Contributions
Abstract: P526
Type: Poster Sessions
Abstract Category: Pathology and pathogenesis of MS - Neuropsychology
Cognitive dysfunction(CD) in multiple sclerosis(MS) is one of the most disabling symptoms, affecting 30-65% of patients. Most commonly affected cognitive domains are memory, attention and processing speed. The protective effect of cognitive reserve(CR) has been demonstrated. We aim to analyze the prevalence of CD and the domain impairment in a Spanish MS cohort. Besides, we examine the effect of CR, mood disorders, fatigue, psychiatric drugs, demographic and clinical variables on cognitive performance(CP).
We enrolled health controls and MS patients over 24 years old diagnosed according to the McDonald-criteria 2010, matched by age, gender and years of education. We used Rao abbreviated Neuropsychological battery to analyze the prevalence of CD; educational level, years of education(YE), profession, vocabulary knowledge and leisure activities to evaluate CR; and validated questionnaires for demographic variables, clinical forms of MS, EDSS, fatigue, anxiety and depression.
We included 82 patients(73.2% women) with a mean age of 40.93 years and 14.32 YE and 74 controls(68.9% women) with a mean age of 43.55 years and 14.57 YE. The prevalence of CD in MS patients was 29.27%. There was a significant difference between MS patients with and without CD in all cognitive domains. In MS patients with CD, verbal memory was affected in 50%, visuospatial skills in 54.2%, verbal fluency in 70.8% and processing speed in 66.7%.
In univariate analyses, YE(p< 0.001), vocabulary knowledge(p=0.016), profession(p=0.016) and educational level(p=0.016) were associated with better CP. On the contrary, age(p=0.004), physical functioning(p=0.018), cognitive functioning(p=0.036), psychosocial functioning(p=0.036), fatigue(p=0.014), EDSS(p=0.001), male gender(p=0,012) and use of psychiatric drugs(p< 0.001) were associated with worse CP.
Multivariate logistical regression model showed that age(p=0.026), EDSS(p=0.030) and male gender(p=0.006) were independent risk factors of CD in MS, and that YE(p=0.042) and vocabulary knowledge(p=0.014) were independent protective factors of CD in MS.
We confirm a similar prevalence of CD in our MS cohort as previously described in the literature. Verbal fluency and processing speed were the most affected cognitive domains. We demonstrate age, male gender and disability as potentials risk factors for CD in MS. Meanwhile, we confirm a protective value of CR(measured by YE and vocabulary knowledge) in the onset of CD in MS.
Disclosure: N Cerdá Fuertes: nothing to disclose
L Lebrato Hernández: nothing to disclose
M Prieto León: nothing to disclose
JL Casado Chocan: nothing to disclose
AJ Uclés Sánchez: nothing to disclose
M Díaz Sánchez: nothing to disclose
Abstract: P526
Type: Poster Sessions
Abstract Category: Pathology and pathogenesis of MS - Neuropsychology
Cognitive dysfunction(CD) in multiple sclerosis(MS) is one of the most disabling symptoms, affecting 30-65% of patients. Most commonly affected cognitive domains are memory, attention and processing speed. The protective effect of cognitive reserve(CR) has been demonstrated. We aim to analyze the prevalence of CD and the domain impairment in a Spanish MS cohort. Besides, we examine the effect of CR, mood disorders, fatigue, psychiatric drugs, demographic and clinical variables on cognitive performance(CP).
We enrolled health controls and MS patients over 24 years old diagnosed according to the McDonald-criteria 2010, matched by age, gender and years of education. We used Rao abbreviated Neuropsychological battery to analyze the prevalence of CD; educational level, years of education(YE), profession, vocabulary knowledge and leisure activities to evaluate CR; and validated questionnaires for demographic variables, clinical forms of MS, EDSS, fatigue, anxiety and depression.
We included 82 patients(73.2% women) with a mean age of 40.93 years and 14.32 YE and 74 controls(68.9% women) with a mean age of 43.55 years and 14.57 YE. The prevalence of CD in MS patients was 29.27%. There was a significant difference between MS patients with and without CD in all cognitive domains. In MS patients with CD, verbal memory was affected in 50%, visuospatial skills in 54.2%, verbal fluency in 70.8% and processing speed in 66.7%.
In univariate analyses, YE(p< 0.001), vocabulary knowledge(p=0.016), profession(p=0.016) and educational level(p=0.016) were associated with better CP. On the contrary, age(p=0.004), physical functioning(p=0.018), cognitive functioning(p=0.036), psychosocial functioning(p=0.036), fatigue(p=0.014), EDSS(p=0.001), male gender(p=0,012) and use of psychiatric drugs(p< 0.001) were associated with worse CP.
Multivariate logistical regression model showed that age(p=0.026), EDSS(p=0.030) and male gender(p=0.006) were independent risk factors of CD in MS, and that YE(p=0.042) and vocabulary knowledge(p=0.014) were independent protective factors of CD in MS.
We confirm a similar prevalence of CD in our MS cohort as previously described in the literature. Verbal fluency and processing speed were the most affected cognitive domains. We demonstrate age, male gender and disability as potentials risk factors for CD in MS. Meanwhile, we confirm a protective value of CR(measured by YE and vocabulary knowledge) in the onset of CD in MS.
Disclosure: N Cerdá Fuertes: nothing to disclose
L Lebrato Hernández: nothing to disclose
M Prieto León: nothing to disclose
JL Casado Chocan: nothing to disclose
AJ Uclés Sánchez: nothing to disclose
M Díaz Sánchez: nothing to disclose