Aims To assess the cognitive impairment of multiple sclerosis (MS) patients using the Brief Repeatable Battery-Neuropsychology (BRB-N) test.
Methods The performance of 59 patients with MS in the BRB-N test was assessed and compared with 152 matched healthy controls (HC).
Results In most tests, MS patients performed worse than controls. Age and educational level strongly influenced the performance of the subjects. The Symbol Digit Modality Test (SDMT) best correlated with the other individual tests and contributed most to the general BRB-N factor. Furthermore, a correlation between physical disability and performance in some BRB-N tests was observed. Indeed, patients with progressive MS and greater physical disability performed worse in some tests than less disabled patients with relapsing MS. By creating a global BRB-N Z score, we found that patients generally performed 0.7 standard deviation (SD) below the level of controls. We obtained cut-off values stratified by age and education to determinate cognitive impairment in MS patients.
Conclusions Our data show that cognitive impairment is prevalent amongst MS patients, and that a single cognitive measurement might be useful for monitoring patients during the progression of this illness.
Compston A , Coles A.Multiple sclerosis . Lancet2002; 359: 1221-1231 .
2.
Rao SM , Leo GJ , Bernardin L , Unverzagt F.Cognitive dysfunction in multiple sclerosis. I. Frequency, patterns, and prediction . Neurology1991; 41: 685-691 .
3.
Rao SM , Leo GJ , Ellington L , Nauertz T , Bernardin L , Unverzagt F.Cognitive dysfunction in multiple sclerosis. II. Impact on employment and social functioning . Neurology1991; 41: 692-696 .
Demaree HA , DeLuca J , Gaudino EA , Diamond BJ.Speed of information processing as a key deficit in multiple sclerosis: implications for rehabilitation . J Neurol Neurosurg Psychiatry1999; 67: 661-663 .
6.
Achiron A , Ziv I , Djaldetti R , Goldberg H , Kuritzky A , Melamed E.Aphasia in multiple sclerosis: clinical and radiologic correlations . Neurology1992; 42: 2195-2197 .
7.
Late S , Hemline P , Revonsuo A , Portin R , Ruutiainen J.Sematic memory deficit in multiple sclerosis; impaired understanding of conceptual meanings . J Neurol Sci1999; 162: 152-161 .
8.
Dujardin K , Donze AC , Hautecoeur P.Attention impairment in recently diagnosed multiple sclerosis . Eur J Neurol1998; 5: 61-66 .
9.
Ruggieri RM , Palermo R , Vitello G , Gennuso M , Settipani N , Piccoli F.Cognitive impairment in patients suffering from relapsing-remitting multiple sclerosis with EDSS B > or = 3.5 . Acta Neurol Scand2003; 108: 323-326 .
10.
Beatty WW , Goodkin DE.Screening for cognitive impairment in multiple sclerosis. An evaluation of the Mini-Mental State Examination . Arch Neurol1990; 47: 297-301 .
11.
Rao SM , in collaboration with the Cognitive Function Study Group of the National Multiple Sclerosis Society . A manual for the Brief Repeatable Battery of Neuropsychological Tests in multiple sclerosis. Section of Neuropsychology, Medical College of Wisconsin, 1000 N. 92 Street, Milwaukee, WI 53226 , 1990.
12.
Huijbregts SCKN , de Sonneville LM , de Groot V , Reuling IE , Polman CH.Differences in cognitive impairment of relapsing remitting, secondary, and primary progressive MS . Neurology2004; 63: 335-339 .
13.
European Study Group on interferon beta-1b in secondary progressive MS.Placebo-controlled multi-centre randomised trial of interferon beta-1b in treatment of secondary progressive multiple sclerosis . Lancet1998; 352: 1491-1497 .
14.
Poser CM , Paty DW , Scheinberg L , McDonald WI , Davis FA , Ebers GCet al.New diagnostic criteria for multiple sclerosis: guidelines for research protocols . Ann Neurol1983; 13: 227-231 .
15.
