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A longitudinal study of cognition in primary progressive multiple sclerosis
S J Camp1, V L Stevenson, A J Thompson
1Department of Clinical Neurology, Institute of Neurology, London, UK.
Brain : a Journal of Neurology
|July 29, 2005
Summary
Cognitive decline in primary progressive multiple sclerosis (PPMS) is complex. While overall cognitive scores remained stable over two years, individual declines were observed, with initial cognitive status predicting future ability.
Area of Science:
- Neurology
- Neuroimmunology
- Cognitive Neuroscience
Background:
- Limited longitudinal studies exist on cognition in multiple sclerosis (MS).
- No serial neuropsychological data are available for exclusively primary progressive MS (PPMS).
- Cross-sectional studies show correlations between cognition and MRI in PPMS.
Purpose of the Study:
- To investigate cognitive and magnetic resonance imaging (MRI) changes over two years in PPMS patients.
- To assess the relationship between cognitive changes and MRI parameters in PPMS.
Main Methods:
- Longitudinal study of 99 PPMS patients across five European centers.
- Annual assessments over two years included cognitive tests (Brief Repeatable Battery, reasoning, depression).
- MRI parameters (T1 hypointensity load, T2 lesion load, partial brain volume) were measured at each time point.
Main Results:
- No significant difference in mean cognitive scores between baseline and two-year follow-up.
- One-third of patients showed absolute cognitive decline on individual tests.
- Initial cognitive status predicted cognitive ability at two years; weak correlations found between cognitive and MRI changes.
Conclusions:
- Cognitive function in PPMS may remain stable on average over two years, but individual variability exists.
- Baseline cognitive assessment is a valuable predictor of future cognitive status in PPMS.
- The relationship between cognitive changes and MRI metrics in PPMS is complex and likely multifactorial.