Cognitive screening in adults with multiple sclerosis

Authors

DOI:

https://doi.org/10.21527/2176-7114.2023.47.13996

Keywords:

Esclerose Múltipla, Instrumento de Triagem de Avaliação Cognitiva, Cognição, Memória, Linguagem

Abstract

Objective: To analyze the performance of adults with Multiple Sclerosis (MS) in cognitive screening and to observe the correlation between age and cognitive abilities. Methods: It is a descriptive, observational, transversal and quantitative research. It was performed with 27 individuals with a medical diagnosis of MS, 22 women, 5 men, aged between 20 and 60 years. Data collection was performed using three instruments: Montreal Cognitive Assessment (Moca); Battery Brief of cognitive screening; and a Personal Identification Protocol. Data analysis was performed quantitatively, descriptively and inferentially. The Mann-Whitney test and Spearman correlation were applied, with a significance of p<0.05. Results: Most participants had memory complaints and difficulties in subtraction and delayed recall tests. It was found that there was a negative correlation between age and performance in cognitive screening tests. Participants were divided into two groups according to the MOCA score and statistical differences were observed in incidental memory (p=0.049), immediate memory (p=0.019), delayed memory (p=0.007) , in clock design (p=0.037), in semantic verbal fluency (p=0.008), repetition of digits (p=0.006), in subtraction (p=0.026), language (p=0.001), phonemic verbal fluency (p= 0.05), abstraction (p=0.019), delayed recall (p<0.001) and in the total score of the MOCA (p<0.001). Conclusion: The older the patient with multiple sclerosis, the worse the cognitive functioning, especially memory and executive functions.

References

Cotsapas C, Mitrovic M, Hafler D. Multiple sclerosis. Handb Clin Neurol. 2018;148:723-730. DOI: 10.1016/B978-0-444-64076-5.00046-6

Franco RC, Curib HT, Andrade LF, Ferretti EC. Compreensão das dificuldades e dos fatores contextuais nas atividades cotidianas de pessoas com esclerose múltipla: um estudo piloto. Cad Bras Ter Ocup. 2022;30:e2942. DOI: 10.1590/2526-8910.ctoAO222929422

Multiple Sclerosis International Federation [Internet]. Atlas of MS 2013: mapping multiple sclerosis around the world. MSIF.org; 2013. Disponível em: https://www.msif.org/ wpcontent/uploads/2014/09/Atlas-of-MS

Moreira CEA, Telles IR, Barone Junior C. Análise das características da esclerose múltipla: revisão de literatura. Rev Eletrônica Acervo Médico. 2022;20:e11194. DOI: 10.25248/reamed.e11194.2022

Miljković D, Spasojević I. Multiple Sclerosis: Molecular Mechanisms and Therapeutic Opportunities. Antioxid Redox Signal 2013;19:2.286-2.334.

Oreja-Guevara C, Ayuso Blanco T, Brieva Ruiz L, Hernández Pérez MÁ, Meca-Lallana V, Ramió-Torrentà L. Cognitive Dysfunctions and Assessments in Multiple Sclerosis. Front Neurol. 2019;10:581. DOI: 10.3389/fneur.2019.00581

Rocca MA, Amato MP, De Stefano N, Enzinger C, Geurts JJ, Penner IK, Rovira A, Sumowski JF, et al. Clinical and imaging assessment of cognitive dysfunction in multiple sclerosis. Lancet Neurol. 2015;14(3):302-317. DOI: 10.1016/S1474-4422(14)70250-9

Bakirtzis C, Ioannidis P, Messinis L, Nasios G, Konstantinopoulou E, Papathanasopoulos P, Grigoriadis N. The Rationale for Monitoring Cognitive Function in Multiple Sclerosis: Practical Issues for Clinicians. Open Neurol J. 2018;12:31-40. DOI: 10.2174/1874205X01812010031

Kim S, Zemon V, Rath JF, Picone M, Gromisch ES, Glubo H, Smith-Wexler L, Foley FW. Screening Instruments for the Early Detection of Cognitive Impairment in Patients with Multiple Sclerosis. Int J MS Care. 2017;19(1):1-10. DOI: 10.7224/1537-2073.2015-001

Patti F, Amato MP, Trojano M, Bastianello S, Tola MR, Goretti B, Caniatti L, Di Monte E, et al. Cognitive impairment and its relation with disease measures in mildly disabled patients with relapsing-remitting multiple sclerosis: baseline results from the Cognitive Impairment in Multiple Sclerosis (COGIMUS) study. Mult Scler. 2009;15(7):779-788. DOI: 10.1177/1352458509105544

Nitrini R, Caramelli P, Herrera Júnior E, Porto CS, Charchat-Fichman H, Carthery MT, et al. Performance of illiterate and literate nondemented elderly subjects in two tests of long-term memory. J Int Neuropsychol Soc. 2004;10(4):634-638. DOI: 10.1017/S1355617704104062

Nasreddine ZS, Phillips NA, Bédirian V, Charbonneau S, Whitehead V, Collin I, et al. The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc. 2005;53(4):695-699. DOI: 10.1111/j.1532-5415.2005.53221.x

Dancey C, Reidy J. Estatística sem matemática para psicologia: usando SPSS para Windows. Artmed; 2006.

