Cognition in patients with neuromyelitis optica spectrum disorders: A prospective multicentre study of 217 patients (CogniNMO-Study)

Author:

Hümmert Martin W1ORCID,Stern Carlotta1ORCID,Paul Friedemann2,Duchow Ankelien3,Bellmann-Strobl Judith3,Ayzenberg Ilya4,Schwake Carolin4,Kleiter Ingo5,Hellwig Kerstin4ORCID,Jarius Sven6,Wildemann Brigitte6,Senel Makbule7,Berthele Achim8,Giglhuber Katrin8,Luessi Felix9,Grothe Matthias10,Klotz Luisa11,Schülke Rasmus12,Gingele Stefan1,Faiss Jürgen H13,Walter Annette14,Warnke Clemens15ORCID,Then Bergh Florian16,Aktas Orhan17,Ringelstein Marius18,Stellmann Jan-Patrick19,Häußler Vivien20ORCID,Havla Joachim21ORCID,Pellkofer Hannah22,Kümpfel Tania22,Kopp Bruno1,Trebst Corinna123

Affiliation:

1. Department of Neurology, Hannover Medical School, Hannover, Germany

2. NeuroCure Clinical Research Center, Charité—Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, and Max Delbrück Center for Molecular Medicine, Berlin, Germany/Experimental and Clinical Research Center, Charité—Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany/ Department of Neurology, Charité—Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin...

3. NeuroCure Clinical Research Center, Charité—Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, and Max Delbrück Center for Molecular Medicine, Berlin, Germany/Experimental and Clinical Research Center, Charité—Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany

4. Department of Neurology, St. Josef Hospital, Ruhr University Bochum, Bochum, Germany

5. Department of Neurology, St. Josef Hospital, Ruhr University Bochum, Bochum, Germany/Marianne-Strauß-Klinik, Behandlungszentrum Kempfenhausen für Multiple Sklerose Kranke, Berg, Germany

6. Molecular Neuroimmunology Group, Department of Neurology, University of Heidelberg, Heidelberg, Germany

7. Department of Neurology, University of Ulm, Ulm, Germany

8. Department of Neurology, School of Medicine, Technical University Munich, Klinikum rechts der Isar, Munich, Germany

9. Department of Neurology, University Medical Center, Johannes Gutenberg University of Mainz, Mainz, Germany

10. Department of Neurology, University Medicine of Greifswald, Greifswald, Germany

11. Department of Neurology, University of Münster, Münster, Germany

12. Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany

13. Department of Neurology, Asklepios Expert Clinic Teupitz, Teupitz, Germany

14. Department of Neurology, Herford Hospital, Herford, Germany

15. Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany

16. Department of Neurology, University of Leipzig, Leipzig, Germany

17. Department of Neurology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany

18. Department of Neurology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany/Department of Neurology, Center for Neurology and Neuropsychiatry, LVR-Klinikum, Heinrich Heine University Düsseldorf, Düsseldorf, Germany

19. Department of Neurology and Institute of Neuroimmunology and Multiple Sclerosis (INIMS), University Medical Center Hamburg-Eppendorf, Hamburg, Germany/Aix-Marseille Univ, CNRS, CRMBM, UMR 7339, Marseille, France/APHM, Hopital de la Timone, CEMEREM, Marseille, France

20. Department of Neurology and Institute of Neuroimmunology and Multiple Sclerosis (INIMS), University Medical Center Hamburg-Eppendorf, Hamburg, Germany

21. Institute of Clinical Neuroimmunology, LMU Hospital, Ludwig-Maximilians-Universität München, Munich, Germany/Data Integration for Future Medicine Consortium, LMU Hospital, Ludwig-Maximilians Universität München, Munich, Germany

22. Institute of Clinical Neuroimmunology, LMU Hospital, Ludwig-Maximilians-Universität München, Munich, Germany

23. Department of Neurology, Hannover Medical School, Carl-Neuberg-Str. 1, Hannover 30625, Germany

Abstract

Background: There is limited and inconsistent information on the prevalence of cognitive impairment in neuromyelitis optica spectrum disorders (NMOSD). Objective: To assess cognitive performance and changes over time in NMOSD. Methods: This study included data from 217 aquaporin-4-IgG-seropositive (80%) and double-seronegative NMOSD patients. Cognitive functions measured by Symbol Digit Modalities Test (SDMT), Paced Auditory Serial-Addition Task (PASAT), and/or Multiple Sclerosis Inventory Cognition (MuSIC) were standardized against normative data ( N = 157). Intraindividual cognitive performance at 1- and 2-year follow-up was analyzed. Cognitive test scores were correlated with demographic and clinical variables and assessed with a multiple linear regression model. Results: NMOSD patients were impaired in SDMT ( p = 0.007), MuSIC semantic fluency ( p < 0.001), and MuSIC congruent speed ( p < 0.001). No significant cognitive deterioration was found at follow-up. SDMT scores were related to motor and visual disability ( pBon < 0.05). No differences were found between aquaporin-4-IgG-seropositive and double-seronegative NMOSD. Conclusions: A subset of NMOSD patients shows impairment in visual processing speed and in semantic fluency regardless of serostatus, without noticeable changes during a 2-year observation period. Neuropsychological measurements should be adapted to physical and visual disabilities.

Publisher

SAGE Publications

Subject

Neurology (clinical),Neurology

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