Cognitive Evoked Potentials – the P300 Wave in Patients with Sclerosis Multiplex: Relation to the Form of the Disease, Somatic Affection and Quality of Life

Czech version

Authors: J. Szilasiová; Z. Novosadová; Z. Gdovinová
Authors‘ workplace: Neurologická klinika LF UPJŠ a FN L. Pasteura, Košice, Slovenská republika
Published in: Cesk Slov Neurol N 2007; 70/103(6): 665-673
Category: Original Paper

Overview

Introduction:
Cognitive function disorders are detected in approximately 65 % of multiple sclerosis (MS) patients. Auditory cognitive evoked potentials (ERP), especially the P300 wave, are an objective electrophysiological indicator of cognitive functions. The objective of the study was to detect cognitive disorders in patients with MS with the use of auditive cognitive evoked potentials, and to compare the disorders with patient demographic and clinical data.

Patient group and method:
The authors of the study examined 110 patients with a definitive MS diagnosis (60 with relapsing/remittent, 41 with secondary progressive and 9 with primary progressive form of MS), and 130 persons from a control group. ERP results were compared with the degree of functional disability measured on the Kurtzke EDSS (Expanded Disability Status Scale), with the degree of cognitive disorders in psychometric tests, the degree of pathological fatigue, depression, and with the patients’ quality of life.

Outcome:
The latencies of the N200 and P300 waves were pathologically prolonged in 69 % of cases as compared with the controls; a higher value of the P300 wave amplitude was detected. Prolonged P300 wave latency highly correlated with cognitive disorders in the psychomotor test (Grassi test), the EDSS score and the quality of life. Low correlations were detected with the patient's age, duration of the disease, degree of EDSS, and the Mini-Mental-State-Examination and IQ scores (evaluated by Raven's progressive matrices). The cognitive deficit did not correlate with the degree of depression in the patients. Patients with progressive forms (primarily and secondarily progressive) showed a higher cognitive deficit as compared with the relapse/remittent form of the disease.

Conclusion:
The rate of incidence of cognitive deficit in our patient group was 69 %. It was related to pathological fatigue and had a negative impact on patients' quality of life. The deficit was more marked in the progressive forms of MS and grew in the course of the disease. Auditive cognitive evoked potentials, the P300 wave, are a suitable method of examining and monitoring cognitive disorders in multiple sclerosis.

Key words:
multiple sclerosis – cognitive disorders – cognitive evoked potentials – P300 wave – quality of life

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