Hostname: page-component-78c5997874-s2hrs Total loading time: 0 Render date: 2024-11-10T07:42:33.423Z Has data issue: false hasContentIssue false

Cognitive abnormalities in multiple sclerosis: a psychometric and MRI study

Published online by Cambridge University Press:  09 July 2009

M. A. Ron*
Affiliation:
National Hospital for Neurology and Neurosurgery: and Institute of Neurology, London
M. M. Callanan
Affiliation:
National Hospital for Neurology and Neurosurgery: and Institute of Neurology, London
E. K. Warrington
Affiliation:
National Hospital for Neurology and Neurosurgery: and Institute of Neurology, London
*
1Address for correspondence: Dr M. A. Ron, National Hospital for Neurology and Neurosurgery, Queen Square, London WCIN 3BG.

Synopsis

This study reports the cognitive abnormalities of a group of 58 patients with definite multiple sclerosis (MS). The psychometric functions measured were: ‘IQ deficit’, verbal and visual memory, abstracting ability, visual and auditory attention and naming ability. The presence of brain pathology was investigated using magnetic resonance imaging (MRI). A group of 46 physically disabled controls without significant brain disease was used for comparison. Normative MRI data were obtained from a groulp of 40 normal volunteers. The psychometric performance of the MS group was compared to the previously reported findings in patients with clinically isolated syndromes.

MS patients had widespread cognitive deficits sparing naming ability and affecting verbal memory less severely than other intellectual functions. The overall performance on psychometric tests was related to the severity of the MRI abnormalities and to the duration of the illness, but was not significantly influenced by the presence of psychiatric morbidity or the degree of physical disability. Patients with clinically isolated syndromes occupied an intermediate position between MS patients and disabled controls in terms cognitive and MRI abnormalities.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 1991

