Differences in cognitive impairment of relapsing remitting, secondary, and primary progressive MS.
OBJECTIVE
To investigate the cognitive skills of patients with relapsing remitting multiple sclerosis (RRMS), secondary progressive MS (SPMS), and primary progressive MS (PPMS) relative to healthy control subjects and to assess whether there is heterogeneity in the type of cognitive disabilities demonstrated by patients with different MS phenotypes.


METHODS
RRMS patients (n = 108), SPMS patients (n = 71), PPMS patients (n = 55), and healthy control subjects (n = 67) underwent neuropsychological assessment with the Brief Repeatable Battery of Neuropsychological Tests.


RESULTS
Relative to controls, cognitive performance of RRMS patients was deficient when tasks required higher-order working memory (WM) processes (Word List Generation, 10/36 Spatial Recall Test, Symbol Digit Modalities Test). PPMS and SPMS patients performed poorer than control subjects on all tasks. SPMS patients performed more poorly than PPMS patients when tasks required higher-order WM processes, except when speed of information processing played a relatively important role (Symbol Digit Modalities Test, Paced Auditory Serial Addition Test). Whereas RRMS patients generally performed better than the progressive subtypes, they showed relatively poor verbal fluency.


CONCLUSIONS
MS patients with different disease courses have different cognitive profiles.
Department of Clinical Neuropsychology, Vrije Universiteit, Amsterdam, The Netherlands.
S C J
SC
Huijbregts
N F
NF
Kalkers
L M J
LM
de Sonneville
V
V
de Groot
I E W
IE
Reuling
C H
CH
Polman
D000328:Adult; D000368:Aged; D003072:Cognition Disorders / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008569:Memory Disorders / Q000209:etiology; D008875:Middle Aged; D020528:Multiple Sclerosis, Chronic Progressive / Q000523:psychology*; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000523:psychology*; D009483:Neuropsychological Tests; D011597:Psychomotor Performance; D012720:Severity of Illness Index; D013064:Speech Disorders / Q000209:etiology