OBJECTIVES: A study of cognitive, psychological and social aspects in benign MS.
METHODS: 163 benign MS’ers (defined as disease duration > or = 15 years and Expanded Disability Status Scale (EDSS) score < or = 3.0 ) underwent neuropsychological testing on the Rao’s Brief Repeatable Battery (BRB)* and the Stroop test*, evaluation of depression on the Montgomery and Asberg Depression Rating Scale (MADRS)*, of fatigue on the Fatigue Severity Scale (FSS)* and of handicap on the Environmental Status Scale (ESS)*.
Patients’ cognitive performance was compared with that of 111 demographically matched healthy controls.
Cognitive impairment was defined as the failure in at least 3 tests, using the fifth percentile of controls’ performance as the cut-off point.
* these are all standardised measurement scales.
RESULTS: Cognitive assessment led to the identification of 74 subjects (45%) with cognitive impairment. Significant fatigue was found in 80 subjects (49%) and depression in 88 patients (54%). In comparison with cognitively preserved subjects, cognitively impaired patients exhibited higher handicap scores on the ESS (p = 0.005). In the regression analysis, only EDSS scores were significantly associated with cognitive impairment (OR 1.8, 95%CI 1.2-2.6).
CONCLUSION: Current definitions of benign MS may overestimate this entity, since they are mainly weighted for the patients’ motor abilities and fail to capture relevant disease-related cognitive, psychological and social problems.
“Despite fulfilling a contemporary definition of benign MS this study shows MS’ers with so called benign MS have significant problems with cognitive impairment (45%), fatigue (49%) and depression (54%).”