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Barnes, D., McDonald, W. I., Johnson, G., Tofts, P. S. & Landon, D. N. (1987). Quantitative nuclear magnetic resonance imaging: characterization of experimental cerebral oedema. Journal of Neurology, Neurosurgery and Psychiatry 50, 125133.CrossRefGoogle ScholarPubMed
Bergin, J. D. (1957). Rapidly progressing dementia in disseminated Sclerosis. Journal of Neurology, Neurosurgery and Psychiatry 20, 285292.CrossRefGoogle ScholarPubMed
Brooks, D. J., Leenders, K. L., Head, G., Marshall, J., Legg, N. J. & Jones, T. (1984). Studies on regional cerebral oxygen utilization and cognitive function in multiple sclerosis. Journal of Neurology, Neurosurgery and Psychiatry 47, 11821191.CrossRefGoogle ScholarPubMed
Van den Burg, W., Zomeren, A. H., Minderhoud, J. M., Prange, A. J. & Meijer, N. S. (1987). Cognitive impairment in patients with multiple sclerosis and mild physical disability. Archives of Neurology 44, 494501.CrossRefGoogle ScholarPubMed
Callanan, M. M., Logsdail, S. J., Ron, M. A. & Warrington, E. K. (1989). Cognitive impairment in patients with clinically isolated lesions of the type seen in multiple sclerosis. Brain 112, 361374.CrossRefGoogle ScholarPubMed
Charcot, J. M. (1877). Lectures on the Diseases of the Nervous System Delivered at the Salpétrière. New Sydenham Society: London.Google Scholar
Coughlan, A. K. & Hollows, S. E. (1984). Use of memory tests in differentiating organic disorder from depression. British Journal of Psychiatry 145, 164167.CrossRefGoogle ScholarPubMed
Fazekas, F., Offenbacher, H., Fuchs, S., Schmidt, R., Niederkorn, K., Horner, S. & Lechner, H. (1988). Criteria for an increased specificity of MRI interpretation in elderly subjects with suspected multiple sclerosis. Neurology 38, 18221825.CrossRefGoogle ScholarPubMed
Filley, C. M., Heaton, R. K., Nelson, L. M., Burks, J. S. & Franklin, G. M. (1989). A comparison of dementia in Alzheimer' disease and multiple sclerosis. Archives of Neurology 46, 157161.CrossRefGoogle ScholarPubMed
Franklin, G. M., Heaton, R. K., Nelson, L. M., Filley, C. M. & Seibert, C. (1988). Correlation of neuropsychological and MRI findings in chronic progressive multiple sclerosis. Neurology 38, 18261929.CrossRefGoogle ScholarPubMed
Franklin, G. M., Nelson, L. M., Filley, C. M. & Heaton, R. K. (1989). Cognitive loss in multiple sclerosis. Archives of Neurology. 46, 162167.CrossRefGoogle ScholarPubMed
Gerard, G. & Wisberg, L. A. (1986). MRI Periventricular lesions in adults. Neurology 36, 9981001.CrossRefGoogle ScholarPubMed
Goldberg, D. P. (1972). The Detection of Psychiatric Illness by Questionnaire. Oxford University Press: London.Google Scholar
Goldberg, D. P., Cooper, B., Eastwood, M. R., Kedward, H. B. & Shepherd, M. (1970). A standardized psychiatric interview for use in community surveys. British Journal of Prventive and Social Medicine 24, 1823.Google ScholarPubMed
Grant, I., McDonald, W. I., Trimble, M. R., Smith, E. & Reed, R. (1984). Deficient learning and memory in early and middle phases of multiple sclerosis. Journal of Neurology, Neurosurgery and Psychiatry 47, 250255.CrossRefGoogle ScholarPubMed
Howarth, R. J. & Hollings, E. M. (1979) Are hospital assessments of daily living activities valid? International Rehabilitation Medicine 1, 5962.CrossRefGoogle Scholar
Huber, S. J., Paulson, G. W., Shuttelworth, E. C., Chakers, D., Clapp, L. E., Pakalnis, A., Weiss, K. & Rammohan, K. (1987). Magnetic resonance imaging correlates of dementia in multiple sclerosis. Archives of Neurology 44, 732736.CrossRefGoogle ScholarPubMed
Isaac, C., Li, D. K. B., Genton, M., Jardine, C., Grochowski, E., Palmer, M., Kastrukoff, L. F., Oger, J. & Paty, D. W. (1988). Multiple sclerosis: a serial study using MRI in relapsing patients. Neurology 38, 15111515.CrossRefGoogle ScholarPubMed
Ivnik, R. J. (1978). Neuropsychological stability in multiple sclerosis. Journal of Consulting and Clinical Psychology 46, 913923.CrossRefGoogle ScholarPubMed
Kermode, A. G., Thompson, A. J., Tofts, P., MacManus, D. G., Kendall, B. E., Kingsley, D. P. E.Moseley, I. F., Rudge, P. & McDonald, W. I. (1990 a). Breakdown of the blood brain barrier precedes symptoms and other MRI signs of new lesions in multiple sclerosis: pathogenic and clinical implications. Brain (in the press).CrossRefGoogle Scholar
Kermode, A. G., Tofts, P. S., Thompson, A. J., MacManus, D. G., Rudge, P., Kendall, B. E., Kingsley, D. P. E., Moseley, I. F., du Boulay, E. P. G. H. & McDonald, W. I. (1990 b). Heterogeneity of blood brain barrier changes in multiple sclerosis: an MRI study. Neurology 40, 229235.CrossRefGoogle ScholarPubMed
