Isolated cognitive relapses in MS

Research into MS and quality of life:

There are many different presentations of a multiple sclerosis relapse. Cognitive relapses lack a clear operational definition applicable in clinical practice and the relevance of cognitive relapses tends to be overlooked. Transient cognitive impairments have previously been described in association with other symptomatic neurological deficits during MS disease activity.

To date, an isolated cognitive relapse (ICR) has been poorly characterised and an ICR describes a transient reduction in cognitive functioning not associated with other subjective or objective neurological symptomatology.

The researchers in this study investigated the relationship between ICR, subjective evaluation of cognitive performance and long-term cognitive decline in 99 patients with RRMS.
Data was collected from four clinical and cognitive evaluations including a baseline evaluation (t0), and an evaluation six months later, which was performed within two weeks after a routine brain scan positive for at least one area of gadolinium  enhancement (t1) and two gadolinium enhancement-negative follow-up evaluations after six months (t2) and one year (t3) from t1. A meaningful change in cognition was defined as a transient reduction in Symbol Digit Modalities Test (SDMT) score of at least four points at t1 compared with t0 and t2.

The results from this study showed that 17 patients had ICRs, and the ICRs were not associated with subjective changes in mood or fatigue levels or with significant subjective cognitive deficits. Patients with ICR had significantly lower cognitive performance at follow-up evaluations after six and 12 months when compared with ICR free patients.

Authors: Pardini M,  Uccelli A
Source: J Neurol Neurosurg Psychiatry. 2014 Mar 31. doi: 10.1136/jnnp-2013-307275. [Epub ahead of print]
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