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

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Item Type:Article
Title:Can we predict cognitive decline after initial diagnosis of multiple sclerosis? Results from the German National early MS cohort (KKNMS)
Creators Name:Johnen, A. and Bürkner, P.C. and Landmeyer, N.C. and Ambrosius, B. and Calabrese, P. and Motte, J. and Hessler, N. and Antony, G. and König, I.R. and Klotz, L. and Hoshi, M.M. and Aly, L. and Groppa, S. and Luessi, F. and Paul, F. and Tackenberg, B. and Bergh, F.T. and Kümpfel, T. and Tumani, H. and Stangel, M. and Weber, F. and Bayas, A. and Wildemann, B. and Heesen, C. and Zettl, U.K. and Zipp, F. and Hemmer, B. and Meuth, S.G. and Gold, R. and Wiendl, H. and Salmen, A.
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.
Keywords:Multiple Sclerosis, Cognition, Neuropsychology, Cohort Study, Longitudinal
Source:Journal of Neurology
ISSN:0340-5354
Publisher:Springer (Germany)
Volume:266
Number:2
Page Range:386-397
Date:February 2019
Official Publication:https://doi.org/10.1007/s00415-018-9142-y
PubMed:View item in PubMed

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