Cognitive ımpairment ın relapsing-remitting multiple sclerosis

Barış TOPÇULAR,M. Emin ÖZCAN,ELİF KURT,Demet KUŞÇU YANDIM,Nilüfer İÇEN KALE,Pakize Nevin SUTLAS,DURSUN KIRBAŞ,Ayhan BİNGÖL

Abstract

Objective: To assess the frequency of cognitive impairment in patients with relapsing- remitting multiple sclerosis (RRMS) using the Brief Repeatable Battery (BRB), as well as to explore the associations of cognitive impairment with demographic and clinical parameters and to evaluate its relation with physical impairment and quality of life. Methods: Patients admitted to our hospital's Multiple Sclerosis and Demyelinating Diseases Outpatients Clinic between March and May 2010 were assessed using the BRB, Multiple Sclerosis Neuropsychological Questionnaire (MSNQ), Beck depression inventory (BDI), and the Functional Assessment of MS Quality of Life Instrument (FAMS). Results: Fifty-one patients fulfilled the study criteria. Mean test scores of the study group were PASAT 42.76±30.41; 10/36 Spatial Recall Test (SPART)-Total Learning (TL) 18.4±6.2; delayed recall (DR) 6.8±3.2; Selective Reminding Test (SRT)-TL 5.67±2.00; SRT-DR 4.67±2.00; Symbol-Digit Modalities Test (SDMT) 29.84±19.50; Word List Generation (WLG) 14.14±5.74. The mean score of MSNQ patient form was 10.27±11.95; BDI mean score was 20.20±12.17; FAMS mean score was 64.18±46.52. 41.17% of patients had cognitive impairment. Age, education level, and EDSS scores correlated with cognitive impairment (p<0.01; p<0.05; p<0,01 respectively). There was no correlation between cognitive impairment and either gender or disease duration (p>0.05; p>0.05, respectively). Patients with cognitive impairment had higher depression scores (p<0.01) and lower quality of life scores (p<0.01). Discussion: Cognitive impairment is a common problem in RRMS patients and plays a major role in the quality of life.

Özet

Amaç: Relapsing Remitting Multipl Skleroz (RRMS) hastalarnda Brief Repeatable Battery (BRB) ile kognitif durum tayini yaplarak kognitif bozukluun sklnn deerlendirmesi, kognitif bozukluk ile iliflkili demografik ve klinik parametrelerin incelenmesi ve kognitif bozukluk ile fiziksel özürlülük ve yaflam kalitesinin iliflkisinin deerlendirilmesi. Yöntem: Hastanemiz Multipl Skleroz ve Demiyelinizan Hastalklar polikliniine Mart-Mays 2010 tarihleri arasnda baflvuran hastalar BRB, Multiple Sclerosis Neuropsychological Questionnairre (MSNQ), Beck depresyon envanteri (BDI), Functional Assessment of MS (FAMS) yaflam kalitesi ölçei ile deerlendirildiler. Bulgular: Çalflma kriterlerine uygun toplam 51 hasta saptand. Çalflma grubunun ortalama skorlar PASAT 42,76±30,41; 10/36 uzamsal hatrlama testi ksa süreli bellek (KSB) 18,4±6,2, uzun süreli bellek (USB) 6,8±3,2; sözel bellek testi KSB 5,67±2,00, USB 4,67±2,00; sembol say modalitesi testi 29,84±19,50; sözel akclk testi 14,14±5,74tü. MSNQ hasta formu skor ortalamas 10,27±11,95; Beck depresyon envanteri skoru ortalamas 20,20±12,17; FAMS skorlar ortalamas 64,18±46,52ydi. Olgularn %41,17'sinde kognitif bozukluk tespit edildi. Yafl, eitim süresi, EDSS kognitif bozukluk ile iliflkiliyken (srasyla p 0,05; p>0,05)). Kognitif bozukluu olan olgularda depresyon skorlar daha yüksek (p<0,01) ve yaflam kalitesi skorlar daha kötüydü (p<0,01). Sonuç: Kogntitif bozukluk RRMS hastalarnda sk karfllafllan bir sorundur ve yaflam kalitesi üzerinde önemli rol oynamaktadr.