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The Multiple Sclerosis Performance Test (MSPT): An iPad-Based Disability Assessment Tool
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Published on: June 30, 2014

Cognitive function in relapsing multiple sclerosis: minimal changes in a 10-year clinical trial.

Steven R Schwid1, Andrew D Goodman, Amy Weinstein

  • 1University of Rochester, Department of Neurology, Rochester, NY 14642, USA. steven_schwid@urmc.rochester.edu

Journal of the Neurological Sciences
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Cognitive function in multiple sclerosis (MS) patients remained largely stable over 10 years, though attention showed declines. These slow changes suggest cognitive tests may not be ideal for short-term clinical trials in MS.

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Area of Science:

  • Neuroscience
  • Clinical Neurology
  • Psychology

Background:

  • Cognitive impairment is prevalent in multiple sclerosis (MS).
  • The utility of cognitive function as a clinical trial endpoint in MS is uncertain.
  • Practice effects can influence neuropsychological test scores in MS clinical trials.

Purpose of the Study:

  • To evaluate long-term (10-year) changes in neuropsychological status.
  • To assess cognitive changes in a cohort undergoing typical immunotherapy.
  • To determine the suitability of cognitive measures as clinical trial endpoints in MS.

Main Methods:

  • Prospective evaluation of participants in an open-label glatiramer acetate (GA) extension study.
  • Repeated administration of the Brief Repeatable Battery of Neuropsychological Tests over approximately 10.6 years.
  • Analysis of cognitive changes, controlling for demographic and clinical factors.

Main Results:

  • Mean scores for memory and semantic retrieval remained stable over 10 years.
  • Attention tests demonstrated significant declines in the overall cohort.
  • Individual cognitive tests showed declines in 27-49% of participants; a composite score worsened in 19%.
  • Worsening cognitive function was associated with better baseline scores and higher EDSS scores.
  • Early cognitive changes predicted long-term outcomes.

Conclusions:

  • Most patients with relapsing MS exhibit stable cognitive performance over a decade.
  • Potential therapeutic effects of glatiramer acetate (GA) may contribute to cognitive stability.
  • The slow average rate of cognitive change may limit responsiveness as endpoints in short-term MS clinical trials.