Brain, Vol. 122, No. 7, 1341-1348,
July 1999
© 1999 Oxford University Press
Cognitive function in primary progressive and transitional progressive multiple sclerosis
A controlled study with MRI correlates
1 Department of Clinical Neurology, Institute of Neurology, London, UK, 2 Unitat de Neuroimmunologia Clinica, Hospitals Vall d'Hebron, Barcelona, Spain, 3 Service de Neurologie, Hôpital Pellegrin, Bordeaux, France, 4 Department of Neuroscience, Scientific Institute Ospedale San Raffaeke, Milan, Italy, 5 Servico de Neurologia, Hospital de Santa Maria, Lisbon, Portugal 6 University Hospital, Free University, Amsterdam, Netherlands
Correspondence to:
Dr D. W. Langdon, Department of Clinical Neurology, Institute of Neurology, Queen Square, London WC1N 3BG, UK
The relative rarity of primary progressive (PP) and transitional progressive (TP) multiple sclerosis has meant that little documentation of cognitive function in such patients is currently available. The aim of this study was to investigate the cognitive skills of patients with PP and TP multiple sclerosis relative to matched healthy controls, and to examine the relationship of this impairment to MRI parameters. Sixty-three patients (43 PP, 20 TP) were individually matched with healthy controls, who undertook the same cognitive tasks as the patient group. The neuropsychological assessment comprised Rao's brief repeatable battery, a reasoning test, and a measure of depression. Patients also underwent T1- and T2-weighted brain MRI. These patients were taken from a larger cohort (158 PP, 33 TP) in whom it had been demonstrated that the re were no significant differences between the mean scores of the PP and TP groups on any of the cognitive variables. The 63 patients were therefore taken as one group for comparison with the healthy controls. These patients performed significantly worse than the controls in tests of verbal memory, attention, verbal fluency and spatial reasoning. An impairment index was constructed and applied to the patient data. This correlated modestly with T2-lesion load (r = 0.45, P = 0.01), T1-hypointensity load (r = 0.45, P = 0.01) and cerebral volume (r = –0.35, P = 0.01). Thus, PP and TP multiple sclerosis patients demonstrate significant cognitive dysfunction when compared with matched healthy controls. The relationship between this impairment and MRI parameters is moderate, suggesting that cognitive dysfunction in PP and TP multiple sclerosis has a complex and multifactorial aetiology, which is not adequately explained by pathology as demonstrated on conventional MRI.
multiple sclerosis; primary progressive; transitional progressive; cognitive function; MRI
BRB = Brief Repeatable Battery; EDSS = Expanded Disability Status Scale; MADRS = Montgomery and Asberg Depression Rating Scale; PP = primary progressive; SP = secondary progressive; TP = transitional progressive; VESPAR = Verbal and Spatial Reasoning Test
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|
|
|
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|
|
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|
|
|
|
|
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|
|
|
|
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|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
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|
|
|
|
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|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
 |
|
 A M M Vlaar and D T Wade Verbal fluency assessment of patients with multiple sclerosis: test-retest and inter-observer reliability Clinical Rehabilitation, July 1, 2003; 17(7): 756 - 764. [Abstract] [PDF]
|
|
|
|
|
|
C. Christodoulou, L. B. Krupp, Z. Liang, W. Huang, P. Melville, C. Roque, W. F. Scherl, T. Morgan, W. S. MacAllister, L. Li, et al. Cognitive performance and MR markers of cerebral injury in cognitively impaired MS patients Neurology, June 10, 2003; 60(11): 1793 - 1798. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A M M Vlaar and D T Wade The Adult Memory and Information Processing Battery (AMIPB) test of information-processing speed: a study of its reliability and feasibility in patients with multiple sclerosis Clinical Rehabilitation, April 1, 2003; 17(4): 386 - 393. [Abstract] [PDF]
