This Article  • References  • Full text PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

Pattern, Predictors, and Impact on Everyday Life in a 4-Year Follow-up

Maria Pia Amato, MD; Giuseppina Ponziani, MD; Giovanni Pracucci, MD; Laura Bracco, MD; Gianfranco Siracusa, MD; Luigi Amaducci, MD

Arch Neurol. 1995;52(2):168-172.

Abstract
Objectives
To assess the evolution of cognitive dysfunction in early-onset multiple sclerosis, to identify clinical predictors of mental decline, and to determine its impact on a patient's everyday life.

Design
The cognitive performance of 50 patients with multiple sclerosis on a neuropsychological battery was compared with that of 70 control subjects initially and again after a 4-year interval. Clinical predictors of cognitive impairment and its effect on daily life were analyzed by stepwise linear regression.

Setting
The research clinic of a university department of neurology.

Participants
A consecutive sample of 50 inpatients and outpatients with multiple sclerosis (mean disease duration, 1.58 years) and 70 demographically matched healthy control subjects selected from the patients' relatives and friends.

Main Outcome Measures
Mean psychometric test scores of both groups at the initial and follow-up testing. Regression coefficients measuring the relationship between clinical parameters and cognitive capacity and between mental decline and performance of common tasks measured by the Environmental and the Incapacity Status scales.

Results
Multiple sclerosis—related deficits in verbal memory and abstract reasoning on initial testing remained more or less stable on the retest, at which time linguistic disturbances on the Set and Token tests also emerged. A patient's initial disability level predicted decreased performance on only four of 13 cognitive variables, and disease duration did so on only two. Extent of intellectual decline on initial testing, initial disability level, and progressive course were independent determinants of handicap in a patient's work and social activities.

Conclusions
Cognitive and neurological deficits appear not to develop in parallel. Yet cognitive dysfunction proves to be a predictor of handicap in everyday life, even in patients in the incipient phase of multiple sclerosis.

Author Affiliations
From the Department of Neurology, University of Florence (Italy).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Early treatment of multiple sclerosis: a Latin American Experts Meeting
Garcea et al.
Mult Scler 2009;15:S1-S12.
ABSTRACT  

Multiple Sclerosis With Predominant, Severe Cognitive Impairment
Staff et al.
Arch Neurol 2009;66:1139-1143.
ABSTRACT | FULL TEXT  

Sensitivity of conventional memory tests in multiple sclerosis: comparing the Rao Brief Repeatable Neuropsychological Battery and the Minimal Assessment of Cognitive Function in MS
Strober et al.
Mult Scler 2009;15:1077-1084.
ABSTRACT  

Cognitive impairment and its relation with disease measures in mildly disabled patients with relapsing-remitting multiple sclerosis: baseline results from the Cognitive Impairment in Multiple Sclerosis (COGIMUS) study
Patti et al.
Mult Scler 2009;15:779-788.
ABSTRACT  

The brief neuropsychological battery for children: a screening tool for cognitive impairment in childhood and juvenile multiple sclerosis
Portaccio et al.
Mult Scler 2009;15:620-626.
ABSTRACT  

Subcutaneous interferon beta-1a has a positive effect on cognitive performance in mildly disabled patients with relapsing--remitting multiple sclerosis: 2-year results from the COGIMUS study
Patti et al.
Therapeutic Advances in Neurological Disorders 2009;2:67-77.
ABSTRACT  

Cognitive impairment in multiple sclerosis
Patti
Mult Scler 2009;15:2-8.
ABSTRACT  

Should SDMT substitute for PASAT in MSFC? A 5-year longitudinal study
Brochet et al.
Mult Scler 2008;14:1242-1249.
ABSTRACT  

Cognitive impairments in relapsing-remitting multiple sclerosis: a meta-analysis
Prakash et al.
Mult Scler 2008;14:1250-1261.
ABSTRACT  

Neuropsychological predictors of powered wheelchair use: a prospective follow-up study
Cullen et al.
Clin Rehabil 2008;22:836-846.
ABSTRACT  

Cognitive assessment and quantitative magnetic resonance metrics can help to identify benign multiple sclerosis
Amato et al.
Neurology 2008;71:632-638.
ABSTRACT | FULL TEXT  

Efficiency of cognitive control recruitment in the very early stage of multiple sclerosis: a one-year fMRI follow-up study
Audoin et al.
Mult Scler 2008;14:786-792.
ABSTRACT  

Cognitive and psychosocial features of childhood and juvenile MS
Amato et al.
Neurology 2008;70:1891-1897.
ABSTRACT | FULL TEXT  

Use of combined conventional and quantitative MRI to quantify pathology related to cognitive impairment in multiple sclerosis
Lin et al.
J. Neurol. Neurosurg. Psychiatry 2008;79:437-441.
ABSTRACT | FULL TEXT  

APOE {varepsilon}4 allele is associated with cognitive impairment in patients with multiple sclerosis
Shi et al.
Neurology 2008;70:185-190.
ABSTRACT | FULL TEXT  

Association of Neocortical Volume Changes With Cognitive Deterioration in Relapsing-Remitting Multiple Sclerosis
Amato et al.
Arch Neurol 2007;64:1157-1161.
ABSTRACT | FULL TEXT  

Screening for cognitive impairment in multiple sclerosis using the Symbol Digit Modalities Test
Parmenter et al.
Mult Scler 2007;13:52-57.
ABSTRACT  

Early cognitive impairment in patients with clinically isolated syndrome suggestive of multiple sclerosis
Feuillet et al.
Mult Scler 2007;13:124-127.
ABSTRACT  

How to detect cognitive dysfunction at early stages of multiple sclerosis?
Deloire et al.
Mult Scler 2006;12:445-452.
ABSTRACT  

