scholarly journals Depression and Cognitive Impairment in Disability-Free Early Multiple Sclerosis

2003 ◽  
Vol 14 (1-2) ◽  
pp. 39-45 ◽  
Author(s):  
Claus G. Haase ◽  
Michael Tinnefeld ◽  
Marc Lienemann ◽  
Reinhard E. Ganz ◽  
Pedro M. Faustmann
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
Physical Disability ◽  
Neuropsychological Tests ◽  
Short Term Memory ◽  
Clinical Signs ◽  
Depression Scale ◽  
Diagnostic Tools ◽  
Disability Status ◽  
Relapsing Remitting

Cognitive and emotional capabilities were evaluated in 73 female patients with stable relapsing-remitting definite, and/or laboratory-supported multiple sclerosis (MS) and were compared with 32 matched healthy controls. Patients were categorized according to their score in the expanded disability status scale (EDSS) to either no (EDSS 0,n= 33) or few clinical signs (EDSS 1–2,n= 40) of MS without physical disability. Patients with EDSS > 0 were characterized by significantly (p These results indicate that depression may present as an early sign in MS followed by cognitive impairment, in particular visuo-spatial short-term memory, before physical disability appears. Neuropsychological tests as mentioned here could serve as early diagnostic tools to detect subtle disease progression and to initiate and monitor disease modifying therapies.Patients with EDSS > 0 were characterized by significantly (p< 0.001) higher scores on “von Zerssen’s“ depression scale, compared to controls. Patients with higher EDSS scores (1–2) showed significantly decreased performance with respect to the total score of Kimura’s Recurring-Figures-Test (p< 0.001), in addition. Regarding visuo-constructive functioning, patients with EDSS = 0 performed to a significantly lower level (p< 0.001), compared to controls.

Olfactory dysfunction in multiple sclerosis: association with secondary progression

2011 ◽  
Vol 18 (5) ◽  
pp. 616-621 ◽  
Author(s):  
Ana Martins Silva ◽  
Ernestina Santos ◽  
Inês Moreira ◽  
Andreia Bettencourt ◽  
Ester Coutinho ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Depression Scale ◽  
Anxiety And Depression ◽  
Clinical Markers ◽  
Systematic Assessment ◽  
Disability Status ◽  
Relapsing Remitting ◽  
Threshold Score ◽  
State Examination ◽  
Smell Identification

Objective: The Brief Smell Identification Test (B-SIT) was used to explore odour identification capacities in multiple sclerosis (MS). Methods: In total, 153 consecutive patients with MS and 165 healthy controls (HC) participated in the study. All participants were asked to answer the B-SIT and the Hospital Anxiety and Depression Scale (HADS). The Expanded Disability Status Scale (EDSS), the Multiple Sclerosis Severity Scale (MSSS), and the Mini-Mental State Examination (MMSE) were used for patients’ clinical and cognitive characterization. Results: Patients with MS (11.1%) were more impaired on the B-SIT than HC participants (3%). The frequency of impairment was higher for patients with secondary progressive (SPMS; 11/16, 68.8%) than relapsing–remitting (RRMS; 4/121, 3.3%) or primary progressive (2/16, 12.5%) courses. A threshold score of ≤ 8 on the B-SIT provided a sensitivity of 69% and a specificity of 97% in the identification of SPMS among patients with relapsing onset. The association between SPMS and impaired B-SIT remained statistically significant after adjusting for demographic (i.e. age and education), clinical (i.e. disease duration, EDSS, and MSSS), psychopathological (i.e. HADS anxiety and depression scores), and cognitive (i.e. MMSE) variables. Conclusions: A brief odour identification measure provided a good discrimination between SPMS and RRMS courses. A systematic assessment of olfactory functions may contribute to the development of clinical markers of SPMS.

