1Department of Neurologic clinic, University Hospital AHEPA, Greece
2Department of Neurologic clinic, Aristotle University, Greece
3Department of Neurologic clinic, University of Thessaly, Greece
Submission: January 17, 2019; Published: March 13, 2019
*Corresponding author: Effrosyni Koutsouraki, Department of Neurologic clinic, University Hospital AHEPA, Thessaloniki, Greece
How to cite this article: Effrosyni K, Theodoros K, Marianthi A, Dimitrios M, Stavros B. Preliminary Results on Cognitive Impairment in A Cohort of
Greek Multiple Sclerosis Patients. Open Access J Neurol Neurosurg. 2019; 10(1): 555776. DOI:
Cognitive impairment is a common phenomenon in Multiple Sclerosis (MS), occurring at all stages of the disease, even at the earliest, and can be a major source of disability, social impairment, and impoverished quality of life. Cognitive dysfunction is mainly focused on working memory, conceptual reasoning, verbal fluency, speed of information processing, attention and executive functions. Additional clinical factors, including the progression of the disease, fatigue and affective disturbance, can impact the degree of MS-related cognitive impairment [1,2].
We present the initial observations of a prospective study on cognitive impairment in a Greek cohort of MS patients, living in the Northern Greek city of Thessaloniki. For a 30-month period, in 6-months intervals, we followed clinically and neuropsychologically 40 patients with CDMS (revised diagnostic criteria Mc. Donald 2010) as well as 20 healthy controls matched for age and gender . The clinical data we analyzed included: gender, age, family status, education, profession, duration of MS, type of MS, the most affected parts of the CNS as indicated by their MRIs and Expanded Disability Status Scale (EDSS) scores.
For the neuropsychological evaluation we used interviews (with the patient as well as his family), the Mini Mental State Examination (MMSE), the SKT (Questionnaire for critical
capacity and memory), the Hamilton scale (for depression), the BDI scale (for depression) and the GHQ-25 scale (for emotional disturbances).
severe emotional or cognitive disturbances from the beginning of the study, treatment with high doses of corticosteroids or antidepressants Patients and healthy controls were informed and agreed to participate in the above study, anonymously.
a. Cognitive disorders mainly concerned memory and attention.
b. MMSE was found to be non-specific for the detection of disorders since 91% of patients had a final score of over 25/30.
c. Very useful was the combination of the interview with the SKT. 57% of the patients had difficulty recalling earlier memories of objects of everyday life such as cups, umbrellas, chairs, dogs, etc. 35% of them had memory disturbances (in the same objects) and only 18 % of patient disorders in the memory of recognition. Difficulty in classifying numbers found in 20% of patients attributed more to attention disturbance than to critical impairment.
d. Cognitive fatigue was found at 57% of the patients, especially when they were tasked with evaluating numerous parameters at the same time. This disorder was particularly evident in patients with university education and those with increased professional responsibilities, causing difficulties
in their daily functioning, with consequent anxiety disorder
which increased their cognitive fatigue and decreased
their self-esteem. An indication of cognitive fatigue was
manifested as a disturbance of attention and concentration.
University students who suffered from MS noticed that they
could not concentrate and that they had to take many breaks
in order to achieve the desired result.
e. 43% of the patients showed difficulties in classifying
and organizing priorities in their daily life, resulting in
easy loss of control and this lead them to anxiety and panic
attacks. Most of them admitted that they felt safe following
their daily routine and became terrified to the idea of any
sudden change even on simple issues.
f. Most of the cognitive disorders were characterized as
mild to moderate, causing difficulties in the everyday life.
g. Two patients, suffered from SPMS for more than ten
years, were diagnosed with dementia, showed high disability
status and the greatest demyelination in the cerebral lobes.