The follow-UP of the cognitive functions in the multipl skleroz

Introduction: The incidence of cognitive impairment in MS patients is 43-70%. The most frequently affected cognitive functions are; speed of information processing, memory, executive functions, attention, visual-perceptual functions. Disability scales used in the routine do not assess cognitive performance. However, cognitive loss is an important influence that causes problems in business, social and family life. For this reason, in MS patients, cognitive status is definitely evaluated with appropriate scales and it is recommended to follow it periodically. The BICAMS battery is the battery that has been developed for this purpose and is the most convenient to use in practice. Objective: In this longitudinal study, we aimed to evaluate cognitive disorders in MS patients through the BICAMS battery consisting of SDMT, CVLT-II, BVMT-R tests, and to follow them longitudinally for 1 year. Method: 51 patients were enrolled in this study, 41 of whom had RRMS and 10 of whom had progressive MS (PMS), who were followed by Celal Bayar University Faculty of Medicine, Department of Neurology MS policlinic. EDSS and MSFC were performed as the neurological examinations and disability scale, at 6th and 12th months in the baseline. Additionally, FIS for fatigue, Beck depression scale for depression, MusiQoL for quality of life, and BICAMS battery for cognitive functions were applied. Findings: Cognitive performance was significantly lower in the PMS group than in the RRMS group.The cognitive performance showed an inverse correlation with age, yet, a linear correlation with the level of education. The gender factor was not found to be effective, in this study. Examining the relationship between the characteristics of the disease and the cognitive performance, it was observed that the cognitive performance decreased as the duration of illness and the age of onset increased. The annual incidence of attacks appeared to be positively correlated with the cognitive performance, which was probably related to the high number of RRMS patients. EDSS and MSFC scores were found to be associated with all the cognitive tests. So as the disability increased, the cognitive performance decreased. Fatigue and depression were also observed to negatively affect the cognitive performance. The quality of life was also inversely related to the cognitive performance. It was observed that the cognitive performance did not change except for the increase in the BMW-R and PASAT score in the 6th month. The fact that the cognitive performance did not generally show a change and even showed a change in one of the tests, although the status of disability did not change and the fatigue score increased, was found to be due to the short duration of the follow-up and the learning effect arising from the repetition of the tests at short intervals. When the subgroups of the disease were examined, the fact that not many associations were observed in the PMS group, while, in general, the RMS group showed similar correlations to the total MS group, was associated with the low number of patients in this group. Conclusion: In MS patients, cognition should certainly be monitored routinely and accepted as a criterion for disease activation, and the follow-up periods should not be shorter than one year due to the learning effect and appropriate psychometric tests should be utilized during the follow-up.