Abstract
Objective: Self-and informant-reports may be used to evaluate perceived neurocognitive functioning, such as with the Multiple Sclerosis Neuropsychological Screening Questionnaire (MSNQ). However, these measures may be influenced by depression, anxiety, and fatigue. This study aims to further examine the potential influence of affect and fatigue on MSNQ scores.
Method: 86 persons with Multiple Sclerosis (PwMS) (F = 65,M = 21) completed a comprehensive neuropsychological battery that included self-report measures of anxiety, depression, fatigue, and self-reported neurocognitive function with the MSNQ-Self-Report (MSNQ-S) and MSNQ-Informant-Report (MSNQ-I). Hierarchical regressions were conducted with MSNQ-S and MSNQ-I as outcome variables and with depression, anxiety, cognitive fatigue, and physical fatigue as predictors. Predicted full-scale IQ (FSIQ) was included as a covariate.
Results: The model including only FSIQ and depression showed that depression was positively correlated with the MSNQ-S, F(2,82) = 15.12, p < 0.001, ∆R2 = 0.15. When including anxiety in the model, depression was still positively associated with the MSNQ-S, F(3,81) = 4.57, p = 0.04, as was anxiety, F(3,81) = 8.07, p = 0.006, ∆R2 = 0.07. However, when including cognitive fatigue, the relationships between the MSNQ-S and depression and anxiety were no longer significant, though cognitive fatigue was positively correlated with MSNQ-S scores, F(5,79) = 71.32, p < 0.001, ∆R2 = 0.35. The MSNQ-I was not correlated with the affective measures or physical fatigue, though there was a positive relationship between the MSNQ-I and cognitive fatigue, F(5,79) = 14.58, p < 0.001, ∆R2 = 0.14.
Conclusions: Findings suggest that cognitive fatigue impacts subjective report of neurocognitive impairment for both patients and informants. Notably, when accounting for cognitive fatigue, affective disturbance was no longer significantly associated with reported neurocognitive functioning, which highlights the importance of examining fatigue and mood in PwMS.