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Perceived and objective cognitive impairment in newly diagnosed versus established multiple sclerosis: impact of disease duration

Irish Journal of Medical Science (1971 -) volume 190, pages 1149–1154 (2021)Cite this article

Abstract

Background

Cognitive impairment (CI) is common in multiple sclerosis (MS), including newly diagnosed MS, where it is particularly underrecognised. Determining the presence of CI in the outpatient clinic often relies on patient-reported complaints, with limited time and resources in this setting. Prior studies have shown that self-reported cognition relates poorly to formal neuropsychological testing in the MS population and correlates more with factors such as anxiety, depression and fatigue.

Aims

In this study, we assess the prevalence of perceived cognitive dysfunction in newly diagnosed MS patients and compare results with an established MS cohort.

Results

Thirty-nine patients with newly diagnosed MS (12 months following diagnosis) and 24 patients with an established diagnosis (3 years) were included. Similar levels of perceived and objective CI were seen in both groups. There was a strong correlation of perceived cognitive dysfunction with anxiety, mood and fatigue. Perceived cognition did not correlate with objective CI, assessed using the Brief International Cognitive Assessment in MS (BICAMS), in either group.

Conclusions

Study findings add to the literature of perceived cognition in MS, in a newly diagnosed cohort. Findings are consistent with previous research using detailed neuropsychological assessments, confirming the sensitivity of BICAMS, applicable in a routine clinical setting.

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References

  1. Chiaravalloti ND, DeLuca J (2008) Cognitive impairment in multiple sclerosis. Lancet Neurol 7(12):1139–1151

    Article  Google Scholar 

  2. Romero K, Shammi P, Feinstein A (2015) Neurologists’ accuracy in predicting cognitive impairment in multiple sclerosis. Mult Scler Relat Disord 4(4):291–295

    Article  Google Scholar 

  3. Julian L, Merluzzi N, Mohr D (2007) The relationship among depression, subjective cognitive impairment, and neuropsychological performance in multiple sclerosis. Mult Scler J 13(1):81–86

    CAS  Article  Google Scholar 

  4. Maor Y, Olmer L, Mozes B (2001) The relation between objective and subjective impairment in cognitive function among multiple sclerosis patients--the role of depression. Mult Scler (Houndmills, Basingstoke, England) 7(2):131–135

    CAS  Google Scholar 

  5. Middleton LS, Denney DR, Lynch SG, Parmenter B (2006) The relationship between perceived and objective cognitive functioning in multiple sclerosis. Arch Clin Neuropsychol 21(5):487–494

    Article  Google Scholar 

  6. Benedict RH, Cox D, Thompson LL et al (2004) Reliable screening for neuropsychological impairment in multiple sclerosis. Mult Scler J 10(6):675–678

    Article  Google Scholar 

  7. Bruce JM, Arnett PA (2004) Self-reported everyday memory and depression in patients with multiple sclerosis. J Clin Exp Neuropsychol 26(2):200–214

    Article  Google Scholar 

  8. Krupp LB, Alvarez LA, LaRocca NG, Scheinberg LC (1988) Fatigue in multiple sclerosis. Arch Neurol 45(4):435–437

    CAS  Article  Google Scholar 

  9. Parmenter BA, Denney DR, Lynch SG (2003) The cognitive performance of patients with multiple sclerosis during periods of high and low fatigue. Mult Scler (Houndmills, Basingstoke, England) 9(2):111–118

    Article  Google Scholar 

  10. Klepstad P, Hilton P, Moen J et al (2002) Self-reports are not related to objective assessments of cognitive function and sedation in patients with cancer pain admitted to a palliative care unit. Palliat Med 16(6):513–519

    Article  Google Scholar 

  11. Sawrie SM, Martin RC, Kuzniecky R et al (1999) Subjective versus objective memory change after temporal lobe epilepsy surgery. Neurology. 53(7):1511–1517

    CAS  Article  Google Scholar 

  12. Royall DR, Mahurin R (1994) EXIT, QED, and DSM-IV: very early Alzheimer's disease. J Neuropsychiatry Clin Neurosci 6(1):62–65

    CAS  Article  Google Scholar 

  13. Sullivan MEK, DeHousx E (1990) A survey of multiple sclerosis, part 1: perceived cognitive problems and compensatory strategy use. Can J Rehabil 4:99–105

    Google Scholar 

  14. Langdon D, Amato M, Boringa J et al (2012) Recommendations for a brief international cognitive assessment for multiple sclerosis (BICAMS). Mult Scler J 18(6):891–898

    CAS  Article  Google Scholar 

  15. Honarmand K, Feinstein A (2009) Validation of the Hospital Anxiety and Depression Scale for use with multiple sclerosis patients. Mult Scleros (Houndmills, Basingstoke, England) 15(12):1518–1524

    Article  Google Scholar 

  16. Krupp LB, LaRocca NG, Muir-Nash J, Steinberg AD (1989) The fatigue severity scale. Application to patients with multiple sclerosis and systemic lupus erythematosus. Arch Neurol 46(10):1121–1123

    CAS  Article  Google Scholar 

  17. O'Connell K, Langdon D, Tubridy N et al (2015) A preliminary validation of the brief international cognitive assessment for multiple sclerosis (BICAMS) tool in an Irish population with multiple sclerosis (MS). Mult Scler Relat Disord 4(6):521–525

    CAS  Article  Google Scholar 

  18. Randolph JJ, Randolph JS, Wishart HA (2017) Association between cognitive complaints and vulnerability to environmental distraction in multiple sclerosis. Arch Clin Neuropsychol 32(1):21–28

    Article  Google Scholar 

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Affiliations

  1. Department of Neurology, St. Vincent’s University Hospital, Elm park, Dublin 4, Ireland

    Nuala McNicholas, Niall Tubridy, Michael Hutchinson & Chris McGuigan

  2. School of Medicine and Medical Sciences, University College Dublin, Dublin, Ireland

    Nuala McNicholas, Niall Tubridy, Michael Hutchinson & Chris McGuigan

Authors
  1. Nuala McNicholas
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  2. Niall Tubridy
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  3. Michael Hutchinson
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  4. Chris McGuigan
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Correspondence to Nuala McNicholas.

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McNicholas, N., Tubridy, N., Hutchinson, M. et al. Perceived and objective cognitive impairment in newly diagnosed versus established multiple sclerosis: impact of disease duration. Ir J Med Sci 190, 1149–1154 (2021). https://doi.org/10.1007/s11845-020-02404-2

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  • DOI: https://doi.org/10.1007/s11845-020-02404-2

Keywords

  • BICAMS
  • Cognition
  • Multiple sclerosis