title: A longitudinal study of cognition in primary progressive multiple sclerosis.
abstract: There are few longitudinal studies of cognition in patients with multiple sclerosis, and the results of these studies remain inconclusive. No serial neuropsychological data of an exclusively primary progressive series are available. Cross-sectional analyses have revealed significant correlations between cognition and magnetic resonance imaging (MRI) parameters in primary progressive multiple sclerosis (PPMS). This study investigated cognitive and MRI change in 99 PPMS patients from five European centres for 2 years. They were assessed at 12 month intervals using the Brief Repeatable Battery, a reasoning test, and a measure of depression. The MRI parameters of T1 hypointensity load, T2 lesion load, and partial brain volume were also calculated at each time point. There were no significant differences between the mean cognitive scores of the patients at year 0 and year 2. However, one-third of the patients demonstrated absolute cognitive decline on individual test scores. Results indicated that initial cognitive status on entry into the study was a good predictor of cognitive ability at 2 years. There was only a small number of significant correlations between changes in cognition and changes on MRI, notably T1 hypointensity load with the two attentional tasks (r = -0.266, P = 0.017; r = -0.303, P = 0.012). It is probable that multiple factors underlie this weak relation between the cognitive and MRI measures.
authors.affiliation: Department of Clinical Neurology, Institute of Neurology, London, UK.
authors.forename: S J
authors.initials: SJ
authors.lastname: Camp
authors.forename: V L
authors.initials: VL
authors.lastname: Stevenson
authors.forename: A J
authors.initials: AJ
authors.lastname: Thompson
authors.forename: G T
authors.initials: GT
authors.lastname: Ingle
authors.forename: D H
authors.initials: DH
authors.lastname: Miller
authors.forename: C
authors.initials: C
authors.lastname: Borras
authors.forename: B
authors.initials: B
authors.lastname: Brochet
authors.forename: V
authors.initials: V
authors.lastname: Dousset
authors.forename: M
authors.initials: M
authors.lastname: Falautano
authors.forename: M
authors.initials: M
authors.lastname: Filippi
authors.forename: N F
authors.initials: NF
authors.lastname: Kalkers
authors.forename: X
authors.initials: X
authors.lastname: Montalban
authors.forename: C H
authors.initials: CH
authors.lastname: Polman
authors.forename: D W
authors.initials: DW
authors.lastname: Langdon
mesh_terms: D000328:Adult; D001921:Brain / Q000473:pathology; D003072:Cognition Disorders / Q000473:pathology / Q000523:psychology*; D018450:Disease Progression; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000473:pathology / Q000523:psychology*; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D011581:Psychological Tests; D018709:Statistics, Nonparametric