Contributions
Abstract: P842
Type: Poster Sessions
Abstract Category: Pathology and pathogenesis of MS - Neuropsychology
Introduction: Cognitive impairment is frequent in multiple sclerosis (MS), but its natural history has still to be completely elucidated. This is partly due to the early treatment approach, which is able to modify neurodegeneration and brain volume, likely deflecting the natural trajectory of cognitive decline (1). On this background, the aim of our study is to assess the cognitive performance of MS patients who did not undergo early disease modifying treatment (DMT) and to correlate findings with well-established clinical and imaging prognostic measures collected at disease onset.
Methods: Complete neuropsychological testing (T1) was administered at last follow-up consult (from May 2017) to all MS patients who did not receive DMT over the first five years of disease. Patients were defined as cognitively healthy or impaired. We retrospectively collected clinical (sex, age, type and recovery from first attack, relapse-rate) and MRI white matter lesion load (WMLL) rated < =10 or >10, data at onset.
Results: So far we enrolled 32 patients. Disease duration at NP evaluation was 18,5 years (SD 8,5y). Despite the long disease duration, half patients were cognitively preserved, and half were impaired. We found a statistically significant association between current cognitive state and MRI WMLL at onset < or > 10 (chi-square=4,8; p=0,02) and a trend of association stratifying MRI WMLL < 6; 6-10; >10 (chi-square=4,8; p=0,08). We found a trend of association with CI and older age at onset (>=35year-old, chi-square=3,2 p=0,07). Conversely, we found no other significant association with known prognostic factors evaluated at disease onset.
Conclusions: Our data suggest that WMLL at onset may predict cognitive changes over time in MS patients who underwent delayed or no DMT. Currently, most data support a correlation between MS CI and cortical and deep grey matter atrophy and lesions; however, a recent report reappraised the importance of WMLL at onset as a predictive factor of CI after a 9 year follow up (2). We plan to extend our analysis to a group of early treated patients matched for severity and disease duration. This is particularly relevant since there is no agreement on the protective effect of early DMT on cognitive function in MS. Further perspectives include an increase of our sample size and MRI analysis on grey matter. Finally, the tendency to a higher risk of CI in older patients need to be further explored since there is no robust data in the literature.
Disclosure: no disclosures
Abstract: P842
Type: Poster Sessions
Abstract Category: Pathology and pathogenesis of MS - Neuropsychology
Introduction: Cognitive impairment is frequent in multiple sclerosis (MS), but its natural history has still to be completely elucidated. This is partly due to the early treatment approach, which is able to modify neurodegeneration and brain volume, likely deflecting the natural trajectory of cognitive decline (1). On this background, the aim of our study is to assess the cognitive performance of MS patients who did not undergo early disease modifying treatment (DMT) and to correlate findings with well-established clinical and imaging prognostic measures collected at disease onset.
Methods: Complete neuropsychological testing (T1) was administered at last follow-up consult (from May 2017) to all MS patients who did not receive DMT over the first five years of disease. Patients were defined as cognitively healthy or impaired. We retrospectively collected clinical (sex, age, type and recovery from first attack, relapse-rate) and MRI white matter lesion load (WMLL) rated < =10 or >10, data at onset.
Results: So far we enrolled 32 patients. Disease duration at NP evaluation was 18,5 years (SD 8,5y). Despite the long disease duration, half patients were cognitively preserved, and half were impaired. We found a statistically significant association between current cognitive state and MRI WMLL at onset < or > 10 (chi-square=4,8; p=0,02) and a trend of association stratifying MRI WMLL < 6; 6-10; >10 (chi-square=4,8; p=0,08). We found a trend of association with CI and older age at onset (>=35year-old, chi-square=3,2 p=0,07). Conversely, we found no other significant association with known prognostic factors evaluated at disease onset.
Conclusions: Our data suggest that WMLL at onset may predict cognitive changes over time in MS patients who underwent delayed or no DMT. Currently, most data support a correlation between MS CI and cortical and deep grey matter atrophy and lesions; however, a recent report reappraised the importance of WMLL at onset as a predictive factor of CI after a 9 year follow up (2). We plan to extend our analysis to a group of early treated patients matched for severity and disease duration. This is particularly relevant since there is no agreement on the protective effect of early DMT on cognitive function in MS. Further perspectives include an increase of our sample size and MRI analysis on grey matter. Finally, the tendency to a higher risk of CI in older patients need to be further explored since there is no robust data in the literature.
Disclosure: no disclosures