title: Longitudinal changes in social functioning in mildly disabled patients with relapsing-remitting multiple sclerosis receiving subcutaneous interferon β-1a: results from the COGIMUS (COGnitive Impairment in MUltiple Sclerosis) study (II).
abstract: OBJECTIVE
  To report longitudinal changes in and explore the influence of cognition on social functioning in mildly disabled patients with relapsing-remitting multiple sclerosis (RRMS).
  
  
  METHODS
  Italian patients (18-50 years) with RRMS and Expanded Disability Status Scale (EDSS) score ≤4.0 were assigned to interferon β-1a, 44 or 22 μg subcutaneously three times weekly, and underwent annual assessments for social functioning (Environmental Status Scale [ESS]) over 3 years.
  
  
  RESULTS
  Baseline total ESS score did not differ between patients with and without cognitive impairment (P = 0.505). Total ESS score remained low (<2.0) and stable over 3 years in the whole study population, but worsened slightly when assessed by assigned treatment or treatment and baseline cognitive status (both P = 0.004), driven mostly by changes in the 'transportation' and 'financial/economic status' subscales. The strongest independent predictor of worsening ESS score was baseline EDSS score. Test-retest analyses confirmed that total ESS score and most subscales changed little over 3 years.
  
  
  CONCLUSIONS
  ESS scores remained low and changed minimally over 3 years, reflecting the mild physical disability and good cognitive performance in this patient population. Determining the influence of cognitive function and treatment on longitudinal changes in social functioning requires further studies.
authors.affiliation: Multiple Sclerosis Centre Sicilia Region, First Neurology Clinic, University Hospital, and Department of Neurology, University of Catania, Catania, Italy. patti@unict.it
authors.forename: Francesco
authors.initials: F
authors.lastname: Patti
authors.forename: Maria Pia
authors.initials: MP
authors.lastname: Amato
authors.forename: Maria
authors.initials: M
authors.lastname: Trojano
authors.forename: Stefano
authors.initials: S
authors.lastname: Bastianello
authors.forename: Maria Rosalia
authors.initials: MR
authors.lastname: Tola
authors.forename: Orietta
authors.initials: O
authors.lastname: Picconi
authors.forename: Sabina
authors.initials: S
authors.lastname: Cilia
authors.forename: Salvatore
authors.initials: S
authors.lastname: Cottone
authors.forename: Luigi M E
authors.initials: LM
authors.lastname: Grimaldi
mesh_terms: D000293:Adolescent; D000328:Adult; D002986:Clinical Trials as Topic; D003071:Cognition; D006233:Persons with Disabilities / Q000523:psychology; D005260:Female; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use*; D000068556:Interferon beta-1a; D016899:Interferon-beta / Q000627:therapeutic use*; D007398:Interpersonal Relations; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology*; D011788:Quality of Life; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D007155:Immunologic Factors; D016899:Interferon-beta; D000068556:Interferon beta-1a