Functional basis of memory impairment in MS: a [18F]FDG PET study

Hypometabolism of thalamic and deep cortical gray structures of the temporal lobe is associated with episodic memory dysfunction in MS.

On the other hand, pathological performance on tests designed to assess frontal functions was associated with widespread reduction of glucose metabolism.

Cognition in MS: a marker of silent progression

Longitudinal prospective study correlating baseline cognitive impairment with progression of disability in 45 relapsing-remitting MS (RRMS) patients over a period of 7 years

Multivariate linear regressions showed significant correlations between :

― the change in the EDSS over 5 years and baseline SDMT (r2=0.19, p=0.032) the change in the EDSS over 7 years and baseline CLTR score (r2=0.17, p=0.05)

Early cognitive impairment may predict disability outcome after several years

EDSS progression over 7 years is explained by the baseline CLTR

Cut-off value : 29

CLTR, consistent long-term retrieval; EDSS, expanded disability status score; MS, multiple sclerosis; RRMS, relapsing remitting multiple sclerosis; SDMT, symbol digits modalities test Deloire M et al. Multiple Sclerosis 2010;16:581–587. Figure adapted with permission from Multiple Sclerosis

Cognition in MS: a marker of silent progression

• Cognitive impairment occurs early in patients with RMS1

– Reliable identification depends on assessment tools used

• The PASAT assesses several cognitive domains, including processing speed, working memory, calculation ability, divided attention, and mental flexibility1,2

• The SDMT assesses processing speed and working memory and is more sensitive and reliable than the PASAT3,4

Cognition in MS: a marker of silent progression