Polish validation of the Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS battery): correlation of cognitive impairment with mood disorders and fatigue.

BACKGROUND: Cognitive impairment is recognised as a significant clinical issue in Multiple Sclerosis (MS). It can occur at any stage of the disease, affecting quality of life, occupational activity, and adherence to therapy. This makes the availability of a validated assessment tool for detecting and monitoring cognitive dysfunction in multiple sclerosis essential. The Brief International Cognitive Assessment for Multiple Sclerosis is a practical and simple means of administering a battery of three neuropsychological tests, and does not require any formal neuropsychological training. OBJECTIVE: To establish the validity of BICAMS in the Polish MS population; to assess the correlations of cognitive status with demographic and clinical factors, including affective symptoms and fatigue. METHODS: BICAMS was administered to 61 MS patients and 61 HC subjects. Examination of 20 participants with MS was repeated after one to three weeks to assess test-retest reliability. The patients with MS and HC subjects also completed the Hospital Anxiety and Depression Scale (HADS) and Modified Fatigue Impact Scale (MFIS). RESULTS: The MS group performed worse than the HC group in all three BICAMS components, obtaining the following values respectively: 51.7 and 56.1 (p = 0.02) for CVLT, 25 and 28 (p = 0.03) for BVMT-R, and 48.8 and 57.2 (p < 0.001) for SDMT. All BICAMS tests had very significant correlations in test-retest reliability (r = 0.83, p < 0.001 for CVLT; r = 0.84, p < 0.001 for BVMTR; r = 0.9, p < 0.001 for SDMT). 34% of MS patients presented cognitive dysfunction based on the criterion of one or more test scores below the 5th percentile value of the HC group. Significant anxiety and depressive symptoms were reported by 31.1% and 18.0% of MS patients. 31.1% of PwMS reported significant fatigue. BICAMS test results were not associated with HADS or MFIS scores. CONCLUSIONS: The Polish version of BICAMS is a valid and reliable tool for the assessment of cognitive impairment in patients with MS.

Predictive Value of the Third Ventricle Width for Neurological Status in Multiple Sclerosis.

The third ventricle width (3VW) is an easily calculated measure of brain atrophy. The aim of this study was to evaluate the relation of 3VW to cognitive impairment with adjustment for demographic and clinical confounders, including depression, anxiety, and fatigue, as well as to disability in patients with multiple sclerosis (MS). Symbol Digit Modalities Test, California Verbal Learning Test, Brief Visuospatial Memory Test-Revised, Expanded Disability Status Scale (EDSS), Hospital Anxiety and Depression Scale, and Modified Fatigue Impact Scale (MFIS) were analysed in 93 patients with MS. Neuropsychological performance was compared to that of 150 healthy controls. Axial images from 3D FLAIR were used to measure 3VW. In total, 25% of MS patients were impaired in at least two neuropsychological tests. Cognitive impairment and EDSS were associated with 3VW. Age and 3VW were the strongest predictors of cognitive impairment. The multiple regression model including age, 3VW, education, EDSS, and MFIS explained 63% of the variance of neuropsychological tests results, whereas 3VW, age and duration of the disease were significant predictors of EDSS. This study confirms the predictive value of 3VW for neurological status of patients with MS, especially for cognitive impairment after adjustment for demographic and clinical confounders.

Memory in Polish multiple sclerosis patients - correlations with mood and fatigue. / Pamiec u polskich pacjentów ze stwardnieniem rozsianym ­ korelacje z nastrojem i zespolem zmeczenia.

OBJECTIVES: Assessment of the selected aspects of memory in Polish patients with multiple sclerosis (MS) and the associations between memory and clinical course, neurological status, mood, fatigue, and employment status. METHODS: The initial five learning trials of the California Verbal Learning Test (CVLT), the initial three learning trials of the Brief Visuospatial Memory Test-revised (BVMT-R), the Hospital Anxiety and Depression Scale and Modified Fatigue Impact Scale were administered to 100 MS patients and 150 healthy participants (HP). RESULTS: The MS group performed worse than the HP group on both the CVLT and the BVMT-R. The lowest scores were obtained by secondary progressive MS patients. There were significant differences between the MS and HP group on fatigue and depression, but not anxiety. Multivariate analysis showed worse neurological status was the only clinical predictor of memory disturbances. CVLT scores were significantly associated with employment status. CONCLUSIONS: Memory impairment occurs in patients with MS and affects employment status. Depressive symptoms, anxiety and fatigue, unlike neurological status, were not directly related to memory status.

Behavioral variant frontotemporal dementia with dominant gait disturbances - case report. / Wariant behawioralny otepienia czolowo-skroniowego z dominujacymi zaburzeniami chodu w obrazie klinicznym - opis przypadku.

INTRODUCTION.: Behavioural variant frontotemporal dementia is a clinically and pathologically heterogeneous neurodegenerative disorder, characterised by progressive behavioural changes and executive function impairment. It is the second most common neurodegenerative cause of dementia after Alzheimer's type dementia. Atypical course of the disease, including cases with other symptoms relevantly interfering with the clinical picture, provides a challenge in the diagnostic process. AIM AND MATERIAL.: The aim of this paper is to present a case of patient with BvFTD and gait disturbance as a main reported symptom masking behavioural changes and cognitive function impairment. Gait disturbance commonly occurs at the late stage of dementia disorders. It results from gait apraxia, extrapyramidal syndrome or motor neuron dysfunction. However, it is not a predominant symptom of behavioural variant frontotemporal dementia excluding terminal stage of the disease. RESULTS: Presented case emphasises the significance of accurately gathered anamnesis with patient and his family. Behavioural variant frontotemporal dementia should be considered in cases of unexplained gait abnormalities.