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Cognitive impairment, mood, and fatigue in various multiple sclerosis subtypes: a one-year follow-up study
Daniela Taranu1, Luisa T Balz1, Jill Holbrook1
1Department of Neurology, Faculty of Medicine, Ulm University, D-89071, Ulm, Germany.
Background:
Multiple sclerosis (MS) subtypes-relapsing-remitting (RRMS), secondary-progressive (SPMS), and primary-progressive (PPMS) - have been associated with distinct cognitive impairment profiles, with progressive subtypes, in contrast to RRMS, showing additional deficits in more widespread domains. Research has largely focused on RRMS, leaving SPMS and PPMS underexplored due to their lower prevalence and limited therapeutic targeting. Data on the interplay between cognitive impairment, mood, and fatigue over time are also scarce. This study examined cognition, fatigue, and psychopathology over a period of one year to identify subtype-specific impairments and progression trajectories.
Methods:
Sixty-six MS patients (22 each with RRMS, SPMS, and PPMS) and 22 healthy controls (HC) were assessed using neuropsychological tests for attention, memory, processing speed, working memory, fluency and visuospatial functions. Patient-reported outcomes for depression, anxiety, and fatigue were also collected. Analyses included correlations, within-group comparisons (paired t-tests), and between-group comparisons (ANOVAs/ANCOVAs).
Results:
Progressive MS subtypes exhibited more severe cognitive impairments, fatigue, and mood disturbances than RRMS. Over one year, treated RRMS patients improved in various cognitive domains, while PPMS patients showed gains only in visuospatial abilities. On the other hand, SPMS patients exhibited no significant changes, suggesting more pronounced cognitive deficits.
Conclusions:
Cognitive impairments differed significantly across MS subtypes. While RRMS patients improved over one year and PPMS patients showed selective gains in one domain, SPMS showed no significant changes, indicating reduced cognitive reserve. These between-group differences suggest different cognitive trajectories. The findings underscore the need for tailored, holistic interventions for different MS subtypes.
Insights
Cognitive impairments in multiple sclerosis (MS) vary by subtype. Progressive MS subtypes showed more severe deficits, while relapsing-remitting MS patients improved, highlighting the need for tailored interventions.
Area of Science:
- Neuroscience
- Clinical Neurology
Background:
- Multiple sclerosis (MS) subtypes present distinct cognitive profiles, with progressive forms exhibiting broader deficits than relapsing-remitting MS (RRMS).
- Research has predominantly focused on RRMS, leaving secondary-progressive MS (SPMS) and primary-progressive MS (PPMS) less explored.
- Limited data exist on the longitudinal interplay of cognitive impairment, mood, and fatigue across different MS subtypes.
Purpose of the Study:
- To investigate subtype-specific cognitive impairments, fatigue, and psychopathology in MS over one year.
- To identify distinct progression trajectories for cognition, mood, and fatigue in RRMS, SPMS, and PPMS.
- To compare these trajectories with healthy controls (HC).
Main Methods:
- Sixty-six MS patients (22 each of RRMS, SPMS, PPMS) and 22 HC underwent neuropsychological testing (attention, memory, processing speed, working memory, fluency, visuospatial functions).
- Patient-reported outcomes for depression, anxiety, and fatigue were collected.
- Analyses included correlations, paired t-tests for within-group changes, and ANOVAs/ANCOVAs for between-group comparisons.
Main Results:
- Progressive MS subtypes (SPMS, PPMS) demonstrated more severe cognitive impairments, fatigue, and mood disturbances compared to RRMS.
- Over one year, RRMS patients showed cognitive improvements in multiple domains.
- PPMS patients achieved gains solely in visuospatial abilities, whereas SPMS patients exhibited no significant cognitive changes, indicating pronounced deficits.
Conclusions:
- Significant differences in cognitive impairments and trajectories exist across MS subtypes.
- RRMS patients showed improvement, PPMS patients had selective gains, and SPMS patients displayed a lack of significant change, suggesting varying cognitive reserve.
- Findings emphasize the necessity for tailored, holistic interventions addressing the unique needs of each MS subtype.
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