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Abstract Details

Longitudinal Observation of Attentional and Fronto-Temporal Cognitive Functions in Relapsing-Remitting Multiple Sclerosis (RRMS) - 6 Years Follow-Up
MS and Related Diseases
S10 - (-)
003
While cross-sectional data indicate a high prevalence of cognitive dysfunction in MS, their long-term evolution is poorly understood.
Trial at 6 MS outpatient centers, longitudinal analyses 1, 2 and 6 years (T12, T24, T72) after baseline (BL). Inclusion criteria: 18-55 yr, RRMS/Mc Donald, EDSS 0-3.0. From 106 RRMS patients (38 Avonex, 40 Copaxone, 18 untreated) and 30 matched controls at BL, a total of 100/29 (T12), 87/28 (T24) and 50/16 (T72) patients/controls were available for follow-up. Assessments: clinical and behavioral parameters (neurostatus, EDSS, clinical global impression/CGI, ambulation index, functional status, Fatigue Severity Scale, depression/BDI, quality of life/EQ5d; neuropsychology (verbal and non-verbal fluency, interference control, working memory, learning and memory and complex attention. As a compound measure of cognitive deficit, a global Cognitive Impairment-Index (CIIglobal) was calculated across 54 cognitive variables (in reference to Amato), and a specific CIIdom in relation to cognitive domains.
Over time, the CIIglobal indicated a significantly progressing cognitive deficit for all RRMS patients compared to controls (p<0.04), but not for treated RRMS vs. controls (p<0.1). Comparing RRMS subgroups, the CIIglobal did not significantly discriminate between treated and untreated patients, although being higher in the latter. Fatigue, but not depression, revealed to be a significant covariate of cognition (0.004). The CIIdom, showed a significantly different impairment of single domains (p<0.0001). Significant vulnerability over time was found for "learning and memory" and "executive functions".
(1) Cognitive and attentional deficits begin early in MS and increase over time, while healthy controls improve due to test repetition effects (2) A significant treatment effect was not demonstrated, although cognitive deficit was more expressed in untreated patients. (3) Selection/drop-out bias and test repetition effects seem to mask higher effects (4) Cognitive vulnerability is domain-related.
Authors/Disclosures
Herbert Schreiber
PRESENTER 		Herbert Schreiber has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche. Herbert Schreiber has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis . Herbert Schreiber has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Herbert Schreiber has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Herbert Schreiber has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche . Herbert Schreiber has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Almirall. Herbert Schreiber has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Novartis . Herbert Schreiber has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Merck. Herbert Schreiber has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Teva. Herbert Schreiber has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Biogen.
David C. Spencer, MD, FAAN Dr. Spencer has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Jazz Pharmaceuiticals. Dr. Spencer has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for NeuroPace Inc. Dr. Spencer has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Various. The institution of Dr. Spencer has received research support from NIH. Dr. Spencer has received publishing royalties from a publication relating to health care. Dr. Spencer has received personal compensation in the range of $500-$4,999 for serving as a Faculty in Teaching Course supported by unrestricted educational grants with Creative 好色先生 Concepts.
No disclosure on file
Michael Lang, MD No disclosure on file
No disclosure on file
No disclosure on file
No disclosure on file
Werner E. Hofmann, MD No disclosure on file
No disclosure on file
No disclosure on file
No disclosure on file
No disclosure on file
Arnfin Bergmann Dr. Bergmann has nothing to disclose.
No disclosure on file
No disclosure on file
No disclosure on file
Iris Katharina Penner, PhD (COGITO Center & Heinrich Heine University, Neurology Dept, Medical Faculty) The institution of Dr. Penner has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Merck. The institution of Dr. Penner has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche. The institution of Dr. Penner has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Janssen. The institution of Dr. Penner has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Genzyme. The institution of Dr. Penner has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen. The institution of Dr. Penner has received personal compensation in the range of $500-$4,999 for serving as a Consultant for TEVA. The institution of Dr. Penner has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Celgene. The institution of Dr. Penner has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Bayer. The institution of Dr. Penner has received personal compensation in the range of $500-$4,999 for serving as a Consultant for BMS. The institution of Dr. Penner has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Novartis. Dr. Penner has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Janssen. Dr. Penner has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Penner has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Celgene . Dr. Penner has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Penner has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck. Dr. Penner has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. The institution of Dr. Penner has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck.