In MS, Relapse Associated with Worsened Cognitive Function

New findings published in Multiple Sclerosis Journal provide additional evidence that cognitive function worsens during a relapse among patients with multiple sclerosis (MS).

Researchers arrived at their conclusion after evaluating 50 patients with an MS relapse and matched stable participants at baseline, during their relapse, and at 3 months follow-up.

All participants underwent tests for cognitive processing speed, including the Symbol Digit Modalities Test (SDMT), as well as consensus opinion measures of ambulation, memory, and manual dexterity. In addition, all participants experiencing a relapse received a 5-day course of treatment with Acthar Gel (5 mL/80 IU).

The results of the study indicated that SDMT had decreased from 55.2 to 44.6 during a relapse and had recovered to 51.7 among patients with an MS relapse. This slope was found to contrast with that of stable controls. The researchers noted a statistical trend for the same effect for verbal memory, and it was also significant for ambulation.

Among participants who experienced a relapse, the Cerebral Function Score on the EDSS had changed and was associated with incomplete recovery compared with controls.

“These results replicate earlier reports of cognitive worsening during relapse in MS,” the researchers wrote. “Clinically meaningful improvements followed relapse on SDMT and ambulation. Cognitive decline during relapse can be appreciated on neurological exam but not patient-reported outcomes.”

—Christina Vogt

Benedict RHB, Pol J, Yasin F, et al. Recovery of cognitive function after relapse in multiple sclerosis. Mult Scler J. 2021;27(1):71-78. doi:10.1177/1352458519898108