While there is evidence of differences in the disease characteristics of multiple sclerosis (MS) across ethnic and racial groups, there has been limited research on cognitive functioning.
OBJECTIVE:
To explore potential differences among Caucasian (CA), African-American (AA), and Hispanic (HA) adults from a clinical sample on the Minimal Assessment of Cognitive Function in MS (MACFIMS).
METHODS:
A total of 245 age- and disease duration-matched individuals (194 CA, 23 AA, and 28 HA) were included in the analyses. Their rates of impairment, using the criterion of two standard deviations (SD) below the normative mean, on the MACFIMS were compared using chi-square analyses with post-hoc pairwise comparisons (Bonferroni adjusted).
RESULTS:
Compared to CA, AA had higher rates of impairment on measures of complex attention (p < 0.001) and executive functions (p < 0.001).
CONCLUSIONS:
These findings raise questions of whether the observed differences reflect the more aggressive disease course noted among AA or are due to discrepancies in performance on neuropsychological assessment that is associated with race/ethnicity in the general population. Future directions and implications are discussed.
Al-Kawaz,M., Monohan,E., Morris,E., Perumal,J. S., Nealon,N., Vartanian,T., & Gauthier,S. A. (2017). Differential Impact of Multiple Sclerosis on Cortical and Deep Gray Matter Structures in African Americans and Caucasian Americans. Journal of Neuroimaging, 27(3), 333–338.
2.
Benedict,R. H. B., Fischer,J. S., Archibald,C. J., Arnett,P. A., Beatty,W. W., Bobholz,J., & Munschauer,F. (2002). Minimal neuropsychological assessment of MS patients: A consensus approach. The Clinical Neuropsychologist, 16, 381–397.
3.
Cree,B., & Waubant,E. (2010). Does race matter for multiple sclerosis?Neurology, 74(7), 532–533.
4.
Diehr,M. C., Heaton,R. K., Miller,W., & Grant,I. (1998). The Paced Auditory Serial Addition Task (PASAT): Norms for age, education, and ethnicity. Assessment, 5(4), 375–387.
5.
Do,C. B., & Batzoglou,S. (2008). What is the expectation maximization algorithm?Nature Biotechnology, 26(8), 897.
6.
Hadjixenofontos,A., Beecham,A. H., Manrique,C. P., Pericak-Vance,M. A.,Tornes,L., Ortega,M., & Delgado,S. R. (2015). Clinical expression of multiple sclerosis in Hispanic whites of primarily Caribbean ancestry. Neuroepidemiology, 44(4), 262–268.
7.
International Federation of Multiple Sclerosis Societies. (1985). M.R.D. Minimal record of disability of multiple sclerosis. New York, NY: National Multiple Sclerosis Society.
8.
Khan,O., Williams,M. J., Amezcua,L., Javed,A., Larsen,K. E., & Smrtka,J. M. (2015). Multiple sclerosis in US minority populations Clinical practice insights. Neurology: Clinical Practice, 5(2), 132–142.
9.
Koffman,J., Gao,W., Goddard,C., Burman,R., Jackson,D., Shaw,P., & Higginson,I. J. (2013). Progression, symptoms and psychosocial concerns among those severely affected by multiple sclerosis: A mixed-methods cross-sectional study of black Caribbean and white British people. PloS one, 8(10), e75431.
10.
Marrie,R. A. (2010). Cognitive test results in pediatric MS What do racial disparities tell us?Neurology, 75(23), 2054–2055.
11.
Marrie,R. A., Cutter,G., Tyry,T., Vollmer,T., & Campagnolo,D. (2006). Does multiple sclerosis–associated disability differ between races?Neurology, 66(8), 1235–1240.
12.
Mungas,D., Reed,B. R., Farias,S. T., & DeCarli,C. (2009). Age and education effects on relationships of cognitive test scores with brain structure in demographically diverse older persons. Psychology and Aging, 24(1), 116.
13.
Norman,M. A., Moore,D. J., Taylor,M., FranklinJr, D., Cysique,L., Ake,C.,... & Group,H. (2011). Demographically corrected norms for African Americans and Caucasians on the hopkins verbal learning test–revised, brief visuospatial memory test–revised, stroop color and word test, and wisconsin card sorting test 64-card version. Journal of Clinical and Experimental Neuropsychology, 33(7), 793–804.
14.
Parmenter,B. A., Testa,S. M., Schretlen,D. J., Weinstock-Guttman,B. & Benedict,R. H. (2010). The utility of regression-based norms in interpreting the minimal assessment of cognitive function in multiple sclerosis (MACFIMS). Journal of the International Neuropsychological Society, 16(1), 6–16.
15.
Rahn,K., Slusher,B., & Kaplin,A. (2012). Cognitive impairment in multiple sclerosis: A forgotten disability remembered. Paper presented at the Cerebrum: The Dana forum on brain science.
16.
Ross,K., Schwebel,D., Rinker,J., Ness,J., & Ackerson,J. (2010). Neurocognitive sequelae in African American and Caucasian children with multiple sclerosis. Neurology, 75(23), 2097–2102.
17.
Rosti,E., Hämäläinen,P., Koivisto,K., & Hokkanen,L. (2007). PASAT in detecting cognitive impairment in relapsing-remitting MS. Applied Neuropsychology, 14(2), 101–112.
18.
Ventura,R. E., Antezana,A. O., Bacon,T., & Kister,I. (2017). Hispanic Americans and African Americans with multiple sclerosis have more severe disease course than Caucasian Americans. Multiple Sclerosis Journal, 23(11), 1554–1557.
19.
Wallin,M. T., Wilken,J. A., & Kane,R. (2006). Cognitive dysfunction in multiple sclerosis: Assessment, imaging, and risk factors. Journal of Rehabilitation Research and Development, 43(1), 63.
20.
Wechsler,D. (2001). WTAR manual. San Antonio, TX: The Psychological Corporation.
21.
Weinstock-Guttman,B., Jacobs,L., Brownscheidle,C., Baier,M., Rea,D., Apatoff,B.,... & Goodman,A. (2003). Multiple sclerosis characteristics in African American patients in the New York State Multiple Sclerosis Consortium. Multiple Sclerosis Journal, 9(3), 293–298.
22.
Weinstock-Guttman,B., Ramanathan,M., Hashmi,K., Abdelrahman,N., Hojnacki,D., Dwyer,M.,... & Zivadinov,R. (2010). Increased tissue damage and lesion volumes in African Americans with multiple sclerosis. Neurology, 74(7), 538–544.
