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Cognitive Impairment in Patients with Early Relapsing-Remitting Multiple Sclerosis

Keywords: Multiple Sclerosis , cognitive impairment

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Abstract:

Objective: Cognitive impairment is a common symptom in every phase and every type of multiple sclerosis. Different results, between 32% and 70%, have been reported in studies on the incidence and characteristics of cognitive impairment in patients with relapsing-remitting multiple sclerosis (RRMS). This big difference is explained by the use of different neuropsychological tests and different patient groups. The aim of this study was to analyze the incidence and characteristics of cognitive impairment in patients with early RRMS by applying standardized Turkish neuropsychological tests, commonly used in our country.Methods: 67 patients followed with diagnosis of RRMS and with disease duration up to 5 years were enrolled in the study. All participants underwent neuropsychological, magnetic resonance imaging (MRI) and clinical evaluation. Functional deficits of the subjects were assessed using the Expanded Disability Status Scale (EDSS). The patients without depression according to the Hamilton Depression Rating Scale (HDRS), underwent the Frenchay Aphasia Screening Test (FAST), the Standardized Mini-Mental State Examination (SMME) and the Alzheimer’s Disease Assessment Scale-cognitive subscale (ADAS-cog). All results were assessed statistically.Results: Out of 67 RRMS patients (41 women, 26 men) evaluated in this study, 17 (23.4%) patients had depression. Of the rest 50 patients, 7 (14%) had a cognitive impairment according to SMME, 22 (44%) patients had cognitive impairment according to ADAS-cog and 1 patients had aphasia according to FAST. No statistically significant correlation was observed between cognitive impairment and clinical features, EDSS score or cranial MRI lesion load.Conclusion: Our results suggest that 44% of patients with early RRMS had cognitive impairment. There was no statistically significant correlation between cognitive impairment, EDSS score or number of lesions on cranial MRI. (Archives of Neuropsychiatry 2010; 47: 88-90)

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