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Neuropsychology of multiple sclerosis

An overview

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Abstract

Neuropsychological dysfunctions have been well documented in patients with multiple sclerosis. We herein give an overview of the main findings of recent decades. The pros and cons of considering the cognitive deficits of multiple sclerosis patients as a form of ‘subcortical dementia’ are discussed. By comparing the neuropsychological descriptions of multiple sclerosis patients as given in the literature to other neurological diseases which are also associated with neuropsychological deficiencies, we propose the term ‘multiple disconnection syndrome’ to describe the variety of neuropsychological deficits encountered in this demyelinating disease. Furthermore, a ‘ threshold of cerebral tolerance’ is assumed which must be crossed before cognitive dysfunctions are manifested clinically.

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References

  1. Amato MP, Bartolozzi ML, Zipoli V, Portaccio E, Mortella M, Guidi L, Siracusa G, Sorbi S, Federico A, De Stefano N (2004) Neocortical volume decrease in relapsing-remitting MS patients with mild cognitive impairment. Neurology 63:89–93

    CAS  PubMed  Google Scholar 

  2. Anzola GP, Bevilacqua L, Cappa SF, Capra R, Faglia L, Farina E, Frisoni G, Mariani C, Pasolini MP, Vignolo LA (1990) Neuropsychological assessment in patients with relapsing-remitting multiple sclerosis and mild functional impairment: correlation with magnetic resonance imaging. J Neurol Neurosurg Psychiatry 53:142–145

    CAS  PubMed  Google Scholar 

  3. Baddeley A (1986) Working memory. Oxford: Oxford University Press

  4. Beatty WW, Goodkin DE, Monson N, Beatty PA (1989) Cognitive disturbances in patients with relapsing remitting multiple sclerosis. Arch Neurol 46:1113–1119

    CAS  PubMed  Google Scholar 

  5. Beatty WW, Goodkin DE, Monson N, Beatty PA (1990a) Implicit learning in patients with chronic progressive multiple sclerosis. Int J Clin Neuropsychol 12:166–172

    Google Scholar 

  6. Beatty WW, Goodkin DE, Monson N, Beatty PA, Hertsgaard D (1988) Anterograde and retrograde amnesia in patients with chronic progressive multiple sclerosis. Arch Neurol 45:611–619

    CAS  PubMed  Google Scholar 

  7. Beatty WW, Monson N (1990) Semantic priming in multiple sclerosis. Bulletin of the Psychonomic Society 28:397–400

    Google Scholar 

  8. Beatty, WW, Monson,N (1991a). Memory for temporal order in multiple sclerosis. Bulletin of the Psychonomic Society 29:10–12

    Google Scholar 

  9. Beatty WW, Monson N (1991b) Metamemory in multiple sclerosis. J Clin Exp Neuropsychol 13:309–327

    CAS  Google Scholar 

  10. Caine ED, Bamford KA, Schiffer RB, Shoulson I, Levy S (1986) A controlled neuropsychological comparison of Huntington’s disease and multiple sclerosis. Arch Neurol 43:249–254

    CAS  PubMed  Google Scholar 

  11. Calabrese P, Haupts M, Babinsky R, Markowitsch HJ, Gehlen W (1993) Alltagsgedächtnisleistungen bei Multipler Sklerose. Zeitschrift für Neuropsychologie 4:4–16

    Google Scholar 

  12. Callanan MM, Logsdail SJ, Ron MA, Warrington EK (1989) Cognitive impairment in patients with clinically isolated lesions of the type seen in multiple sclerosis. A psychometric and MRI study. In: Jensen K, Knudsen L, Stenager E,Grant I (eds) Mental disorders and cognitive deficits in multiple sclerosis. London: Libbey, pp 63–75

  13. Canter AH (1951) Direct and indirect measures of psychological deficit in multiple sclerosis. J Gen Psychol 44:3–50

    Google Scholar 

  14. Charcot JM (1877) Lectures on the diseases of the nervous system delivered at La Salpetrière. London: New Sydenham Society

