Cognitive impairment in early MS. Time is brain. #MSBlog #MSResearch
Epub: Hankomäki et al. The progress of cognitive decline in newly diagnosed MS patients. Acta Neurol Scand. 2013 Jun 15.
OBJECTIVES: Cognitive impairment occurs in multiple sclerosis already in the early stages of the disease. Less is known about the evolution of cognitive decline, especially in newly diagnosed MSers. The results of existing studies are contradictory in that both cognitive preservation and progressive deterioration have been reported. The purpose of this study was to examine how cognitive impairment evolves over time in the early stages of MS.
MATERIAL AND METHODS: At baseline, the participants were 36 newly diagnosed MSers and 37 controls. A group of 30 MSers were followed longitudinally at a mean test-retest interval of 6.1 years. The test battery covered attention, information processing, memory and learning, verbal and motor functions and reasoning.
RESULTS: There was a significant decline in divided attention (dual task) and information-processing speed (SDMT) at follow-up, but no significant deterioration in overall cognitive performance.
CONCLUSIONS: Overall cognitive functioning remained quite stable during the 6-year follow-up, whereas divided attention and processing speed deteriorated. However, deterioration in performance on the SDMT and the dual task does not seem to indicate more extensive cognitive deterioration. Given the impact of cognitive impairment on MSers’ quality of life, early detection of its occurrence in MS is extremely important.
“This small study reiterates that cognitive impairment is there early and that if you institute early treatment you can delay the onset of progressive cognitive impairment. Fortunately Finland does not have a problem with access to DMTs early in the course of the disease and most MSers with CIS get offered treatment. Unlike the UK where you have to have at least 2 clinical attacks or relapses in a 2 year period before accessing first-line treatments. Current Department of Health guidance does not allow us to take into account sub-clinical disease activity on MRI. This is a great pity as we know that this activity is associated with a poor outcome. Time is Brain.”