title: Relevance of cognitive deterioration in early relapsing-remitting MS: a 3-year follow-up study.
abstract: OBJECTIVE
  To assess longitudinally cognitive functioning in relapsing-remitting multiple sclerosis (RRMS) patients and its relationship with clinical and MRI variables.
  
  
  METHODS
  Early RRMS patients and matched healthy controls were assessed in parallel in three testing sessions over 3 years, using the Rao's Brief Repeatable Battery of Neuropsychological Tests. Patients also underwent an MRI analysis of T2-weighted lesion volume (T2LV), number of gadolinium-enhanced lesions and whole brain atrophy. Forty-nine RRMS patients (mean age 36.9 ± 8.9 years; mean disease duration 2.9 ± 1.7 years, mean Expanded Disability Status Scale, 1.7 ± 0.7) and 56 healthy controls were recruited.
  
  
  RESULTS
  At baseline, cognitive impairment was detected in 15 patients (30.6%). After 3 years, cognitive functioning worsened in the 29.3% of patients, whereas Expanded Disability Status Scale progression was observed in only three patients. The most sensitive test to detect cognitive deterioration over time was the Symbol Digit Modalities Test (SDMT). Only the presence of moderate cognitive impairment at baseline predicted further cognitive deterioration (p = 0.03). Among MRI variables, T2LV showed a weak to moderate relationship with some cognitive tasks.
  
  
  CONCLUSIONS
  Over a 3-year period cognitive deterioration can be expected in approximately one-third of MS patients with relatively short disease duration. The SDMT is particularly suitable for longitudinal assessment of MS-related cognitive changes.
authors: Department of Neurology, University of Florence, Italy. mariapia.amato@unifi.it
authors: Maria P
authors: MP
authors: Amato
authors: Emilio
authors: E
authors: Portaccio
authors: Benedetta
authors: B
authors: Goretti
authors: Valentina
authors: V
authors: Zipoli
authors: Alfonso
authors: A
authors: Iudice
authors: Dario
authors: D
authors: Della Pina
authors: Gianmichele
authors: G
authors: Malentacchi
authors: Simonetta
authors: S
authors: Sabatini
authors: Pasquale
authors: P
authors: Annunziata
authors: Mario
authors: M
authors: Falcini
authors: Monica
authors: M
authors: Mazzoni
authors: Marzia
authors: M
authors: Mortilla
authors: Claudio
authors: C
authors: Fonda
authors: Nicola
authors: N
authors: De Stefano
mesh_terms: D000328:Adult; D003071:Cognition; D003072:Cognition Disorders / Q000175:diagnosis* / Q000209:etiology*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000150:complications* / Q000473:pathology*; D009483:Neuropsychological Tests