To analyze the relationship between objective measure of cognitive flexibility and subjective measure of executive functions (EFs) with clinical and cognitive variables and Health Related Quality of Life (HRQoL) in Persons with Multiple Sclerosis (PwMS).

Current dynamic world forces young adults with MS to adapt to continuous changes. The objective and subjective study of cognitive flexibility may benefit the understanding of PwMS adaptation in the real world.

60 PwMS were included (RR=83.9%, PP=1.8%, SP=14.3%). 73.20% female; mean age: 46.39±13.37 years; education: 14.63±2.70; Expanded Disability Status Scale (EDSS): 3.46±2.25; disease evolution: 18.09±11.11. Measure instruments: Objective measure of cognitive flexibility: Brixton Spatial Anticipation Test; Subjective measure of EFs: Dysexecutive Questionnaire (DEX); HRQoL: Multiple Sclerosis International Quality of Life Questionnaire (MusiQol); Cognitive variables: BICAMS Battery (California Verbal Learning Test-I, Brief Visual Memory Test-Revised, Symbol Digit Modalities Test), Paced Auditory Serial Addition Test, Verbal Fluency; Clinical variables: EDSS, Fatigue Severity Scale and Beck Depression Inventory-II. Parametrics statistics were used, to define significance a value of p<0.05 was accepted.

Objective and subjective measures of EFs were unrelated (p>0.05). More errors in the cognitive flexibility task were negatively and moderate to large correlated with learning (r=-0.50; p=0.00) and verbal episodic memory (r=-0.53; p=0.00), processing speed (r=-0.54; p=0.00), working memory (r=-0.50; p=0.00) and phonological fluency (r=-0.44; p=0.00). In addition, number of errors were associated with high EDSS (r=0.34; p<0.05), less MusiQol index (r=-0.36; p<0.05) and did not correlate with depression and fatigue (p>0.05). DEX were unrelated with cognitive performance and EDSS (p>0.05), but correlated positively with depression (r=0.64; p=0.00), fatigue (r=0.49; p=0.00) and negatively with MusiQol index (r=-0.37; p<0.05).

Cognitive flexibility objective measure is associated with poor cognitive perfomance and more physical disability, meanwhile subjective experienced is associated with higher levels of depression and fatigue. Both measures may be clinically relevant to understanding PwMS daily life functioning.