Cognitive Impairment in Relapsing-Remitting Multiple Sclerosis Patients with Very Mild Clinical Disability

Area of Science:

• Neuroscience
• Neurology
• Cognitive Science

Background:

• Cognitive dysfunction is prevalent in multiple sclerosis (MS), affecting 40-65% of patients.
• It can manifest early in the disease course, even with minimal physical disability.

Purpose of the Study:

• To investigate cognitive functions in relapsing-remitting MS (RRMS) patients with very mild disability using the Italian Minimal Assessment of Cognitive Function in MS (MACFIMS).
• To identify the primary cognitive domains affected in early-stage RRMS.

Main Methods:

• Ninety-two RRMS patients (Expanded Disability Status Scale [EDSS] ≤ 2.5) and 42 healthy controls (HC) were assessed.
• Cognitive functions were evaluated using the Italian version of MACFIMS.
• Patients were subgrouped based on EDSS scores (≤ 1.5 and 2-2.5).

Main Results:

• 51.1% of RRMS patients exhibited cognitive dysfunction compared to HC.
• Impairments were observed in verbal memory, visual memory, working memory, and executive functions.
• Subgroup analysis revealed specific deficits in verbal memory and executive functions (EDSS ≤ 1.5), and information processing speed and visual memory (EDSS 2-2.5).

Conclusions:

• Approximately half of MS patients with very mild physical disability show cognitive impairment.
• Early-stage MS primarily involves prefrontal cognitive functions, particularly executive functions.
• Identifying executive function deficits early can facilitate prompt enrollment in targeted neurorehabilitation programs.