Mapping cognitive dysfunction in relapsing multiple sclerosis with mild disability: A cross-sectional study from South India.

IF 2.5 Q2 CLINICAL NEUROLOGY

Multiple Sclerosis Journal - Experimental, Translational and Clinical Pub Date : 2024-12-12 eCollection Date: 2024-10-01 DOI:10.1177/20552173241304302

Sruthi S Nair, Jissa Vinodha Thulaseedharan, Neenumol Kandagathparambil Rajan, Elshal Bava, Gowthami Nair, Soumya Sundaram, Muralidharan Nair, Chandrasekharan Kesavadas, Ramshekhar N Menon

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Abstract

Background: Cognitive dysfunction in multiple sclerosis (MS) occurs early. Locally adapted neuropsychological data from India in MS is scarce.

Objectives: We aimed to identify the pattern of cognitive impairment in relapsing MS (RMS) with mild disability using a regionally-adapted MS-specific cognitive battery.

Methodology: The study included 59 persons with MS (pwMS) with expanded disability status scale (EDSS)≤ 4 and 62 controls. The battery had 8 neuropsychological tests (Paced Auditory Serial Addition Test [PASAT], Symbol Digit Modalities Test [SDMT], Rey Auditory Verbal Learning Test [RAVLT], Brief Visuospatial Memory Test-Revised [BVMT-R], verbal fluency [VF], Judgement of Line Orientation Test [JOLOT], Wisconsin Card Sorting Test [WCST] and Trail Making Test-B [TMT-B]) with 11 measures. The scores were compared between the groups for pattern and associations of cognitive impairment.

Results: The pwMS cohort had 39 (66.1%) females; mean age of 32.56 (±8.17) years. Scores were significantly worse for pwMS in 10 of 11 tests (except JOLOT). Cohen's-d test showed the largest effect sizes for PASAT, SDMT, VF and TMT-B. Cognitive impairment (defined as ≥2 abnormal tests) were noted in 41 (69.5%) pwMS. Male sex was associated with cognitive impairment (p = 0.002).

Conclusions: In pwMS with mild disability, nearly two-thirds had cognitive abnormalities, predominantly involving processing speed, working memory, executive function, and VF.

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绘制伴有轻度残疾的复发性多发性硬化症患者的认知功能障碍图：南印度横断面研究

背景：多发性硬化症（MS）的认知功能障碍发生较早。在印度，适应当地情况的多发性硬化症神经心理学数据很少：我们的目的是使用适合当地情况的多发性硬化症特定认知电池，确定轻度残疾的复发性多发性硬化症（RMS）患者的认知功能障碍模式：研究对象包括 59 名残疾状况扩展量表（EDSS）≤ 4 的多发性硬化症患者（pwMS）和 62 名对照组患者。测试包括 8 项神经心理学测试（步调听觉连续加法测试 (PASAT)、符号数字模型测试 (SDMT)、雷伊听觉言语学习测试 (RAVLT)、简明视觉空间记忆测试-修订版 (BVMT-R)、言语流畅性 (VF)、线条方向判断测试 (JOLOT)、威斯康星卡片分类测试 (WCST) 和路径制作测试-B (TMT-B)），共 11 项测量指标。对各组之间的得分进行比较，以了解认知障碍的模式和关联：认知障碍患者中有 39 名女性（66.1%），平均年龄为 32.56（±8.17）岁。在 11 项测试中，pwMS 在 10 项测试（JOLOT 除外）中的得分明显较低。Cohen's-d 检验显示，PASAT、SDMT、VF 和 TMT-B 的效应大小最大。41 名（69.5%）心理障碍患者存在认知障碍（定义为≥2 项异常测试）。男性与认知障碍有关（P = 0.002）：结论：在轻度残疾的 pwMS 中，近三分之二存在认知异常，主要涉及处理速度、工作记忆、执行功能和 VF。

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