|
|
|
|
|
|
D. H. Miller, F. Barkhof, J. A. Frank, G. J. M. Parker, and A. J. Thompson Measurement of atrophy in multiple sclerosis: pathological basis, methodological aspects and clinical relevance Brain, August 1, 2002; 125(8): 1676 - 1695. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Bozzali, M. Cercignani, M. P. Sormani, G. Comi, and M. Filippi Quantification of Brain Gray Matter Damage in Different MS Phenotypes by Use of Diffusion Tensor MR Imaging AJNR Am. J. Neuroradiol., June 1, 2002; 23(6): 985 - 988. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. B. Krupp and S. A. Rizvi Symptomatic therapy for underrecognized manifestations of multiple sclerosis Neurology, April 23, 2002; 58(90084): S32 - 39. [Abstract] [Full Text]
|
|
|
|
|
|
X Montalban and A J Thompson Workshop on primary progressive multiple sclerosis: meeting summary Multiple Sclerosis, April 1, 2002; 8(2): 177 - 178. [PDF]
|
|
|
|
|
|
M. Rovaris, M. Bozzali, G. Santuccio, A. Ghezzi, D. Caputo, E. Montanari, A. Bertolotto, R. Bergamaschi, R. Capra, G. Mancardi, et al. In vivo assessment of the brain and cervical cord pathology of patients with primary progressive multiple sclerosis Brain, December 1, 2001; 124(12): 2540 - 2549. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. P. Amato, G. Ponziani, G. Siracusa, and S. Sorbi Cognitive Dysfunction in Early-Onset Multiple Sclerosis: A Reappraisal After 10 Years Arch Neurol, October 1, 2001; 58(10): 1602 - 1606. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J B Boringa, R H. Lazeron, I E. Reuling, H J Ader, L E. Pfennings, J Lindeboom, L M. de Sonneville, N F Kalkers, and C H Polman The Brief Repeatable Battery of Neuropsychological Tests: normative values allow application in multiple sclerosis clinical practice Multiple Sclerosis, August 1, 2001; 7(4): 263 - 267. [Abstract] [PDF]
|
|
|
|
|
|
R Zivadinov, J Sepcic, D Nasuelli, R De Masi, L M. Bragadin, M A Tommasi, S Zambito-Marsala, R Moretti, A Bratina, M Ukmar, et al. A longitudinal study of brain atrophy and cognitive disturbances in the early phase of relapsing-remitting multiple sclerosis J. Neurol. Neurosurg. Psychiatry, June 1, 2001; 70(6): 773 - 780. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M Cercignani, M Bozzali, G Iannucci, G Comi, and M Filippi Magnetisation transfer ratio and mean diffusivity of normal appearing white and grey matter from patients with multiple sclerosis J. Neurol. Neurosurg. Psychiatry, March 1, 2001; 70(3): 311 - 317. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Filippi, M. Cercignani, M. Inglese, M.A. Horsfield, and G. Comi Diffusion tensor magnetic resonance imaging in multiple sclerosis Neurology, February 13, 2001; 56(3): 304 - 311. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. A. Sperling, C. R. G. Guttmann, M. J. Hohol, S. K. Warfield, M. Jakab, M. Parente, E. L. Diamond, K. R. Daffner, M. J. Olek, E. J. Orav, et al. Regional Magnetic Resonance Imaging Lesion Burden and Cognitive Function in Multiple Sclerosis: A Longitudinal Study Arch Neurol, January 1, 2001; 58(1): 115 - 121. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R H. Benedict, A Shapiro, R. Priore, C Miller, F Munschauer, and L Jacobs Neuropsychological counseling improves social behavior in cognitively-impaired multiple sclerosis patients Multiple Sclerosis, December 1, 2000; 6(6): 391 - 396. [Abstract] [PDF]
|
|
|
|
|
|
R H. Lazeron, D W Langdon, M Filippi, J H. van Waesberghe, V L Stevenson, J B. Boringa, D Origgi, A J Thompson, M Falautano, C. Polman, et al. Neuropsychological impairment in multiple sclerosis patients: the role of (juxta)cortical lesion on FLAIR Multiple Sclerosis, August 1, 2000; 6(4): 280 - 285. [Abstract] [PDF]
|
|