The association between cognitive impairment and physical disability in multiple sclerosis

2005 ◽  
Vol 11 (4) ◽  
pp. 469-476 ◽  
Author(s):  
Sharon G Lynch ◽  
Brett A Parmenter ◽  
Douglas R Denney
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
Physical Disability ◽  
Cross Sectional ◽  
Delayed Recall ◽  
Physical Decline ◽  
Disability Status ◽  
Duration Of Disease ◽  
Cross Sectional Design ◽  
The Relationship

Background: The association between cognitive impairment and physical disability was examined in a larger, more representative sample of patients with multiple sclerosis (MS) than in previous studies. Method: Two hundred and fifty-three patients attending an MS clinic were assessed with respect to physical disability using the Expanded Disability Status Scale and cognitive impairment using a battery of neuropsychological tests. Results: Physical disability correlated with duration of disease; cognitive impairment did not. Virtually all measures derived from the cognitive battery were significantly correlated with physical disability. Three measures of speeded information processing and one involving delayed recall of verbal material were unique predictors of disability status. The relationship between cognitive impairment and physical disability was equivalent for patients with shorter (<3 years) versus longer (>10 years) disease duration. Cognitive impairment correlated with the rate of disability progression as reflected by the progression index. Conclusion: Cognitive impairment is more closely associated with physical disability than most previous studies indicate. This relationship appears to be stable throughout the duration of MS, although this conclusion is qualified by the cross-sectional design of the study. Further attention should be paid to cognitive impairment as a possible predictor of the rate of patients’ physical decline.

Fatigue in multiple sclerosis and its relationship to depression and neurologic disability

2000 ◽  
Vol 6 (3) ◽  
pp. 181-185 ◽  
Author(s):  
R Bakshi ◽  
Z A Shaikh ◽  
R S Miletich ◽  
D Czarnecki ◽  
J Dmochowski ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Physical Disability ◽  
Depression Severity ◽  
Severity Scale ◽  
Severity Scores ◽  
Disability Status ◽  
Relapsing Remitting ◽  
Neurologic Disability ◽  
Fatigue Severity ◽  
Improve Fatigue

We studied multiple sclerosis fatigue (MSF) and its relationship to depression and disability. Seventy-one patients [50 relapsing-remitting, 21 secondary progressive] were grouped by Fatigue Severity Scale (FSS) into MS-fatigue (MSF) (FSS55; n=46) or MS-nonfatigue (MSNF) (FSS44; n=20). Forty-one patients were grouped into MS-depression (MSD) (n=15) or MS-nondepression (MSND) (n=26) by interview. Higher expanded disability status scale (EDSS) scores were noted in MSF than MSNF patients (P=0.0003); EDSS scores correlated with FSS scores (rho=0.43, P=0.003). However, fatigue was present in 58% (n=29) of relapsing-remitting patients and in 52% (n=26) of patients with mild physical disability (EDSS53.5). Hamilton/Beck depression severity scores were higher in MSF than MSNF patients and correlated with FSS scores (P50.05). MSD had higher FSS scores than MSND patients (P=0.008). After controlling for EDSS, depression severity continued to correlate with FSS scores (rho=0.37, P=0.02). After controlling for depression, FSS scores no longer correlated with EDSS scores (rho=0.27, P=0.09). Thus, MSF is independent of physical disability, but is associated with depression, suggesting that common mechanisms play a role in MSF and MSD including psychological factors or brain lesions in specific neuroanatomic pathways. Further study is warranted to determine if antidepressant medications improve fatigue in MS.

scholarly journals The correlation between EDSS and cognitive impairment in MS patients. Assessment of a Brazilian population using a BICAMS version

2016 ◽  
Vol 74 (12) ◽  
pp. 974-981 ◽  
Author(s):  
Marco A. G. de Caneda ◽  
Maria Cecília A. de Vecino
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
Neuropsychological Tests ◽  
Verbal Learning ◽  
Therapeutic Interventions ◽  
California Verbal Learning Test ◽  
Cognitive Evaluation ◽  
Disability Status ◽  
Learning Test

ABSTRACT Multiple sclerosis (MS) may present with a cognitive impairment as disabling as the physical disabilities. Therefore, routine cognitive evaluation is pivotal. Valid and reliable neuropsychological tests are essential in follow-up and to define future therapeutic interventions. Objectives To investigate the correlation between the disabilities of MS patients and their cognitive impairment assessed by the Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS). Methods Forty patients with definitive diagnoses of MS were selected. The correlation coefficient (r) between the Expanded Disability Status Scale (EDSS) and the neuropsychological tests of BICAMS were calculated. Results The correlation was clinically substantial and significant with r = 0.55 (p < 0.01) in the Symbol Digit Modalities Test (SDMT), 0.54 (p < 0.01) in the Brief Visuospacial Memory Test (BVMT) and 0.40 (p < 0.05) in the California Verbal Learning Test (CVLT). Conclusion BICAMS has easy and satisfactory application and evaluation for routine visits and presents a significant correlation with the EDSS. Its use may be indicated for screening and monitoring of cognitive impairment in patients with MS.