Folstein MF , Folstein SE , McHugh PR.‘Mini-mental state’. A practical method for grading the cognitive state of patients for the clinician . J Psychiatr Res1975; 12: 189-198 .
16.
Kurtzke JF.Rating neurologic impairment in multiple sclerosis: an expanded disability status scale (EDSS) . Neurology1983; 33: 1444-1452 .
17.
Fischer JS , Rudick RA , Cutter GR , Reingold SC , Baier ML , Cookfair DLet al.The Multiple Sclerosis Functional Composite Measure (MSFC): an integrated approach to MS clinical outcome assessment. National MS Society Clinical Outcomes Assessment Task Force . Mult Scler1999; 5: 244-250 .
18.
Cutter GR , Baier ML , Rudick RA , Cookfair DL , Fischer JS , Petkau Jet al.Development of a multiple sclerosis functional composite as a clinical trial outcome measure . Brain1999; 122 (Pt 5): 871-882 .
Hamilton M.A rating scale for depression . J Neurol Neurosurg Psychiatry1960; 23: 56-62 .
21.
Boringa JB , Lazeron RH , Reuling IE , Ader HJ , Pfennings L , Lindeboom Jet al.The brief repeatable battery of neuropsychological tests: normative values allow application in multiple sclerosis clinical practice . Mult Scler2001; 7: 263-267 .
22.
Solari A , Mancuso L , Motta A , Mendozzi L , Serrati C.Comparison of two brief neuropsychological batteries in people with multiple sclerosis . Mult Scler2002; 8: 169-176 .
23.
Aupperle RL , Beatty WW , Shelton Fde N , Gontkovsky ST.Three screening batteries to detect cognitive impairment in multiple sclerosis . Mult Scler2002; 8: 382-389 .
24.
Benedict RH , Fischer JS , Archibald CJ , Arnett PA , Beatty WW , Bobholz Jet al.Minimal neuropsychological assessment of MS patients: a consensus approach . Clin Neuropsychol2002; 16: 381-397 .
25.
De Sonneville LM , Boringa JB , Reuling IE , Lazeron RH , Ader HJ , Polman CH.Information processing characteristics in subtypes of multiple sclerosis . Neuropsychologia2002; 40: 1751-1765 .
26.
Christodoulou C , Krupp LB , Liang Z , Huang W , Melville P , Roque Cet al.Cognitive performance and MR markers of cerebral injury in cognitively impaired MS patients . Neurology2003; 60: 1793-1798 .
27.
Beatty WW , Goodkin DE , Hertsgaard D , Monson N.Clinical and demographic predictors of cognitive performance in multiple sclerosis. Do diagnostic type, disease duration, and disability matter?Arch Neurol1990; 47: 305-308 .
28.
Foong J , Rozewicz L , Chong WK , Thompson AJ , Miller DH , Ron MA.A comparison of neuropsychological deficits in primary and secondary progressive multiple sclerosis . J Neurol2000; 247: 97-101 .
29.
Vleugels L , Lafosse C , van Nunen A , Nachtergaele S , Ketelaer P , Charlier Met al.Visuoperceptual impairment in multiple sclerosis patients diagnosed with neuropsychological tasks . Mult Scler2000; 6: 241-254 .
30.
Kujala P , Portin R , Ruutiainen J.The progress of cognitive decline in multiple sclerosis. A controlled 3- year follow-up . Brain1997; 120 (Pt 2): 289-297 .
31.
Smith A.The Symbol Digit Modalities Test manual. Los Angeles: Western Psychological Services , 1982.
32.
Filley CM , Heaton RK , Nelson LM , Burks JS , Franklin GM.A comparison of dementia in Alzheimer’s disease and multiple sclerosis . Arch Neurol1989; 46: 157-161 .
33.
Comi G , Filippi M , Martinelli V , Campi A , Rodegher M , Alberoni Met al.Brain MRI correlates of cognitive impairment in primary and secondary progressive multiple sclerosis . J Neurol Sci1995; 132: 222-227 .