  15. Coo H, Hopman WM, Edgar CM, McBride EV, Brunet DG (2005) The paced auditory serial addition test (PASAT): to what extent is it performed as instructed, and is it associated with disease course? Multiple Sclerosis 11:85–89

    Article  CAS  PubMed  Google Scholar 

  16. DeLuca J, Johnson SK, Natelson BH (1993) Information processing efficiency in chronic fatigue syndrome and multiple sclerosis. Arch Neurol 50:301–304

    CAS  PubMed  Google Scholar 

  17. Elsass P, Zeeberg I (1983) Reaction time deficits in multiple sclerosis. Acta Neurol Scand 68:257–261

    CAS  PubMed  Google Scholar 

  18. Franklin GM, Nelson LN, Filley CM, Heaton RK (1989) Cognitive loss in multiple sclerosis. Case reports and review of the literature. Arch Neurol 46:162–167

    CAS  PubMed  Google Scholar 

  19. Graf P, Squire LR, Mandler G (1987) The information that amnesic patients do not forget. J Exp Psychol Learn Mem Cogn 10:164–178

    Google Scholar 

  20. Grafman J, Rao SM, Litvan I (1990) Disorders of memory. In: Rao SM (ed) Neurobehavioral aspects of multiple sclerosis. New York: Oxford University Press, pp 102–117

    Google Scholar 

  21. Grant I, McDonald WI, Trimble MR (1989b) Neuropsychological impairment in early multiple sclerosis. In: Jensen K, Knudsen L, Stenager E, Grant I (eds) Mental disorders and cognitive deficits in multiple sclerosis. London: Libbey, pp 17–26

  22. Grant I, McDonald WI, Trimble MR, Smith E, Reed R (1984) Deficient learning and memory in early and middle phases of multiple sclerosis. J Neurol Neurosurg Psychiatry 47:250–255

    CAS  PubMed  Google Scholar 

  23. Gronning M, Hannisdal E, Mellgren SI (1990) Multivariate analyses of factors associated with onemployment in people with multiple sclerosis. J Neurol Neurosurg Psychiatry 53:388–390

    CAS  PubMed  Google Scholar 

  24. Heindel WC, Butters N, Salmon DP (1988) Impaired learning of a motor skill in patients with Huntington’s disease. Behav Neurosci 102:141–147

    Article  CAS  PubMed  Google Scholar 

  25. Huber SJ, Paulson GW, Shuttleworth EW, Chakeres D, Clapp LE, Pakalnis A, Weiss K, Rammohan K (1987) Magnetic resonance imaging correlates of dementia in multiple sclerosis. Arch Neurol 44:732–736

    CAS  PubMed  Google Scholar 

  26. Jambor K (1969) Cognitive functioning in multiple sclerosis. Br J Psychiatry 115:765–775

    CAS  PubMed  Google Scholar 

  27. Jennekens-Schinkel A, Laboyrie PM, Lanser JBK, van der Velde EA (1990) Cognition in patients with multiple sclerosis. After four years. J Neurol Sci 99:229–247

    Article  CAS  PubMed  Google Scholar 

  28. Klonoff H, Clark C, Oger J, Paty D, Li D (1991) Neuropsychological performance in patients with mild multiple sclerosis. J Nerv Ment Dis 179:127–131

    CAS  PubMed  Google Scholar 

  29. Kurtzke JF (1983) Rating neurologic impairment in multiple sclerosis: an extended disability status scale (EDSS). Neurology 33:1444–1452

    CAS  PubMed  Google Scholar 

  30. Kurtzke JF, Beebe GW, Nagler B, Auth TL, Kurland LT, Nefzger MD (1972) Studies on the natural history of multiple sclerosis. 6. Clinical and laboratory findings at first diagnosis. Acta Neurol Scand 48:19–46

    CAS  PubMed  Google Scholar 

  31. LaPointe LL, Maitland CG, Blanchard AA, Kemker BE, Stierwalt JA, Heald GR (2005) The effect of auditory distraction on visual cognitive performance in multiple sclerosis. J Neuroophthalmol 25:92–94

