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RESEARCH PRODUCT

Cognitive dysfunction in patients with relapsing-remitting multiple sclerosis

Alessandra LugaresiD. FarinaGiovanni SavettieriG. TedeschiCarlo CaltagironeSimona BonavitaF. Le PiraM. F. De CaroMaria TrojanoUgo NocentiniAldo QuattronePaolo GirlandaArturo ReggioPatrizio PasqualettiGiuseppe SalemiMaria BuccafuscaPaola Valentino

subject

Adult050103 clinical psychologymedicine.medical_specialtyMultiple Sclerosismultiple sclerosis cognition single digit modality test information processingNeuropsychological TestsAudiologyDevelopmental psychology03 medical and health sciencesCognitionMultiple Sclerosis Relapsing-Remitting0302 clinical medicineMemoryOutpatientsOutpatients; Humans; Patient Selection; Multiple Sclerosis Relapsing-Remitting; Cognition; Cognition Disorders; Italy; Demography; Memory; Adult; Language; Neuropsychological Tests; SpeechmedicineHumansSpeech0501 psychology and cognitive sciencesMemory disorderCognitive deficitDemographyLanguagemedicine.diagnostic_testPatient SelectionMemoriaMultiple sclerosiscognition impairment05 social sciencesCognitive disorderNeuropsychologyCognitionNeuropsychological testmedicine.diseaserelapsing-remittingItalyinformation processing speedNeurologymultiple sclerosiSettore MED/26 - NeurologiaNeurology (clinical)medicine.symptomCognition DisordersPsychology030217 neurology & neurosurgeryrelapsing remitting

description

Cognitive dysfunction is considered one of the clinical markers of multiple sclerosis (MS). However, in the literature there are inconsistent reports on the prevalence of cognitive dysfunction, and separate data for the relapsing-remitting (RR) type of the disease are not always presented. In this study, we submitted 461 RRMS patients to a battery of neuropsychological tests to investigate their impairment in various cognitive domains. As a consequence of the exclusion criteria, the sample is not fully representative of the entire population of RRMS patients. In this selected sample, when only the eight scores of a core battery (Mental Deterioration Battery) were considered (with respective cutoffs), it emerged that 31% of the patients were affected by some degree of cognitive deficit. In particular, 15% had mild, 11.2% moderate and 4.8% had severe impairment. Information processing speed was the most frequently impaired area, followed by memory. When two other tests (SDMT and MCST) were added and cognitive domains were considered, it emerged that 39.3% of the patients were impaired in two or more domains. When four subgroups were obtained by means of cluster analysis and then compared, it emerged that information processing speed and memory deficits differentiated the still cognitively unimpaired from the mildly impaired MS patients. Significant associations were found between cognitive and clinical characteristics. However, due to the large sample size, clinically irrelevant relationships may also have emerged. Even with the limitations imposed by the sample selection and the possible underestimation of the prevalence and severity of cognitive dysfunction, these results seem to provide further evidence that information processing speed deficit may be an early and important marker of cognitive impairment in MS patients.

10.1191/135248506ms1227oahttp://hdl.handle.net/11570/1672275