Brief international cognitive assessment for MS (BICAMS) and NEDA maintenance in MS patients: A 2-year follow-up longitudinal study

IF 4.5 2区医学 Q1 CLINICAL NEUROLOGY

European Journal of Neurology Pub Date : 2024-12-21 DOI:10.1111/ene.70007

E. Leveraro, M. Cellerino, C. Lapucci, M. Dighero, L. Nasone, T. Sirito, D. Boccia, N. Cavalli, G. Bavestrello, A. Uccelli, G. Boffa, M. Inglese

{"title":"Brief international cognitive assessment for MS (BICAMS) and NEDA maintenance in MS patients: A 2-year follow-up longitudinal study","authors":"E. Leveraro, M. Cellerino, C. Lapucci, M. Dighero, L. Nasone, T. Sirito, D. Boccia, N. Cavalli, G. Bavestrello, A. Uccelli, G. Boffa, M. Inglese","doi":"10.1111/ene.70007","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>The Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) has been validated in many cross-sectional studies. However, longitudinal data on BICAMS subset trajectories and their correlation with disease activity during follow-up are scarce.</p>\n </section>\n \n <section>\n \n <h3> Objectives</h3>\n \n <p>We aimed to (i) assess BICAMS changes in MS patients initiating high-efficacy disease-modifying-treatments (DMTs), (ii) compare these changes based on maintenance of “no-evidence-of-disease-activity” (NEDA-3) status over 24 months, and (iii) determine baseline clinical parameters predictive of cognitive changes.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>We enrolled 101 MS patients (mean age:40,45 ± 11; Relapsing–Remitting-MS:81%) initiating highly-effective-DMTs. Patients underwent Expanded Disability Status Scale (EDSS), BICAMS, and Hospital Anxiety and Depression Scale (HADS), at baseline and after 24 months. Regression-based change index (RB-CI) had been used for cognitive change evaluation over follow-up.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>During follow-up, 78 (77.3%) patients maintained NEDA-3 status. Considering a 90% of confidence levels for RB-CI, 12 (11.9%) improved at SDMT, 13 (12.9%) at CVLT-II and 13 (12.9%) at BVMT-R; while 7 (6.9%) were classified as worsened at SDMT, 11 (10.9%) at CVLT-II and 8 (7.9%) at BVMT-R. SDMT scores significantly improved at follow-up for the entire group (<i>p</i> = 0.003) and in patients maintaining NEDA-3 (<i>p</i> < 0.001). The multivariable regression model assessing the SDMT improvement (<i>n</i> = 12; <i>z</i> = 1.65), was significant and explained 21% of the variance (<i>p</i> = 0.038; Nagelkerke <i>R</i><sup>2</sup> = 0.212). Lower EDSS proved to be an independent predictor of SDMT reliable improvement (<i>p</i> = 0.027) in our sample.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>Our findings showed that early disease activity control—especially in patients with low baseline disability—may yield significant benefits even in terms of cognitive performance.</p>\n </section>\n </div>","PeriodicalId":11954,"journal":{"name":"European Journal of Neurology","volume":"32 1","pages":""},"PeriodicalIF":4.5000,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ene.70007","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Journal of Neurology","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/ene.70007","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background

The Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) has been validated in many cross-sectional studies. However, longitudinal data on BICAMS subset trajectories and their correlation with disease activity during follow-up are scarce.

Objectives

We aimed to (i) assess BICAMS changes in MS patients initiating high-efficacy disease-modifying-treatments (DMTs), (ii) compare these changes based on maintenance of “no-evidence-of-disease-activity” (NEDA-3) status over 24 months, and (iii) determine baseline clinical parameters predictive of cognitive changes.

Methods

We enrolled 101 MS patients (mean age:40,45 ± 11; Relapsing–Remitting-MS:81%) initiating highly-effective-DMTs. Patients underwent Expanded Disability Status Scale (EDSS), BICAMS, and Hospital Anxiety and Depression Scale (HADS), at baseline and after 24 months. Regression-based change index (RB-CI) had been used for cognitive change evaluation over follow-up.

Results

During follow-up, 78 (77.3%) patients maintained NEDA-3 status. Considering a 90% of confidence levels for RB-CI, 12 (11.9%) improved at SDMT, 13 (12.9%) at CVLT-II and 13 (12.9%) at BVMT-R; while 7 (6.9%) were classified as worsened at SDMT, 11 (10.9%) at CVLT-II and 8 (7.9%) at BVMT-R. SDMT scores significantly improved at follow-up for the entire group (p = 0.003) and in patients maintaining NEDA-3 (p < 0.001). The multivariable regression model assessing the SDMT improvement (n = 12; z = 1.65), was significant and explained 21% of the variance (p = 0.038; Nagelkerke R² = 0.212). Lower EDSS proved to be an independent predictor of SDMT reliable improvement (p = 0.027) in our sample.

Conclusions

Our findings showed that early disease activity control—especially in patients with low baseline disability—may yield significant benefits even in terms of cognitive performance.

查看原文本刊更多论文

多发性硬化症患者的简短国际认知评估（BICAMS）和 NEDA 维护：为期两年的追踪纵向研究

背景多发性硬化症简明国际认知评估（BICAMS）已在许多横断面研究中得到验证。然而，有关 BICAMS 子集轨迹及其与随访期间疾病活动相关性的纵向数据却很少。目标我们的目的是：(i) 评估开始接受高效疾病改变疗法（DMT）的多发性硬化症患者的 BICAMS 变化；(ii) 根据 24 个月内 "无疾病活动证据"（NEDA-3）状态的维持情况比较这些变化；(iii) 确定预测认知变化的基线临床参数。方法我们招募了 101 名开始接受高效 DMTs 治疗的多发性硬化症患者（平均年龄：40.45 ± 11；复发-缓解型多发性硬化症：81%）。患者在基线和 24 个月后接受了残疾状况扩展量表 (EDSS)、BICAMS 和医院焦虑抑郁量表 (HADS)。基于回归的变化指数（RB-CI）用于评估随访期间的认知变化。结果在随访期间，78 名（77.3%）患者保持了 NEDA-3 状态。在RB-CI的90%置信水平下，12例（11.9%）患者的SDMT评分有所改善，13例（12.9%）患者的CVLT-II评分有所改善，13例（12.9%）患者的BVMT-R评分有所改善；7例（6.9%）患者的SDMT评分有所恶化，11例（10.9%）患者的CVLT-II评分有所恶化，8例（7.9%）患者的BVMT-R评分有所恶化。整组患者的 SDMT 评分在随访时均有明显改善（p = 0.003），NEDA-3 患者的 SDMT 评分也有明显改善（p < 0.001）。评估 SDMT 改善情况的多变量回归模型（n = 12；z = 1.65）具有显著性，可解释 21% 的方差（p = 0.038；Nagelkerke R2 = 0.212）。在我们的样本中，较低的 EDSS 是 SDMT 可靠性改善的独立预测因子（p = 0.027）。结论我们的研究结果表明，早期疾病活动控制--尤其是对基线残疾程度较低的患者--可能会在认知表现方面产生显著的益处。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

European Journal of Neurology 医学-临床神经学

CiteScore

9.70

自引率

2.00%

发文量

418

审稿时长

1 months

期刊介绍： The European Journal of Neurology is the official journal of the European Academy of Neurology and covers all areas of clinical and basic research in neurology, including pre-clinical research of immediate translational value for new potential treatments. Emphasis is placed on major diseases of large clinical and socio-economic importance (dementia, stroke, epilepsy, headache, multiple sclerosis, movement disorders, and infectious diseases).