Contributions
Abstract: P361
Type: Poster
Abstract Category: Clinical aspects of MS - 7 MS symptoms
Background: Cognitive impairment (CI) is common, and an important determinant of quality of life in multiple sclerosis (MS). Perceived cognitive function does not always correlate with objective neuropsychological measurements: this can lead to inaccurate assumptions when estimating CI in the MS clinic.
Global perceptions of cognitive function are persistently unrelated to objective measurements, but whether the discrepancy exists in self-reported performances of specific cognitive domains remains unclear.
The Perceived Deficits Questionnaire (PDQ) is a 20 item self-reported questionnaire testing four cognitive domains affected in MS: attention, planning, retrospective and prospective memory. The Brief International Cognitive Assessment in MS (BICAMS), composed of the Symbol Digit Modalities test (SDMT), the California Verbal Learning Test (CVLT-2), and the Brief Visuospatial Memory test (BVMT-R), is a neuropsychological battery which is sensitive and specific for detecting CI in MS.
Aim: To compare objective measurements of cognition using BICAMS with self-reported cognition assessed by PDQ.
Methods: 63 people with MS were cognitively assessed using BICAMS and also completed the PDQ. Symptoms of anxiety, depression and fatigue were analysed with the Hospital Anxiety and Depression Scale (HADS) and the Fatigue Severity Scale (FSS).
Results: 42/63 (67%) patients were female, mean age 39 (range 18 - 64) and mean years of education 15 (range 10 - 20). Median EDSS was 1.0 (range 0 - 7). Correlational analyses were used to assess the relationship between subjective concerns and objective cognitive measurements. Additional correlations were performed to assess the relationship with factors thought to confound subjective or objective cognitive performance (fatigue, anxiety and depression).
No significant correlation was seen between any domain of subjective cognition and SDMT, CVLT-2 or BVMT-R (BICAMS). There was a strong correlation between anxiety (r=0.63), depression (r=0.58) and fatigue (r=0.7) with PDQ score, but no correlation with objective measures.
Conclusions: Objective measurements of cognition were not associated with subjective perceptions of cognitive performance in this cohort. Subjective cognitive complaints were highly influenced by fatigue, anxiety and depression.This study supports the need for objective screening of CI in the MS clinic, not self-reported performance. BICAMS is an appropriate screening tool for use in the clinical setting.
Disclosure:
N McNicholas has received a Newman fellowship sponsored by Biogen.
SM Yap has received a Newman fellowship sponsored by Novartis.
N Tubridy has received, on behalf of the Department of Neurology, St Vincent's University Hospital, educational and research grants from Novartis, Biogen, Teva and Bayer.
M Hutchinson has received speaker's honoraria from Biogen, Bayer-Schering, Merck Serono and Novartis and receives research grants from Dystonia Ireland, the Health Research Board of Ireland (CSA-2012/5) and the Irish Institute of Clinical Neuroscience.
C McGuigan has received honoraria, participated in advisory boards and/or received research funding from Biogen, Merck Serono, Novartis, Roche, Genzyme and Bayer.
Abstract: P361
Type: Poster
Abstract Category: Clinical aspects of MS - 7 MS symptoms
Background: Cognitive impairment (CI) is common, and an important determinant of quality of life in multiple sclerosis (MS). Perceived cognitive function does not always correlate with objective neuropsychological measurements: this can lead to inaccurate assumptions when estimating CI in the MS clinic.
Global perceptions of cognitive function are persistently unrelated to objective measurements, but whether the discrepancy exists in self-reported performances of specific cognitive domains remains unclear.
The Perceived Deficits Questionnaire (PDQ) is a 20 item self-reported questionnaire testing four cognitive domains affected in MS: attention, planning, retrospective and prospective memory. The Brief International Cognitive Assessment in MS (BICAMS), composed of the Symbol Digit Modalities test (SDMT), the California Verbal Learning Test (CVLT-2), and the Brief Visuospatial Memory test (BVMT-R), is a neuropsychological battery which is sensitive and specific for detecting CI in MS.
Aim: To compare objective measurements of cognition using BICAMS with self-reported cognition assessed by PDQ.
Methods: 63 people with MS were cognitively assessed using BICAMS and also completed the PDQ. Symptoms of anxiety, depression and fatigue were analysed with the Hospital Anxiety and Depression Scale (HADS) and the Fatigue Severity Scale (FSS).
Results: 42/63 (67%) patients were female, mean age 39 (range 18 - 64) and mean years of education 15 (range 10 - 20). Median EDSS was 1.0 (range 0 - 7). Correlational analyses were used to assess the relationship between subjective concerns and objective cognitive measurements. Additional correlations were performed to assess the relationship with factors thought to confound subjective or objective cognitive performance (fatigue, anxiety and depression).
No significant correlation was seen between any domain of subjective cognition and SDMT, CVLT-2 or BVMT-R (BICAMS). There was a strong correlation between anxiety (r=0.63), depression (r=0.58) and fatigue (r=0.7) with PDQ score, but no correlation with objective measures.
Conclusions: Objective measurements of cognition were not associated with subjective perceptions of cognitive performance in this cohort. Subjective cognitive complaints were highly influenced by fatigue, anxiety and depression.This study supports the need for objective screening of CI in the MS clinic, not self-reported performance. BICAMS is an appropriate screening tool for use in the clinical setting.
Disclosure:
N McNicholas has received a Newman fellowship sponsored by Biogen.
SM Yap has received a Newman fellowship sponsored by Novartis.
N Tubridy has received, on behalf of the Department of Neurology, St Vincent's University Hospital, educational and research grants from Novartis, Biogen, Teva and Bayer.
M Hutchinson has received speaker's honoraria from Biogen, Bayer-Schering, Merck Serono and Novartis and receives research grants from Dystonia Ireland, the Health Research Board of Ireland (CSA-2012/5) and the Irish Institute of Clinical Neuroscience.
C McGuigan has received honoraria, participated in advisory boards and/or received research funding from Biogen, Merck Serono, Novartis, Roche, Genzyme and Bayer.