UCL Discovery
UCL home » Library Services » Electronic resources » UCL Discovery

Staging and stratifying cognitive dysfunction in multiple sclerosis

Wojcik, C; Fuchs, TA; Tran, H; Dwyer, MG; Jakimovski, D; Unverdi, M; Weinstock-Guttman, B; ... Benedict, RH; + view all (2021) Staging and stratifying cognitive dysfunction in multiple sclerosis. Multiple Sclerosis Journal 10.1177/13524585211011390. (In press). Green open access

[thumbnail of Eshaghi_20201122_ebm_AE.docx[96].pdf]
Preview
Text
Eshaghi_20201122_ebm_AE.docx[96].pdf - Accepted Version

Download (326kB) | Preview

Abstract

BACKGROUND: The sequence in which cognitive domains become impaired in multiple sclerosis (MS) is yet to be formally demonstrated. It is unclear whether processing speed dysfunction temporally precedes other cognitive impairments, such as memory and executive function. OBJECTIVE: Determine the order in which different cognitive domains become impaired in MS and validate these findings using clinical and vocational outcomes. METHODS: In a longitudinal sample of 1073 MS patients and 306 healthy controls, we measured performance on multiple, consensus-standard, neurocognitive tests. We used an event-based staging approach to model the sequence in which cognitive domains become impaired. Linear and logistic mixed-effects models were used to explore associations between stages of impairment, neurological disability, and employment status. RESULTS: Our model suggested that the order of impairments was as follows: processing speed, visual learning, verbal learning, working memory/attention, and executive function. Stage of cognitive impairment predicted greater neurological disability, β = 0.16, SE = 0.02, p < 0.001, and probability of unemployment, β = 1.14, SE = 0.001, p < 0.001. CONCLUSION: This is the first study to introduce a cognitive staging and stratification system for MS. Findings underscore the importance of using the Symbol Digit Modalities Test in routine screening for cognitive impairment and memory testing to assess patients later in disease evolution.

Type: Article
Title: Staging and stratifying cognitive dysfunction in multiple sclerosis
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1177/13524585211011390
Publisher version: http://doi.org/10.1177/13524585211011390
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Multiple sclerosis, cognition, cognitive decline, longitudinal, neuropsychology, probabilistic modeling
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Neuroinflammation
URI: https://discovery.ucl.ac.uk/id/eprint/10128498
Downloads since deposit
392Downloads
Download activity - last month
Download activity - last 12 months
Downloads by country - last 12 months

Archive Staff Only

View Item View Item