Abstract
The study investigates primary and secondary verbal memory and motor/executive functions (response inhibition and strategy shifting ability) in multiple sclerosis (MS) patients with clinically isolated syndrome (CIS). We studied 44 CIS patients and compared them to 49 patients with relapsing remitting MS (RR-MS) displaying mild disability and to a large cohort of age- and education level-matched healthy volunteers (n= 230). Results showed that both CIS and RR-MS patients evidenced a disproportionate impairment in the immediate and delayed recall of the second (as compared to the first) of two short narratives of the Logical Memory WMS-III subtest, and reduced performance on the Memory for Digits-Forward. Performance of either group on the executive tasks was not impaired, showing evidence of a reversed speed-accuracy trade-off. Illness duration emerged as a significant predictor of memory and executive task performance. Clinical, psychoemotional, and brain imaging findings were also examined as potential correlates of memory deficits and disease progression among CIS patients. These findings may signify early-onset decline of specific cognitive functions in CIS, which merits regular follow-up assessments and monitoring of psychoemotional adaptation and everyday functioning.
Highlights
Multiple Sclerosis is considered to be an autoimmune disorder of the CNS typified by inflammatory demyelination and secondary axonal degeneration
All clinically isolated syndrome (CIS) patients included in this study showed white matter lesion(s) that could be attributed to multiple sclerosis (MS) ([3], incorporated into the McDonald criteria)
The present study investigated primary and secondary memory and motor/executive performance of patients with CIS in reference to age- and educationadjusted Greek population norms and in comparison to patients with relapsing-remitting MS selected from a larger clinical cohort for displaying mild physical disability
Summary
Multiple Sclerosis is considered to be an autoimmune disorder of the CNS typified by inflammatory demyelination and secondary axonal degeneration. While lesion/symptom dissemination in space and time is a characteristic feature of MS, the disorder often starts as a clinically isolated syndrome (CIS). Multisymptomatic presentations, indicative of dissemination in space, are associated with a higher conversion rate to clinically definite MS [42]. In this regard, brain imaging findings appear to have a predictive value. There is evidence that the number and distribution of MRI lesions, detected at the time of the initial clinical presentation, is predictive of MS course, including the degree of subsequent disability [43,44,46]. Other studies maintain that, while the presence of MRI lesions predicts the devel-
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