Cognitive impairment at diagnosis predicts 10-year multiple sclerosis progression

Moccia, Marcello; Lanzillo, Roberta; Palladino, Raffaele; Chang, Kiara; Costabile, Teresa; Russo, Cinzia Valeria; Rosa, Anna De; Carotenuto, Antonio; Saccà, Francesco; Maniscalco, Giorgia Teresa; Morra, Vincenzo Brescia

doi:10.1177/1352458515599075

Cited by 119 publications

(116 citation statements)

References 35 publications

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“…In the longitudinal analysis of the present study, the patients showed stabilization or improvement in VEM performance, corroborating the findings of some longitudinal studies 17,18,19,20,21,22,23,24 , yet contrasting with others showing decline 4,6,25,26 in this domain. These incongruent findings have been reported in recently-published systematic reviews on the subject 1,2,3 .…”

Section: Discussionsupporting

confidence: 91%

“…A 10-year longitudinal study revealed that decline in information processing speed and verbal episodic memory (VEM) in early RRMS patients predicted progression to the secondary progressive MS clinical form. Given that secondary progressive MS is a more severe stage of the disease, assessing these cognitive domains in the early stages of MS is vital 4 . A scientific review of the related literature 1 reported that episodic memory is one of the most common deficits found in MS, occurring in 40-65% of patients.…”

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confidence: 99%

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Longitudinal analysis of verbal episodic memory in patients with relapsing-remitting multiple sclerosis

Boa

Rimkus

Campanholo

et al. 2018

Arq. Neuro-Psiquiatr.

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Objective: A 4.5-year follow-up study was conducted to characterize baseline verbal episodic memory (VEM) and its behavior and to assess the effects of relapsing-remitting multiple sclerosis (RRMS) on this domain. Methods: Twenty-nine patients with RRMS underwent two neuropsychological assessments performed an average of 4.5 years apart. Twenty-six control participants underwent a single neuropsychological assessment. A significance level of p < 0.005 was adopted to denote a significant difference between the groups on the Mann Whitney and Wilcoxon paired statistical analyses. Results: No statistical difference was found in the results of the VEM tests between the first and second neuropsychological assessments of the patients. However, a statistical difference was evident between the patient and control groups in the results of the VEM tests. Conclusion: The patient group showed changes in the VEM relative to the control group. After approximately 4.5 years of disease, the patient performance on the VEM stabilized or improved.Keywords: multiple sclerosis; cognition; longitudinal studies. RESUMOObjetivo: Neste estudo, propomos a caracterização da Memória Episódica Verbal (MEV) basal e o seu comportamento após o período de 4,5 anos de doença, a fim de avaliar o efeito da EMRR neste domínio. Métodos: Vinte e nove pacientes com EMRR foram submetidos a duas avaliações neuropsicológicas realizadas entre um intervalo de tempo médio de 4,5 anos. Vinte e seis controles foram submetidos à avaliação neuropsicológica única. Considerou-se nível de significância p <0,005 para delinear diferença significante entre os grupos nas análises estatísticas Mann Whitney e Wilcoxon pareado. Resultados: Não houve diferença estatística nos resultados dos testes de MEV entre a primeira e segunda avaliação neuropsicológica realizada pelos pacientes. Houve discrepância estatística nos resultados dos testes de MEV entre o grupo dos pacientes e controles. Conclusão: O grupo de pacientes apresentou alterações de MEV quando comparado aos controles. Após 4,5 anos aproximadamente os pacientes estabilizaram ou melhoraram seu desempenho em MEV.Palavras chave: esclerose múltipla; cognição; estudos longitudinais.Patients with multiple sclerosis (MS) clinically present with a myriad of neurologic symptoms, including cognitive decline, regarded as having the greatest impact on key aspects of their daily living, such as managing domestic tasks, participating in society and holding down a job 1 . According to reviews of the scientific literature, one third of MS patients with the relapsing-remitting (RRMS) clinical form show cognitive impairments that are often milder than that found in the progressive subtypes of the disease 2,3 . Cognitive impairments can vary, but an impact on episodic memory is evident in the early stages of the disease. A 10-year longitudinal study revealed that decline in information processing speed and verbal episodic memory (VEM) in early RRMS patients predicted progression to the secondary progressive MS clinical form....

