http://data.spotlighthealth.com/nasp/faxwatch/msarticle.asp?article_id=195

June 8, 2001

In the early phase of relapsing-remitting MS, cognitive deterioration depends more on loss of brain function rather than progression of disease burden, a new study demonstrated.

For a two-year period, 53 patients with clinically definite relapsing-remitting MS were monitored. The patients had a disease duration of one to five years and their Expanded Disability Status Scale (EDSS) was less than or equal to five at the beginning of the study.

Neuropsychological performances, psychological functioning, neurological impairment and disability were assessed at baseline and after two years. All patients underwent MRI screening.

Overall, 26.4 percent of the patients were cognitively impaired at baseline as compared with 52.8 percent at the end of the follow-up period.

Of the 18 neuropsychological tests performed in the study, patients with MS failed approximately six and eight tests at the beginning and end of the study, respectively.

Five patients were cognitively improved, 33 remained stable, and 15 patients worsened during the follow-up period.

Change in brain parenchymal volumes, or volume of functional elements of the brain, independently predicted cognitive impairment during the study period, the scientists noted.

Moreover, 10 patients who had worsened by one or more points in the EDSS experienced significant decreases in brain parenchymal volumes. At the end of the study, a significant correlation was reported between loss of brain function and change in EDSS.

“These data support the debated opinion that disease modifying therapy should be initiated as early as possible,” the investigators concluded.

The study appears in the June issue of the Journal of Neurology, Neurosurgery and Psychiatry.