Contributions
Abstract: P771
Type: Poster
Abstract Category: Therapy - disease modifying - 30 Tools for detecting therapeutic response
Background: Cognitive dysfunction is considered one of the most important non-motor deficits of MS representing an essential predictive factor for MS-associated the quality of life (QoL) and disease progression.
Objective: Baseline analysis of cognitive profiles of RRMS patients starting therapy with dimethylfumarate (DMF, deNovo) or switching from other MS medications (switchers) with respect to the following questions:
1) Which areas define differences in the cognitive profile of RRMS patients and healthy controls?
2) Does cognitive profile distinguish between deNovo and switchers?
3) Which are the vulnerable domains affected by the MS disease process?
Methods: Baseline analysis of a prospective, non-interventional, multicenter (15 German practices) study of 24 months with assessments at baseline/T0 and after 6,12 and 24 months follow-up (T6, T12, T24).
Inclusion: 18-60 yr, RRMS/Mc Donald, EDSS: 0,0-6,0.
Groups: 210 RRMS patients compared to 129 healthy controls, among the latter 136 switchers and 74 deNovo patients.
Assessments: clinical status (EDSS, ambulation index, functional status), behavioral (CGI, fatigue/FSS/FSMC, daytime sleepiness/ESS, self-rated attention/FEDA, depression/BDI, QoL/EQ5D) and cognitive domains (executive function, i.e.verbal and non-verbal fluency/RWT,RFFT, interference control/Stroop; working memory/WMSr-BS/ZS, information processing/SDMT, learning & memory (non-verbal/BVMT and verbal/CVLT domains).
Results:
1) When comparing the RRMS group vs. controls, significant cognitive impairment was shown among the patients in the domains of information processing (SDMT: p< .0001), executive function as represented by verbal fluency (RWT, lexical (p< .01) and semantic category change (p < .0001) and design fluency (RFFT: p< .0001), as well as verbal working memory (WMS-ZS:p< .007).
2) Subgroup analysis showed significant deficits for switchers concerning information processing (SDMT: p< .0001) and verbal (RWT, semantic category change p< .01) as well as design fluency (RFFT: p< .003).
Conclusion:
1) Data provide evidence that the MS disease process primarily affects information processing speed, executive function, fluency and verbal working memory which have to be considered as vulnerable cognitive domains due to a network insufficieny.
2) Switchers are more affected by information processing and working memory deficits suggesting that these areas may be particulary vulnerable in case of medication failure and longer disease duration.
Disclosure:
MS & ER have nothing to declare;
HS, ML: Research grants from Bayer, Biogen and Teva. Honoraria (speaker fees, symposia, adboards) and travel grants from Almiall, Biogen, Genzyme, Merck, Novartis and Teva.
AB: resarch grants from Novartis, Biogen, Genzyme,
KOS, JF, UK, ES, SG, GR, WH, ES, MP, SSP, SS, JK, BE, WE: received travel grants, speakers` honoraria from Almirall, Bayer, Biogen, Genzyme, Merck, Novartis, Roche & Teva
Abstract: P771
Type: Poster
Abstract Category: Therapy - disease modifying - 30 Tools for detecting therapeutic response
Background: Cognitive dysfunction is considered one of the most important non-motor deficits of MS representing an essential predictive factor for MS-associated the quality of life (QoL) and disease progression.
Objective: Baseline analysis of cognitive profiles of RRMS patients starting therapy with dimethylfumarate (DMF, deNovo) or switching from other MS medications (switchers) with respect to the following questions:
1) Which areas define differences in the cognitive profile of RRMS patients and healthy controls?
2) Does cognitive profile distinguish between deNovo and switchers?
3) Which are the vulnerable domains affected by the MS disease process?
Methods: Baseline analysis of a prospective, non-interventional, multicenter (15 German practices) study of 24 months with assessments at baseline/T0 and after 6,12 and 24 months follow-up (T6, T12, T24).
Inclusion: 18-60 yr, RRMS/Mc Donald, EDSS: 0,0-6,0.
Groups: 210 RRMS patients compared to 129 healthy controls, among the latter 136 switchers and 74 deNovo patients.
Assessments: clinical status (EDSS, ambulation index, functional status), behavioral (CGI, fatigue/FSS/FSMC, daytime sleepiness/ESS, self-rated attention/FEDA, depression/BDI, QoL/EQ5D) and cognitive domains (executive function, i.e.verbal and non-verbal fluency/RWT,RFFT, interference control/Stroop; working memory/WMSr-BS/ZS, information processing/SDMT, learning & memory (non-verbal/BVMT and verbal/CVLT domains).
Results:
1) When comparing the RRMS group vs. controls, significant cognitive impairment was shown among the patients in the domains of information processing (SDMT: p< .0001), executive function as represented by verbal fluency (RWT, lexical (p< .01) and semantic category change (p < .0001) and design fluency (RFFT: p< .0001), as well as verbal working memory (WMS-ZS:p< .007).
2) Subgroup analysis showed significant deficits for switchers concerning information processing (SDMT: p< .0001) and verbal (RWT, semantic category change p< .01) as well as design fluency (RFFT: p< .003).
Conclusion:
1) Data provide evidence that the MS disease process primarily affects information processing speed, executive function, fluency and verbal working memory which have to be considered as vulnerable cognitive domains due to a network insufficieny.
2) Switchers are more affected by information processing and working memory deficits suggesting that these areas may be particulary vulnerable in case of medication failure and longer disease duration.
Disclosure:
MS & ER have nothing to declare;
HS, ML: Research grants from Bayer, Biogen and Teva. Honoraria (speaker fees, symposia, adboards) and travel grants from Almiall, Biogen, Genzyme, Merck, Novartis and Teva.
AB: resarch grants from Novartis, Biogen, Genzyme,
KOS, JF, UK, ES, SG, GR, WH, ES, MP, SSP, SS, JK, BE, WE: received travel grants, speakers` honoraria from Almirall, Bayer, Biogen, Genzyme, Merck, Novartis, Roche & Teva