Abstract
Background:Progressive MS is associated with a high frequency of cognitive impairment. However, it is not clear to what extent this reflects global dysfunction, or independent deficits in specific functions.Objective:To characterise patterns of cognitive impairment in progressive MS on a multi-dimensional cognitive assessment tool well established in neurodegenerative diseases.Methods:Patients with secondary (SPMS;n= 60) and primary progressive MS (PPMS;n= 28) were assessed using the Addenbrooke’s Cognitive Examination-Revised (ACE-R) multi-dimensional cognitive assessment scale. Independent dimensions of impairment and their relative contribution to the overall burden of cognitive dysfunction were then determined by factor analysis.Results:Two independent dimensions of impairment were seen: frontal-executive (attention, verbal fluency, recall) on one hand, and language and visuospatial functions on the other. These accounted for 55% and 45% respectively of the variance not explained by a global influence (14.2% and 11.6% respectively of total variance). Isolated language and visuospatial dysfunction was seen in both groups, whereas isolated impairment in frontal-executive functions was underrepresented in SPMS (p= 0.001) and not seen in PPMS patients (p= 0.040).Conclusions:In addition to a prominent global influence on cognitive performance, patients with progressive MS commonly exhibit language and visuospatial deficits. Evaluation of these abilities should therefore be included in clinical assessment of cognition in progressive MS.
Highlights
Multiple sclerosis (MS) is the commonest nontraumatic cause of acquired disability amongst young European adults [1], with cognitive impairment seen in 40–70% of cases [2]
By using multivariate statistical analysis, we evaluated the contribution of global dysfunction and dysfunction in specific mental abilities to the overall pattern of cognitive impairment in progressive MS
The secondary progressive MS (SPMS) group had a higher mean disease duration than the primary progressive MS (PPMS) group (13.6 ± 7.8 years vs. 9.4 ± 5.6 years; p = 0.02), but there were no other differences in demographic or disease characteristics; or in cognitive performance assessed by the Addenbrooke’s Cognitive Examination-Revised (ACE-R) and paced auditory serial additions test (PASAT) (Table 1)
Summary
Multiple sclerosis (MS) is the commonest nontraumatic cause of acquired disability amongst young European adults [1], with cognitive impairment seen in 40–70% of cases [2]. Language and visuospatial functions have received less attention, despite evidence of involvement in large cohort studies [5] as well as in studies assessing these domains [6,7] It remains unclear whether cognitive dysfunction in MS always reflects a universal deficit of all functions, or whether impairment of specific functions can occur independently. RESULTS: Two independent dimensions of impairment were seen: frontal-executive (attention, verbal fluency, recall) on one hand, and language and visuospatial functions on the other. These accounted for 55% and 45% respectively of the variance not explained by a global influence (14.2% and 11.6% respectively of total variance). Evaluation of these abilities should be included in clinical assessment of cognition in progressive MS
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
