Neuropsychiatric assessments in patients with multiple sclerosis in early phases and with low disability

Sergio L Schmidt,1,2 Michele Santos da Silva,2 Juliana J Schmidt,2 Ana Lucia Novais Carvalho,3 Claudia Cristina Ferreira Vasconcelos,2 Renata Alves Paes,2 Yolanda EM Boechat,4 Rafael Neder,2 Regina P Alvarenga2 1Department of Neurophysiology, State University of Rio de Janeiro, RJ, Brazil; 2Neurology Department, Federal University of the State of Rio de Janeiro, RJ, Brazil; 3Department of Psychology, Fluminense Federal University, Niteroi, Brazil; 4Department of Internal Medicine, Fluminense Federal University, Niteroi, Brazil Background: In the early phases of multiple sclerosis (MS), patients exhibit slight neuropsychiatric deficits that can only be detected using reliable tools. Aim: The present investigation aimed to examine neuropsychological performance in 35 patients with incipient MS. Patients and methods: For the MS group, the inclusion criteria included time of disease <3 years and low disability. The neuropsychological battery consisted of Rey Auditory Learning Test, Controlled Oral Word Association Test, Hooper Visual Organization Test, and Symbol Digit Modalities Test (SDMT). Results: After correction for the educational level, no significant effect of MS on performance was found for all the tests except for the number of errors of the SDMT (NE-SDMT). Higher levels of education were associated with better performances in all tests, except for the NE-SDMT. MS patients made more errors than the controls. Conclusion: The effect on the NE-SDMT may reflect difficulties in the ability to inhibit inadequate responses. Patients may exhibit impulsive control disorders in incipient MS, independent of their educational level. Keywords: processing speed, cognitive impairments, neuropsycholog