Abstract Details

Title The Impact of Cognitive Testing on Disability Measurement during the Follow-up of People with Multiple Sclerosis

Topic Multiple Sclerosis

Presentation(s) P3 - Poster Session 3 (5:30 PM-6:30 PM)

Poster/Presentation
Number 15-018

Objective To evaluate the impact of the integrated Expanded Disability Status Scale (iEDSS), and the weight of single Functional Systems (FS) on disability measurement during a two-year follow-up of People with Multiple Sclerosis (MS)

Background Cognitive tests are not routinely performed during disability evaluation of MS. We previously showed that the integration of the Brief International Cognitive Assessment for MS (BICAMS) and orientation tests (OTs) in the EDSS (iEDSS) resulted in an improvement of disability measurement in 25% of cases.

Design/Methods To determine the weight of single FSs, we selected patients with worsened follow-up iEDSS and calculated the iEDSS either including all FSs, or by excluding one FS at the time. We obtained eight different follow-up iEDSSs (each for every missing FS), and calculated the number of worsenings imputable to each FS.

Results

We studied 371 patients with complete iEDSS and cognitive measures at baseline and 2-year follow-up. Baseline variables were: iEDSS 3.77±1.7 (0-7.5), age 43.1±11.6 (14-71), female 68.5%. After 2 years, 125 patients (33.7%) showed a worsening in their iEDSS score, with a mean change of +1.03±0.7 (range 0.5-4). The cognitive-FS worsened in 27 patients (7.3%) with a mean change of +1.2±0.4.

Of all patients showing a deterioration in the EDSS score, we found a higher impact of ambulation (56.8%), followed by cognitive-FS (18.4%), pyramidal (18.4%), sensory (16%), bowel/bladder (12%), cerebellar (4.8%), brainstem (4%), visual (1.6%).

When considering patients with and EDSS≤4.0, the most impacting FS essential for an EDSS deterioration was the cognitive-FS (9.8%), followed by pyramidal (8.5%), ambulation (6.4%), sensory (5.1%), brainstem (5.1%), bowel/bladder (2.1%), cerebellar (2.1%), visual (1.7%).

Conclusions

We show that cognition is the most impacting FS, after ambulation, on disability progression. We recommend that neuropsychological tests be performed at the same time of the EDSS to allow a more accurate determination of disability progression.

Authors/Disclosures
Francesco Sacca, MD, FAAN (University Federico II) PRESENTER	Dr. Sacca has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Alexion. Dr. Sacca has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Argenx. Dr. Sacca has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Lexeo. Dr. Sacca has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Biogen. Dr. Sacca has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genpharm. Dr. Sacca has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Dr. Sacca has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Medpharma. Dr. Sacca has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Madison Pharma. Dr. Sacca has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Zai Lab. Dr. Sacca has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Dianthus. Dr. Sacca has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Reata. Dr. Sacca has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Sandoz. Dr. Sacca has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Neopharm Israel. Dr. Sacca has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Johnson&Johnson. Dr. Sacca has received personal compensation in the range of $500-$4,999 for serving as a Consultant for UCB. Dr. Sacca has received personal compensation in the range of $50,000-$99,999 for serving as a Consultant for Astrazeneca. The institution of Dr. Sacca has received research support from AIFA. The institution of Dr. Sacca has received research support from FARA.
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
Elisabetta Signoriello	Elisabetta Signoriello has nothing to disclose.
Giacomo Lus (Policlinico di Napoli)	Giacomo Lus has nothing to disclose.
Vincenzo Brescia Morra, MD (Universita Federico II - Napoli)	Dr. Brescia Morra has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi. Dr. Brescia Morra has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for NOVARTIS. Dr. Brescia Morra has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for BIOGEN. Dr. Brescia Morra has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for ROCHE. Dr. Brescia Morra has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for TEVA. Dr. Brescia Morra has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for ALMIRALL. Dr. Brescia Morra has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for MERK. Dr. Brescia Morra has received personal compensation in the range of $0-$499 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for MERK. The institution of Dr. Brescia Morra has received research support from FISM. Dr. Brescia Morra has a non-compensated relationship as a PI with FISM that is relevant to AAN interests or activities.

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