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

S Migliore1,2, A Ghazaryan3, I Simonelli4

  • 1Clinical Psychology, University Campus Bio-Medico of Rome, Rome, Italy.

Behavioural Neurology
|September 16, 2017
PubMed

Insights

Cognitive dysfunction impacts over half of multiple sclerosis (MS) patients, even with mild disability. Early detection of impaired executive functions is key for timely rehabilitation.

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.

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