Patterns of Cognitive Impairment in Secondary Progressive Stable Phase of Multiple Sclerosis: Correlations with MRI Findings

Abstract

Cognitive impairment is commonly described in multiple sclerosis (MS), but conflicting results have been reported about its pattern by previous studies focused on heterogeneous patient groups. The aim of this study was to investigate the cognitive skills of a homogeneous group of secondary progressive MS patients, and to examine the relationship of this impairment to MRI parameters. Forty-four MS patients underwent a series of neuropsychological tests devised to explore the main cognitive domains, and T1- and T2-weighted brain MRI. Results showed the presence of deficits of attention, memory, planning abilities, problem-solving and conceptual reasoning (frontal functions) in a subgroup of MS patients. Correlations between the performance in some ‘frontal’ tests and the extent of frontal lobe MRI lesional area were present, but rather unspecific, the same performance being also correlated with the nonfrontal lesional area. These findings suggest that in MS, overall macroscopic and microscopic brain damage is more important than the corresponding focal brain disease, even in determining deficits of selective cognitive domains.

Fatigue and depression in multiple sclerosis: pharmacological and non-pharmacological interventions

“…101 Executive dysfunction has traditionally been associated with frontal lobe pathology, for example, lesions, 102 but the relationship is not at all clear, 103 consistent with newer evidence of more complex cerebral pathways regulating executive function.…”

Evaluation of the Impact of Cognitive Training on Quality of Life in Patients with Multiple Sclerosis

“…Moreover, CI is considered to be a negative prognostic factor for rehabilitation outcome [5,6] . The estimated prevalence of higher cognitive ability dysfunction ranges from 30 to 70% [7] . Between 5 and 20% of CI cases classified as severe MS patients with CI encounter significantly more difficulties in their work, social contacts, sex life and activities of daily living (ADL) than MS patients without CI [8,9] .…”

Fatigue and progression of corpus callosum atrophy in multiple sclerosis

“…Fatigue is one of the most common symptoms encountered in MS, leading to a severe level of disability and impaired quality of life [13,15,20,21]. Fatigue occurs in all stages of the disease and usually does not correlate with demographic or disease characteristics such as age, gender, disability or disease severity [2,3,18,22,23,28,40]. The pathophysiology of MS-related fatigue is not fully understood and seems to be multifactorial [7].…”