Cognitive impairment in patients with clinically isolated syndrome

Anhoque, Carolina Fiorin; Biccas Neto, Laurentino; Domingues, Simone Cristina Aires; Teixeira, Antônio Lúcio; Domingues, Renan Barros

doi:10.1590/S1980-57642012DN06040011

ABSTRACT

Cognitive abnormalities have been extensively studied in Multiple Sclerosis (MS). However, little is known about the cognitive involvement in patients with Clinically Isolated Syndrome (CIS).

Objective:

This study aimed to investigate cognitive impairment in patients with CIS compared with healthy subjects.

Methods:

18 CIS patients and 18 controls were subjected to the Wechsler memory scale, Rey Auditory Verbal Learning, Rey Complex Figure, Paced Auditory Serial Addition, Digit Span, verbal fluency, Stroop color card test, D2, and Digit Symbol tests.

Results:

CIS patients had significantly worse performance on the Paced Auditory Serial Addition Test (PASAT) 2 seconds (P=0.009) and on verbal fluency tests (P=0.0038) than controls.

Conclusion:

CIS patients had worse cognitive performance than controls on neuropsychological tests evaluating executive functioning.

Key words:
cognition; clinically isolated syndrome; neuropsychological tests

RESUMO.

As alterações cognitivas na Esclerose Múltipla (EM) têm sido bastante estudadas. No entanto, ainda são poucos os estudos acerca do comprometimento cognitivo em pacientes com Síndrome Clinicamente Isolada (SCI).

Objetivo:

O objetivo deste estudo foi o de investigar funções cognitivas em pacientes com SCI em relação a um grupo controle.

Métodos:

Dezoito pacientes com SCI e 18 controles saudáveis foram submetidos à avaliação neuropsicológica, incluindo os seguintes testes: Escala Wechsler de Memória, "Rey Auditory Verbal Learning Test", Figura Complexa de Rey, "Paced Auditory Serial Addition (PASAT) 2 e 3 segundos, "Digit Span", fluência verbal, teste de Stroop, D2 e "Digit Symbol Test".

Resultados:

Pacientes com SCI tiveram desempenho significativamente inferior nos testes PASAT 2 segundos (P=0.009) e fluência verbal (P=0.0038) quando comparados ao grupo controle.

Conclusão:

Pacientes com síndrome clinicamente isolada apresentaram pior desempenho cognitivo em testes relacionados a funções executivas.

Palavras-chave:
cognição; síndrome clínica isolada; testes neuropsicológicos

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REFERENCES

Tintoré M, Rovira A, Rio J, et al. Is optic neuritis more benign than other first attacks in multiple sclerosis? Ann Neurol 2005;57:210-215.
Simioni S, Ruffieux C, Bruggimann L, Annoni JM, Schluep M. Cognition, mood and fatigue in patients in the early stage of multiple sclerosis. Swiss Med Wkly 2007;137:496-501.
Feinstein A, Kartsounis LD, Miller DH, Youl BD, Ron MA. Clinically isolate lesions of the type seen in multiple sclerosis: a cognitive, psychiatric and MRI follow up study. J Neurol Neurosurg Psychiatry 1992;55:869-876.
Achiron A, Barak Y. Cognitive changes in early MS: A call for a common framework. J Neurol Sci 2006;245:47-51.
De Stefano N, Narayanan S, Francis GS, Arnaoutelis R, Tartaglia MC, Antel JP. Evidence of axonal damage in the early stages of multiple sclerosis and its relevance to disability. Arch Neurol 2001;58:65-70.
Glanz BI, Holland CM, Gauthier SA, et al. Cognitive dysfunction in patients with clinically isolated syndromes or newly diagnosed multiple sclerosis. Mult Scler 2007;13:1004-1010.
Potagas C, Giogkaraki E, Koutsis G, et al. Cognitive impairment in different MS subtypes and clinically isolated syndromes. J Neurol Sci 2008;267:100-106.
Feuillet L, Reuter F, Audoin B, et al. Early cognitive impairment in patients with clinically isolated syndrome suggestive of multiple sclerosis. Mult Scler 2007;13:124-127.
Anhoque CF, Domingues SCA, Carvalho, T, Teixeira AL, Domingues RB. Anxiety and depressive symptoms in clinically isolated syndrome and multiple sclerosis. Arq Neuropsiquiatr 2011;69:882-886.
Anhoque CF , Domingues SCA , Teixeira AL , Domingues RB. Cognitive impairment in clinically isolated syndrome: A systematic review. Dement Neuropsychol 2010;4:86-90.
Folstein MF, Folstein SE, McHugh PR. Mini-mental state: a practical method for grading the cognitive state of patients for the clinician. J Psychiatric Res 1975;12:189-198.
Polman CH, Reingold SC, Banwell B, et al. Diagnostic Criteria for Multiple Sclerosis: 2010 Revisions to the McDonald Criteria. Ann Neurol 2011;69: 292-302.
Kurtzek JF. Rating neurologic impairment in multiple sclerosis: an expanded disability status scale (EDSS). Neurology 1983;33:1444- 1452.
Amato MP, Zipoli V, Goretti B, et al. Benign multiple sclerosis Cognitive, psychological and social aspects in a clinical cohort. J Neurol 2006; 253:1054-1059.
Summers M, Swanton J, Fernando K, et al. Cognitive impairment in multiple sclerosis can be predicted by imaging early in the disease. J Neurol Neurosurg Psychiatry 2008;79:955-958.
Audoin B, Au Duong MV, Ranjeva JP, et al. Magnetic resonance study of the influence of tissue damage and cortical reorganization on PASAT performance at the earliest stage of multiple sclerosis. Hum Brain Mapp 2005;24:216-228.
Nilsson P, Rorsman I, Larsson EM, Norrving B, Sandberg-Wollheim M. Cognitive dysfunction 24-31 years after isolated optic neuritis. Mult Scler 2008;14:913-918.