Cognitive impairment at diagnosis predicts 10-year multiple sclerosis progression

2015 ◽  
Vol 22 (5) ◽  
pp. 659-667 ◽  
Author(s):  
Marcello Moccia ◽  
Roberta Lanzillo ◽  
Raffaele Palladino ◽  
Kiara Chu-Mei Chang ◽  
Teresa Costabile ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
Newly Diagnosed ◽  
Delayed Recall ◽  
Selective Reminding ◽  
Conversion Rates ◽  
Disability Status ◽  
Relapsing Remitting ◽  
Selective Reminding Test

Background: Cognitive impairment occurs from the early phases of multiple sclerosis (MS), and more frequently affects secondary progressive (SP) subjects than relapsing–remitting (RR). Objective: To investigate relationships between cognitive dysfunctions in newly diagnosed RRMS, and long-term MS-related outcomes. Methods: The present 10-year retrospective longitudinal study included 155 RRMS subjects, tested with the Rao Brief Repeatable Battery at MS diagnosis. The reaching of Expanded Disability Status Scale (EDSS) 4.0, and the SP conversion were recorded. Results: 67 subjects (43.2%) reached EDSS 4.0, and 34 subjects (21.9%) converted to SP during a follow-up period of 10.0±1.8 years. Subjects with cognitive impairment at diagnosis had a rate of reaching EDSS 4.0 more than three times greater ( p<0.001; HR=3.183), and a rate of SP conversion more than two times greater, as compared to cognitively preserved subjects ( p=0.008; HR=2.535). In particular, better scores in the Selective Reminding Test-Delayed Recall and in the Symbol Digit Modalities Test at baseline were associated with lower SP conversion rates during the follow-up period ( p=0.018; HR=0.835; and p=0.001; HR=0.941, respectively). Conclusion: Cognitive impairment, with particular involvement of processing speed and memory, predicts disability progression and SP conversion in newly diagnosed RRMS, highlighting the importance of cognitive assessment from the beginning of MS.

scholarly journals Predictive Value of the Third Ventricle Width for Neurological Status in Multiple Sclerosis

2021 ◽  
Author(s):  
Wojciech Guenter ◽  
Ewa Betscher ◽  
Robert Bonek
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
Predictive Value ◽  
Neuropsychological Tests ◽  
Third Ventricle ◽  
Verbal Learning ◽  
Depression Scale ◽  
Neurological Status ◽  
Multiple Regression Model ◽  
The Third

Abstract The third ventricle width (3VW) is an easily calculated measure of brain atrophy. The aim of this study was to evaluate the relation of 3VW to cognitive impairment with adjustment for demographic and clinical confounders, including depression, anxiety, and fatigue, as well as to disability in patients with multiple sclerosis (MS). Symbol Digit Modalities Test, California Verbal Learning Test, Brief Visuospatial Memory Test-Revised, Expanded Disability Status Scale (EDSS), Hospital Anxiety and Depression Scale, and Modified Fatigue Impact Scale (MFIS) were analysed in 93 patients with MS. Neuropsychological performance was compared to that of 150 healthy controls. Axial images from 3D FLAIR were used to measure 3VW. 25% of MS patients were impaired in at least two neuropsychological tests. Cognitive impairment and EDSS were associated with 3VW. Age and 3VW were the strongest predictors of cognitive impairment. The multiple regression model including age, 3VW, education, EDSS and MFIS explained 63% of the variance of neuropsychological tests results, while 3VW, age and duration of the disease were significant predictors of EDSS. This study confirms predictive value of 3VW for neurological status of patients with MS, especially for cognitive impairment after adjustment for demographic and clinical confounders.

