Cognitive trajectories in multiple sclerosis: a long-term follow-up study.

Area of Science:

• Neurology
• Neuroimmunology
• Cognitive Neuroscience

Background:

• Cognitive impairment is a common and progressive symptom in multiple sclerosis (MS).
• Predicting the trajectory of cognitive function in MS patients remains a clinical challenge.
• Understanding baseline predictors is crucial for proactive management of cognitive decline in MS.

Purpose of the Study:

• To identify baseline clinical and imaging predictors of cognitive worsening in relapsing-remitting MS (RR-MS) patients.
• To analyze cognitive trajectories over a 15-year period post-disease onset.
• To evaluate the predictive value of early clinical and MRI data for long-term cognitive outcomes.

Main Methods:

• Latent trajectory analysis was used to model cognitive performance over time.
• Clinical data (age, sex, education, 9-hole peg test, timed 25-foot walk) and MRI measures (grey matter volume, lesion load) were collected at baseline.
• The Symbol Digit Modalities Test (SDMT) assessed cognitive status, with impairment defined by normative values.

Main Results:

• Out of 148 RR-MS patients, 48.6% experienced cognitive worsening over an 11-year follow-up.
• Patients with cognitive worsening showed significantly higher timed 25-foot walk (T25FW) times at baseline.
• Reduced hippocampal volume at baseline was also associated with cognitive decline in MS patients.

Conclusions:

• Baseline physical disability (indicated by T25FW) and hippocampal atrophy are significant predictors of cognitive worsening in MS.
• These findings may help clinicians identify MS patients at risk for cognitive impairment.
• Early identification can facilitate timely cognitive rehabilitation interventions for affected individuals.