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Published in: BMC Neurology 1/2018

Open Access 01-12-2018 | Research article

Performance in daily activities, cognitive impairment and perception in multiple sclerosis patients and their caregivers

Authors: G. Fenu, M. Fronza, L. Lorefice, M. Arru, G. Coghe, J. Frau, M. G. Marrosu, E. Cocco

Published in: BMC Neurology | Issue 1/2018

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Abstract

Background

The relationship between cognitive assessment results in multiple sclerosis (MS) and performance in daily activities (DAs) remains unclear. Our study aimed to evaluate the relationship between cognitive functions (CF) measured by tests, performance in DAs, and the perception of CF in patients and their caregivers (CG) in MS.

Methods

The Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) battery was used to evaluate cognitive status. We created an ad hoc questionnaire (DaQ) to assess performance in DAs not requiring specific motor skills. We used the Multiple Sclerosis Neuropsychological Questionnaire (MSNQ) to measure each patient self-judgment and caregiver’s perception of CF.

Results

Forty-nine patients and their caregivers were included in the study. Significant correlations were found between the BICAMS and the DaQ (Symbol Digit Modalities Test (SDMT): r = − 0.48, p < 0.001; California Verbal Learning Test (CVLT): r = − 0.33, p = 0.01; Brief Visual Memory Test (BVMT-R): r = − 0.42; p = 0.002); patients self-judgment (SDMT: r = − 0.38, p = 0.004; CVLT: r = − 0.26, p = 0.03); caregiver perception of patient’s CF (SDMT: r = − 0.52, p < 0.001; CVLT: r = − 0.3, p = 0.01; BVMT-R: r = − 0.42, p = 0.002). The difference in perception between the patients and their caregivers was related to patient age (p = 0.001) and severity of cognitive impairment (p = 0.03).

