Cognitive impairment in Neuromyelitis Optica

Abstract

Introduction: There are few studies on cognitive impairment in neuromyelitis optica (NMO). The purpose of this study is to assess the factors that may be related with the frequency and level of cognitive impairment in Turkish NMO patients. Methods: 22 patients with the diagnosis of NMO are evaluated retrospectively. Cognitive function was evaluated with Brief Repeatable Battery of Neuropsychological tests (BRB-N), Beck Depression Inventory (BDI) and Addenbrooke Cognitive Evaluation (ACE-R). The groups with and without cognitive impairment were compared according to age, sex, level of education, pathologic findings on cranial MRI, NMO Ig existence and EDSS score. The relation of the clinical, radiological and demographic values and patients’ depression level was evaluated. The specificity and sensitivity of ACE-R test on detecting cognitive impairment were assessed through ACE-R test results. Results: The mean age of the patients was 42.8±10.9.45.5% (n=10) of the patients had cognitive impairment and 50% (n=11) had depression. The group with cognitive impairment had significantly older age, lower educational status, higher EDSS and BDI scores (p<0.05). The mostly affected cognitive domains were memory impairment, attention and processing dysfunction. When the specificity and sensitivity of ACE-R test on NMO patients were evaluated, diagnostic level of the test was found to be statistically good since it could detect cognitive impairment with a sensitivity of 88% and specificity of 75% on a cut off level of 82.5. Conclusion: In our study, cognitive impairment and depression were detected in approximately half of the patients with BRB-N and BDI tests. It can be concluded that ACE-R test can be used to detect cognitive impairment in NMO patients. Since cognitive impairment and depression are frequent in NMO patients, it is important to assess the patients’ cognitive functions and arrange the treatments to improve their quality of life, .

Cognitive Performance and Health-Related Quality of Life in Patients with Neuromyelitis Optica Spectrum Disorder

“…Our results are in agreement with other studies reporting that around 34% of the patients can be classified as having CI [ 22 , 23 ]. However, the proportion of patients suffering impairment in our study differs from others with smaller cohorts [ 24 , 25 , 26 ], which applied different criteria for CI [ 6 ] or used other neuropsychological tools for cognitive assessment [ 27 ]. The most affected domain in our cohort was visual memory, followed by attention-IPS and verbal memory.…”

Frequency of cognitive impairment in patients with neuromyelitis optica spectrum disorder in Mexico

“…Several previous studies have assessed and compared CI in MS and NMOSD patients. 14 , 17 , 18 , 20 , 39 – 41 In Latin America (LATAM) there is a lack of research and information regarding the prevalence of CI in NMOSD patients. To date, only one study has been conducted in LATAM (Argentina; 39) that included patients diagnosed NMOSD ( n = 14), MS ( n = 14), and HCs ( n = 14).…”

“…For instance: (a) the sample size of the groups is different, especially in the NMOSD group, as we included 40 NMOSD patients, while a study conducted in Egypt by Salama et al, 26 included 20 NMOSD patients and found that 75% of them had CI in two or more cognitive domains (Information processing speed and memory). In Turkey, a retrospective study conducted by Yabalak et al, 41 included 22 patients and reported that 45.5% of NMOSD patients had a CI (Memory, attention, and processing speed). In Japan, a study conducted by Fujimori et al 35 included 12 patients with NMOSD and showed that 41.7% had CI (Perceptual organization, working memory, and processing speed).…”

“…(b) Additionally, the number of cognitive domains evaluated by the neuropsychological test batteries varied from study to study. For Example, some studies assessed CI using the Brief Repeatable Battery of Neuropsychological Test, 18 , 35 , 41 – 43 while others used the BICAMS to assess. 26 , 27…”