Abstract

Patients suffering from multiple sclerosis experience various cognitive and affective impairments, resulting in a negative impact on social behavior and personal independence to differing degrees. According to these often clinically subtle but conflicting cognitive-affective impairments, recordings of these socially relevant issues are still of demand to stratifying clinical and social support in a sophisticated way. Therefore, we studied specific cognitive and affective capacities in eleven patients with a predominant relapsing-remitting type of multiple sclerosis by applying paradigms of event-related potentials and a well-selected neuropsychological test protocol. Thus far, distinct cognitive disturbances of executive and attentional domains and the Wechsler Memory Test's four memory indices were found in multiple sclerosis patients. Concerning affective domains, patients showed discrete impairments of affect discrimination and affected naming as proved by specific testing (Tuebinger Affect Battery). Neurophysiologically, event-related potentials recordings in multiple sclerosis patients, were associated with decreased implicit emotion processing to cues of different emotion arousal at the early processing stage depending on attentional capacities and alterations of implicit emotion modulation at late processing stages. These clinical neurophysiological and neuropsychological data were correlated in part to quantitative magnetic resonance imaging brain lesions. Summarizing our data, our data indicate certain neurocognitive and neuroaffective dysfunctions in patients with multiple sclerosis, thus highlighting the validity of sensitive recording of less apparent neurologic disturbances in multiple sclerosis for optimizing the individual care management in patients.

Highlights

  • 70% of patients with multiple sclerosis (MS) at all stages and in all subtypes of the disease exhibit various cognitive dysfunctions during their illness [1,2,3,4,5,6,7]

  • Impaired attention, executive function and working memory might be a matter of reduced process quality at the prefrontal cortex sites in forwarding cues of the emotional content of the inner and/or outer environment, so studying affective impairments at one hand, and the consideration of possible confounding high order cognitive disturbances at the other hand, seems to be reasonable for implementing cognitive domains in studying emotion processing in MS, guiding a comprehensive approach in disentangling the features of affective impairments in MS

  • We examined eleven ambulatory patients with a confined relapsing-remitting course of multiple sclerosis (RRMS), whereby three patients met the criteria of an advanced illness stage of the secondary chronic course of MS, according to the criteria of McDonald et al [38, 39]

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Summary

Introduction

70% of patients with multiple sclerosis (MS) at all stages and in all subtypes of the disease exhibit various cognitive dysfunctions during their illness [1,2,3,4,5,6,7]. Neuropsychological tests consistently reveal impairments to several cognitive domains such as episodic and working memory, attention, executive functioning, and information processing speed as the significant areas [8,9,10,11,12,13]. Besides these cognitive impairments, patients suffering from MS are at particular risk for affective disturbances such as perceiving and recognizing emotion with their sequelae to social interaction and affective functioning [14]. Impaired attention, executive function and working memory might be a matter of reduced process quality at the prefrontal cortex sites in forwarding cues of the emotional content of the inner and/or outer environment, so studying affective impairments at one hand, and the consideration of possible confounding high order cognitive disturbances at the other hand, seems to be reasonable for implementing cognitive domains in studying emotion processing in MS, guiding a comprehensive approach in disentangling the features of affective impairments in MS

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