Predominant cognitive phenotypes in multiple sclerosis: Insights from patient-centered outcomes

Area of Science:

• Neuroscience
• Psychiatry
• Clinical Psychology

Background:

• Combining data from different domains can improve prediction accuracy for cognitive impairment in multiple sclerosis (MS).
• Understanding distinct subtypes of cognitive impairment is crucial for advancing treatment strategies in MS.

Purpose of the Study:

• To identify distinct cognitive phenotypes in people with multiple sclerosis (PwMS) by considering both cognitive function and mood disorders.
• To classify PwMS into homogeneous subgroups based on their cognitive and emotional profiles.

Main Methods:

• Latent class analysis (LCA) was performed on data from 872 PwMS.
• Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA) and Symbol Digit Modalities Test (SDMT).
• Mood disorders were evaluated using the Hospital Anxiety and Depression Scale (HADS). Demographic and clinical data were also analyzed.

Main Results:

• Four distinct cognitive phenotypes were identified in people with MS.
• Phenotype 1: Memory difficulties only (28.3%).
• Phenotype 2: Minor memory/language deficits with mood disorders (21.2%).
• Phenotype 3: Moderate memory, language, and attention impairments (18.8%).
• Phenotype 4: Severe impairments across memory, language, attention, processing speed, and executive functions (31.7%).

Conclusions:

• A taxonomy of distinct cognitive subtypes, integrating cognition and mood, is essential for a deeper understanding of cognitive deterioration in MS.
• These identified phenotypes present opportunities for developing tailored interventions and treatments for cognitive impairments in MS patients.