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Address correspondence and reprint requests to Dr. Stephen M. Rao, Section of Neuropsychology, Medical College of Wisconsin, 1000 North 92nd Street, Milwaukee, WI 53226.
Previous frequency estimates of cognitive dysfunction in multiple sclerosis have ranged from 54 to 65 percent. These studies may overestimate the frequency in the general MS population, since the patients in these studies were recruited from clinic populations. In the present study, we administered a comprehensive neuropsychological test battery to 100 community-based MS patients and 100 demographically matched healthy controls. Of 31 cognitive test indices examined, 48 MS patients and five controls were impaired on four or more test indices, yielding an overall frequency rate of 43% for the MS group. The pattern of cognitive decline was not uniform: MS patients were more frequently impaired on measures of recent memory, sustained attention, verbal fluency, conceptual reasoning, and visuospatial perception, and less frequently impaired on measures of language and immediate and remote memory. We developed a brief (20-minute) screening battery empirically by selecting the four most sensitive test indices from the comprehensive battery. The brief battery yielded a sensitivity value of 71% and a specificity value of 94% in discriminating cognitively intact from impaired MS patients, as defined by the comprehensive battery. Cognitive impairment was not significantly associated with illness duration, depression, disease course, or medication usage, but was significantly (albeit weakly) correlated with physical disability.
NEUROLOGY 1991;41:685-691
From the Department of Neurology, Medical College of Wisconsin, Milwaukee, WI.
Supported in part by a Research Career Development Award (K04 NS01055-04) and a Research Grant (R01 NS22128-05) from NINDS to Dr. Rao.
Presented in part at the 42nd annual meeting of the American Academy of Neurology, Miami Beach, FL, April 1990.
Received August 17, 1990. Accepted for publication in final form November 12, 1990.
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A Achiron, M Polliack, S M Rao, Y Barak, M Lavie, N Appelboim, and Y Harel Cognitive patterns and progression in multiple sclerosis: construction and validation of percentile curves J. Neurol. Neurosurg. Psychiatry, May 1, 2005; 76(5): 744 - 749. [Abstract] [Full Text] [PDF]
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W. S. MacAllister, A. L. Belman, M. Milazzo, D. M. Weisbrot, C. Christodoulou, W. F. Scherl, T. E. Preston, C. Cianciulli, and L. B. Krupp Cognitive functioning in children and adolescents with multiple sclerosis Neurology, April 26, 2005; 64(8): 1422 - 1425. [Abstract] [Full Text] [PDF]
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R J Siegert and D A Abernethy Depression in multiple sclerosis: a review J. Neurol. Neurosurg. Psychiatry, April 1, 2005; 76(4): 469 - 475. [Abstract] [Full Text] [PDF]
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M S A Deloire, E Salort, M Bonnet, Y Arimone, M Boudineau, H Amieva, B Barroso, J-C Ouallet, C Pachai, E Galliaud, et al. Cognitive impairment as marker of diffuse brain abnormalities in early relapsing remitting multiple sclerosis J. Neurol. Neurosurg. Psychiatry, April 1, 2005; 76(4): 519 - 526. [Abstract] [Full Text] [PDF]
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D. C Mohr, D. Cox, and N. Merluzzi Self-Injection Anxiety Training: a treatment for patients unable to self-inject injectable medications Multiple Sclerosis, April 1, 2005; 11(2): 182 - 185. [Abstract] [PDF]
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B. L. Banwell and P. E. Anderson The cognitive burden of multiple sclerosis in children Neurology, March 8, 2005; 64(5): 891 - 894. [Abstract] [Full Text] [PDF]
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 G. D'Intino, M. Paradisi, M. Fernandez, A. Giuliani, L. Aloe, L. Giardino, and L. Calza Cognitive deficit associated with cholinergic and nerve growth factor down-regulation in experimental allergic encephalomyelitis in rats PNAS, February 22, 2005; 102(8): 3070 - 3075. [Abstract] [Full Text] [PDF]
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N. D Chiaravalloti, J. DeLuca, N. B Moore, and J. H Ricker Treating learning impairments improves memory performance in multiple sclerosis: a randomized clinical trial Multiple Sclerosis, February 1, 2005; 11(1): 58 - 68. [Abstract] [PDF]
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R. A. Marrie, G. J Chelune, D. M Miller, and J. A Cohen Subjective cognitive complaints relate to mild impairment of cognition in multiple sclerosis Multiple Sclerosis, February 1, 2005; 11(1): 69 - 75. [Abstract] [PDF]
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H Coo, W M Hopman, C M Edgar, E V McBride, and D G Brunet The Paced Auditory Serial Addition Test: to what extent is it performed as instructed, and is it associated with disease course? Multiple Sclerosis, February 1, 2005; 11(1): 85 - 89. [Abstract] [PDF]
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H. Crayton, R. A. Heyman, and H. S. Rossman A multimodal approach to managing the symptoms of multiple sclerosis Neurology, December 14, 2004; 63(11_suppl_5): S12 - S18. [Abstract] [Full Text]
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D. Cox, D. Pelletier, C. Genain, S. Majumdar, Y. Lu, S. Nelson, and D. C Mohr The unique impact of changes in normal appearing brain tissue on cognitive dysfunction in secondary progressive multiple sclerosis patients Multiple Sclerosis, December 1, 2004; 10(6): 626 - 629. [Abstract] [PDF]
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R. H. Benedict, D. Cox, L. L Thompson, F. Foley, B. Weinstock-Guttman, and F. Munschauer Reliable screening for neuropsychological impairment in multiple sclerosis Multiple Sclerosis, December 1, 2004; 10(6): 675 - 678. [Abstract] [PDF]
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S Ozakbas, B Ormeci, B B.K. Akdede, K Alptekin, and E Idiman Utilization of the auditory consonant trigram test to screen for cognitive impairment in patients with multiple sclerosis: comparison with the paced auditory serial addition test Multiple Sclerosis, December 1, 2004; 10(6): 686 - 689. [Abstract] [PDF]
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L. B. Krupp, C. Christodoulou, P. Melville, W. F. Scherl, W. S. MacAllister, and L. E. Elkins Donepezil improved memory in multiple sclerosis in a randomized clinical trial Neurology, November 9, 2004; 63(9): 1579 - 1585. [Abstract] [Full Text] [PDF]
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R. H. Lazeron, S. A. Rombouts, P. Scheltens, C. H Polman, and F. Barkhof An fMRI study of planning-related brain activity in patients with moderately advanced multiple sclerosis Multiple Sclerosis, October 1, 2004; 10(5): 549 - 555. [Abstract] [PDF]
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