Relationship Between Anxiety and Cognition in Multiple Sclerosis

Abstract

Background: Anxiety, which is very prevalent in multiple sclerosis (MS) but understudied, has been shown to negatively affect cognition in many different populations. Slowed information processing speed underlies most cognitive impairments in MS, including verbal learning. The aim of this study was to look at how anxiety influences cognition—specifically processing speed and verbal learning—in MS. Methods: Eligibility criteria were adults (≥18 years) who had a diagnosis of clinically definite MS and had participated in neuropsychological research projects. A retrospective medical record review was conducted on the neuropsychological testing data. Two hierarchical multiple regressions were conducted to determine the unique contributions of processing speed and anxiety on verbal learning in MS, after adjusting for demographic and disability variables. Two separate mediation analyses were conducted to determine the relationship between processing speed, verbal learning, and anxiety. Results: Participants (N = 141) ranged in age from 18–91 years. Based on the multiple regression analyses, processing speed (β = 0.55, ΔR2 = 0.27, P < .001) and anxiety (β = −0.34, ΔR2 = 0.11, P < .001) were uniquely significant predictors of verbal learning. Based on the mediation analyses, there was a significant indirect effect of anxiety on verbal learning through processing speed (ab = −0.31, 95% CI = −0.60 to −0.09). There was also a significant indirect effect of processing speed on verbal learning through anxiety (ab = −0.05, 95% CI = 0.01 to 0.12). Conclusions: Results suggest a bidirectional relationship of anxiety and processing speed on verbal learning in MS. Anxiety has a significant effect on cognition and should not be overlooked. Interventions targeting anxiety may improve cognition in MS.

Cortical Thickness and Serum NfL Explain Cognitive Dysfunction in Newly Diagnosed Patients With Multiple Sclerosis

“…Notably, anxiety-state scores, in combination with other biomarkers, also contributed to a prediction of neuropsychological performance in our patient cohort, highlighting the significant effect of anxiety symptoms on cognition in patients with MS. 32 These findings are not surprising given that high prevalence rates of psychiatric comorbidity 33 have been well documented in patients with MS and underscore the importance of establishing a psychiatric assessment in patients with MS from initial stages of the disease.…”

Neuropsychiatric and cognitive effects of the COVID-19 outbreak on multiple sclerosis patients

“…Researchers have shown that anxiety harms verbal learning in MS patients, probably through interfering with attention and information processing speed. They have suggested that treatment of anxiety may improve cognitive function of MS patients (Vissicchio et al, 2019).…”

The Relationship Between Sensitivity to Anxiety and Executive Functions and Quality of Life of MS Patients: Path Analysis Pattern

“…Marck et al and Kos et al showed that there is a relationship between the sensitivity to anxiety and the QoL of people with MS [13,17]. Vissicchio et al showed that there is a relationship between anxiety and cognition in MS patients and anxiety has a significant effect on cognition [18]. Also, Rigikouteh et al showed that there is a relationship between the executive functions and QoL of people with MS [2].…”

“…In explaining these results, it can be stated that the goal of proper functioning of executive functions is to increase behaviors that are likely to lead to rewards from the patient, pleasure or sense of accomplishment (internal) or social attention (external) [6]. This increase in rewards first helps to improve the patient's positive emotional tolerance and ultimately improves intimate relationships [18]. The use of appropriate executive functions by reducing anxiety and sensitivity to anxiety leading to improving proper cognitive and emotional performance makes the MS patients able to solve the problem and increase their QoL [2].…”

“…The anxiety sensitivity questionnaire is a 36-item selfreport questionnaire. This questionnaire was developed by Taylor and Cox [22] and is scored on a five-point Likert scale (very low=0 to very high=4). The more severe fear of anxiety symptoms is determined by higher scores (minimum total score is 0 and the maximum score is 144).…”