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Cognitive Deficit in Patients with Clinical Isolated Syndrome and Multiple Sclerosis


Authors: T. Štecková;  P. Hluštík;  V. Sládková;  J. Doláková;  J. Zapletalová;  P. Kaňovský
Authors‘ workplace: Neurologická klinika LF UP a FN Olomouc
Published in: Cesk Slov Neurol N 2011; 74/107(5): 551-555
Category: Short Communication

Overview

Objective:
The goal of the study was to evaluate and compare the nature of cognitive deficits in clinical isolated syndrome and the relapsing-remitting type of multiple sclerosis (MS) at disease durations of 5 and 10 years.

Methods:
The study group comprised 41 patients, including 19 patients with clinically isolated syndrome and 24 patients with relapsing-remitting MS (15 patients had been treated for 5 years and 9 patients for 10 years). Patients were evaluated by means of an extensive neuropsychological test battery, aiming to address executive function, psychomotor speed, concentration and distribution of attention, visual-spatial abilities, auditory, visual and working memory, tactile perception, verbal fluency and severity of symptoms of depression.

Results:
Even at an early stage of the disease, cognitive impairment was detected in a large proportion of the MS patients, who appear to be most affected in lexical verbal fluency, auditory memory, and slower psychomotor speed. Further abnormalities included worsening of executive functions and deficits in the distribution of attention. Also weakened was the initial encoding in the visual modality of memory. The duration of the disease was not found to be significantly correlated to the severity of cognitive impairment or of symptoms of depression.

Conclusion:
Cognitive deficits in the clinical isolated syndrome are similar to those found in the later stages of relapsing-remitting MS.

Key words:
clinically isolated syndrome – multiple sclerosis – neuropsychological testing


Sources

1. Rao SM, Leo GJ, Bernardin L, Unverzaqt F. Cognitive dysfunction in multiple sclerosis. I. Frequency, patterns and prediction. Neurology 1991; 41(5): 685–691.

2. Feuillet L, Reuter F, Audoin B, Malikova I, Barrau K, Cherif AA et al. Early cognitive impairment in patients with clinically isolated syndrome suggestive of multiple sclerosis. Mult Scler 2007; 13(1): 124–127.

3. Deloire MS, Salort E, Bonnet M, Arimone Y, Boudineau M, Amieva H et al. Cognitive impairment as marker of diffuse brain abnormalities in early relapsing remitting multiple sclerosis. J Neurol Neurosurg Psychiatry 2005; 76(4): 519–526.

4. Benedict RH, Fischer JS, Archibald CJ, Arnett PA, Beatty WW, Bobholz J et al. Minimal neuropsychological assessment of MS patients: a consensus approach. Clin Neuropsychol 2002; 16(3): 381–397.

5. Olivares T, Nieto A, Sánchez MP, Wollmann T, Hernández MA, Barroso J. Pattern of neuropsychological impairment in the early phase of relapsing-remitting multiple sclerosis. Mult Scler 2005; 11(2): 191–197.

6. Achiron A, Barak Y. Cognitive changes in early MS: a call for common framework. J Neurol Sci 2006; 245(1–2): 47–51.

7. Huijbregts SC, Kalkers NF, de Sonneville LM, de Groot V, Reuling IE, Polman CH. Differences in cognitive impairment of relapsing remitting, secondary and primary progressive MS. Neurology 2004; 63(2): 335–339.

8. Huijbregts SC, Kalkers NF, de Sonneville LM, de Groot V, Polman CH. Cognitive impairment and decline in different MS subtypes. J Neurol Sci 2006; 245(1–2): 187–194.

9. Potagas C, Giogkaraki E, Koutsis G, Mandellos D, Tsirempolou E, Sfagos C et al. Cognitive impairment in different MS subtypes and clinically isolated syndromes. J Neurol Sci 2008 15; 267(1–2): 100–106.

10. Charcot JM. Lectures on the diseases of the nervous system, delivered at La Salpêtrière. London: New Sydenham Society 1877.

11. Callanan MM, Logsdail SJ, Ron MA, Warrington EK. Cognitive impairment in patients with clinically isolated lesions of the type seen in multiple sclerosis. A psychometric and MRI study. Brain 1989; 112(Pt 2): 361–364.

12. Feinstein A, Kartsounis LD, Miller DH, Youl BD, Ron MA. Clinically isolated lesions of the type seen in multiple sclerosis: a cognitive, psychiatric, and MRI follow up study. J Neurol Neurosurg Psychiatry 1992; 55(10): 869–876.