Publication Dates

Publication in this collection
Oct-Dec 2012

History

Received
02 Sept 2012
Accepted
03 Nov 2012

This is an open-access article distributed under the terms of the Creative Commons Attribution License

[1] Tintoré M, Rovira A, Rio J, et al. Is optic neuritis more benign than other first attacks in multiple sclerosis? Ann Neurol 2005;57:210-215.

[2] Simioni S, Ruffieux C, Bruggimann L, Annoni JM, Schluep M. Cognition, mood and fatigue in patients in the early stage of multiple sclerosis. Swiss Med Wkly 2007;137:496-501.

[3] Feinstein A, Kartsounis LD, Miller DH, Youl BD, Ron MA. Clinically isolate lesions of the type seen in multiple sclerosis: a cognitive, psychiatric and MRI follow up study. J Neurol Neurosurg Psychiatry 1992;55:869-876.

[4] Achiron A, Barak Y. Cognitive changes in early MS: A call for a common framework. J Neurol Sci 2006;245:47-51.

[5] De Stefano N, Narayanan S, Francis GS, Arnaoutelis R, Tartaglia MC, Antel JP. Evidence of axonal damage in the early stages of multiple sclerosis and its relevance to disability. Arch Neurol 2001;58:65-70.

[6] Glanz BI, Holland CM, Gauthier SA, et al. Cognitive dysfunction in patients with clinically isolated syndromes or newly diagnosed multiple sclerosis. Mult Scler 2007;13:1004-1010.

[7] Potagas C, Giogkaraki E, Koutsis G, et al. Cognitive impairment in different MS subtypes and clinically isolated syndromes. J Neurol Sci 2008;267:100-106.

[8] Feuillet L, Reuter F, Audoin B, et al. Early cognitive impairment in patients with clinically isolated syndrome suggestive of multiple sclerosis. Mult Scler 2007;13:124-127.

[9] Anhoque CF, Domingues SCA, Carvalho, T, Teixeira AL, Domingues RB. Anxiety and depressive symptoms in clinically isolated syndrome and multiple sclerosis. Arq Neuropsiquiatr 2011;69:882-886.

[10] Anhoque CF , Domingues SCA , Teixeira AL , Domingues RB. Cognitive impairment in clinically isolated syndrome: A systematic review. Dement Neuropsychol 2010;4:86-90.

[11] Folstein MF, Folstein SE, McHugh PR. Mini-mental state: a practical method for grading the cognitive state of patients for the clinician. J Psychiatric Res 1975;12:189-198.

[12] Polman CH, Reingold SC, Banwell B, et al. Diagnostic Criteria for Multiple Sclerosis: 2010 Revisions to the McDonald Criteria. Ann Neurol 2011;69: 292-302.

[13] Kurtzek JF. Rating neurologic impairment in multiple sclerosis: an expanded disability status scale (EDSS). Neurology 1983;33:1444- 1452.

[14] Amato MP, Zipoli V, Goretti B, et al. Benign multiple sclerosis Cognitive, psychological and social aspects in a clinical cohort. J Neurol 2006; 253:1054-1059.

[15] Summers M, Swanton J, Fernando K, et al. Cognitive impairment in multiple sclerosis can be predicted by imaging early in the disease. J Neurol Neurosurg Psychiatry 2008;79:955-958.

[16] Audoin B, Au Duong MV, Ranjeva JP, et al. Magnetic resonance study of the influence of tissue damage and cortical reorganization on PASAT performance at the earliest stage of multiple sclerosis. Hum Brain Mapp 2005;24:216-228.

[17] Nilsson P, Rorsman I, Larsson EM, Norrving B, Sandberg-Wollheim M. Cognitive dysfunction 24-31 years after isolated optic neuritis. Mult Scler 2008;14:913-918.

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