Contributions
Abstract: EP1381
Type: ePoster
Abstract Category: Clinical aspects of MS - MS symptoms
Background: The profile of cognitive impairment (CI) in MS is well known. However, it remains unclear under which circumstances and at what time during the disease CI is starting to emerge. First cognitive disturbances have been found even before the definite diagnosis of MS, but clinically relevant CI is a symptom typically to be found at later disease stages. Previously published longitudinal data varied in regard to disease duration at inclusion, time to follow-up, and number of drop-outs. Consequently, the results are heterogeneous. Against this background, the present study compares longitudinal changes in cognition and in MRI in two matched groups of early and late MS over the course of 4.5 years.
Goals: To compare the progression of CI and correlated MRI parameters in early and late stage MS.
Methods: 75 MS-patients were assigned to two groups: earlyMS (disease durations < 2 years, N=25) and lateMS (disease durations >12 years, N=50). Patients were individually matched according to age at disease onset, gender and education. Neuropsychological assessment comprised tests of attention (TAP: Alertness, divided attention, cognitive flexibility) and memory (AVLT; DCS; VLT; NVLT; RCFT). Two corresponding composite scores were computed. MRI was used to assess T1/T2 lesion load, brain volume, hippocampal volume, cortical thickness. After 4.5 years, 60 patients were reassessed using the same protocol.
Results: Cognitive data of 32 patients have been evaluated for both time points (12 earlyMS, 20 lateMS). At the beginning 45% of patients with lateMS were affected by CI compared to none in the group of earlyMS. After 4.5 years these numbers were 50% and 0% respectively. At baseline we found a group effect in attention (T=49.7 vs. T=42.6, p< .01) and memory (T=51.3 vs. T=45.2, p< .01). At the follow-up, the values for attention (T=48.4 vs. T=42.1) and memory (T=52.6 vs. T=47.2) showed no large effects over time (all p>.1). Baseline group difference were also found in all MRI parameters (p< .01). So far, changes in the cortical thickness were evaluated in 51 patients. No changes were found over time (earlyMS: 2.42mm vs. 2.40mm, p=.7; lateMS: 2.30mm vs. 2.30mm, p=.97).
Conclusions: Extensive cognitive deterioration in MS does not happen in the first 6.5 years of MS and not after more than 12 years with MS. A subtle decline in attention may be revealed in larger groups of early MS patients.
Disclosure: This study is supported by: Merck Serono GmbH, Germany, a division of Merck KGaA, Darmstadt, Germany
Köhler, Faiss, Hoffmann, Matzke, Pawlitzki, Sailer, Schwab, Zettl: Received institutional research grants and personal honoraria as speaker from Biogen Idec, Bayer, Genzyme, Merck Serono, Novartis and TEVA Sanofi
Bublak, Fischer, Kunkel, Stadler: nothing to disclose.
Abstract: EP1381
Type: ePoster
Abstract Category: Clinical aspects of MS - MS symptoms
Background: The profile of cognitive impairment (CI) in MS is well known. However, it remains unclear under which circumstances and at what time during the disease CI is starting to emerge. First cognitive disturbances have been found even before the definite diagnosis of MS, but clinically relevant CI is a symptom typically to be found at later disease stages. Previously published longitudinal data varied in regard to disease duration at inclusion, time to follow-up, and number of drop-outs. Consequently, the results are heterogeneous. Against this background, the present study compares longitudinal changes in cognition and in MRI in two matched groups of early and late MS over the course of 4.5 years.
Goals: To compare the progression of CI and correlated MRI parameters in early and late stage MS.
Methods: 75 MS-patients were assigned to two groups: earlyMS (disease durations < 2 years, N=25) and lateMS (disease durations >12 years, N=50). Patients were individually matched according to age at disease onset, gender and education. Neuropsychological assessment comprised tests of attention (TAP: Alertness, divided attention, cognitive flexibility) and memory (AVLT; DCS; VLT; NVLT; RCFT). Two corresponding composite scores were computed. MRI was used to assess T1/T2 lesion load, brain volume, hippocampal volume, cortical thickness. After 4.5 years, 60 patients were reassessed using the same protocol.
Results: Cognitive data of 32 patients have been evaluated for both time points (12 earlyMS, 20 lateMS). At the beginning 45% of patients with lateMS were affected by CI compared to none in the group of earlyMS. After 4.5 years these numbers were 50% and 0% respectively. At baseline we found a group effect in attention (T=49.7 vs. T=42.6, p< .01) and memory (T=51.3 vs. T=45.2, p< .01). At the follow-up, the values for attention (T=48.4 vs. T=42.1) and memory (T=52.6 vs. T=47.2) showed no large effects over time (all p>.1). Baseline group difference were also found in all MRI parameters (p< .01). So far, changes in the cortical thickness were evaluated in 51 patients. No changes were found over time (earlyMS: 2.42mm vs. 2.40mm, p=.7; lateMS: 2.30mm vs. 2.30mm, p=.97).
Conclusions: Extensive cognitive deterioration in MS does not happen in the first 6.5 years of MS and not after more than 12 years with MS. A subtle decline in attention may be revealed in larger groups of early MS patients.
Disclosure: This study is supported by: Merck Serono GmbH, Germany, a division of Merck KGaA, Darmstadt, Germany
Köhler, Faiss, Hoffmann, Matzke, Pawlitzki, Sailer, Schwab, Zettl: Received institutional research grants and personal honoraria as speaker from Biogen Idec, Bayer, Genzyme, Merck Serono, Novartis and TEVA Sanofi
Bublak, Fischer, Kunkel, Stadler: nothing to disclose.