María Sol Román

Gastroenterology Hospital "Saverio de Bellis"

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Lara Bardoneschi

University of Buenos Aires

Loana De Los Santos

Gastroenterology Hospital "Saverio de Bellis"

Maria Luisa Saladino

University of Palermo

Fernando Collar de Cáceres

Gastroenterology Hospital "Saverio de Bellis"

Sandra Vanotti

Gastroenterology Hospital "Saverio de Bellis"

Ariadna Gatti

Gastroenterology Hospital "Saverio de Bellis"

Fernando Caceres

Gastroenterology Hospital "Saverio de Bellis"

Florencia Daniele

Gastroenterology Hospital "Saverio de Bellis"

Sandra Vanotti

University of Buenos Aires

Juan Manuela Iglesias Passada

Gastroenterology Hospital "Saverio de Bellis"

Cooperative Institutions

Gastroenterology Hospital "Saverio de Bellis"

Instituto de Neurología de Buenos Aires

University of Buenos Aires

Instituto de Neurología Cognitiva

University of Melbourne

Jacobs Institute

University at Buffalo, State University of New York

Jacobs (United States)

Hospital Ramos Mejía

Universidad Autónoma de Madrid

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Quality of life of caregivers of people with multiple sclerosis: Correlations between cognition, clinical variables, and functional dependency (P4-12.009)

Neurology (2023)

Lara Bardoneschi María Sol Román Flavia Ferrandina Johana Bauer Roberto Rosa

Objective:

Describe the characteristics of caregivers of people with multiple sclerosis (PwMS) and explore the associations between cognitive and clinical variables of PwMS, and caregiver's quality of life (QoL)

Background:

Caring for PwMS may negatively impact on several aspects of the caregiver's QoL.

Design/Methods:

50 PwMS and their respective caregivers were included. PwMS: 35 women (70%); Relapsing-remitting: 41, Secondary-progressive: 6, Primary-progressive: 3. Age: 47.08±14.43; Education: 14.38±2.91; Physical disability: 4.09±2.65. Depression: 14.30±10.33, Fatigue: 4.01±1.81. Caregivers: 30 women (53%); Age: 53.58±14.05; Education: 14.88±3.08. Outcomes: Expanded Disability Status Scale, Fatigue Severity Scale, Beck Depression Inventory II, Pfeffer Functional Activity Questionnaire, Caregiver Health-related Quality of life in MS (CareQoL-MS), Resource Utilization in Dementia Questionnaire (RUD). Statistical analysis: Descriptive analysis and Pearson's correlation were performed.

Results:

Caregivers' characteristics: 14% of caregivers report presence of depression (6.74±4.47) and 46% of anxiety (7.64±6.51). 67% caregiver currently live with PwEM; The relationships of the caregiver and PwMS reported are: 44% spouses, 20% parents, 12% siblings, son/daughter 6%, friend 4%, 14% other. Significant correlations were reported between caregiver's QoL and PwMS cognition in processing speed (r=0.644, p=0.00), verbal memory (r=0.437, p=0.000), and visual memory (r=0.418, p=0.000). The associations between PwMS cognition in processing speed (r=0.352, p=0.012), verbal memory (r=0.385, p=0.006), and visual memory (r=0.378, p=0.007), and caregiver's anxiety are modest. No association with caregiver's depression is reported. Significant negative correlations are shown between the caregiver's QoL and the patient's physical disability (r=0.546, p=0.00), the number of days of assistance in basic activities of daily living (r=0.537, p=0.00), the number of days of assistance in instrumental activities of daily living (r=0.484, p=0.00) and functional dependency (r=0.683, p=0.00).