Conclusions

Cognitive assessment results show a significant correlation with performance in daily activities and with patients and, especially, caregiver perception of cognitive impairment. These data support the importance of a routine evaluation of cognitive function in MS that includes an anamnestic evaluation of patients, and, when possible, consideration of the caregiver’s point of view.
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Literature
1.
go back to reference Steri M, Orrù V, Idda ML, Pitzalis M, Pala M, Zara I, Sidore C, Faà V, Floris M, Deiana M, Asunis I, Porcu E, Mulas A, Piras MG, Lobina M, Lai S, Marongiu M, Serra V, Marongiu M, Sole G, Busonero F, Maschio A, Cusano R, Cuccuru G, Deidda F, Poddie F, Farina G, Dei M, Virdis F, Olla S, Satta MA, Pani M, Delitala A, Cocco E, Frau J, Coghe G, Lorefice L, Fenu G, Ferrigno P, Ban M, Barizzone N, Leone M, Guerini FR, Piga M, Firinu D, Kockum I, Lima Bomfim I, Olsson T, Alfredsson L, Suarez A, Carreira PE, Castillo-Palma MJ, Marcus JH, Congia M, Angius A, Melis M, Gonzalez A, Alarcón Riquelme ME, da Silva BM, Marchini M, Danieli MG, Del Giacco S, Mathieu A, Pani A, Montgomery SB, Rosati G, Hillert J, Sawcer S, D'Alfonso S, Todd JA, Novembre J, Abecasis GR, Whalen MB, Marrosu MG, Meloni A, Sanna S, Gorospe M, Schlessinger D, Fiorillo E, Zoledziewska M, Cucca F. Overexpression of the cytokine BAFF and autoimmunity risk. N Engl J Med. 2017;376(17):1615–26.CrossRef Steri M, Orrù V, Idda ML, Pitzalis M, Pala M, Zara I, Sidore C, Faà V, Floris M, Deiana M, Asunis I, Porcu E, Mulas A, Piras MG, Lobina M, Lai S, Marongiu M, Serra V, Marongiu M, Sole G, Busonero F, Maschio A, Cusano R, Cuccuru G, Deidda F, Poddie F, Farina G, Dei M, Virdis F, Olla S, Satta MA, Pani M, Delitala A, Cocco E, Frau J, Coghe G, Lorefice L, Fenu G, Ferrigno P, Ban M, Barizzone N, Leone M, Guerini FR, Piga M, Firinu D, Kockum I, Lima Bomfim I, Olsson T, Alfredsson L, Suarez A, Carreira PE, Castillo-Palma MJ, Marcus JH, Congia M, Angius A, Melis M, Gonzalez A, Alarcón Riquelme ME, da Silva BM, Marchini M, Danieli MG, Del Giacco S, Mathieu A, Pani A, Montgomery SB, Rosati G, Hillert J, Sawcer S, D'Alfonso S, Todd JA, Novembre J, Abecasis GR, Whalen MB, Marrosu MG, Meloni A, Sanna S, Gorospe M, Schlessinger D, Fiorillo E, Zoledziewska M, Cucca F. Overexpression of the cytokine BAFF and autoimmunity risk. N Engl J Med. 2017;376(17):1615–26.CrossRef
2.
go back to reference Cocco E, Meloni A, Murru MR, et al. Vitamin D responsive elements within the HLA-DRB1 promoter region in Sardinian multiple sclerosis associated alleles. PLoS One. 2012;7(7):e41678.CrossRef Cocco E, Meloni A, Murru MR, et al. Vitamin D responsive elements within the HLA-DRB1 promoter region in Sardinian multiple sclerosis associated alleles. PLoS One. 2012;7(7):e41678.CrossRef
3.
go back to reference Cocco E, Murru R, Costa G, Kumar A, Pieroni E, Melis C, Barberini L, Sardu C, Lorefice L, Fenu G, Frau J, Coghe G, Carboni N, Marrosu MG. Interaction between HLA-DRB1-DQB1 haplotypes in Sardinian multiple sclerosis population. PLoS One. 2013;8(4):e59790.CrossRef Cocco E, Murru R, Costa G, Kumar A, Pieroni E, Melis C, Barberini L, Sardu C, Lorefice L, Fenu G, Frau J, Coghe G, Carboni N, Marrosu MG. Interaction between HLA-DRB1-DQB1 haplotypes in Sardinian multiple sclerosis population. PLoS One. 2013;8(4):e59790.CrossRef
4.
go back to reference Thompson AJ, Baranzini SE, Geurts J, Hemmer B, Ciccarelli O. Multiple sclerosis. Lancet. 2018;391(10130):1622–36.CrossRef Thompson AJ, Baranzini SE, Geurts J, Hemmer B, Ciccarelli O. Multiple sclerosis. Lancet. 2018;391(10130):1622–36.CrossRef
5.
go back to reference Lorefice L, Fenu G, Frau J, Coghe G, Marrosu MG, Cocco E. The impact of visible and invisible symptoms on employment status, work and social functioning in multiple sclerosis. Work. 2018;60(2):263–70.CrossRef Lorefice L, Fenu G, Frau J, Coghe G, Marrosu MG, Cocco E. The impact of visible and invisible symptoms on employment status, work and social functioning in multiple sclerosis. Work. 2018;60(2):263–70.CrossRef
6.
go back to reference Toosy A, Ciccarelli O, Thompson A. Symptomatic treatment and management of multiple sclerosis. Handb Clin Neurol. 2014;122:513–62.CrossRef Toosy A, Ciccarelli O, Thompson A. Symptomatic treatment and management of multiple sclerosis. Handb Clin Neurol. 2014;122:513–62.CrossRef
7.
