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Prevalence and incidence of cognitive impairment in multiple sclerosis: a population-based survey in Catania, Sicily

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Abstract

Cognitive impairment (CIm) is a frequent finding in multiple sclerosis (MS) affecting up to 65 % of patients. The aim of this study was to evaluate the prevalence and incidence of CIm in a population-based cohort of MS patients identified in the city of Catania from 1995 to 2004. One-hundred and twenty-five patients experiencing the onset of MS during 1995–2004 were enrolled. Cognitive performance was assessed through the Brief Repeatable Battery (BRB) of neuropsychological tests and the Stroop word-color task (ST). CIm was defined as the failure on at least three tests involving at least two different domains. Patients without CIm at baseline were followed up after over 3 years. The most impaired tests were the Symbol Digit Modalities Test (36 %) and the Paced Auditory Serial Addition Test 3 (35 %). At baseline the prevalence of CIm was 44 % (95 % CI 35.2–53.1). An almost sixfold increased risk of developing CIm was found among MS patients aged 40 and above at the time of the NPS examination (OR 5.84; 95 % CI 2.57–13.2; p value <0.0001) and a threefold increased risk for patients with an EDSS score >3 (OR 3.51; 95 % CI 1.30–9.46, p value 0.01). At the follow-up out of the 70 MS patients without CIm at baseline evaluation, 26 (37.1 %) developed CIm. The total person-years at risk was 269 person-years giving an incidence rate of CIm of 96.6/1,000 person-year (95 % CI 57.3–128.7). The overall prevalence of CIm in MS is 44 % and the incidence after 4 years is 37.1 %. CIm affects more frequently patients older than 40 years and with a higher EDSS score.

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Conflict of interest

M. Zappia has received honoraria for speaking activities from Boehringer-Ingelheim, Lundbeck and Bayer-Schering, and scientific grants from AIFA-Agenzia Italiana del Farmaco, Novartis and Lundbeck. A. Nicoletti has received honoraria from UCB-Union Clinique Belge and Lundbeck for medical education symposia. F. Patti has received honoraria for speaking activities from Bayer Schering, Biogen Idec, Merck Serono, Novartis and Sanofi Aventis; he also served as an advisory board member in the following companies: Bayer Schering, Biogen Idec, Merck Serono and Novartis; S. Lo Fermo received honoraria for speaking activities from Biogen Idec and Merck Serono; Dr Messina has received honoraria for speaking activities from Biogen Idec; E. Bruno, G. Quattrocchi, C. G. Chisari, D. Maimone and S. Cilia report no disclosure.

Ethical standards

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study protocol was approved by the Ethical Committee of Policlinico-Vittorio Emanuele; each participant provided written informed consent before any study related procedure.

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    Authors and Affiliations

    1. Department G.F. Ingrassia, Section of Neurosciences, University of Catania, Catania, Italy

      Francesco Patti, Alessandra Nicoletti, Silvia Messina, Elisa Bruno, Salvatore Lo Fermo, Graziella Quattrocchi, Clara Grazia Chisari, Sabina Cilia & Mario Zappia

    2. Garibaldi Hospital, Catania, Italy

      Davide Maimone

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    1. Francesco Patti
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    2. Alessandra Nicoletti
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    3. Silvia Messina
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    4. Elisa Bruno
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    5. Salvatore Lo Fermo
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    6. Graziella Quattrocchi
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    7. Clara Grazia Chisari
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    8. Davide Maimone
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    9. Sabina Cilia
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    10. Mario Zappia
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    Correspondence to Mario Zappia.

    Additional information

    F. Patti and A. Nicoletti equally contributed to the manuscript.

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    Patti, F., Nicoletti, A., Messina, S. et al. Prevalence and incidence of cognitive impairment in multiple sclerosis: a population-based survey in Catania, Sicily. J Neurol 262, 923–930 (2015). https://doi.org/10.1007/s00415-015-7661-3

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    • DOI: https://doi.org/10.1007/s00415-015-7661-3

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