scholarly journals Relationship between Expanded Disability Status Scale scores and the presence of temporomandibular disorders in patients with multiple sclerosis

2018 ◽  
Vol 12 (01) ◽  
pp. 144-148 ◽  
Author(s):  
Lucas Senra Correa Carvalho ◽  
Osvaldo José Moreira Nascimento ◽  
Luciane Lacerda Franco Rocha Rodrigues ◽  
Andre Palma Da Cunha Matta
Keyword(s):  
Multiple Sclerosis ◽  
Temporomandibular Disorders ◽  
Control Group ◽  
Expanded Disability Status Scale ◽  
Exact Test ◽  
Disability Status ◽  
Relapsing Remitting ◽  
Scale Scores ◽  
Axis I ◽  
Relapsing Remitting Multiple Sclerosis

ABSTRACTObjectives: The objectives of this study were to assess the prevalence of temporomandibular disorders (TMDs) in patients with relapsing-remitting multiple sclerosis (MS) and to investigate whether an association exists between the presence of TMD symptoms and the degree of MS-related disability. Materials and Methods: In all, 120 individuals were evaluated: 60 patients with a diagnosis of relapsing-remitting MS and 60 age- and sex-matched controls without neurological impairments. A questionnaire recommended by the European Academy of Craniomandibular Disorders for the assessment of TMD symptoms was administered. For those who answered affirmatively to at least one of the questions, the RDC/TMD Axis I instrument was used for a possible classification of TMD subtypes. The Expanded Disability Status Scale (EDSS) was the measure of the degree of MS-related disability. Statistical Analysis Used: Fisher’s exact test was used to analyze the data. ANOVA was used to detect significant differences between means and to assess whether the factors influenced any of the dependent variables by comparing means from the different groups. Results: The prevalence of TMD symptoms in patients with MS was 61.7% versus 18.3% in the control group (CG). A diagnosis of TMD was established for 36.7% in the MS group and 3.3% in the CG (P = 0.0001). There were statistically significant differences between degrees of MS-related disability and the prevalence of TMD (P = 0.0288). Conclusions: The prevalence of both TMD and TMD symptoms was significantly greater in the MS group. EDSS scores and TMD prevalence rates were inversely related.

scholarly journals A Pilot Study of 24-h Motor Activity Patterns in Multiple Sclerosis: Pre-Planned Follow-Up at 2 Years

2021 ◽  
Vol 3 (3) ◽  
pp. 366-376
Author(s):  
Lorenzo Tonetti ◽  
Federico Camilli ◽  
Sara Giovagnoli ◽  
Vincenzo Natale ◽  
Alessandra Lugaresi
Keyword(s):  
Multiple Sclerosis ◽  
Motor Activity ◽  
Activity Pattern ◽  
Activity Patterns ◽  
Expanded Disability Status Scale ◽  
Disability Status ◽  
Relapsing Remitting ◽  
Edss Score ◽  
Activity Prognosis

Early multiple sclerosis (MS) predictive markers of disease activity/prognosis have been proposed but are not universally accepted. Aim of this pilot prospective study is to verify whether a peculiar hyperactivity, observed at baseline (T0) in early relapsing-remitting (RR) MS patients, could represent a further prognostic marker. Here we report results collected at T0 and at a 24-month follow-up (T1). Eighteen RRMS patients (11 females, median Expanded Disability Status Scale-EDSS score 1.25, range EDSS score 0–2) were monitored at T0 (mean age 32.33 ± 7.51) and T1 (median EDSS score 1.5, range EDSS score 0–2.5). Patients were grouped into two groups: responders (R, 14 patients) and non-responders (NR, 4 patients) to treatment at T1. Each patient wore an actigraph for one week to record the 24-h motor activity pattern. At T0, NR presented significantly lower motor activity than R between around 9:00 and 13:00. At T1, NR were characterized by significantly lower motor activity than R between around 12:00 and 17:00. Overall, these data suggest that through the 24-h motor activity pattern, we can fairly segregate at T0 patients who will show a therapeutic failure, possibly related to a more active disease, at T1. These patients are characterized by a reduced morning level of motor activation. Further studies on larger populations are needed to confirm these preliminary findings.

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