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Premorbid cognitive functioning influences differences between self-reported cognitive difficulties and cognitive

Clara Stein1, Fiadhnait O'Keeffe1,2, Caoimhe McManus1,2

  • 1University College Dublin, Dublin, Ireland.

Journal of Neuropsychology
|May 22, 2023
PubMed
Summary

High premorbid cognitive function in people with MS (pwMS) explains discrepancies between self-reported and assessed cognitive abilities, even when accounting for depression and fatigue. This highlights the importance of considering pre-MS cognitive abilities in clinical evaluations.

Keywords:
cognitive assessmentcognitive impairmentfatiguemoodmultiple sclerosispremorbid cognitive functioningself-reported cognitive difficulties

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Area of Science:

  • Neuroscience
  • Cognitive Psychology
  • Clinical Neurology

Background:

  • Cognitive difficulties affect up to 60% of people with Multiple Sclerosis (pwMS).
  • A notable gap often exists between how pwMS perceive their cognitive function and their actual performance on assessments.
  • Factors like depression and fatigue contribute to this discrepancy, but premorbid cognitive abilities may also play a crucial role.

Purpose of the Study:

  • To investigate if estimated premorbid cognitive functioning (ePCF) predicts the difference between self-reported and assessed cognitive abilities in pwMS.
  • To determine if ePCF predicts performance on cognitive assessments in pwMS, considering depression and fatigue.
  • To explore the relationship between ePCF and self-reported cognitive difficulties in pwMS.

Main Methods:

  • Eighty-seven pwMS completed the Test of Premorbid Functioning (TOPF) for ePCF, the Brief International Cognitive Assessment for MS (BICAMS) for cognitive performance.
  • Self-reported cognitive difficulties were measured using the MS Neuropsychological Questionnaire (MSNQ).
  • Fatigue and depression were assessed using the MS Fatigue Impact Scale (MFIS) and Hospital Anxiety and Depression Scale (HADS), respectively.

Main Results:

  • ePCF significantly predicted the discrepancy between self-reported and assessed cognitive abilities (explaining 29.35% of variance, p < .001).
  • ePCF also significantly predicted performance on cognitive assessments (explaining 46.00% of variance, p < .001).
  • ePCF did not significantly predict self-reported cognitive difficulties (p = .545), despite the model explaining 35.10% of variance.

Conclusions:

  • Estimated premorbid cognitive functioning is a key predictor of the observed differences between perceived and actual cognitive abilities in pwMS.
  • Understanding premorbid cognitive status is vital for interpreting cognitive assessment results and self-reported experiences in Multiple Sclerosis.
  • These findings underscore the need to incorporate premorbid cognitive evaluations into the clinical management of pwMS experiencing cognitive challenges.