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26.11.2023 | Original Communication

Cognitive phenotypes in multiple sclerosis: mapping the spectrum of impairment

verfasst von: Damiano Mistri, Nicolò Tedone, Diana Biondi, Carmen Vizzino, Elisabetta Pagani, Maria A. Rocca, Massimo Filippi

Erschienen in: Journal of Neurology | Ausgabe 4/2024

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Abstract

Background

Available criteria for cognitive phenotypes in multiple sclerosis (MS) do not consider the severity of impairment.

Objectives

To identify cognitive phenotypes with varying degrees of impairment in MS patients and describe their demographic, clinical and MRI characteristics.

Methods

Two hundred and forty-three MS patients and 158 healthy controls underwent neuropsychological tests to assess memory, attention, and executive function. For each domain, mild impairment was defined as performing 1.5 standard deviations below the normative mean on two tests, while the threshold for significant impairment was 2 standard deviations. Patients were classified into cognitive phenotypes based on severity of the impairment (mild/significant) and number of domains affected (one/more).

Results

Five cognitive phenotypes emerged: Preserved cognition (PC; 56%), Mild Single-Domain Impairment (MSD; 15%), Mild Multi-Domain Impairment (MMD; 9%), Significant Single-Domain Impairment (SSD; 12%), Significant Multi-Domain Impairment (SMD; 8%). Compared with PC, MSD patients were older, had longer disease duration (DD) and higher T2-hyperintense lesion volume (LV; all p ≤ 0.02); MMD patients were older, had longer DD, higher disability, higher T2 LV and lower thalamic volume (all p ≤ 0.01); SSD patients had longer DD and lower gray matter cortical volume, thalamic, caudate, putamen and accumbens volumes (all p ≤ 0.04); and SMD patients were older, had longer DD, higher disability and more extensive structural damage in all brain regions explored (all p ≤ 0.03), except white matter and amygdala volumes.

Conclusions

We identified five cognitive phenotypes with graded levels of impairment. These phenotypes were characterized by distinct demographic, clinical and MRI features, indicating potential variations in the neural substrates of dysfunction throughout disease stages.

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Titel: Cognitive phenotypes in multiple sclerosis: mapping the spectrum of impairment
verfasst von: Damiano Mistri
Nicolò Tedone
Diana Biondi
Carmen Vizzino
Elisabetta Pagani
Maria A. Rocca
Massimo Filippi
Publikationsdatum: 26.11.2023
Verlag: Springer Berlin Heidelberg
Erschienen in: Journal of Neurology / Ausgabe 4/2024
Print ISSN: 0340-5354
Elektronische ISSN: 1432-1459
DOI: https://doi.org/10.1007/s00415-023-12102-5

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