Determination of the Factors Related to Neuropsychological Competence in People with Multiple Sclerosis

INTRODUCTION: Cognitive impairment occurs in 34-65% of persons with multiple sclerosis (pwMS). MS Neuropsychological Screening Questionnaire (MSNQ) is a self-report scale that measures neuropsychological competence and has the power to detect cognitive impairment. However, there are many other objective tests that can measure cognitive impairment. The aim of this study is to examine the relationship between neuropsychological competence and anxiety, depression, cognitive functions, fatigue, quality of life, disease duration and disability level in pwMS.
METHODS: Six hundred and forty-eight pwMS (n=479 female) were enrolled in this study. PwMS with a score of 23 and above on the MSNQ were considered positive for neuropsychological competence impairment test, while pwMS with a score below 23 in MSNQ were considered negative. Disability was assessed using the Expanded Disability Status Scale (EDSS), quality of life with EuroQol 5-Dimensions (EQ-5-D), cognitive functions with the Brief International Cognitive Assessment in Multiple Sclerosis, fatigue with the brief Modified Fatigue Impact Scale, and anxiety and depression levels with The Hospital Anxiety and Depression Scale.
RESULTS: Positive MSNQ was detected in 264 (41%) pwMS, which means worse neuropsychological competence. A statistically significant difference was found between pwMS with positive MSNQ and pwMS with negative MSNQ in terms of age, education, gender, EDSS, fatigue, quality of life, anxiety and depression levels, and cognitive functions. While increasing anxiety level was considered a risk factor for positive MSNQ, each additional increase in the usual activities subscore of the EQ-5D was found to be related to the decrease in the odds of having positive MSNQ.
DISCUSSION AND CONCLUSION: In this study, it was found that pwMS with positive MSNQ had worse cognitive functions, had higher fatigue levels, were unemployed, and had higher levels of depression and anxiety. Also, the dependence and anxiety level of the pwMS should be considered during cognitive rehabilitation.