13. Feinstein A, Youl B, Ron M. Acute optic neuritis. A cognitive and magnetic resonance imaging study. Brain 1992; 115(Pt 5): 1403–1415.

14. Pelosi L, Geesken JM, Holly M, Hayward M, Blumhardt LD. Working memory impairment in early multiple sclerosis. Evidence from an event-related potential study of patients with clinically isolated myelopathy. Brain 1997; 120(Pt 11): 2039–2058.

15. Achiron A, Barak Y. Cognitive impairment in probable multiple sclerosis. J Neurol Neurosurg Psychiatry 2003; 74(4): 443–446.

16. McDonald WI, Compston A, Edan G, Goodkin D, Hartung HP, Lublin FD et al. Recommended diagnostic criteria for multiple sclerosis: guidelines from the International Panel on the diagnosis of multiple sclerosis. Ann Neurol 2001; 50(1): 121–127.

17. Kurtzke JF. Rating neurologic impairment in multiple sclerosis: an expanded disability status scale (EDSS). Neurology 1983; 33(11): 1444–1452.

18. Artiola I, Fortuny LA, Heaton RK. Standard versus computerized administration of the Wisconsin Card Sorting Test. Clin Neuropsychol 1996; 10: 419–424.

19. Culbertson WC, Zillmer EA. Tower of London – Drexel University (TOLdx). 2nd ed. Toronto: Multi-Health Systems 2005.

20. Lezak MD, Howieson DB, Loring DW. Orientation and attention. In: Lezak MD, Howieson DB, Loring DW (eds). Neuropsychological assessment. 4th ed. New York: Oxford University Press 2004: 365–367.

21. Beck AT, Steer RA, Ball R, Ranieri WF. The beck depression inventory (BDI, BDI-II). 2nd ed. San Antonio: Psychological Corporation 1996.

22. Reitan RM., Wolfson D. A selective and critical review of neuropsychological deficits and the frontal lobes. Neuropsychol Rev 1994; 4(3): 161–198.

23. Kempen JH, Krichevsky M, Feldman ST. Effect of visual impairment on neuropsychological test performance. J Clin Exp Neuropsychol 1994; 16(2): 223–231.

24. Dee HL, Benton AL. A cross-modal investigation of spatial performances in patients with unilateral cerebral disease. Cortex 1970; 6(3): 261–272.

25. Strauss E, Sherman EM, Spreen O. A compendium of neuropsychological tests: administration, norms, and commentary. 3rd ed. New York: Oxford University Press 2006.

26. Preiss M, Kalivodová Z, Kundrátová I, Mrlinová L, Ježková T, Kubů M et al. Test verbální fluence – vodítka pro všeobecnou dospělou populaci. Psychiatrie 2002; 6(2): 74–77.

27. Gronwall DM. Paced auditory serial-addition task: a measure of recovery from concussion. Percept Mot Skills 1977; 44(2): 367–373.

28. Benedict RH, Brandt J. Brief Visuospatial Memory Test-Revised Professional Manual. Odessa: Psychological Assessment Resources 1997.

29. Achiron A, Polliack M, Rao SM, Barak Y, Lavie M, Appelboim N et al. Cognitive patterns and progression in multiple sclerosis: construction and validation of percentile curves. J Neurol Neurosurg Psychiatry 2005; 76(5): 744–749.

30. Assouad R, Viret AC, Bensa C, Gueguen A, Lecanuet P, Moulignier A et al. Cognitive Impairment in Patients with Clinically Isolated Syndrome: A Reappraisal after 8 Years. Neurology 2010; 74: 362.

31. Ivnik RJ. Neuropsychological test performance as a function of the duration of MS-related symptomatology. J Clin Psychiatry 1978; 39(4): 304–307.

32. Marsh GG. Disability and intellectual function in multiple sclerosis patients. J Nerv Ment Dis 1980; 168(12): 758–762.

33. Kesselring J, Beer S. Symptomatic therapy and neurorehabilitation in multiple sclerosis. Lancet Neurol 2005; 4(10): 643–652.

34. O’Brien AR, Chiaravalloti N, Goverover Y, Deluca J. Evidenced-based cognitive rehabilitation for persons with multiple sclerosis: a review of the literature. Arch Phys Med Rehabil 2008; 89(4): 761–769.

Labels
Paediatric neurology Neurosurgery Neurology

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Czech and Slovak Neurology and Neurosurgery

Issue 5

2011 Issue 5

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