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A longitudinal study of cognitive function in multiple sclerosis: is decline inevitable?

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Abstract

Background

Numerous cross-sectional studies report cognitive impairment in multiple sclerosis (MS), but longitudinal studies with sufficiently long-term follow-up are scarce.

Objective

We aimed to investigate the cognitive 10-year course of a cohort of MS patients.

Methods

59 patients with clinically isolated syndrome (CIS) or relapsing–remitting (RR) MS were evaluated with Rao’s Brief Repeatable Battery of Neuropsychological Tests at baseline and follow-up (at least 10 years later). They constituted 47.2% of 124 consecutive CIS and RRMS patients originally evaluated at baseline. Patients assessed at follow-up were well matched for baseline clinical characteristics with dropouts.

Results

The proportion of MS patients with overall cognitive impairment was increased by 10% within the 10-year period. When grouped on the basis of impairment in specific cognitive domains at baseline, patients originally impaired showed improvement at follow-up, while the opposite trend was observed for patients non-impaired at first assessment. A detailed case-by-case investigation revealed mixed evolution patterns, several patients fail in fewer domains at follow-up compared to baseline or failing at different domains at follow-up compared to baseline.

Conclusions

This study suggests a more fluid picture for the evolution of cognitive function in a subgroup of MS patients and contradicts the concept of an inevitable, progressively evolving “dementia”.

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Funding

This research is co-financed by Greece and the European Union (European Social Fund—ESF) through the Operational Programme «Human Resources Development, Education and Lifelong Learning» in the context of the project “Strengthening Human Resources Research Potential via Doctorate Research” (MIS-5000432), implemented by the State Scholarships Foundation (ΙΚΥ).

Author information

Author notes

  1. Marina Katsari, Dimitrios S. Kasselimis, Georgios Koutsis, and Constantin Potagas have equally contributed to this work.

Authors and Affiliations

  1. 1st Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens, 74 Vas. Sofias Av., 11528, Athens, Greece

    Marina Katsari, Dimitrios S. Kasselimis, Erasmia Giogkaraki, Marianthi Breza, Maria-Eleftheria Evangelopoulos, Maria Anagnostouli, Elisabeth Andreadou, Costas Kilidireas, Ioannis Zalonis, Georgios Koutsis & Constantin Potagas

  2. Department of Psychiatry, School of Medicine, University of Crete, Heraklion, Greece

    Dimitrios S. Kasselimis

  3. School of Medicine, National and Kapodistrian University of Athens, Athens, Greece

    Alia Hotary

Authors
  1. Marina Katsari
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  2. Dimitrios S. Kasselimis
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  3. Erasmia Giogkaraki
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  4. Marianthi Breza
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  5. Maria-Eleftheria Evangelopoulos
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  6. Maria Anagnostouli
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  7. Elisabeth Andreadou
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  8. Costas Kilidireas
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  9. Alia Hotary
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  10. Ioannis Zalonis
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  11. Georgios Koutsis
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  12. Constantin Potagas
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Corresponding author

Correspondence to Dimitrios S. Kasselimis.

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Conflicts of interest

The authors report no conflicts of interest.

Disclosures

Dr Koutsis has received research grants from Teva and Genesis Pharma and provided consultation services for and received honoraria from Novartis, Genzyme, Genesis Pharma, Specifar, Pfizer, and Teva. Dr Breza reports no disclosures. Dr Zalonis reports no disclosures. Dr Potagas reports no disclosures. Dr Evangelopoulos has provided consultation services for and received honoraria from Novartis, Biogen, and Teva. Dr Anagnostouli has received research grants from Biogen, Merck- Serono, Novartis, Teva, Bayer, and Genzyme, as well as lecture-fees from Novartis, Teva, Biogen and Genzyme. Dr Andreadou has received research grants from Biogen, Merck-Serono, Novartis, and Sanofi-Aventis, as well as lecture-fees from Teva. Dr Kilidireas has received research grants from Biogen, Novartis, Teva, and Merck-Serono. Dr Kasselimis is supported by IKY Scholarships Programme co-financed by the European Union (European Social Fund [ESF]) and Greek national funds through the action entitled “Reinforcement of Postdoctoral Researchers,” in the framework of the Operational Programme “Human Resources Development Program, Education and Lifelong Learning” of the National Strategic Reference Framework (NSRF) 2014–2020.

Ethical approval

The study was approved by the Eginition hospital ethics committee.

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Katsari, M., Kasselimis, D.S., Giogkaraki, E. et al. A longitudinal study of cognitive function in multiple sclerosis: is decline inevitable?. J Neurol 267, 1464–1475 (2020). https://doi.org/10.1007/s00415-020-09720-8

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  • DOI: https://doi.org/10.1007/s00415-020-09720-8

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