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Detecting isolated cognitive relapses in persons with MS.
Morrow, Sarah A; Weinstock, Zachary L; Mirmosayyeb, Omid; Conway, Devon; Fuchs, Tom; Jaworski, Michael G; Eckert, Sveltlana; Hojnacki, David H; Dwyer, Michael G; Zivadinov, Robert; Weinstock-Guttman, Bianca; Benedict, Ralph H B.
Afiliación
  • Morrow SA; University Hospital, London Health Sciences Center, Department of Clinical Neurological Sciences, Western University, London, ON, Canada.
  • Weinstock ZL; Jacobs School of Medicine and Biomedical Sciences, Department of Neurology, State University of New York, Buffalo, NY, USA.
  • Mirmosayyeb O; Jacobs School of Medicine and Biomedical Sciences, Department of Neurology, State University of New York, Buffalo, NY, USA.
  • Conway D; Mellen Center for Multiple Sclerosis Treatment, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA.
  • Fuchs T; Jacobs School of Medicine and Biomedical Sciences and Buffalo Neuroimaging Analysis Center, Department of Neurology, State University of New York, Buffalo, NY, USA.
  • Jaworski MG; Jacobs School of Medicine and Biomedical Sciences, Department of Neurology, State University of New York, Buffalo, NY, USA.
  • Eckert S; Jacobs School of Medicine and Biomedical Sciences, Department of Neurology, State University of New York, Buffalo, NY, USA.
  • Hojnacki DH; Jacobs School of Medicine and Biomedical Sciences, Department of Neurology, State University of New York, Buffalo, NY, USA.
  • Dwyer MG; Jacobs School of Medicine and Biomedical Sciences and Buffalo Neuroimaging Analysis Center, Department of Neurology, State University of New York, Buffalo, NY, USA.
  • Zivadinov R; Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, State University of New York, Buffalo, NY, USA.
  • Weinstock-Guttman B; Center for Biomedical Imaging, Clinical Translational Science Institute, State University of New York, Buffalo, NY, USA.
  • Benedict RHB; Jacobs School of Medicine and Biomedical Sciences, Department of Neurology, State University of New York, Buffalo, NY, USA.
Mult Scler ; 29(14): 1786-1794, 2023 Dec.
Article en En | MEDLINE | ID: mdl-37776097
BACKGROUND: The existence of isolated cognitive relapses (ICRs) in persons with MS (PwMS) has been debated. OBJECTIVE: To examine relapses with decline on Symbol Digit Modalities Test (SDMT) but no change on Expanded Disability Status Scale (EDSS). METHODS: This 3-year prospective cohort study identified PwMS experiencing a relapse with decrease on SDMT. Participants with SDMT decline/stable EDSS were labeled "ICR," while those with a corresponding decrease on EDSS were classified "Relapse with Cognitive Decline (RCD)." Two definitions of SDMT decline were explored: (1) ⩾ 8 points, and (2) ⩾ 4 points. Logistic regression was used to analyze the relationship between ICR and RCD. RESULTS: The full cohort had 592 participants: 83 experienced relapses; 22 (26.5%) had an SDMT decrease of ⩾ 8 points; 14 (63.6%) met ICR criteria. Logistic regression (X2(1) = 5.112, p = 0.024) using demographics and disease characteristics explained 28.4% of the variance in ICR versus RCD. Only the MS Neuropsychological Questionnaire was associated with ICR (odds ratio (OR): 8.6; 95% confidence interval (CI): 1.1-16.4) 40 relapsing participants with SDMT decrease of ⩾ 4 points were identified: 26 (65%) had a stable EDSS (ICR). Logistic regression did not find any variable predictive of ICR. CONCLUSION: This prospective study demonstrates evidence of ICR in PwMS.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Disfunción Cognitiva / Esclerosis Múltiple Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Mult Scler Asunto de la revista: NEUROLOGIA Año: 2023 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Disfunción Cognitiva / Esclerosis Múltiple Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Mult Scler Asunto de la revista: NEUROLOGIA Año: 2023 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Reino Unido