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ABSTRACT: Background
Cognitive impairment (CI) affects approximately one-third of the patients with early multiple sclerosis (MS) and clinically isolated syndrome (CIS). Little is known about factors predicting CI and progression after initial diagnosis.Methods
Neuropsychological screening data from baseline and 1-year follow-up of a prospective multicenter cohort study (NationMS) involving 1123 patients with newly diagnosed MS or CIS were analyzed. Employing linear multilevel models, we investigated whether demographic, clinical and conventional MRI markers at baseline were predictive for CI and longitudinal cognitive changes.Results
At baseline, 22% of patients had CI (impairment in ?2 cognitive domains) with highest frequencies and severity in processing speed and executive functions. Demographics (fewer years of academic education, higher age, male sex), clinical (EDSS, depressive symptoms) but no conventional MRI characteristics were linked to baseline CI. At follow-up, only 14% of patients showed CI suggesting effects of retesting. Neither baseline characteristics nor initiation of treatment between baseline and follow-up was able to predict cognitive changes within the follow-up period of 1 year.Conclusions
Identification of risk factors for short-term cognitive change in newly diagnosed MS or CIS is insufficient using only demographic, clinical and conventional MRI data. Change-sensitive, re-test reliable cognitive tests and more sophisticated predictors need to be employed in future clinical trials and cohort studies of early-stage MS to improve prediction.
SUBMITTER: Johnen A
PROVIDER: S-EPMC6373354 | biostudies-literature | 2019 Feb
REPOSITORIES: biostudies-literature
Johnen Andreas A Bürkner Paul-Christian PC Landmeyer Nils C NC Ambrosius Björn B Calabrese Pasquale P Motte Jeremias J Hessler Nicole N Antony Gisela G König Inke R IR Klotz Luisa L Hoshi Muna-Miriam MM Aly Lilian L Groppa Sergiu S Luessi Felix F Paul Friedemann F Tackenberg Björn B Bergh Florian Then FT Kümpfel Tania T Tumani Hayrettin H Stangel Martin M Weber Frank F Bayas Antonios A Wildemann Brigitte B Heesen Christoph C Zettl Uwe K UK Zipp Frauke F Hemmer Bernhard B Meuth Sven G SG Gold Ralf R Wiendl Heinz H Salmen Anke A
Journal of neurology 20181204 2
<h4>Background</h4>Cognitive impairment (CI) affects approximately one-third of the patients with early multiple sclerosis (MS) and clinically isolated syndrome (CIS). Little is known about factors predicting CI and progression after initial diagnosis.<h4>Methods</h4>Neuropsychological screening data from baseline and 1-year follow-up of a prospective multicenter cohort study (NationMS) involving 1123 patients with newly diagnosed MS or CIS were analyzed. Employing linear multilevel models, we i ...[more]