Detecting isolated cognitive relapses in persons with MS-Reference-Cited by-同舟云学术

Detecting isolated cognitive relapses in persons with MS

Published:2023-09-30 Issue:14 Volume:29 Page:1786-1794
ISSN:1352-4585
Container-title:Multiple Sclerosis Journal
language:en
Short-container-title:Mult Scler

Author:

Morrow Sarah A¹,Weinstock Zachary L²^ORCID,Mirmosayyeb Omid²,Conway Devon³^ORCID,Fuchs Tom⁴^ORCID,Jaworski Michael G²,Eckert Sveltlana²,Hojnacki David H²,Dwyer Michael G⁴,Zivadinov Robert⁵⁶^ORCID,Weinstock-Guttman Bianca²^ORCID,Benedict Ralph H B²^ORCID

Affiliation:

1. University Hospital, London Health Sciences Center, Department of Clinical Neurological Sciences, Western University, London, ON, Canada

2. Jacobs School of Medicine and Biomedical Sciences, Department of Neurology, State University of New York, Buffalo, NY, USA

3. Mellen Center for Multiple Sclerosis Treatment, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA

4. Jacobs School of Medicine and Biomedical Sciences and Buffalo Neuroimaging Analysis Center, Department of Neurology, State University of New York, Buffalo, NY, USA

5. Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, State University of New York, Buffalo, NY, USA

6. Center for Biomedical Imaging, Clinical Translational Science Institute, State University of New York, Buffalo, NY, USA

Abstract

Background: The existence of isolated cognitive relapses (ICRs) in persons with MS (PwMS) has been debated. Objective: To examine relapses with decline on Symbol Digit Modalities Test (SDMT) but no change on Expanded Disability Status Scale (EDSS). Methods: This 3-year prospective cohort study identified PwMS experiencing a relapse with decrease on SDMT. Participants with SDMT decline/stable EDSS were labeled “ICR,” while those with a corresponding decrease on EDSS were classified “Relapse with Cognitive Decline (RCD).” Two definitions of SDMT decline were explored: (1) ⩾ 8 points, and (2) ⩾ 4 points. Logistic regression was used to analyze the relationship between ICR and RCD. Results: The full cohort had 592 participants: 83 experienced relapses; 22 (26.5%) had an SDMT decrease of ⩾ 8 points; 14 (63.6%) met ICR criteria. Logistic regression (X2(1) = 5.112, p = 0.024) using demographics and disease characteristics explained 28.4% of the variance in ICR versus RCD. Only the MS Neuropsychological Questionnaire was associated with ICR (odds ratio (OR): 8.6; 95% confidence interval (CI): 1.1–16.4) 40 relapsing participants with SDMT decrease of ⩾ 4 points were identified: 26 (65%) had a stable EDSS (ICR). Logistic regression did not find any variable predictive of ICR. Conclusion: This prospective study demonstrates evidence of ICR in PwMS.

Funder

National Multiple Sclerosis Society

Publisher

SAGE Publications

Subject

Neurology (clinical),Neurology

Link

http://journals.sagepub.com/doi/pdf/10.1177/13524585231201219

Reference31 articles.

1. Cognitive dysfunction in multiple sclerosis.: I. Frequency, patterns, and prediction

2. Cognition in multiple sclerosis

3. Do isolated cognitive relapses exist? – No