Our results support the hypothesis that prevalence of vascular cognitive impairment may be higher in Bulgaria than in most European countries.

ABSTRACT:An association of MS with different anaemic syndromes, most often pernicious and Vit. B12 deficiency anaemia has been reported in the literature. Accordingly, the coincidence of anaemia with MS has been considered to impact seriously on clinical presentation, therapeutic strategy and patient's quality of life.Objective: To perform a retrospective analysis of 18 cases with anaemic syndrome as a factor of comorbidity in patients with MS.Material and methods: 18 MS patients (15 women and 3 men) with RRMS (13), PPMS (2), and SPMS (3) diagnosed according to McDonald criteria were included in the present study. Average age was 36.4±8.5 (22-42) years, average disease duration 10.6±6.8 (4-18) years and means EDSS -3.5±2.5 points (2-6). All individuals underwent clinical, MRI and hematological examinations.Results: The study group included patients with pernicious (n=8), Vitamin B12 (n=6), and iron (n=3) deficiency anaemia, as well as with β-thalassemia (n=1). In 12 patients anaemic syndrome proceeded MS and in 6 evolved during the course of the desease.Conclusion: Our own notices and literature review suggests a possible causative relation between MS and anaemic syndrome. The role of this coincidence on clinical presentation, necessity of additional treatment, and patient's quality of life is discussed.

INTRODUCTION: Cognitive impairment is frequent in multiple sclerosis and predominantly affects visuospatial abilities, memory, attention, and executive functions. Because of the specific cognitive profile, different from that in Alzheimer's disease and other frequent disorders presenting with dementia, specific neuropsychological instruments need to be used in multiple sclerosis. The aim of the present study is to assess the applicability of the Rey-Osterrieth complex figure test (ROCFT) for assessing cognitive impairment in patients with multiple sclerosis in comparison with a control group. MATERIAL AND METHODS: One hundred and two individuals, 70 patients with MS and 32 healthy control subjects were assessed using ROCFT. A standardized system for assessment by points and percentages was used. The results from both groups were compared statistically using independent samples t-test. RESULTS: On the copying task, the differences between patients and controls reached statistical significance, p<0.05 for the raw score, and p<0.001 after results were grouped by percentiles. On the drawing by memory task the differences between the two groups also showed statistical significance, p<0.01. CONCLUSION: ROCFT shows statistically significant differences between patients with multiple sclerosis and healthy subjects. Highest levels of significance were observed for copying, scored by percentiles, and for drawing by memory. The application of ROCFT can provide valuable information about cognitive dysfunction in multiple sclerosis.

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