Contributions
Abstract: P1114
Type: Poster
Abstract Category: Pathology and pathogenesis of MS - Neuropsychology
Background: Cognitive impairment is observed in more than half of patients with Multiple Sclerosis and recent studies suggest that cognitive deficits are detectable as early as the first neurological event. Characterizing cognitive profiles could identify patients who would benefit from rehabilitation and prevention strategies at the earliest phases of the disease.
Objective: To investigate cognitive profiles among patients within 6 months of the first neurological event.
Methods: We included 132 patients after a first clinical event. From these, 110 patients were diagnosed with Clinically Isolated Syndrome (CIS), average age 32.6 years (SD=8.6), 65% females, and 22 patients were diagnosed with Relapsing Remitting Multiple Sclerosis (RRMS), average age 32.7 years (SD=10.1), 73% females, according to the 2010 McDonald criteria. Primary outcome measures were scores of the Brief Repeatable Battery of Neuropsychological Tests (BRB-N) normalized for age and education to the German population. Z-scores between patients with CIS and RRMS were compared with t-tests. We performed a within-groups linkage cluster analysis for the entire cohort to detect distinct cognitive profile clusters.
Results: There was no difference between RRMS and CIS patients" performance on any of the cognitive domains. We identified three meaningful cognitive profile clusters. Clusters did not differentiate RRMS from CIS patients. Cluster 1 (N=97) performed average or slightly above average on all cognitive domains (BRB-N total z-score = 0.846). Cluster 2 (N=22) performed significantly lower on concentration and attention (BRB-N concentration/attention z-score = -1.442) but had normal performance on the remaining cognitive domains, and a total BRB-N z-score = -0.255. Cluster 3 (N=12) performed below average on all cognitive domains, and their BRB-N total z-score =-0.898.
Conclusion: Cognitive performance at the first neurological event does not differ between patients diagnosed with CIS and RRMS, but distinct cognitive profiles delineate three patient groups. The majority of patients (74%) perform slightly above average on all cognitive domains. A small group (17%) perform below average only on tests of concentration and attention. Another small group (9%) perform worse than average on all cognitive domains. Further work should address how these different profiles relate to neuroimaging findings and disease progression.
Disclosure: This work was supported by Deutsche Forschungsgemeinschaft (DFG Exc 257 to FP and VSC) and Bundesministerium für Bildung und Forschung (Competence Network Multiple Sclerosis) to JB, FP, KR.
All authors report no conflicts of interest for this work.
VSC has nothing to disclose. EF has nothing to disclose. JB has nothing to disclose. JBS, SP, CF, MS report no potential conflicts of interest. KR has received research support from Novartis, speaking fees and travel grants from Guthy Jackson Charitable Foundation, Bayer, Biogen, Merck Serono, Sanofi/Genzyme, Teva, Roche, and Novartis. AUB reports grants, speaker honoraria or consulting fees from Novartis, Biogen, Teva, Bayer, Nexus and Motognosis outside the submitted work. FP reports travel funding, speaker honoraria or research support from Bayer, Novartis, Biogen Idec, Teva, Sanofi-Aventis/Genzyme, and Merck Serono outside the submitted work.
Abstract: P1114
Type: Poster
Abstract Category: Pathology and pathogenesis of MS - Neuropsychology
Background: Cognitive impairment is observed in more than half of patients with Multiple Sclerosis and recent studies suggest that cognitive deficits are detectable as early as the first neurological event. Characterizing cognitive profiles could identify patients who would benefit from rehabilitation and prevention strategies at the earliest phases of the disease.
Objective: To investigate cognitive profiles among patients within 6 months of the first neurological event.
Methods: We included 132 patients after a first clinical event. From these, 110 patients were diagnosed with Clinically Isolated Syndrome (CIS), average age 32.6 years (SD=8.6), 65% females, and 22 patients were diagnosed with Relapsing Remitting Multiple Sclerosis (RRMS), average age 32.7 years (SD=10.1), 73% females, according to the 2010 McDonald criteria. Primary outcome measures were scores of the Brief Repeatable Battery of Neuropsychological Tests (BRB-N) normalized for age and education to the German population. Z-scores between patients with CIS and RRMS were compared with t-tests. We performed a within-groups linkage cluster analysis for the entire cohort to detect distinct cognitive profile clusters.
Results: There was no difference between RRMS and CIS patients" performance on any of the cognitive domains. We identified three meaningful cognitive profile clusters. Clusters did not differentiate RRMS from CIS patients. Cluster 1 (N=97) performed average or slightly above average on all cognitive domains (BRB-N total z-score = 0.846). Cluster 2 (N=22) performed significantly lower on concentration and attention (BRB-N concentration/attention z-score = -1.442) but had normal performance on the remaining cognitive domains, and a total BRB-N z-score = -0.255. Cluster 3 (N=12) performed below average on all cognitive domains, and their BRB-N total z-score =-0.898.
Conclusion: Cognitive performance at the first neurological event does not differ between patients diagnosed with CIS and RRMS, but distinct cognitive profiles delineate three patient groups. The majority of patients (74%) perform slightly above average on all cognitive domains. A small group (17%) perform below average only on tests of concentration and attention. Another small group (9%) perform worse than average on all cognitive domains. Further work should address how these different profiles relate to neuroimaging findings and disease progression.
Disclosure: This work was supported by Deutsche Forschungsgemeinschaft (DFG Exc 257 to FP and VSC) and Bundesministerium für Bildung und Forschung (Competence Network Multiple Sclerosis) to JB, FP, KR.
All authors report no conflicts of interest for this work.
VSC has nothing to disclose. EF has nothing to disclose. JB has nothing to disclose. JBS, SP, CF, MS report no potential conflicts of interest. KR has received research support from Novartis, speaking fees and travel grants from Guthy Jackson Charitable Foundation, Bayer, Biogen, Merck Serono, Sanofi/Genzyme, Teva, Roche, and Novartis. AUB reports grants, speaker honoraria or consulting fees from Novartis, Biogen, Teva, Bayer, Nexus and Motognosis outside the submitted work. FP reports travel funding, speaker honoraria or research support from Bayer, Novartis, Biogen Idec, Teva, Sanofi-Aventis/Genzyme, and Merck Serono outside the submitted work.