Relationship between stress and relapse in multiple sclerosis: part II. Direct and indirect relationships
Brown et al.
Mult Scler 2006;12:465-475.
ABSTRACT  

Longitudinal course of depression symptoms in multiple sclerosis
Arnett and Randolph
J. Neurol. Neurosurg. Psychiatry 2006;77:606-610.
ABSTRACT | FULL TEXT  

Correlation of global N-acetyl aspartate with cognitive impairment in multiple sclerosis.
Mathiesen et al.
Arch Neurol 2006;63:533-536.
ABSTRACT | FULL TEXT  

A longitudinal study of cognition in primary progressive multiple sclerosis
Camp et al.
Brain 2005;128:2891-2898.
ABSTRACT | FULL TEXT  

Regional Lobar Atrophy Predicts Memory Impairment in Multiple Sclerosis
Benedict et al.
Am. J. Neuroradiol. 2005;26:1824-1831.
ABSTRACT | FULL TEXT  

The association between cognitive impairment and physical disability in multiple sclerosis
Lynch et al.
Mult Scler 2005;11:469-476.
ABSTRACT  

Magnetic Resonance Spectroscopy of Memory and Frontal Brain Region in Early Multiple Sclerosis
Staffen et al.
J. Neuropsychiatry Clin. Neurosi. 2005;17:357-363.
ABSTRACT | FULL TEXT  

Cognitive impairment as marker of diffuse brain abnormalities in early relapsing remitting multiple sclerosis
Deloire et al.
J. Neurol. Neurosurg. Psychiatry 2005;76:519-526.
ABSTRACT | FULL TEXT  

Pattern of neuropsychological impairment in the early phase of relapsing-remitting multiple sclerosis
Olivares et al.
Mult Scler 2005;11:191-197.
ABSTRACT  

Subjective cognitive complaints relate to mild impairment of cognition in multiple sclerosis
Marrie et al.
Mult Scler 2005;11:69-75.
ABSTRACT  

Neocortical volume decrease in relapsing-remitting MS patients with mild cognitive impairment
Amato et al.
Neurology 2004;63:89-93.
ABSTRACT | FULL TEXT  

Cognitive strategies application of multiple sclerosis patients
Birnboim and Miller
Mult Scler 2004;10:67-73.
ABSTRACT  

Spectroscopic axonal damage of the right locus coeruleus relates to selective attention impairment in early stage relapsing-remitting multiple sclerosis
Gadea et al.
Brain 2004;127:89-98.
ABSTRACT | FULL TEXT  

Validity and reliability of the MSQ LI in cognitively impaired patients with multiple sclerosis
Marrie et al.
Mult Scler 2003;9:621-626.
ABSTRACT  

Longitudinal study of cognitive dysfunction in multiple sclerosis: neuropsychological, neuroradiological, and neurophysiological findings
Piras et al.
J. Neurol. Neurosurg. Psychiatry 2003;74:878-885.
ABSTRACT | FULL TEXT  

The utility of computerized neuropsychological assessment of cognitive dysfunction in patients with relapsing-remitting multiple sclerosis
Wilken et al.
Mult Scler 2003;9:119-127.
ABSTRACT  

Electrophysiological evidence for a defect in the processing of temporal sound patterns in multiple sclerosis
Jones et al.
J. Neurol. Neurosurg. Psychiatry 2002;73:561-567.
ABSTRACT | FULL TEXT  

Three screening batteries to detect cognitive impairment in multiple sclerosis
Aupperle et al.
Mult Scler 2002;8:382-389.
ABSTRACT  

Cognitive function and fMRI in patients with multiple sclerosis: evidence for compensatory cortical activation during an attention task
Staffen et al.
Brain 2002;125:1275-1282.
ABSTRACT | FULL TEXT  

Comparison of two brief neuropsychological batteries in people with multiple sclerosis
Solari et al.
Mult Scler 2002;8:169-176.
ABSTRACT  

Cognitive impairments in multiple sclerosis: A review
DeSousa et al.
AM J ALZHEIMERS DIS OTHER DEMEN 2002;17:23-29.
ABSTRACT  

Cognitive Dysfunction in Early-Onset Multiple Sclerosis: A Reappraisal After 10 Years
Amato et al.
Arch Neurol 2001;58:1602-1606.
ABSTRACT | FULL TEXT  

A longitudinal study of brain atrophy and cognitive disturbances in the early phase of relapsing-remitting multiple sclerosis
Zivadinov et al.
J. Neurol. Neurosurg. Psychiatry 2001;70:773-780.
ABSTRACT | FULL TEXT  

Assessment of cognitive and psychological functions in patients with multiple sclerosis: considerations for databasing
Beatty
Mult Scler 1999;5:239-243.
ABSTRACT  

Neuropsychologic Status in Multiple Sclerosis After Treatment With Glatiramer
Weinstein et al.
Arch Neurol 1999;56:319-324.
ABSTRACT | FULL TEXT  

Impairments of attention in individuals with Multiple Sclerosis
Paul et al.
Mult Scler 1998;4:433-439.
ABSTRACT  

Neurophysiological and cognitive markers of disease evolution in multiple sclerosis
Comi et al.
Mult Scler 1998;4:260-265.
ABSTRACT  

Relation between neuropsychological impairment and functional disability in patients with chronic fatigue syndrome
Christodoulou et al.
J. Neurol. Neurosurg. Psychiatry 1998;64:431-434.
ABSTRACT | FULL TEXT  

Serial Neuropsychological Assessment and Magnetic Resonance Imaging Analysis in Multiple Sclerosis
Hohol et al.
Arch Neurol 1997;54:1018-1025.
ABSTRACT