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Discrepancy between subjective and objective cognitive function in multiple sclerosis and association with mood,
Nour Farah1, Simon Charbonneau2, Sarah A Morrow3
1Neuroimmunology Unit, Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CR-CHUM), Montréal, Québec, Canada.
Summary
Many persons with multiple sclerosis (PwMS) report cognitive impairment (CI) despite objective testing showing otherwise. Subjective CI in PwMS is linked to anxiety, depression, and fatigue, highlighting the need for comprehensive assessment.
Area of Science:
- Neuroscience
- Psychology
- Clinical Medicine
Background:
- Cognitive impairment (CI) in persons with multiple sclerosis (PwMS) presents challenges due to discrepancies between subjective reports and objective evaluations.
- Understanding this gap is crucial for accurate diagnosis and management of neurological conditions.
Purpose of the Study:
- To investigate the relationship between subjective and objective measures of cognitive function in PwMS.
- To identify factors that may contribute to the observed discrepancies in cognitive assessments.
Main Methods:
- Utilized the Multiple Sclerosis Neuropsychological Questionnaire (MSNQ) for subjective reporting.
- Administered objective tests including the Processing Speed Test (PST), Rey Auditory Verbal Learning Test (RAVLT), Visual Memory Test (VMT), and Face Emotion Recognition (FER).
- Employed Spearman correlations, diagnostic metrics, and latent profile analysis to analyze data from 83 PwMS.
Main Results:
- A significant portion of PwMS (42.2%) reported subjective CI, while objective impairment was found in fewer individuals (4.8-15.7% domain-specific, 51.8% in at least one domain).
- Subjective CI without objective findings correlated with higher scores on anxiety, depression, and fatigue scales.
- Latent profile analysis revealed distinct cognitive profiles, with one cluster showing better objective performance despite similar MSNQ scores.
Conclusions:
- A notable discrepancy exists between self-reported and objectively measured cognitive impairment in PwMS.
- Subjective cognitive concerns in PwMS are associated with psychological distress and fatigue.
- Multidomain cognitive testing and evaluation of contributing factors are recommended to better understand and address cognitive challenges in MS.
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