Relationship Between Global Cognitive Decline and Depressive Symptoms in Multiple Sclerosis

Abstract

Cognitive impairment and depressed mood are common symptoms in multiple sclerosis (MS), which significantly impact patients' role functioning and quality of life. Cross-sectional studies indicate a modest association between cognitive impairment and depressive symptoms in MS. Longitudinal studies show inconsistent results but provide some data indicating a relationship between increasing global cognitive decline and increasing depressive symptoms over time. Establishing whether such a relationship exists represents an important first step in understanding the temporal nature of that relationship along with any treatment implications. The current study investigated this relationship by using the adjusted difference between a demographic estimate of premorbid intellectual functioning (Barona) and a performance measure of current intellectual functioning (Shipley Institute of Living) to capture long-term global cognitive decline in MS patients. Degree of global cognitive decline was then related to a self-report measure of mood, evaluative, and vegetative depression symptoms (Chicago Multiscale Depression Inventory). Global cognitive decline accounted for 5% of the variance in mood-evaluative symptoms but none of the variance in vegetative symptoms. When groups experiencing moderate, mild, and no global cognitive decline were compared on depression symptom subscales, MS patients experiencing moderate cognitive decline reported significantly higher mood and evaluative, but not vegetative, depressive symptoms than MS patients with stable cognitive functioning.

Psychiatric manifestations in cerebrotendinous xanthomatosis

“…MS may cause cognitive disturbance or dementia and, less often, organic psychopathology encompassing behavioural/personality disturbance, mood/affective disorders or psychosis. 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104 Psychiatric syndromes, such as bipolar disorders and atypical psychosis, often unassociated with cognitive disturbance or dementia, have been described, and euphoria sclerotica is a characteristic psychosyndrome in MS. 83, 84, 85, 89, 91, 94, 95, 96, 99, 104, 105, 106, 107 Pure psychiatric presentation in MS is rare, as is the case for CTX. 83, 89, 91, 106, 107 Major depressive disorder, which often is prodromal leading to diagnostic delay, is overrepresented in MS patients, as are suicidal ideation, anxiety and sleep disorders, and they are mainly believed to be secondary to physical illness and/or disease-modifying treatment.…”

“…83, 89, 91, 106, 107 Major depressive disorder, which often is prodromal leading to diagnostic delay, is overrepresented in MS patients, as are suicidal ideation, anxiety and sleep disorders, and they are mainly believed to be secondary to physical illness and/or disease-modifying treatment. 84, 85, 86, 87, 90, 93, 95, 96, 98, 99, 102, 104, 107, 108 Athough in MS a detrimental autoimmune process is the culprit, and not an enzymatic metabolic defect as in CTX, the relative infrequence, variability and complexity of psychiatric signs in both these diseases can be explained by the stochasticity and widespread nature of neural tissue damage, and the prerequisite of a cumulative effect and critical burden of white/grey matter loss or dysfunction. 85, 86, 90, 103, 104, 106, 107, 108, 109, 110, 111, 112, 113 Moreover, one can further classify the organic neuropsychiatric syndromes associated with CTX and MS, as primarily related to the integrity of subcortical myelinated systems, as is also reflected in similarities in their neuropsychological profiles with cognitive slowing, dysexecutive syndrome and attentional disorder.…”

Does Fatigue Complaint Reflect Memory Impairment in Multiple Sclerosis?

“…Verbal episodic memory impairment and memory complaint are common in the early stage of the disease. Among previous studies that examined the relationship between fatigue, cognition, and mood disorders, some found a link between depression and cognitive impairment [11] whereas others did not [12, 13]. Although a relationship has been demonstrated between fatigue and depression [14], the relationship between fatigue and cognitive impairment is still debated.…”

Influence of anxiety on memory performance in temporal lobe epilepsy

“…Indeed, out of multiple articles reviewed, we only located one where verbal list learning performance was lower among individuals with anxiety disorders [28]. Depression on the other hand, has appeared to have more general effects on cognition [29, 30], rather than specifically impacting visual memory. Thus, it is possible that anxiety could have contributed to inconsistent findings among drawing-based visual memory tests whereas prior research does not suggest the same relationship between depression and visual memory.…”