Abstract
Despite the large number of studies on cognitive dysfunction in multiple sclerosis (MS) published over the last decade, the bulk of information still comes mainly from cross-national surveys. In the present study, the cognitive performance of 50 patients with early-onset MS was compared with that of 70 demographically matched healthy controls over a 4-year follow-up period. On initial testing, patients showed significant impairment on verbal memory and abstract reasoning tasks. On the second evaluation, linguistic disturbances on the set and token tests also emerged. Clinical characteristics of the disease at onset had a limited predictive power for the cognitive outcome; however, the extent of cognitive decline proved to be an independent predictor of handicap in work and social activities beyond the degree of neurological impairment.
Sommario
Questo studio di follow-up longitudinale indaga le funzioni cognitive di un campione di 50 pazienti con sclerosi multipla (SM) all' esordio della malattia, confrontato con un campione di 70 controlli sani. Alla valutazione iniziale i pazienti presentavano deficit significativi nei test di memoria verbale e di ragionamento astratto. Alla seconda valutazione, 4 anni dopo, emergevano anche disturbi delle funzioni linguistiche valutate mediante il Set e il Token test. Le caratteristiche cliniche della malattia risultavano scarsamente predittive dell'evoluzione della disfunzione cognitiva, mentre l' entità dei deficit cognitivi risultava essere uno dei predittori principali dello sviluppo di disabilityd nelle attivitd della vita quotidiana e di handicap nella sfera sociale e lavorativa.
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References
Canter AH (1951) Direct and indirect measures of psychological deficit in multiple sclerosis. J Gen Psychol 44:3–50
Fink SL, Houser HB (1966) An investigation of physical and intellectual changes in multiple sclerosis. Arch Phys Med Rahabil 47:56–61
Ivnik RJ (1978) Neuropsychological test performance as a function of the duration of MS related symptomatology. J Clin Psychiatry 46:304–312
Ivnik RJ (1978) Neuropsychological stability in multiple sclerosis. J Consul Clin Psychol 46:913–923
Jennekens-Schinkel A, Laboyrie PM, Lanser JBK, van der Velde EA (1990) Cognition in patients with multiple sclerosis after 4 years. J Neurol Sci 99:229–247
Feinstein A, Kartsounis L, Miller D et al (1992) Clinically isolated lesions of the type seen in multiple sclerosis followed-up: A cognitive, psychiatric and MRI study. J Neurol Neurosurg Psychiatry 55:869–876
Feinstein A, Thompson A, Ron MA (1993) A serial study of psychometric, psychiatric and MRI abnormalities in multiple sclerosis. Brain 116:569–602
Bernardin LJ, Rao SM, Luchetta TL et al (1993) A prospective Longerm, longitudinal study of cognitive dysfunction in MS. J Clin Exp Neuropsychol 15:17
Amato MP, Ponziani G, Pracucci G, Bracco L, Siracusa G, Amaducci L (1995) Cognitive impairment in early-onset multiple sclerosis: Pattern, predictors, and impact on everyday life in a 4-year follow-up. Arch Neurol 52:168–172
Hohol MJ, Guttmann RG, Orav J et al (1997) Serial neuropsychological assessment and magnetic resonance imaging analysis in multiple sclerosis. Arch Neurol 54:1018–1025
Kurtzke JF (1981) A proposal for a uniform minimal record of disability in multiple sclerosis. Acta Neurol Scand 64 [Suppl 87]:110–129
Granger CV (1981) Assessment of functional status: A model for multiple sclerosis. Acta Neurol Scand 64 [Suppl 87]:40–47
Poser CNM, Paty DW, Scheinberg L et al (1983) New diagnostic criteria for multiple sclerosis: Guidelines for research protocols. Ann Neurol 13:227–231
Kurtzke JF (1983) Rating neurological impairment in multiple sclerosis: An expanded disability status scale (EDSS). Neurology 33:1444–1452
Bracco L, Amaducci L, Pedone D et al (1990) Italian multicentre study on dementia (SMID): A neuropsychological test battery for assessing Alzheimer's disease. J Psychiatr Res 24:213–226
Blessed G, Tomlinson BE, Roth M (1968) The association between quantitative measures of dementia and of senile change in the cerebral gray matter of elderly subjects. Br J Psychiatry 114:797–811
Wechsler D (1945) A standardized memory scale for clinical use. J Psychol 19:87–95
Randt CT, Brown ER, Osborne DP Jr (1980) A memory test for longitudinal measurement of mild to moderate deficits. Clin Neuropsychol 4:184–194
Milner B (1971) Interhemispheric differences in the localization of psychological processes in man. Br Med Bull 27:272–276
Isaacs B, Kennie A (1973) The set test as an aid to the detection of dementia in old people. Br J Psychiatry 123:467–470
De Renzi E, Faglioni P (1978) Normative data and screening power of a shortened version of the token test. Cortex 14:41–49
Arrigoni G, De Renzi E (1964) Constructional apraxia and hemispheric locus of lesions. Cortex 1:170–178
Raven JC (1960) Guide to the Standard Progressive Matrices. HK Lewis, London
Hamilton M (1967) Development of a rating scale for primary depressive illness. Br J Soc Clin Psychol 6:278–296
Young AC, Saunders J, Ponsford JR (1976) Mental changes as an early feature of multiple sclerosis. J Neurol Neurosurg Psychiatry 39:1008–1013
Grant CM, McDonald WI, Trimble MR et al (1984) Deficient learning and memory in early and middle phases of multiple sclerosis. J Neurol Neurosurg Psychiatry 47:250–255
Lyon-Caen O, Jouvent R, Hauser S et al (1986) Cognitive function in recent-onset demyelinating diseases. Arch Neurol 41:1138–1141
Rao SM, Leo GJ, Haughton VM, St Aubin-Faubert P, Bernardin L (1989) Correlation of magnetic resonance imaging with neuropsychological testing in multiple sclerosis. Neurology 39:161–166
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Amato, M.P., Ponziani, G. Natural history of cognitive dysfunction in multiple sclerosis: a 4-year longitudinal study. Ital J Neuro Sci 19 (Suppl 6), S388–S391 (1998). https://doi.org/10.1007/BF00539593
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DOI: https://doi.org/10.1007/BF00539593