Recovery of cognitive function after relapse in multiple sclerosis

Area of Science:

• Neurology
• Neuroimmunology
• Rehabilitation Medicine

Background:

• Cognitive impairment is a frequent yet underrecognized symptom of multiple sclerosis (MS).
• Acute disease activity during MS relapses can significantly affect cognitive and motor functions.
• Understanding recovery patterns is crucial for managing MS progression.

Purpose of the Study:

• To investigate cognitive and motor function recovery following MS relapses.
• To explore correlations between functional recovery and clinical/imaging markers, including Expanded Disability Status Scale (EDSS), MRI, and cognitive reserve.
• To assess the impact of Acthar Gel treatment on recovery.

Main Methods:

• A study involving 50 relapsing-remitting MS patients and matched stable controls.
• Assessments conducted at baseline, during relapse, and at 3-month follow-up.
• Utilized Symbol Digit Modalities Test (SDMT) for processing speed, alongside measures for memory, ambulation, and manual dexterity.

Main Results:

• Significant decline and partial recovery in SDMT scores observed in relapsing patients compared to controls.
• Trends towards recovery noted in verbal memory, with significant improvement in ambulation.
• Incomplete recovery of the Cerebral Function Score (EDSS) in the relapsing group.

Conclusions:

• Study findings confirm cognitive worsening during MS relapses.
• Clinically meaningful improvements in processing speed and ambulation were observed post-relapse.
• Cognitive decline during relapse is detectable via neurological examination but not patient-reported outcomes.