go back to reference Solaro C, Trabucco E, Signori A, Martinelli V, Radaelli M, Centonze D, Rossi S, Grasso MG, Clemenzi A, Bonavita S, D'Ambrosio A, Patti F, D'Amico E, Cruccu G, Truini A. Depressive symptoms correlate with disability and disease course in multiple sclerosis patients: an Italian multi-center study using the Beck depression inventory. PLoS One. 2016;11(9):e0160261.CrossRef Solaro C, Trabucco E, Signori A, Martinelli V, Radaelli M, Centonze D, Rossi S, Grasso MG, Clemenzi A, Bonavita S, D'Ambrosio A, Patti F, D'Amico E, Cruccu G, Truini A. Depressive symptoms correlate with disability and disease course in multiple sclerosis patients: an Italian multi-center study using the Beck depression inventory. PLoS One. 2016;11(9):e0160261.CrossRef
9.
go back to reference Langdon DW, Amato MP, Boringa J, Brochet B, Foley F, Fredrikson S, Hämäläinen P, Hartung HP, Krupp L, Penner IK, Reder AT, Benedict RH. Recommendations for arief international cognitive assessment for multiple sclerosis (BICAMS). Mult Scler. 2012;18(6):891–8.CrossRef Langdon DW, Amato MP, Boringa J, Brochet B, Foley F, Fredrikson S, Hämäläinen P, Hartung HP, Krupp L, Penner IK, Reder AT, Benedict RH. Recommendations for arief international cognitive assessment for multiple sclerosis (BICAMS). Mult Scler. 2012;18(6):891–8.CrossRef
10.
go back to reference Korakas N, Tsolaki M. Cognitive impairment in multiple sclerosis: a review of neuropsychological assessments. Cogn Behav Neurol. 2016;29(2):55–67.CrossRef Korakas N, Tsolaki M. Cognitive impairment in multiple sclerosis: a review of neuropsychological assessments. Cogn Behav Neurol. 2016;29(2):55–67.CrossRef
11.
go back to reference Saccà F, Costabile T, Carotenuto A, Lanzillo R, Moccia M, Pane C, Russo CV, Barbarulo AM, Casertano S, Rossi F, Signoriello E, Lus G, Brescia Morra V. The EDSS integration with the brief international cognitive assessment for multiple sclerosis and orientation tests. Mult Scler. 2017;23(9):1289–96.CrossRef Saccà F, Costabile T, Carotenuto A, Lanzillo R, Moccia M, Pane C, Russo CV, Barbarulo AM, Casertano S, Rossi F, Signoriello E, Lus G, Brescia Morra V. The EDSS integration with the brief international cognitive assessment for multiple sclerosis and orientation tests. Mult Scler. 2017;23(9):1289–96.CrossRef
13.
go back to reference Goverover Y, Chiaravalloti N, DeLuca J. Brief international cognitive assessment for multiple sclerosis (BICAMS) and performance of everyday life tasks: actual reality. Mult Scler. 2016;22(4):544–50.CrossRef Goverover Y, Chiaravalloti N, DeLuca J. Brief international cognitive assessment for multiple sclerosis (BICAMS) and performance of everyday life tasks: actual reality. Mult Scler. 2016;22(4):544–50.CrossRef
14.
go back to reference Campbell J, Rashid W, Cercignani M, Langdon D. Cognitive impairment among patients with multiple sclerosis: associations with employment and quality of life. Postgrad Med J. 2017;93(1097):143–7.CrossRef Campbell J, Rashid W, Cercignani M, Langdon D. Cognitive impairment among patients with multiple sclerosis: associations with employment and quality of life. Postgrad Med J. 2017;93(1097):143–7.CrossRef
15.
go back to reference Benedict RH, Munschauer F, Linn R, Miller C, Murphy E, Foley F, Jacobs L. Screening for multiple sclerosis cognitive impairment using a self-administered 15-item questionnaire. Mult Scler. 2003;9(1):95–101.CrossRef Benedict RH, Munschauer F, Linn R, Miller C, Murphy E, Foley F, Jacobs L. Screening for multiple sclerosis cognitive impairment using a self-administered 15-item questionnaire. Mult Scler. 2003;9(1):95–101.CrossRef
16.
go back to reference Polman CH, Reingold SC, Banwell B, Clanet M, Cohen JA, Filippi M, Fujihara K, Havrdova E, Hutchinson M, Kappos L, Lublin FD, Montalban X, O'Connor P, Sandberg-Wollheim M, Thompson AJ, Waubant E, Weinshenker B, Wolinsky JS. Diagnostic criteria for multiple sclerosis: 2010 revisions to the McDonald criteria. Ann Neurol. 2011;69(2):292–302.CrossRef Polman CH, Reingold SC, Banwell B, Clanet M, Cohen JA, Filippi M, Fujihara K, Havrdova E, Hutchinson M, Kappos L, Lublin FD, Montalban X, O'Connor P, Sandberg-Wollheim M, Thompson AJ, Waubant E, Weinshenker B, Wolinsky JS. Diagnostic criteria for multiple sclerosis: 2010 revisions to the McDonald criteria. Ann Neurol. 2011;69(2):292–302.CrossRef
17.
go back to reference Kurtzke JF. Rating neurologic impairment in multiple sclerosis: an expanded disability status scale (EDSS). Neurology. 1983;33(11):1444–52.CrossRef Kurtzke JF. Rating neurologic impairment in multiple sclerosis: an expanded disability status scale (EDSS). Neurology. 1983;33(11):1444–52.CrossRef
