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

Johnen, A.; Burkner, P. C.; Landmeyer, N. C.; Ambrosius, B.; Calabrese, P.; Motte, J.; Hessler, N.; Antony, G.; Konig, I. R.; Klotz, L.; Hoshi, M. M.; Aly, L.; Groppa, S.; Luessi, F.; Paul, F.; Tackenberg, B.; Bergh, F. T.; Kumpfel, T.; Tumani, H.; Stangel, M.; ... (2019). Can we predict cognitive decline after initial diagnosis of multiple sclerosis? Results from the German National early MS cohort (KKNMS). Journal of neurology, 266(2), pp. 386-397. Springer-Medizin-Verlag 10.1007/s00415-018-9142-y

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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.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology

UniBE Contributor:

Salmen, Anke

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0340-5354

Publisher:

Springer-Medizin-Verlag

Language:

English

Submitter:

Panagiota Milona

Date Deposited:

30 Jan 2019 16:00

Last Modified:

09 Feb 2019 01:33

Publisher DOI:

10.1007/s00415-018-9142-y

PubMed ID:

30515631

Uncontrolled Keywords:

Cognition Cohort study Longitudinal Multiple sclerosis Neuropsychology

BORIS DOI:

10.7892/boris.124707

URI:

https://boris.unibe.ch/id/eprint/124707

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