Abstract
Cognitive impairments are frequent in patients with Multiple Sclerosis (MS). Yet, the influence of MS-related symptoms on cognitive status is not clear. Studies investigating the impact of trait fatigue along with anxio-depressive symptoms on cognition are seldom, and even less considered fatigue as multidimensional. Moreover, these studies provided conflicting results.Twenty-nine MS patients and 28 healthy controls, matched on age, gender and education underwent a full comprehensive neuropsychological assessment. Anxio-depressive and fatigue symptoms were assessed using the HAD scale and the MFIS, respectively. Six composite scores were derived from the neuropsychological assessment, reflecting the cognitive domains of working memory, verbal and visual learning, executive functions, attention and processing speed. Stepwise regression analyses were conducted in each group to investigate if trait cognitive and physical fatigue, depression and anxiety are relevant predictors of performance in each cognitive domain. In order to control for disease progression, patient’s EDSS score was also entered as predictor variable.In the MS group, trait physical fatigue was the only significant predictor of working memory score. Cognitive fatigue was a predictor for executive functioning performance and for processing speed (as well as EDSS score for processing speed). In the healthy controls group, only an association between executive functioning and depression was observed.Fatigue predicted cognition in MS patients only, beyond anxio-depressive symptoms and disease progression. Considering fatigue as a multidimensional symptom is paramount to better understand its association with cognition, as physical and cognitive fatigue are predictors of different cognitive processes.
Highlights
Multiple Sclerosis (MS) is a chronic inflammatory disease resulting from immune-mediated damage in the central nervous system
There was no significant difference between groups for the HAD scale anxiety score, as well as for the cognitive fatigue sub-score of the MFIS
COGNITIVE PERFORMANCE AND SELF-REPORT QUESTIONNAIRES IN MS The comparison of the composite cognitive scores showed a lower performance in the MS group, by comparison to healthy controls (HC), for processing speed and attention, which is consistent with the existing literature (Bobholz & Rao, 2003; Chiaravalloti & DeLuca, 2008)
Summary
Multiple Sclerosis (MS) is a chronic inflammatory disease resulting from immune-mediated damage in the central nervous system. It is characterized by demyelination and axonal damage to white and grey matters, and leads to various neurologic symptoms (Calabrese et al, 2015; Kutzelnigg et al, 2005). Three different clinical courses are usually recognized (Lublin & Reingold, 1996; Reich, Lucchinetti, & Calabresi, 2018). The relapsingremitting form of MS (RRMS) is characterized by acute neurologic relapses, followed by total or partial remission. The disease can evolve into a progressive form, known as secondary progressive multiple sclerosis (SPMS), during which a progressive and constant increase of disease burden occurs with or without any clearly clinically identified relapses. A minority of patients present a progressive course from disease onset, namely a primary progressive disease course (PPMS)
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