18.
go back to reference Goretti B, Niccolai C, Hakiki B, Sturchio A, Falautano M, Minacapelli E, Martinelli V, Incerti C, Nocentini U, Murgia M, Fenu G, Cocco E, Marrosu MG, Garofalo E, Ambra FI, Maddestra M, Consalvo M, Viterbo RG, Trojano M, Losignore NA, Pietrolongo E, Lugaresi A, Langdon D, Portaccio E, Amato MP. The brief international cognitive assessment for multiple sclerosis (BICAMS): normative values with gender, age and education corrections in the Italian population. BMC Neurol. 2014;14:171.CrossRef Goretti B, Niccolai C, Hakiki B, Sturchio A, Falautano M, Minacapelli E, Martinelli V, Incerti C, Nocentini U, Murgia M, Fenu G, Cocco E, Marrosu MG, Garofalo E, Ambra FI, Maddestra M, Consalvo M, Viterbo RG, Trojano M, Losignore NA, Pietrolongo E, Lugaresi A, Langdon D, Portaccio E, Amato MP. The brief international cognitive assessment for multiple sclerosis (BICAMS): normative values with gender, age and education corrections in the Italian population. BMC Neurol. 2014;14:171.CrossRef
21.
go back to reference Nucci M, Mapelli D, Mondini S. Cognitive reserve index questionnaire (CRIq): a new instrument for measuring cognitive reserve. Aging Clin Exp Res. 2012;24(3):218–26.PubMed Nucci M, Mapelli D, Mondini S. Cognitive reserve index questionnaire (CRIq): a new instrument for measuring cognitive reserve. Aging Clin Exp Res. 2012;24(3):218–26.PubMed
22.
go back to reference Fenu G, Lorefice L, Arru M, et al. Cognition in multiple sclerosis: between cognitive reserve and brain volume. J Neurol Sci. 2018;386:19–22.CrossRef Fenu G, Lorefice L, Arru M, et al. Cognition in multiple sclerosis: between cognitive reserve and brain volume. J Neurol Sci. 2018;386:19–22.CrossRef
23.
go back to reference Strober LB, Binder A, Nikelshpur OM, Chiaravalloti N, DeLuca J. The perceived deficits questionnaire: perception, deficit, or distress? Int J MS Care. 2016;18(4):183–90.CrossRef Strober LB, Binder A, Nikelshpur OM, Chiaravalloti N, DeLuca J. The perceived deficits questionnaire: perception, deficit, or distress? Int J MS Care. 2016;18(4):183–90.CrossRef
24.
go back to reference Benedict RH, Cox D, Thompson LL, Foley F, Weinstock-Guttman B, Munschauer F. Reliable screening for neuropsychological impairment in multiple sclerosis. Mult Scler. 2004;10(6):675–8.CrossRef Benedict RH, Cox D, Thompson LL, Foley F, Weinstock-Guttman B, Munschauer F. Reliable screening for neuropsychological impairment in multiple sclerosis. Mult Scler. 2004;10(6):675–8.CrossRef
26.
go back to reference Julian L, Merluzzi NM, Mohr DC. The relationship among depression, subjective cognitive impairment, and neuropsychological performance in multiple sclerosis. Mult Scler. 2007;13(1):81–6.CrossRef Julian L, Merluzzi NM, Mohr DC. The relationship among depression, subjective cognitive impairment, and neuropsychological performance in multiple sclerosis. Mult Scler. 2007;13(1):81–6.CrossRef
28.
go back to reference Niccolai C, Portaccio E, Goretti B, Hakiki B, Giannini M, Pastò L, Righini I, Falautano M, Minacapelli E, Martinelli V, Incerti C, Nocentini U, Fenu G, Cocco E, Marrosu MG, Garofalo E, Ambra FI, Maddestra M, Consalvo M, Viterbo RG, Trojano M, Losignore NA, Zimatore GB, Pietrolongo E, Lugaresi A, Pippolo L, Roscio M, Ghezzi A, Castellano D, Stecchi S, Amato MP. A comparison of the brief international cognitive assessment for multiple sclerosis and the brief repeatable battery in multiple sclerosis patients. BMC Neurol. 2015;15:204.CrossRef Niccolai C, Portaccio E, Goretti B, Hakiki B, Giannini M, Pastò L, Righini I, Falautano M, Minacapelli E, Martinelli V, Incerti C, Nocentini U, Fenu G, Cocco E, Marrosu MG, Garofalo E, Ambra FI, Maddestra M, Consalvo M, Viterbo RG, Trojano M, Losignore NA, Zimatore GB, Pietrolongo E, Lugaresi A, Pippolo L, Roscio M, Ghezzi A, Castellano D, Stecchi S, Amato MP. A comparison of the brief international cognitive assessment for multiple sclerosis and the brief repeatable battery in multiple sclerosis patients. BMC Neurol. 2015;15:204.CrossRef
Metadata
Title
Performance in daily activities, cognitive impairment and perception in multiple sclerosis patients and their caregivers
Authors
G. Fenu
M. Fronza
L. Lorefice
M. Arru
G. Coghe
J. Frau
M. G. Marrosu
E. Cocco
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Neurology / Issue 1/2018
Electronic ISSN: 1471-2377
DOI
https://doi.org/10.1186/s12883-018-1224-z

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