Engel C, Greim B, Zettl UK. Diagnostics of cognitive dysfunctions in multiple sclerosis. J Neurol. 2007;254 (Suppl 2):II30-4. DOI: 10.1007/s00415-007-2009-2

Ruet A, Hamel D, Deloire MS, Charré-Morin J, Saubusse A, Brochet B. Information processing speed impairment and cerebellar dysfunction in relapsing-remitting multiple sclerosis. J Neurol Sci. 2014 Dec 15;347(1-2):246-250. DOI: 10.1016/j.jns.2014.10.008

Migliore S, Curcio G, Couyoumdjian A, Ghazaryan A, Landi D, Moffa F, Quintiliani L, Squitieri F, et al. Executive functioning in relapsing-remitting multiple sclerosis patients without cognitive impairment: A task-switching protocol. Mult Scler. 2018;24(10):1.328-1.336. DOI: 10.1177/1352458517719149

Arnett PA, Strober LB. Cognitive and neurobehavioral features in multiple sclerosis. Expert Rev Neurother. 2011;11(3):411-24. DOI: 10.1586/ern.11.12. PMID: 21375446

González Torre JA, Cruz-Gómez ÁJ, Belenguer A, Sanchis-Segura C, Ávila C, Forn C. Hippocampal dysfunction is associated with memory impairment in multiple sclerosis: A volumetric and functional connectivity study. Mult Scler. 2017;23(14):1.854-1.863. DOI: 10.1177/1352458516688349

Cristofori I, Cohen-Zimerman S, Grafman J. Executive functions. Handb Clin Neurol. 2019;163:197-219. DOI: 10.1016/B978-0-12-804281-6.00011-2

Amato MP, Portaccio E, Goretti B, Zipoli V, Iudice A, Della Pina D, Malentacchi G, Sabatini S, et al. Relevance of cognitive deterioration in early relapsing-remitting MS: a 3-year follow-up study. Mult Scler. 2010;16(12):1.474-1.482. DOI: 10.1177/1352458510380089

Freitas JOF, Aguiar CRRA. Avaliação das funções cognitivas de atenção, memória e percepção em pacientes com esclerose múltipla. Psicol Refl Crít. 2012;25(3):457-466. DOI: 10.1590/S0102-79722012000300005

Goldacre MJ, Wotton CJ, Seagroatt V, Yeates D. Multiple sclerosis after infectious mononucleosis: record linkage study. J Epidemiol Community Health. 2004;58(12):1.032-1.035. DOI: 10.1136/jech.2003.018366

Baumstarck-Barrau K, Simeoni MC, Reuter F, Klemina I, Aghababian V, Pelletier J, Auquier P. Cognitive function and quality of life in multiple sclerosis patients: a cross-sectional study. BMC Neurol. 2011;11:17. DOI: 10.1186/1471-2377-11-17

Kalb R, Beier M, Benedict RH, Charvet L, Costello K, Feinstein A, Gingold J, Goverover Y, et al. Recommendations for cognitive screening and management in multiple sclerosis care. Mult Scler. 2018;24(13):1.665-1.680. DOI: 10.1177/1352458518803785

Sumowski JF, Benedict R, Enzinger C, Filippi M, Geurts JJ, Hamalainen P, et al. Cognition in multiple sclerosis: State of the field and priorities for the future. Neurology. 2018;90(6):278-288. DOI: 10.1212/WNL.0000000000004977

Rosti-Otajärvi EM, Hämäläinen PI. Neuropsychological rehabilitation for multiple sclerosis. Cochrane Database Syst Rev. 2014;(2):CD009131. DOI: 10.1002/14651858.CD009131.pub3.

Published

2023-11-30

How to Cite

Wanderley, C. M. S. F., Almeida, L. N. A., de Oliveira, B. E. S., & Lima, I. L. B. (2023). Cognitive screening in adults with multiple sclerosis. Revista Contexto &Amp; Saúde, 23(47), e13996. https://doi.org/10.21527/2176-7114.2023.47.13996

Issue

Section

Artigos