Search

Background: Neuropsychiatric changes are common in multiple sclerosis (MS). Personality in persons with MS (pwMS) is understudied despite its implications for health behaviours, symptoms, and quality of life (QOL)., Objective: To assess baseline personality characteristics and their relationship to information processing speed (IPS) and mood in persons with early MS., Methods: A retrospective chart review of 384 pwMS who had psychometric testing within 2 years of diagnosis between February 2012 and May 2021. Testing included the NEO-Five Factor Inventory, Symbol Digit Modalities Test, and Hospital Anxiety and Depression Scale (HADS)., Results: Participants were highly agreeable (53.7%). Most had impaired IPS (60.5%). Anxiety and depression were present in 194 (50.5%) and 87 (22.6%) participants, respectively. Females were more agreeable and conscientious. Neuroticism, conscientiousness, and extraversion had moderate-high correlations with anxiety and depression. Despite weak correlations with conscientiousness, extraversion, and openness, pwMS with impaired versus normal IPS had no significant personality differences., Conclusions: Individuals with recently diagnosed MS are agreeable, typically have impaired IPS, and often have anxiety or depression. Significant personality differences exist between sexes and between pwMS with or without anxiety or depression. Early identification of these neuropsychiatric traits in pwMS may improve treatment adherence, symptoms, and QOL., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Bladder dysfunction is common in persons with MS (PwMS), often due to detrusor muscle overactivity. Anticholinergic medications are considered the first line treatment for bladder dysfunction and are known to worsen cognition in healthy older adults and in persons with dementia. Yet, it is not known if these medications have the same effect on PwMS. Thus, the Objective of this prospective matched-cohort study was to determine if anticholinergic medications affect objective measures of cognition in PwMS. We recruited PwMS starting either oxybutynin or tolterodine (cases). Cases and controls were tested with the Brief International Cognitive Assessment for MS (BiCAMS) battery prior to starting anticholinergic medications and 12weeks later. The primary outcome was change on the Symbol Digit Modalities Test (SDMT) between groups; secondary outcomes were changes on the other BiCAMS measures. Analysis of Covariance with baseline measures as covariates to assess the significance of between group differences was performed at 12weeks. Forty eight PwMS starting anticholinergic medications and 21 matched PwMS controls were recruited. There was a significant difference (p<0.001) in the change on the cognitive measures over 12weeks between groups. The controls demonstrated improvement, consistent with practice effect, while the cases remained unchanged. This study demonstrates that anticholinergic medications may have a negative effect on cognition in PwMS; further confirmatory studies are needed., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Objectives: One of the most frequently disabling symptoms in Multiple Sclerosis (MS) is cognitive impairment which is often insidious in onset and therefore difficult to recognize in the early stages, for both persons with MS and clinicians. A biomarker that would help identify those at risk of cognitive impairment, or with only mild impairment, would be a useful tool for clinicians. Using MRI, already an integral tool in the diagnosis and monitoring of disease activity in MS, would be ideal. Thus, this study aimed to determine if simple measures on routine MRI could serve as potential biomarkers for cognitive impairment in MS., Patients and Methods: We retrospectively identified 51 persons with MS who had a cognitive assessment and MRI within six months of the MRI. Simple linear measurements of the hippocampi, bifrontral and third ventricular width, bicaudate width and the anterior, mid and posterior corpus callosum were made. Pearson's correlations examined the relationship between these MRI measures and cognitive tests, and MRI measures were compared in persons with MS who were either normal or cognitively impaired on objective cognitive tests using Analysis of Covariance (ANCOVA)., Results: Bicaudate span and third ventricular width were both negatively correlated, while corpus callosal measures were positive correlated with cognitive test performance. After controlling for potential confounders, bicaudate span was significant different on measures of immediate recall. Both anterior and posterior corpus collosal measure were significantly different on measures of verbal fluency, immediate recall and higher executive function; while the anterior corpus callosum was also significantly different on processing speed. The middle corpus collosal measure was significantly different on immediate recall and higher executive function., Conclusion: This study presents data demonstrating that simple to apply MRI measures of atrophy may serve as biomarkers for cognitive impairment in persons with MS. Further prospective studies are needed to validate these findings., (Copyright © 2016 Elsevier B.V. All rights reserved.)