Hostname: page-component-cd9895bd7-jn8rn Total loading time: 0 Render date: 2024-12-28T12:42:41.688Z Has data issue: false hasContentIssue false

Cognitive impairment in relapsing and primary progressive multiple sclerosis: Mostly a matter of speed

Published online by Cambridge University Press:  01 November 2004

DOUGLAS R. DENNEY
Affiliation:
Department of Psychology, University of Kansas, Lawrence, Kansas
SHARON G. LYNCH
Affiliation:
Department of Neurology, University of Kansas Medical Center, Kansas City, Kansas
BRETT A. PARMENTER
Affiliation:
Department of Psychology, University of Kansas, Lawrence, Kansas
NIKKI HORNE
Affiliation:
Joint PhD Program San Diego State University–University of California, San Diego

Abstract

Based on the assumption that cognitive impairment in MS is consistent with subcortical dementia, a battery of neuropsychological tests was assembled that included measures of executive function (Tower of London and Wisconsin Card Sorting Test), verbal learning and memory (a paired associates learning test), and speeded information processing (Stroop Color Word Interference Test). The battery was administered to patients with relapsing and primary progressive MS and to healthy controls. Differences between patients and controls occurred on several of the measures. However, when differences with respect to fatigue and depression were statistically controlled, the only differences that remained significant involved measures relating to the speed of information processing. Patients performed more slowly than controls, with the disparity being greater for relapsing patients than for those with primary progressive disease. The slowing was evident on measures of automatic as well as controlled processing and regardless of whether speed was an explicit feature of successful performance or recorded unobstrusively while the patient concentrated on planning a correct solution to a problem. Parallels were noted between cognitive slowing associated with MS and that of normal aging. (JINS, 2004, 10, 948–956.)

Type
Research Article
Copyright
© 2004 The International Neuropsychological Society

