Subjective Report, Objective Neurocognitive Performance, and "Invisible Symptoms" in Multiple Sclerosis

Area of Science:

• Neuroscience
• Psychology
• Clinical Medicine

Background:

• Self- and informant-reports predict cognitive performance, but links to mood, anxiety, and fatigue need study.
• Association between mood, fatigue, and objective neurocognitive performance in multiple sclerosis (MS) is unclear.

Purpose of the Study:

• Examine the relationship between subjective cognitive complaints and objective cognitive performance in persons with MS (PwMS).
• Investigate the influence of mood (depression, anxiety) and fatigue on self-reported and objective cognitive function in PwMS.

Main Methods:

• Eighty-six PwMS completed neuropsychological tests, the Multiple Sclerosis Neuropsychological Screening Questionnaire (MSNQ) Self-Report (MSNQ-S) and Informant-Report (MSNQ-I), and mood/fatigue scales.
• Hierarchical linear regressions analyzed depression, anxiety, their interaction, cognitive fatigue, and physical fatigue as predictors of cognitive outcomes.

Main Results:

• Cognitive fatigue correlated with perceived cognitive dysfunction but not objective impairment.
• Depression predicted poorer processing speed and verbal memory, but this effect diminished when anxiety was considered.
• The interaction of depression and anxiety predicted greater neurocognitive intraindividual variability (IIV).

Conclusions:

• Cognitive fatigue may alter self-perception of cognition without objective impairment.
• Co-occurring depression and anxiety in PwMS are associated with increased neurocognitive variability, a marker of poorer integrity.
• Addressing depression, anxiety, and cognitive fatigue is crucial in PwMS due to their potential modifiability.