    PubMed  Google Scholar 

  32. Litvan I, Grafman J, Vendrell P, Martinez JM (1988a) Slowed information processing in multiple sclerosis. Arch Neurol 45:281–285

    CAS  Google Scholar 

  33. Litvan I, Grafman J, Vendrell P, Martinez JM, Junqué C, Vendrell JM, Barraquer-Bordas JL (1988b) Multiple memory deficits in patients with multiple sclerosis. Exploring the working memory system. Arch Neurol 45:607–610

    CAS  Google Scholar 

  34. Mariani C, Farina E, Cappa SF, Anzola GP, Faglia L, Bevilacqua L, Capra R, Mattiolo F, Vignolo LA (1991) Neuropsychological assessment in multiple sclerosis: a follow-up study with magnetic resonance imaging. J Neurol 238:395–400

    CAS  PubMed  Google Scholar 

  35. Matthews CG, Cleeland CS, Hopper CL (1970) Neuropsychological patterns in multiple sclerosis. Diseases of the Nervous System, 31:161–170

  36. Maurelli M, Marchioni E, Cerretano R, Bosone D, Bergamaschi R, Citterio A, Martelli A, Sibilla L, Savoldi F (1992) Neuropsychological assessment in MS: clinical, neuropsychological and neuroradiological relationships. Acta Neurol Scand 86:124–128

    CAS  PubMed  Google Scholar 

  37. McIntosh-Michaelis SA, Roberts MH, Wilkinson SM, Diamond ID, McLellan DL, Martin JP, Spackman AJ (1991) The prevalence of cognitive impairment in a community survey of multiple sclerosis. Br J Clin Psychol 30:333–348

    PubMed  Google Scholar 

  38. Minden SL, Moes EJ, Orav J, Kaplan E, Reich P (1990) Memory impairment in multiple sclerosis. J Clin Exp Neuropsychol 12:566–586

    CAS  PubMed  Google Scholar 

  39. Paulesu E, Frith CD, Frackowiak RSJ (1993) The neural correlates of the verbal component of working memory. Nature 362:342–344

    Article  CAS  PubMed  Google Scholar 

  40. Penman M-F (1991) Assessing the prevalence of cognitive impairment in multiple sclerosis: implications for patient management. Axon 13:45–49

    CAS  PubMed  Google Scholar 

  41. Petersen RC, Kokmen E (1989) Cognitive and psychiatric abnormalities in multiple sclerosis. Mayo Clin Proc 64:657–663

    CAS  PubMed  Google Scholar 

  42. Rao SM (1986) Neuropsychology of multiple sclerosis: a critical review. J Clin Exp Neuropsychol 8:503–542

    CAS  PubMed  Google Scholar 

  43. Rao SM (1990) (ed) Neurobehavioral aspects of multiple sclerosis. New York: Oxford University Press

    Google Scholar 

  44. Rao SM, Hammeke TA, McQuillen MP, Khatri BO, Lloyd D (1984) Memory disturbance in chronic progressive multiple sclerosis. Arch Neurol 41:625–631

    CAS  PubMed  Google Scholar 

  45. Rao SM, Hammeke TA, Speech TJ (1987) Wisconsing Card Sorting Test performance in relapsing-remitting and chronic-progressive multiple sclerosis. Journal of Clinical and Consulting Psychology, 55:263–265

    CAS  Google Scholar 

  46. Rao SM, Leo GJ, Bernardin L, Unverzagt F (1991a) Cognitive dysfunction in multiple sclerosis. I. Frequency, patterns and prediction. Neurology 41:685–691

    CAS  Google Scholar 

  47. Rao SM, Leo GJ, St. Aubin-Faubert P (1989a) On the nature of memory disturbances in multiple sclerosis. J Clin Exp Neuropsychol 11:699–712

