subjects had developed clinically definite MS, with memory deficits becoming apparent. Deficits in attention documented at initial assessment were present but unchanged in those subjects who still had a clinically isolated lesion status. However, after MS was categorised into a relapsing-remitting or chronic progressive course, patients with a chronic progressive course were found to have significantly deteriorated with regard to auditory attention tasks. T1 relaxation times in apparently normal white matter correlated with certain indices of cognitive impairment. In developing a model to explain the pathogenesis of intellectual and emotional change in MS, the interaction of organic, psychological, and social factors needs to be emphasised. (7 Neurol Neurosurg Psychiatry 1992;55:869-876 tions were controlled for,'6 the preliminary evidence after a 1 to 2 year follow up period showed little cognitive deterioration. The only available longer follow up study also suggested that cognitive deterioration had occurred in less than a quarter of patients with multiple sclerosis four years after initial assessment and that there was considerable individual variation. 7An analogous position exists with respect to psychiatric disturbance in MS. The high prevalence of affective symptomatology is now well established.'8 Though there is firm evidence linking the presence of euphoria to cerebral involvement'9 it is unclear to what extent depressive features can be similarly explained.20 The developent and evolution of early psychiatric symptoms and the interplay of organic and social factors in their pathogenesis have yet to be studied.The study over time of patients with clinically isolated lesions (CIL-namely, optic neuritis and the brain stem and spinal cord syndromes-which are frequently the harbinger of MS,2' provides an unique opportunity to monitor cognitive and psychiatric changes early in the disease. Cognitive abnormalities are already discernible in some of these studies at presentation,22 23 and a follow up of such cases would allow the early natural history to be observed. In addition, the initial paucity of psychiatric symptomatology in subjects with CIL24 offers the opportunity to unravel the various aetiological factors that contribute to greater psychiatric morbidity in those who subsequently develop MS.In an earlier study, we reported that patients with CIL had significantly greater deficits in auditory and visual attention when compared with a physically disabled control group without brain involvement, matched for age, sex, and pr...

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Mental change as an early feature of multiple sclerosis

Cited by 81 publications

References 18 publications

Cognitive Dysfunction in Early-Onset Multiple Sclerosis

Cognitive Dysfunction in Early-Onset Multiple Sclerosis

Clinical characteristics of cortical multiple sclerosis

Clinically isolated lesions of the type seen in multiple sclerosis: a cognitive, psychiatric, and MRI follow up study.

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