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Archibald, C.J. & Fisk, J.D. (2000). Information processing efficiency in patients with multiple sclerosis. Journal of Clinical and Experimental Neuropsychology, 22, 686701.CrossRefGoogle Scholar
Arnett, P.A., Higginson, C.I., & Randolph, J.J. (2001). Depression in multiple sclerosis: Relationship to planning ability. Journal of the International Neuropsychological Society, 7, 665674.CrossRefGoogle Scholar
Arnett, P.A., Higginson, C.I., Voss, W.D., Wright, B., Bender, W.I., Wurst, J.M., & Tippin, J.M. (1999). Depressed mood in multiple sclerosis: Relationship to capacity-demanding memory and attentional functioning. Neuropsychology, 13, 434446.CrossRefGoogle Scholar
Arnett, P.A., Rao, S.M., Bernardin, L., Grafman, J., Yetkin, F.Z., & Lobeck, L. (1994). Relationship between frontal lobe lesions and Wisconsin Card Sorting Test performance in patients with multiple sclerosis. Neurology, 44, 420425.CrossRefGoogle Scholar
Arnett, P.A., Rao, S.M., Grafman, J., Bernardin, L., Lucetta, T., Binder, J.R., & Lobeck, L. (1997). Executive functions in multiple sclerosis: An analysis of temporal ordering, semantic encoding, and planning abilities. Neuropsychology, 11, 535544.Google Scholar
Beatty, W.W., Goodkin, D.E., Monson, N., Beatty, P.A., & Hertsgaard, D. (1988). Anterograde and retrograde amnesia in patients with chronic progressive multiple sclerosis. Archives of Neurology, 45, 611619.Google Scholar
Beatty, W.W. & Monson, N. (1996). Problem solving by patients with multiple sclerosis: Comparison of performance on the Wisconsin and California Card Sorting Tests. Journal of the International Neuropsychological Society, 2, 134140.CrossRefGoogle Scholar
Brinley, J.F. (1965). Cognitive sets, speed and accuracy of performance in the elderly. In A.T. Welford & J.E. Birrens (Eds.), Behavior, aging, and the nervous system (pp. 114149). Springfield, IL: Thomas.
Caltagirone, C., Carlesimo, G.A., Fadda, L., & Roncacci, S. (1991). Cognitive function in multiple sclerosis: A subcortical pattern of neuropsychological impairment? Behavioural Neurology, 4, 129141.Google Scholar
Carroll, M., Gates, R., & Roldan, F. (1984). Memory impairment in multiple sclerosis. Neuropsychologia, 22, 297302.CrossRefGoogle Scholar
Comi, G., Filippi, M., Martinelli, V., Campi, A., Rodegher, M., Sirabian, G., & Canal, N. (1995). Brain MRI correlates of cognitive impairment in primary and secondary progressive multiple sclerosis. Journal of the Neurological Sciences, 132, 222227.Google Scholar
Cummings, J.L. & Benson, D.F. (1984). Subcortical dementia: Review of an emerging concept. Archives of Neurology, 41, 874879.Google Scholar
DeLuca, J., Barbieri-Berger, S., & Johnson, S.K. (1994). The nature of memory impairment in multiple sclerosis: Acquisition versus retrieval. Journal of Clinical and Experimental Neuropsychology, 18, 5662.Google Scholar
DeLuca, J., Gaudino, E.A., Diamond, B.J., Christodoulou, C., & Engel, R.A. (1998). Acquisition and storage deficits in multiple sclerosis. Journal of Clinical and Experimental Neuropsychology, 20, 376390.Google Scholar
Demaree, H.A., DeLuca, J., Gaudino, E.A., & Diamond, B.J. (1999). Speed of information processing as a key deficit in multiple sclerosis: Implications for rehabilitation. Journal of Neurology, Neurosurgery, and Psychiatry, 67, 661663.CrossRefGoogle Scholar
De Sonneville, L.M.J., Boringa, J.B., Reuling, I.E.W., Lazeron, R.H.C., Adèr, H.J., & Polman, C.H. (2002). Information processing characteristics in subtypes of multiple sclerosis. Neuropsychologia, 40, 17511765.Google Scholar
Filippi, M., Campi, V., Martinelli, V., Rodegher, M., Scotti, G., Canal, N., & Comi, G. (1995). A brain MRI study of different types of chronic progressive multiple sclerosis. Acta Neurologica Scandinavica, 91, 231233.Google Scholar
Filley, C.M., Heaton, R.K., Nelson, L.M., Burks J.S., &Franklin G.M. (1989). A comparison of dementia in Alzheimer's disease and multiple sclerosis. Archives of Neurology, 46, 157161.CrossRefGoogle Scholar
Fischer, J.S., Foley, F.W., Aikens, J.E., Ericson, G.D., Rao, S.M., & Shindell, S. (1994). What do we really know about cognitive dysfunction, affective disorders, and stress in multiple sclerosis? A practitioners guide. Journal of Neurologic Rehabilitation, 8, 151164.Google Scholar
Foong, J., Rozewicz, L., Chong, W.K., Thompson, A.J., Miller, D.H., & Ron, M.A. (2000). A comparison of neuropsychological deficits in primary and secondary progressive multiple sclerosis. Journal of Neurology, 247, 97101.Google Scholar
Foong, J., Rozewicz, L., Quaghebeur, G., Davie, C.A., Kartsounis, L.D., Thompson, A.J., Miller, D.H., & Ron, M.A. (1997). Executive function in multiple sclerosis: The role of frontal lobe pathology. Brain, 120, 1526.Google Scholar
Golden, C.J. (1994). The Stroop Color and Word Test: A manual for clinical and experimental uses. Wood Dale, IL: Stoelting Company.
Heaton, R.K. (1981). Wisconsin Card Sorting Test manual. Odessa, FL: Psychological Assessment Resources, Inc.
Heaton, R.K., Nelson, L.M., Thompson, D.S., Burks, J.S., & Franklin, G.M. (1985). Neuropsychological findings in relapsing-remitting and chronic progressive multiple sclerosis. Journal of Consulting and Clinical Psychology, 53, 103110.Google Scholar
