Clinical evolution in MS may vary widely amongst individuals, and the prediction of long-term clinical outcome is still far from satisfactory. It is well known that some people with MS may develop, with time, some degree of cognitive dysfunction. In this longitudinal study of people with MS, the authors found that a poorer cognitive performance, early in the disease, on tasks assessing verbal memory and information processing speed, was associated with a more rapid clinical worsening over the following years. The results of this study shed some light on the search for clinically relevant predictive markers of future disability, which can be very useful in adapting therapeutic strategies in the early stages of MS. Mult Scler. 2010 Mar 1
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Cognition is frequently impaired in the early stages of multiple sclerosis (MS). The predictive value of cognitive impairment on disability is unknown. The objective of this study was to correlate cognitive impairment and the progression of disability over 7 years. Forty-five patients, recruited after MS diagnosis, were followed for 7 years by yearly Expanded Disability Status Scale (EDSS) and Multiple Sclerosis Functional Composite (MSFC) evaluations and were classified as cognitively impaired (CI) or unimpaired (CU) according to neuropsychological testing at baseline. At baseline, 47.8% of patients were CI, with deficits in mainly memory and information processing speed (IPS). The baseline EDSS correlated significantly with one IPS test. The EDSS, but not the MSFC, deteriorated significantly over the 7 years in the whole group and the CI group, but not the CU group. A multivariate analysis showed correlations between the EDSS change over 5 and 7 years and two baseline tests evaluating IPS and verbal memory. The deterioration of the EDSS after 7 years was significantly correlated with verbal memory testing at baseline after adjustment for age and baseline EDSS. In conclusion, in this sample of MS patients early in the disease, the baseline IPS and verbal memory impairments predict the EDSS score 5 and 7 years later.
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