People with multiple sclerosis (PwMS) often experience symptoms that can have a significant impact on psychological and cognitive functioning. Research has previously shown a significant...Show morePeople with multiple sclerosis (PwMS) often experience symptoms that can have a significant impact on psychological and cognitive functioning. Research has previously shown a significant association between these two functions. The aim of this paper was to study the association between psychological factors (depression and fatigue) and cognitive functions (memory, verbal fluency, and information processing speed). Studying fatigue, depressed mood, and the combination between them can provide important indications to how psychological status relates to cognitive functioning. Cognitive functions of memory, verbal fluency, and information processing speed were measured through Buschke Selective Reminding test, Controlled Oral Word Association test, and the Symbol Digit Modalities test, respectively. Depressed mood was measured with the Hospital Anxiety and Depression Scale, and fatigue was measured with the Fatigue Scale for Motor and Cognitive Functions. Patients (N=124; mean age = 50.77 [SD = 13.5]; 25% male, 93% female; 9.7% PPMS, 28.5% SPMS, 61.3% RRMS) were categorized into four groups based on their depression and fatigue scores using clinical cut-offs (i.e., psychologically intact [no depressive mood, not fatigued], depressive mood but not fatigued, fatigued but no depressive mood, and psychologically impaired [depressive mood and fatigued]). Group did significantly differ on MS type (p < .05), Group 1 (psychologically intact) and Group 4 (no depressive mood but fatigued) were more likely to have a relapse-remitting disease course. However, findings suggest no significant association between group and cognitive functioning. Scores on the cognitive tests were similar across all groups (p = .203). This indicates that cognitive functioning is independent of psychological status. However, in light of the limitations, it is important to build on future studies to investigate this relationship further, to indicate a next step in the treatment and intervention of MS in terms of psychological problems, cognitive deficits, or both.Show less
Information processing speed (IPS) impairment is a disabling cognitive symptom often present in people with multiple sclerosis (PwMS). IPS is the foundation of higher order cognitive processes, and...Show moreInformation processing speed (IPS) impairment is a disabling cognitive symptom often present in people with multiple sclerosis (PwMS). IPS is the foundation of higher order cognitive processes, and therefore IPS dysfunction significantly lowers quality of live. Early identification of PwMS at risk for IPS decline is necessary in order to provide timely cognitive rehabilitation and psychoeducation. As such, identifying who will or will not develop IPS impairment over time is important. Here, we investigated retrospectively which characteristics were associated with IPS impairment in a real-life sample of 218 PwMS (158 female; age M=47±12.7; baseline disease duration M=9.8±9.9) that visited the Noorderhart Rehabilitation and MS Centre in Overpelt (Belgium). IPS decline was determined based on performance on the Symbol Digit Modalities Test (SDMT), with two threshold settings: (1) minus 1.5 standard deviation, and (2) minus eight points decline of raw score. Next to SDMT scores, demographic information was collected (sex, age, educational level) as well as MS-specific characteristics (disease severity [measured with the EDSS], disease duration, MS subtype), and psychological measures (fatigue [FSMC], depression and anxiety [HADS]). The analyses at baseline showed that EDSS score (impaired median=4 [2.5-6]; preserved median=2 [1.1-3.5]; d=0.9), disease duration (impaired M=11±10.8; preserved M=7±7.6; ƞ2=0.04), MS subtype (V=0.26), and perceived fatigue (impaired M=68.2±18.5; preserved M=53.5±20.8; d=0.75) were significantly higher/ progressive for IPS impaired PwMS (N=134) compared to preserved (N=84). Measured over time (average of three years), nine PwMS (N=50) were found to decline from preserved IPS functioning into impairment, independent of threshold setting for impairment. However, for both thresholds no longitudinal differences between IPS impaired and preserved PwMS were found. Our results demonstrate that IPS impairment is very prevalent in PwMS (61% at baseline) and is associated with higher levels of disability (more progressive subtype, longer disease duration, higher disease severity) and more fatigue. Worsening of these factors indicate the need to pay extra attention to IPS functioning. Secondly, IPS impairment does not develop quickly, with only a few PwMS (9/50) who decline into IPS impairment in a three-year period. It is recommended to start early with regular measurements of cognitive functioning to detect initial IPS changes.Show less
