A comparison of cognitive performances between neuromyelitis optica spectrum disorder and multiple sclerosis patients in Indian context

Swati Kumar,Goutam Gangopadhyay,Biman Kanti Ray,Alak Pandit,Souvik Dubey,Shambaditya Das,Atanu Biswas

doi:10.1186/s41983-021-00351-y

Abstract

BackgroundTo compare the frequency and pattern of cognitive impairment in neuromyelitis optica spectrum disorder (NMOSD) and multiple sclerosis (MS) patients.ResultsTwenty NMOSD and forty MS patients were included. Clinical and detailed neuropsychological assessment was done using frontal assessment battery and Kolkata cognitive battery supplemented with additional standard tests for different domains of cognitive functions. Domain wise tests were performed and compared. 15/20 (75%) NMOSD and 32/40 (80%) MS patients had cognitive impairment (p = 0.65). Executive function, verbal fluency, information processing speed, visuo-constructional ability, attention, complex calculation, and memory were more commonly involved in NMOSD in decreasing order. Compared to MS, the pattern was similar except that verbal fluency was more impaired in NMOSD. Expanded Disability Status scale (EDSS) correlated with cognitive involvement in NMOSD (p = 0.02) as against MS.ConclusionsExecutive function, verbal fluencies, and information processing speed were more affected compared to visual and verbal memory in NMOSD patients. The pattern of cognitive performance was similar in the MS group, even though clinical and radiological characteristics and pathophysiology is different, suggesting similar brain involvement.

Highlights

To compare the frequency and pattern of cognitive impairment in neuromyelitis optica spectrum disorder (NMOSD) and multiple sclerosis (MS) patients
The parameters studied were current age, gender, educational level, disease duration, number of relapses, and disability which was measured by the Expanded Disability Status Scale (EDSS) [10], Oligoclonal band (OCB) in cerebrospinal fluid (CSF), and Aquaporin 4 (AQP4) positivity in serum
MS patients had a higher Expanded Disability Status scale (EDSS) compared to NMOSD patients (p = 0.0091) (Table 1)

Summary

Introduction

To compare the frequency and pattern of cognitive impairment in neuromyelitis optica spectrum disorder (NMOSD) and multiple sclerosis (MS) patients. (AQP4), which is a bidirectional water channel protein on the foot process of astrocytes present all over CNS. This further sets up a cascade of reactions altering the synaptic plasticity of neurons. Cognitive impairment is considered to be an attack independent progressive symptom in NMOSD patients, presumably involving a similar phenomenon [3]. Cognitive impairment (CI) in NMOSD as seen in the contemporary studies is present in 30–70% of patients, predominantly involving alteration in attention, language, memory, processing speed, and executive function [3]

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Conclusion