Cognitive Impairment and Brain Atrophy in Relapsing Remitting and Secondary Progressive Multiple Sclerosis

Background: Multiple Sclerosis (MS) is the most common neuroimunological disease. Cognitive impairment affects social relationship, work capacity, and quality of life independently of the disability.Objective: To study the pattern of cognitive impairment in various types of MS and to investigate the relationship between cognitive impairment and clinical parameters and brain atrophy.Methods: This study included 40 patients of both sexes with definite multiple sclerosis (20 RRMS and 20 SPMS) and 20 healthy control persons matched for age, sex and education. Cognitive functions tests have been done for both groups, MRI of the brain have been done for MS group.Results: A significant difference was found between patients and control in most of cognitive function tests and 72.5% of patients had a significant cognitive impairment. Patients with SPMS were more frequently impaired than patients with RRMS in information processing speed (p= 0.001), sustained attention (p 0.001), working memory (p= 0.001) verbal memory (p=0.02). 32589, and visual memory and visuospatial function (p=0.02). Up to 85% patients had signs of brain atrophy (increased global cortical atrophy and bicaudate ratio). The relationships between cognitive impairment and severity of disability as well as brain atrophy were strong.Conclusion: The commonest cognitive impairment in MS subtypes patients was the speed of information processing, working memory and sustained attention. Brain atrophy is a good predictor of cognitive impairment in MS patients.