Mapping cognitive dysfunction in relapsing multiple sclerosis with mild disability: A cross-sectional study from...

Area of Science:

• Neuroscience
• Clinical Neurology
• Psychology

Background:

• Cognitive dysfunction is an early and common symptom in multiple sclerosis (MS).
• There is a scarcity of locally adapted neuropsychological data for MS patients in India.
• Understanding cognitive patterns in diverse populations is crucial for effective MS management.

Purpose of the Study:

• To identify the pattern of cognitive impairment in Indian patients with relapsing MS (RMS) and mild disability.
• To utilize a regionally adapted, MS-specific cognitive assessment battery.
• To compare cognitive performance between persons with MS (pwMS) and healthy controls.

Main Methods:

• A cohort of 59 pwMS (Expanded Disability Status Scale [EDSS] ≤ 4) and 62 controls were assessed.
• A battery of 8 neuropsychological tests measuring 11 cognitive functions was employed.
• Cognitive test scores were compared between groups to identify patterns and associations of impairment.

Main Results:

• Persons with MS performed significantly worse than controls on 10 out of 11 cognitive measures.
• The largest effect sizes for impairment were observed in the Paced Auditory Serial Addition Test (PASAT), Symbol Digit Modalities Test (SDMT), verbal fluency (VF), and Trail Making Test-B (TMT-B).
• Cognitive impairment, defined as performance on two or more abnormal tests, was present in 69.5% of pwMS, with male sex being a significant associated factor.

Conclusions:

• Nearly two-thirds of persons with MS and mild disability exhibit cognitive abnormalities.
• The primary domains affected include processing speed, working memory, executive functions, and verbal fluency.
• These findings highlight the early and widespread nature of cognitive deficits in MS, even with mild disability.