E. Leveraro, M. Cellerino, C. Lapucci, M. Dighero, L. Nasone, T. Sirito, D. Boccia, N. Cavalli, G. Bavestrello, A. Uccelli, G. Boffa, M. Inglese
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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":"{\"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. 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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. 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Brief international cognitive assessment for MS (BICAMS) and NEDA maintenance in MS patients: A 2-year follow-up longitudinal study
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.
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).
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