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Section: Discussionsupporting

confidence: 91%

mentioning

confidence: 99%

Longitudinal analysis of verbal episodic memory in patients with relapsing-remitting multiple sclerosis

Boa

Rimkus

Campanholo

et al. 2018

Arq. Neuro-Psiquiatr.

View full text Add to dashboard Cite

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“…ophthalmology), for MRI procedures, for laboratory exams, for psychological and neuropsychological evaluations, performed in accordance with current guidelines and clinical practice [16,17,19,20]. These procedures were selected for the analyses since they were directly monitored by the MS Centre and recorded in the clinical database.…”

Section: Methodsmentioning

confidence: 99%

“…Endpoints of disability progression (1-point EDSS progression, reaching of EDSS 4.0, reaching of EDSS 6.0, and SP conversion) were chosen because clinically important and unlikely to remit once sustained [20,23,25]. The observation period was extended to 12 months in order not to wrongly estimate disability accrual [26].…”

Section: Methodsmentioning

confidence: 99%

Healthcare Costs for Treating Relapsing Multiple Sclerosis and the Risk of Progression: A Retrospective Italian Cohort Study from 2001 to 2015

et al. 2017

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BackgroundDisease modifying treatments (DMTs) are the main responsible for direct medical costs in multiple sclerosis (MS). The current investigation aims at evaluating possible associations between healthcare costs for treating relapsing remitting MS (RRMS) and disease evolution.MethodsThe present cohort study retrospectively included 544 newly diagnosed RRMS patients, prospectively followed up for 10.1±3.3 years. Costs for DMT administration and management were calculated for each year of observation. Following clinical endpoints were recorded: time to first relapse, 1-point EDSS progression, reaching of EDSS 4.0, reaching of EDSS 6.0, and conversion to secondary progressive MS (SP). Covariates for statistical analyses were age, gender, disease duration and EDSS at diagnosis.ResultsAt time varying Cox regression models, 10% increase in annual healthcare costs was associated with 1.1% reduction in 1-point EDSS progression (HR = 0.897; p = 0.018), with 0.7% reduction in reaching EDSS 6.0 (HR = 0.925; p = 0.030), and with 1.0% reduction in SP conversion (HR = 0.902; p = 0.006).ConclusionHigher healthcare costs for treating MS have been associated with a milder disease evolution after 10 years, with possible reduction of long-term non-medical direct and indirect costs.

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“…Delayed P3 is associated with higher EDSS scores [22,67], disease duration [25], low performance on attention and memory tasks and total MRI lesion burden [30,49,63]. Previous neuroimaging and neuropsychological studies pointed out the need for early detection of cognitive impairment in MS [1,46], possibly at the subclinical level. ERPs could be particularly helpful in the early recognition of cognitive dysfunction and have been already successfully used to this end [43].…”

Section: Introductionmentioning

confidence: 99%

Stroop event-related potentials as a bioelectrical correlate of frontal lobe dysfunction in multiple sclerosis

Amato

Cursi

Rodegher

et al. 2016

Mult Scler Demyelinating Disord

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Background: Dysfunction of higher cognitive abilities occurs in 40-60 % of people with multiple sclerosis (MS), as detected with neuropsychological testing, with predominant involvement of executive functions and processing speed. Event-related potentials to the Stroop are a bioelectrical correlate of executive function. We tested whether event-related potentials to the executive Stroop test may reflect executive dysfunction in MS.

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Cognitive impairment at diagnosis predicts 10-year multiple sclerosis progression

Abstract: Cognitive impairment, with particular involvement of processing speed and memory, predicts disability progression and SP conversion in newly diagnosed RRMS, highlighting the importance of cognitive assessment from the beginning of MS.

Cited by 119 publications

References 35 publications

Longitudinal analysis of verbal episodic memory in patients with relapsing-remitting multiple sclerosis

Longitudinal analysis of verbal episodic memory in patients with relapsing-remitting multiple sclerosis

Healthcare Costs for Treating Relapsing Multiple Sclerosis and the Risk of Progression: A Retrospective Italian Cohort Study from 2001 to 2015

Stroop event-related potentials as a bioelectrical correlate of frontal lobe dysfunction in multiple sclerosis

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