Influence of Clinical Variables on Neuropsychological Performance in Multiple Sclerosis

Abstract

The effects of age, educational level, duration and course of the disease, physical disability and mood status on several cognitive functions (short- and long-term memory, frontal functions, attention, language and visuospatial skills) have been evaluated in 42 multiple sclerosis (MS) patients. The Hamilton Depression Rating Scale (HDRS) scores and a secondary progressive disease course significantly influenced neuropsychological performance. Factorial analysis revealed that indexes of (1) frontal function impairment, (2) long-term verbal memory and language function impairment, and (3) visuospatial short- and long-term memory and visuoperceptive function impairment accounted for 85% of the variance in neuropsychological performance. Only the first factor was significantly related to the presence of depressive symptomatology, as assessed by the HDRS. These results indicate that both the course of the disease and the presence of affective disorders must be taken into account when evaluating the natural history of cognitive impairment in MS and suggest that depressive symptomatology and cognitive dysfunction in MS are related to the involvement of at least partially overlapping anatomofunctional circuits.

Cognitive Dysfunction in Multiple Sclerosis: Methods and Prevalence from the GEDMA Study

“…In another study, a cutoff of two altered tests was used, and 31% of patients were diagnosed as cognitively impaired. Patients were slightly less functionally impaired and control-group correction was not used [27]. The appropriateness of correcting cognitive dysfunction frequency with data from a control group lies in the fact that low cognitive performance may be due to several reasons other than genuine cognitive decline.…”

Cognitive impairment in multiple sclerosis: Evidence-based analysis and recommendations

“…1,101 Rather, major depression may exacerbate existing impairments of cognition, primarily in relation to speed of information processing and working memory. [105][106][107][108][109] While depressed MS patients have been reported to respond well to treatment with either psychotherapy or antidepressant medication, 110 the effects of treatment for major depression on cognitive functioning have not yet been explored in MS. Furthermore, to date, the relationship between other mood disorders and cognitive functioning in MS has not been examined.…”

The role of disability and depression in cognitive functioning within 2 years after multiple sclerosis diagnosis

“…In contrast, intellectual functions and language skills generally remain preserved [9,31,32]. Cognitive impairment is present in all MS subtypes, but is generally more severe in progressive than in relapsing-remitting MS patients [17,19,20]. Yet, studies on the relationship between cognitive functioning and disability have produced conflicting results [7,27,28,31].…”