Can we predict cognitive decline after initial diagnosis of multiple sclerosis? Results from the German National early MS cohort (KKNMS) View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2019-02

AUTHORS

Andreas Johnen, Paul-Christian Bürkner, Nils C. Landmeyer, Björn Ambrosius, Pasquale Calabrese, Jeremias Motte, Nicole Hessler, Gisela Antony, Inke R. König, Luisa Klotz, Muna-Miriam Hoshi, Lilian Aly, Sergiu Groppa, Felix Luessi, Friedemann Paul, Björn Tackenberg, Florian Then Bergh, Tania Kümpfel, Hayrettin Tumani, Martin Stangel, Frank Weber, Antonios Bayas, Brigitte Wildemann, Christoph Heesen, Uwe K. Zettl, Frauke Zipp, Bernhard Hemmer, Sven G. Meuth, Ralf Gold, Heinz Wiendl, Anke Salmen, German Competence Network Multiple Sclerosis (KKNMS)

ABSTRACT

BACKGROUND: Cognitive impairment (CI) affects approximately one-third of the patients with early multiple sclerosis (MS) and clinically isolated syndrome (CIS). Little is known about factors predicting CI and progression after initial diagnosis. METHODS: Neuropsychological screening data from baseline and 1-year follow-up of a prospective multicenter cohort study (NationMS) involving 1123 patients with newly diagnosed MS or CIS were analyzed. Employing linear multilevel models, we investigated whether demographic, clinical and conventional MRI markers at baseline were predictive for CI and longitudinal cognitive changes. RESULTS: At baseline, 22% of patients had CI (impairment in ≥2 cognitive domains) with highest frequencies and severity in processing speed and executive functions. Demographics (fewer years of academic education, higher age, male sex), clinical (EDSS, depressive symptoms) but no conventional MRI characteristics were linked to baseline CI. At follow-up, only 14% of patients showed CI suggesting effects of retesting. Neither baseline characteristics nor initiation of treatment between baseline and follow-up was able to predict cognitive changes within the follow-up period of 1 year. CONCLUSIONS: Identification of risk factors for short-term cognitive change in newly diagnosed MS or CIS is insufficient using only demographic, clinical and conventional MRI data. Change-sensitive, re-test reliable cognitive tests and more sophisticated predictors need to be employed in future clinical trials and cohort studies of early-stage MS to improve prediction. More... »

PAGES

386-397

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00415-018-9142-y

DOI

http://dx.doi.org/10.1007/s00415-018-9142-y

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1110374966

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/30515631


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