Neurobehavioral Aspects of Different Forms of Multiple Sclerosis

Abstract

Introduction: Multiple sclerosis (MS) is an inflammatory disease of the central nervous system in young adults. Cognitive impairment during MS has been overlooked for a long time and raises a renewed interest recently. Objective: Determine prevalence of cognitive dysfunction in MS in a cohort hospital, particularities and factors affecting progression of cognitive dysfunction in individuals with MS. Methods: Thirty patients (21 women and 9 men) with MS aged 18 to 43 years followed at the Neurology Department of Charles-Nicolle Hospital from 2008 to 2013 participated in this study. Patients participating in this study were chosen randomly without considering their cognitive status. Evaluation included a neuropsychological assessment, physical examination and brain and spine MRI. Results: About 86% had cognitive impairment in at least one neuropsychological test. Predominant impaired domains were attention and information processing followed by verbal memory and executive functions. Depression was the most prevalent psychiatric disorder. Cognitive dysfunction was correlated with clinical form of MS, EDSS, radiological findings and disease’s course. Conclusion: Cognitive dysfunction might be more relevant to patients than mobility restrictions. Incorporating a systematic neuropsychological assessment in patients followed for MS allows psychosocial adaptation, monitoring disease activity and elucidating the effects of disease-modifying medications.