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Updated: Jun 29, 2025

Comprehensive Autopsy Program for Individuals with Multiple Sclerosis
Published on: July 19, 2019
Accelerated long-term forgetting reveals everyday memory deficits in early-stage multiple sclerosis
J Stalter1,2, K Pars3,4, K Witt3,4,5
1Department of Neurology, School of Medicine and Health Sciences, Carl von Ossietzky Universität Oldenburg, Oldenburg, Germany. Johannes.stalter@uni-oldenburg.de.
Background:
Patients with multiple sclerosis (MS) patients report subjective memory impairment (SMI) escaping routine neuropsychological testing. Accelerated long-term forgetting (ALF) refers to above average loss of information over an extended period of time (e.g., 7 days). This study investigates ALF in mildly affected MS patients and relates long-term memory performance to SMI.
Methods:
This prospective study included 30 patients with early MS (mean EDSS ± SD = 1.1 ± 0.9) and 30 healthy controls (HC) matched for age and education. Participants underwent ALF testing [word list (RAVLT), geometric figure (RCF), logical memory (WMS)] at three time points (baseline, 30 min, 7 days). Cognition (Montreal Cognitive Assessment), depression, SMI and fatigue were assessed. The primary outcome (PO) was defined as the quotient of the 7-day score and the 30-min memory score for the verbal (RAVLT, WMS) and figural (RCF) memory tests. The study was approved by the local ethics committee and is registered in the German Register of Clinical Studies (DRKS00025791).
Results:
MS patients showed impairments in PORAVLT (MS 0.66 ± 0.13 vs HC 0.82 ± 0.16; p < 0.001), whereas POWMS (MS 0.88 ± 0.15 vs HC 1.01 ± 0.12; p = 0.02) showed only a tendency. Regression analysis revealed significant associations for PORAVLT and fatigue (p = 0.034), and PORAVLT and SMI (p = 0.01) in patients but not in HC.
Conclusion:
The ALF test quantifies SMI in MS-patients. With fatigue as a relevant associated factor, this fills the gap in objectifying SMI in MS for diagnostic purposes.
Insights
Multiple sclerosis patients exhibit accelerated long-term forgetting (ALF), impacting memory recall. This study shows ALF testing can quantify subjective memory impairment (SMI) in MS, linked to fatigue.
Area of Science:
- Neuroscience
- Clinical Psychology
- Neurology
Background:
- Subjective memory impairment (SMI) is common in multiple sclerosis (MS) but often missed by standard tests.
- Accelerated long-term forgetting (ALF) is defined as a significant loss of information over time.
- This study explores ALF in early MS patients and its correlation with SMI.
Discussion:
- MS patients demonstrated significantly impaired verbal memory recall over 7 days compared to healthy controls.
- Fatigue and SMI were significantly associated with impaired long-term verbal memory recall in MS patients.
- The Accelerated Long-Term Forgetting (ALF) test effectively quantifies SMI in MS.
Key Insights:
- The Accelerated Long-Term Forgetting (ALF) test provides an objective measure for subjective memory impairment (SMI) in multiple sclerosis (MS).
- Impaired verbal memory recall in MS is linked to fatigue and subjective memory complaints.
- ALF testing can aid in the diagnostic process for MS-related memory issues.
Outlook:
- Further research should explore therapeutic interventions targeting fatigue to improve memory in MS.
- Longitudinal studies can track the progression of ALF and SMI in MS patients.
- Integration of ALF testing into routine MS care could enhance patient management.
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