Kail, R. (1997). The neural noise hypothesis: Evidence from processing speed in adults with multiple sclerosis. Aging, Neuropsychology, and Cognition, 4, 157165.CrossRefGoogle Scholar
Kail, R. (1998). Speed of information processing in patients with multiple sclerosis. Journal of Clinical and Experimental Neuropsychology, 20, 98106.CrossRefGoogle Scholar
Krikorian, R., Bartok, J., & Gay, N. (1994). Tower of London procedure: A standard method and developmental data. Journal of Clinical and Experimental Neuropsychology, 16, 840850.CrossRefGoogle Scholar
Krupp, L.B. & Elkins, L.E. (2000). Fatigue and declines in cognitive functioning in multiple sclerosis. Neurology, 55, 934939.CrossRefGoogle Scholar
Krupp, L.B., LaRocca, N.G., Muir-Nash, J., & Steinberg, A.D. (1989). The fatigue severity scale: Application to patients with multiple sclerosis and systemic lupus erythematosus. Archives of Neurology, 46, 11211123.Google Scholar
Kujala, P., Portin, R., Revonsuo, A., & Ruutiainen, J. (1994). Automatic and controlled information processing in multiple sclerosis. Brain, 117, 11151126.Google Scholar
Kujala, P., Portin, R., Revonsuo, A., & Ruutiainen, J. (1995). Attention related performance in two cognitively different subtypes of patients with multiple sclerosis. Journal of Neurology, Neurosurgery, and Psychiatry, 59, 7782.Google Scholar
Kurtzke, J.F. (1983). Rating neurologic impairment in multiple sclerosis: An expanded disability status scale (EDSS). Neurology, 33, 14441452.CrossRefGoogle Scholar
Laatu, S., Hämäläinen, P., Revensuo, A., Portin, R., & Ruutiainen, J. (1999). Semantic memory deficit in multiple sclerosis: Impaired understanding of conceptual meanings. Journal of the Neurological Sciences, 162, 152161.CrossRefGoogle Scholar
Litvan, I., Grafman, J., Vendrell, P., & Martinez, J.M. (1988). Slowed information processing speed in multiple sclerosis. Archives of Neurology, 45, 281285.CrossRefGoogle Scholar
McDonald, W.I., Compston, A., Edan, G., Goodkin, D., Hartung, H.P., Lublin, F.D., McFarland, H.F., Paty, D.W., Polman, C.H., Reingold, S.C., Sandberg-Wollheim, M., Sibley, W., Thompson, A., van den Noort, S., Weinshenker, B.Y., & Wolinsky, J.S. (2001). International Panel on the Diagnosis of Multiple Sclerosis. Annals of Neurology, 50, 121127.CrossRefGoogle Scholar
Miller, E.M. (1994). Intelligence and brain myelination: A hypothesis. Personality and Individual Differences, 17, 803832.CrossRefGoogle Scholar
Parmenter, B.A., Denney, D.R., & Lynch, S.G. (2003). The cognitive performance of patients with multiple sclerosis during periods of high and low fatigue. Multiple Sclerosis, 9, 111118Google Scholar
Paul, R.H., Beatty, W.W., Schneider, R., Blanco, C., & Hames, K. (1998). Impairments of attention in individuals with multiple sclerosis. Multiple Sclerosis, 4, 433439.CrossRefGoogle Scholar
Peters, A. (2002). Structural changes that occur during normal aging of primate cerebral hemispheres. Neuroscience and Biobehavioral Reviews, 26, 733741.Google Scholar
Pujol, J., Vendrell, P., Deus, J., Junque, C., Bello, J., Marti-Vilalta, J.L., & Capdevila, A. (2001). The effect of medial frontal and posterior parietal demyelinating lesions on stroop interferences. Neuroimage, 13, 6875.Google Scholar
Radloff, L. (1977). The CES–D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385401.CrossRefGoogle Scholar
Rao, S.M. (1996). White matter disease and dementia. Brain and Cognition, 31, 250268.CrossRefGoogle Scholar
Rao, S.M., Grafman, J., DiGiulio, D., Mittenberg, W., Bernardin, L., Leo, G.J., Luchetta, T., & Univerzagt, F. (1993). Memory dysfunction in multiple sclerosis: Its relation to working memory, semantic encoding, and implicit memory. Neuropsychology, 7, 364374.Google Scholar
Rao, S.M., Hammeke, T.A., McQuillen, M.P., Khatri, B.O., & Lloyd, D. (1984). Memory disturbance in chronic progressive multiple sclerosis. Archives of Neurology, 41, 625631.CrossRefGoogle Scholar
Rao, S.M., Hammeke, T.A., & Speech, T.J. (1987). Wisconsin card sorting test performance in relapsing-remitting and chronic progressive multiple sclerosis. Journal of Consulting and Clinical Psychology, 55, 263265.CrossRefGoogle Scholar
Rao, S.M., St. Aubin-Faubert, P., & Leo, G.S. (1989). Information processing speed in patients with multiple sclerosis. Journal of Clinical and Experimental Neuropsychology, 11, 471477.Google Scholar
Revesz, T., Kidd, D., Thompson, A.J., Barnard, R.O., & McDonald, W.I. (1994). A comparison of the pathology of primary and secondary progressive multiple sclerosis. Brain, 117, 756765.Google Scholar
Ryan, L., Clark, C.M., Klonoff, H., Li, D., & Paty, D. (1996). Patterns of cognitive impairment in relapsing-remitting multiple sclerosis and their relationship to neuropathology on magnetic resonance images. Neuropsychology, 10, 176193.CrossRefGoogle Scholar
Scarrabelotti, M. & Carroll, M. (1999). Memory dissociation and metamemory in multiple sclerosis. Neuropsychologia, 37, 13351350.Google Scholar
Stroop, J.R. (1935). Studies of interference in serial verbal reactions. Journal of Experimental Psychology, 18, 643662.Google Scholar
Thornton, A.E. & Raz, N. (1997). Memory impairment in multiple sclerosis: A quantitative review. Neuropsychology, 11, 357366.CrossRefGoogle Scholar
Vitkovitch, M., Bishop, S., Dancey, C., & Richards, A. (2002). Stroop interference and negative priming in patients with multiple sclerosis. Neuropsychologia, 40, 15601576.Google Scholar