The role of disability and depression in cognitive functioning within 2 years after multiple sclerosis diagnosis.
OBJECTIVE
To investigate cognitive functioning shortly after multiple sclerosis (MS) diagnosis and to examine the relationship with disability, depression and anxiety.


METHODS
Data were available for 101 recently diagnosed MS patients and 117 healthy controls. Neuropsychological and clinical assessment included Rao's Brief Repeatable Battery, Expanded Disability Status Scale (EDSS), and Hospital Anxiety and Depression scale (HADS).


RESULTS
Patients had lower scores than controls on timed tasks (Paced Auditory Serial Addition Test (PASAT3, p-value adjusted for age, sex and education = 0.04; PASAT2, p = 0.001), Word List Generation Test (WLG, p = 0.04)). Scores on Symbol Digit Modalities Test (SDMT; p = 0.001), PASAT3 (p = 0.01) and PASAT2 (p < 0.001) showed significant association with EDSS. Patients with EDSS >or= 3.0 had significantly lower scores on Selective Reminding Test (SRTC, p = 0.04), SDMT (p = 0.002), PASAT3 (p = 0.002), PASAT2 (p < 0.001) and WLG (p = 0.01) than controls from the general population. Patients with clinically borderline scores of depression scored lower on SDMT (49.5 versus 57.1, p = 0.06) and PASAT3 (39.8 versus 47.1, p = 0.03). However, after adjustment for EDSS and time since disease onset, these differences were not statistically significant.


CONCLUSIONS
Within two years after diagnosis, patients with MS had lower scores compared to healthy controls on timed tasks, suggesting cognitive slowing in patients with early MS. Cognitive impairment was associated with symptoms of depression, but this association could be explained by differences in disability.
Siepman
T A M
TA
Dept. of Neurology, MS Centre ErasMS, Erasmus MC's Gravendijkwal 230, 3015, CE Rotterdam, The Netherlands.
Janssens
A C J W
AC
de Koning
I
I
Polman
C H
CH
Boringa
J B
JB
Hintzen
R Q
RQ
D000203:Activities of Daily Living / Q000523:psychology; D000328:Adult; D000367:Age Factors; D001008:Anxiety Disorders / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology; D003071:Cognition / Q000502:physiology; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology*; D015897:Comorbidity; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology*; D004185:Disability Evaluation; D006233:Persons with Disabilities; D005260:Female; D006117:Grief; D006801:Humans; D015994:Incidence; D008297:Male; D008568:Memory / Q000502:physiology; D008606:Mental Processes / Q000502:physiology; D009103:Multiple Sclerosis / Q000453:epidemiology* / Q000503:physiopathology / Q000523:psychology*; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D011597:Psychomotor Performance / Q000502:physiology; D012737:Sex Factors; D013997:Time Factors