    CAS  Google Scholar 

  48. Rao SM, St. Aubin-Faubert P, Leo GJ (1989b) Information processing speed in patients with multiple sclerosis. J Clin Exp Neuropsychol 11:471–477

    CAS  Google Scholar 

  49. Ron MA (1986) Multiple sclerosis: psychiatric and psychometric abnormalities. J Psychosom Res 30:3–11

    Article  CAS  PubMed  Google Scholar 

  50. Ron MA, Callanan MM, Warrington EK (1991) Cognitive abnormalities in multiple sclerosis: a psychometric and MRI study. Psychol Med 21:59–68

    CAS  PubMed  Google Scholar 

  51. Ross AT, Reitan RM (1955) Intellectual and affective functions in multiple sclerosis. Arch Neurol Psychiatry 73:663–677

    CAS  Google Scholar 

  52. Ross DM (1917) The mental symptoms in disseminated sclerosis. Rev Neurol Psychiatry 13:361–373

    Google Scholar 

  53. Rovaris DM (1917) The mental symptoms in disseminated sclerosis. Rev Neurol Psychiatry 13:361–373

    Google Scholar 

  54. Seiffer W (1905) Über psychische, insbesondere Intelligenzstörungen bei multipler Sklerose. Archiv für Psychiatrie und Nervenkrankrankheiten 40:252–303

    Google Scholar 

  55. Staples D, Lincoln NB (1979) Intellectual impairment in multiple sclerosis and its relation to functional abilities. Rheumatology and Rehabilitation 18:153–160

    CAS  PubMed  Google Scholar 

  56. Stenager E, Knudsen L, Jensen K (1989a) Correlation of Beck Depression Inventory score, Kurtzke Disability Status Scale and cognitive functioning in multiple sclerosis. In: Jensen K, Knudsen L, Stenager E, Grant I (eds) Mental disorders and cognitive deficits in multiple sclerosis. London: Libbey, pp 147–151

  57. Stenager E, Knudsen L, Jensen K (1989b) Multiple sclerosos: correlation of cognitive dysfunction with Kurtzke Disability Status Scale. In: Jensen K, Knudsen L, Stenager E,Grant I (eds) Mental disorders and cognitive deficits in multiple sclerosis. London: Libbey, pp 27–37

  58. Swirsky-Sacchetti T, Mitchell DR, Seward J, Gonzales C, Lublin F, Knobler R, Field HL (1992) Neuropsychological and structural brain lesions in multiple sclerosis: a regional analysis. Neurology 42:1291–1295

    CAS  PubMed  Google Scholar 

  59. Van den Burg W, van Zomeren AH, Minderhoud JM, Prange AJA, Meijer NSA (1987) Cognitive impairment in patients with multiple sclerosis and mild physical disability. Arch Neurol 44:494–501

    CAS  PubMed  Google Scholar 

  60. Vowels LM (1979) Memory impairment in multiple sclerosis. In: Molloy M, Stanley GV, Walsh KW (eds) Brain impairment: Proceedings of the 1978 brain impairment workshop.Melbourne: University of Melbourne, pp 10–22

  61. Wachowius U, Talley M, Silver N, Heinze HJ, Sailer M (2005) Cognitive impairment in primary and secondary progressive multiple sclerosis. J Clin Exp Neuropsychol 27:65–77

    PubMed  Google Scholar 

  62. Vowels LM, Gates GR (1984) Neuropsychological findings. In: Simons AF (ed) Multiple sclerosis: psychological and social aspects. London: Heinemann, pp 82–90

  63. Young IR, Hall AS, Pallis CA, Bydder GM, Legg NJ, Steiner RE (1981) Nuclear magnetic resonance imaging of the brain in multiple sclerosis. Lancet 2:1063–1066

    CAS  PubMed  Google Scholar 

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Correspondence to Pasquale Calabrese Ph. D., M. D. habil..

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Calabrese, P. Neuropsychology of multiple sclerosis. J Neurol 253 (Suppl 1), i10–i15 (2006). https://doi.org/10.1007/s00415-006-1103-1

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