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The Multiple Sclerosis Performance Test MSPT: An iPad-Based Disability Assessment Tool

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Detecting isolated cognitive relapses in persons with MS.

Sarah A Morrow¹, Zachary L Weinstock², Omid Mirmosayyeb²

¹University Hospital, London Health Sciences Center, Department of Clinical Neurological Sciences, Western University, London, ON, Canada.

Multiple Sclerosis (Houndmills, Basingstoke, England)

|September 30, 2023

Summary

This summary is machine-generated.

Isolated cognitive relapses (ICRs) in persons with MS (PwMS) are supported by this study. Relapses affecting cognition (SDMT) without worsening disability (EDSS) were identified in PwMS.

Keywords:

Multiple sclerosis SDMT cognition isolated cognitive relapse relapses

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Area of Science:

Neurology
Neuroimmunology
Cognitive Science

Background:

The existence of isolated cognitive relapses (ICRs) in persons with multiple sclerosis (PwMS) remains a subject of debate.
ICRs represent cognitive decline without a corresponding increase in physical disability.

Purpose of the Study:

To investigate relapses characterized by cognitive decline, measured by the Symbol Digit Modalities Test (SDMT), without changes in the Expanded Disability Status Scale (EDSS).
To differentiate between ICRs and relapses with cognitive decline (RCD) in PwMS.

Main Methods:

A 3-year prospective cohort study involving 592 participants with MS.
Identified PwMS with relapses showing SDMT decrease. Defined ICR as SDMT decline with stable EDSS, and RCD as SDMT decline with EDSS increase.
Explored two definitions for SDMT decline (⩾ 8 points or ⩾ 4 points) and used logistic regression to analyze ICR versus RCD.

Main Results:

Of 83 relapsing participants, 22 had an SDMT decrease of ⩾ 8 points, with 14 (63.6%) meeting ICR criteria.
Logistic regression indicated that the MS Neuropsychological Questionnaire was associated with ICR (OR: 8.6; 95% CI: 1.1-16.4).
Among 40 participants with SDMT decrease of ⩾ 4 points, 26 (65%) had stable EDSS (ICR).

Conclusions:

This prospective study provides evidence supporting the existence of isolated cognitive relapses in persons with MS.
Findings suggest that cognitive relapses can occur independently of significant physical disability progression.