Litvan, I., Grafman, J., Vendrell, P. & Martinez, J. M. (1988 a). Slowed information processing in multiple sclerosis. Archives of Neurology 45, 281285.CrossRefGoogle ScholarPubMed
Litvan, I., Grafman, J., Vendrell, P., Martinez, J. M., Junque, C., Vendrell, J. M. & Barraquer-Bordas, J. L. (1988 b). Multiple memory deficits in patients with multiple sclerosis. Exploring the working memory system. Archives of Neurology 45, 607610.CrossRefGoogle ScholarPubMed
Logsdail, S. J., Callanan, M. M. & Ron, M. A. (1988). Psychiatric morbidity in patients with clinically isolated lesions of the type seen in multiple sclerosis: a clinical and MRI study. Psychological Medicine 18, 355364.CrossRefGoogle ScholarPubMed
McKenna, P. & Warrington, E. K. (1976). Graded Naming Test: Manual. NFER, Nelson: Windsor.Google Scholar
Nelson, H. E. (1976). A modified card sorting test sensitive to frontal lobe defects. Cortex 12, 313324.CrossRefGoogle ScholarPubMed
Nelson, H. E. (1982). National Adult Reading Test: Manual. NFER, Nelson, Windor.Google Scholar
Omerod, I. E., Miller, D. H., McDonald, W. I., du Boulay, G. H., Rudge, P., Kendall, B. E., Moseley, I. F., Johnson, G., Tofts, P. S., Halliday, A. M., Bronstein, A. M., Scaravilli, F., Harding, A. E., Barnes, D. & Zilkha, K. J. (1987). The role of NMR imaging in the assessment of multiple sclerosis and isolated neurological lesions: a quantitative study. Brain 110, 15791616.CrossRefGoogle Scholar
Parsons, O. A., Steward, K. D., & Arenberg, D. (1957). Impairment of abstracting ability in multiple sclerosis. Journal of Nervous and Mental Disease 125, 221225.CrossRefGoogle ScholarPubMed
Poser, C. M., Paty, D. W., Scheinberg, L., McDonald, W. I., Davis, F. A., Ebers, G. C., Johnson, K. P., Sibley, W. A., Silberberg, D. H. & Tourtelotte, W. W. (1983). New diagnostic criteria for multiple sclerosis: guidelines for research protocols. Annals of Neurology 13, 227231.CrossRefGoogle ScholarPubMed
Press, G. A., Amaral, D. G. & Squire, L. R. (1989). Hippocampal abnormalities in amnesic patients revelated by high resolution magnetic resonance imaging. Nature 341, 5457.CrossRefGoogle Scholar
Rabins, P. V., Brooks, B. R., O'Donnell, P., Pearlson, G. D., Moberg, P., Jubelt, B., Coyle, P., Daloes, N. & Folstein, M. F. (1986). Structural brain correlates of emotional disorder in multiple sclerosis. Brain 109, 585597.CrossRefGoogle ScholarPubMed
Rao, S. M., Hammeke, T. A., McQuillen, M. P., Khatri, B. O. & Lloyd, D. (1984). Memory disturbance in chronic progressive multiple sclerosis. Archives of neurology 41, 625631.CrossRefGoogle ScholarPubMed
Rao, S. M., Glatt, S., Hammeke, T. A., McQuillen, M. P., Khatri, B. O., Rhodes, A. M. & Pollard, S. (1985). Chronic Progressive multiple sclerosis: relationship between cerebral ventricular size and neuropsychological impariment. Archives of Neurology 42, 678682.CrossRefGoogle Scholar
Rao, S. M., St Aubin-Faubert, P. & Leo, G. J. (1989 a). Information processing in patients with multiple sclerosis. Journal of Clinical and Experimental Neuropsychology 11, 471477.CrossRefGoogle ScholarPubMed
Rao, S. M., Leo, G. J., Haughton, V. M., St Aubin-Faubert, P. & Bernardin, L. (1989 b). Correlation of magnetic resonance imaging with neurposychological testing in multiple sclerosis. Neurology 39, 161166.CrossRefGoogle ScholarPubMed
Reitan, R. M., Reed, J. C. & Dyken, M. L. (1971). Cognitive, psychomotor and motor correlations of multiple sclerosis. Journal of Nervous and Mental Disease 153, 218224.CrossRefGoogle ScholarPubMed
Ron, M. A. & Logsdail, S. J. (1989). Psychiatric morbidity in multiple sclerosis: a clinical and MRI study. Psychological Medicine 19, 887895.CrossRefGoogle ScholarPubMed
Thompson, A. J., Kermode, A. G., McManus, D. G., Kingsley, D. P. E., Kendall, B. E., Moseley, I. F. & McDonald, W. I. (1989). Pathogenesis of progressive multiple sclerosis. Lancet i, 13221323.CrossRefGoogle Scholar
Warrington, E. K. (1984). Recognition Memory Tests. NFER, Nelson: Windsor.Google Scholar
Wechsler, D. (1955). Wechsler Adult Intelligence Scale: Manual. Psychological Corporation: New York.Google Scholar
Willison, J. R., Thomas, D. J., du Boulay, G. H., Marshall, J., Paul, E. A., Person, T. C., Ross Russell, R. W., Symon, L. & Wetherley-Mein, G. (1980). Effect of high haematocrit on alertness. Lancet i, 846848.CrossRefGoogle Scholar