Cognitive Profiles in Hong Kong Chinese with Relapsing and Progressive Multiple Sclerosis
ECTRIMS Online Library. Lau A. 10/25/17; 199472; EP1452
Alexander Lau
Alexander Lau
Contributions
Abstract

Abstract: EP1452

Type: ePoster

Abstract Category: Clinical aspects of MS - 11 Comorbidity

Background: We evaluated the cognitive profiles in Hong Kong Chinese with multiple sclerosis (MS).
Methods: We recruited subjects from the Hong Kong Multiple Sclerosis Registry. We administered a 45-minute neuropsychological battery, covering verbal learning and memory, processing speed, selective attention, executive function, visual perception, simple auditory attention span, and auditory working memory. Hong Kong version of Montreal Cognitive Assessment (HK-MoCA) was performed as a cognitive screening tool. Fatigue and physical disability were assessed by Modified Fatigue Impact Scale (MFIS) and Expanded Disability Status Scale (EDSS), respectively. Neuropsychological test scores were converted into z-scores using normative data for local Chinese, with impairment defined as z-score < -1.0.
Results: Fifty-five subjects (87% females; 78% relapsing MS, 13% PPMS, and 9% SPMS) were recruited. The mean age, education, and EDSS were 38.5±11.0 years, 13.6±3.32 years, and 3.6±2.6, respectively. Relapsing MS subjects were younger (36 vs. 47 years), better educated (14 vs. 11 years), and less disabled (EDSS 2.5 vs. 6.75) than progressive MS (p< 0.05). Overall, 52/55 (95%) subjects had cognitive impairment(s): verbal learning and memory-62%, executive function-50%, processing speed-50%, auditory working memory-49%, visual perception-43%, selective attention-37%, simple auditory attention span-16%. Multiple (>=3) impaired domains are found in 54% subjects; progressive MS subjects had worse cognitive performance (p< 0.05). Cognitive impairment was strongly correlated with high EDSS, low HK-MOCA and education years (p< 0.01). In multivariate regression model, HK-MOCA predicted multiple cognitive domain impairments (OR 0.70, 95% CI 0.50-0,98, p=0.035). At a cut-off score of 24, HK-MOCA has sensitivity of 81% and specificity of 71% (AUC 0.80). MFIS was not predictive of impaired cognitive performance.
Discussions: Cognitive impairment is highly prevalent among Chinese MS patients, affecting one or more cognitive domains in 95% patients. HK-MOCA is useful to screen for subjects with multiple impaired cognitive domains. Cognitive fatigue may be compensatory to preserve cognitive function.
Disclosure: The study is funded by the Health and Medical Research Fund of Food and Health Bureau, Hong Kong SAR (HMRF #14152291).

Abstract: EP1452

Type: ePoster

Abstract Category: Clinical aspects of MS - 11 Comorbidity

Background: We evaluated the cognitive profiles in Hong Kong Chinese with multiple sclerosis (MS).
Methods: We recruited subjects from the Hong Kong Multiple Sclerosis Registry. We administered a 45-minute neuropsychological battery, covering verbal learning and memory, processing speed, selective attention, executive function, visual perception, simple auditory attention span, and auditory working memory. Hong Kong version of Montreal Cognitive Assessment (HK-MoCA) was performed as a cognitive screening tool. Fatigue and physical disability were assessed by Modified Fatigue Impact Scale (MFIS) and Expanded Disability Status Scale (EDSS), respectively. Neuropsychological test scores were converted into z-scores using normative data for local Chinese, with impairment defined as z-score < -1.0.
Results: Fifty-five subjects (87% females; 78% relapsing MS, 13% PPMS, and 9% SPMS) were recruited. The mean age, education, and EDSS were 38.5±11.0 years, 13.6±3.32 years, and 3.6±2.6, respectively. Relapsing MS subjects were younger (36 vs. 47 years), better educated (14 vs. 11 years), and less disabled (EDSS 2.5 vs. 6.75) than progressive MS (p< 0.05). Overall, 52/55 (95%) subjects had cognitive impairment(s): verbal learning and memory-62%, executive function-50%, processing speed-50%, auditory working memory-49%, visual perception-43%, selective attention-37%, simple auditory attention span-16%. Multiple (>=3) impaired domains are found in 54% subjects; progressive MS subjects had worse cognitive performance (p< 0.05). Cognitive impairment was strongly correlated with high EDSS, low HK-MOCA and education years (p< 0.01). In multivariate regression model, HK-MOCA predicted multiple cognitive domain impairments (OR 0.70, 95% CI 0.50-0,98, p=0.035). At a cut-off score of 24, HK-MOCA has sensitivity of 81% and specificity of 71% (AUC 0.80). MFIS was not predictive of impaired cognitive performance.
Discussions: Cognitive impairment is highly prevalent among Chinese MS patients, affecting one or more cognitive domains in 95% patients. HK-MOCA is useful to screen for subjects with multiple impaired cognitive domains. Cognitive fatigue may be compensatory to preserve cognitive function.
Disclosure: The study is funded by the Health and Medical Research Fund of Food and Health Bureau, Hong Kong SAR (HMRF #14152291).

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