Screening of Cognitive Impairment in Patients with Multiple Sclerosis: A Cross-Sectional Study in Georgia.

Nazibrola Botchorishvili,Ann Dzagnidze,Maia Tighashvili,Marina Janelidze,Nino Shiukashvili,Nino Mikava,Nina Mikeladze,Carol Milligan

doi:10.1155/2021/5591078

Nazibrola Botchorishvili, Ann Dzagnidze + Show 6 more

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https://doi.org/10.1155/2021/5591078

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Abstract

Cognitive impairment (CI) is a common symptom of multiple sclerosis (MS), with a significant negative impact on the occupational and social functioning of patients. This study aimed to estimate the prevalence and characteristics of CI among MS patients in Georgia. Sixty-eight patients with MS attending a neurology outpatient clinic in Tbilisi, Georgia, were enrolled in the study. Cognitive status was evaluated using two screening tools: the Brief International Cognitive Assessment for MS and the Montreal Cognitive Assessment. The overall prevalence of CI in our MS patients was 47%. We found negative associations between cognitive test results and patients' age, disability status, and depression. Lower education, higher scores on the Expanded Disability Status Scale, and the progressive course of MS were the main predictors of CI in the logistic regression analysis. This is the first study in Georgia to evaluate CI in patients with MS. The prevalence of CI in our study was comparable with those reported in other countries; however, we found greater impairment of the executive system compared to other cognitive domains. In our study, patients who were on continuous DMT showed significantly better performance on the cognitive tests used, indicating possible favorable effect of immunomodulatory drugs on cognition.

Highlights

Multiple sclerosis (MS) is a chronic demyelinating and degenerative disease of the central nervous system [1]
An age, sex, and education-matched controls were subselected from a large group of 178 individuals who participated in the Brief International Cognitive Assessment for MS (BICAMS) validation study. e following inclusion criteria were applied: (1) age ≥18 years; (2) no history of neurological and psychiatric disease or severe head trauma; and (3) proficiency in the Georgian language
Cognitive impairment (CI) appears to be quite prevalent in Georgian patients with MS

Summary

Introduction

Multiple sclerosis (MS) is a chronic demyelinating and degenerative disease of the central nervous system [1]. According to estimates from the Global Burden of Disease Study, there were over two million MS patients in 2016 [2]. E clinical presentation of MS is diverse, depending on the number and location of demyelinated lesions as well as the extent of gray matter atrophy [5]. E majority of patients develop relapsingremitting multiple sclerosis (RRMS), characterized by alternating episodes of relapse and remission. Most RRMS patients eventually transition to a secondary progressive multiple sclerosis (SPMS), characterized by progressive worsening of neurologic functions. 10% of patients develop primary progressive multiple sclerosis (PPMS). PPMS is identified by steadily worsening neurologic functions from the onset of the disease

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