Conclusions:

Better cognitive performance of the PwMS is associated with a lower level of anxiety and better QoL in caregivers. QoL of caregivers is also correlated with lower functional dependency of PwMS and the time of care. Disclosure: Miss Bardoneschi has nothing to disclose. Maria Sol Román has nothing to disclose. Flavia Ferrandina has nothing to disclose. Dr. Bauer has nothing to disclose. Dr. Rosa has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for Merck. Maria Laura Saladino has nothing to disclose. Fernando Caceres has nothing to disclose. Sandra Vanotti has received research support from Merck S.A.,Buenos Aires, Argentina, an affiliate Merck S.A.,Buenos Aires, Argentina, an affiliate of Merck KGaA, Darmstadt, Germany Merck KGaA, Darmstadt, Germany.

Depression

10.1212/wnl.0000000000202480

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Idiosyncrasy in a Spanish-speaking developing country and Employment: study of general population and Multiple Sclerosis (P5-3.005)

Neurology (2023)

Sandra Vanotti María Sol Román Lara Bardoneschi Michael Jaworski Loana De Los Santos

Objective:

Assess differences in the association of cognitive and clinical variables with work status between people with multiple sclerosis (PwMS) and healthy controls (HCs) and study the association between work-related difficulties - negative work events (NWE) and work hours per week - and work status in PwMS and HCs through the BVMS.

Background:

PwMS are vulnerable to diverse unfavorable work experiences, from reduced hours to unemployment.

Design/Methods:

We enrolled 80 PwMS & 80 HCs for a single examination that included Symbol Digit Modalities Test (SDMT), California Verbal Learning Test (CVLT), Brief Visuospatial Memory Test-Revised (BVMTR), & Dysexecutive Questionnaire (DEX). We used the Buffalo Vocational Monitoring Survey (BVMS) to investigate work status and work-related difficulties. Work status was classified into: Stable, Challenged or Loss. Work-related difficulties includes absenteeism, income, hours worked per week, and NWEs (verbal reprimands, demotions, etc.). Exploratory factor analyses (EFA) and Pearson correlations were performed.

Results:

PwMS and HCs were matched on demographics. PwMS (EDSS: 3.18±2.44; disease duration: 13.23±9.14), were impaired on SDMT: 45.16±14.56, CVLT: 48.71±12.71, BVMTR: 21.30±12.65, and DEX: 21.36±12.04. Work status (PwMS vs. HCs): Stable: 51.2% vs. 90%, Challenged: 25% vs. 6.2%, & Loss: 23.8% vs. 3.8%. PwMS: EFA (KMO 0.664, Bartlett 0.000), work status (0.779), SDMT (0.841), CVLT (0.821), and BVMTR (0.560) (α=.590) loaded into the 1° factor, and work status (0.021), DEX (0.891) and depression (0.897) (α=.765) into the 2° factor. HCs: EFA (KMO 0.572, Bartlett 0.000) work status (0.182), SDMT (0.790), CVLT (0.678) and BVMTR (0.751) (α .593) loaded into the 1° factor, and work status (−0.431), DEX (0.808) and depression (0.856) (α=.459) into the 2° factor. In both groups, work status was associated with NWEs (PwMS: r=.864; p=.000, HCs: r= −.758; p=.000) and work hours per week (PwMS: r=.778;p=.000, HCs: r=.393; p=.000).

Conclusions:

Processing speed and memory are associated with worse work status in PwMS, and depression and impaired executive functioning in HCs. Disclosure: Sandra Vanotti has received research support from Merck S.A.,Buenos Aires, Argentina, an affiliate Merck S.A.,Buenos Aires, Argentina, an affiliate of Merck KGaA, Darmstadt, Germany Merck KGaA, Darmstadt, Germany. Maria Sol Román has nothing to disclose. Miss Bardoneschi has nothing to disclose. Mr. Jaworski III has nothing to disclose. Mrs. De Los Santos has nothing to disclose. Miss Daniele has nothing to disclose. Maria Laura Saladino has nothing to disclose. Dr. Benedict has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Novartis. Dr. Benedict has received personal compensation in the range of $50,000-$99,999 for serving as a Consultant for Roche. Dr. Benedict has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Sanofi. Dr. Benedict has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Biogen. Dr. Benedict has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Bristol Meyers Squibb. Dr. Benedict has received personal compensation in the range of $50,000-$99,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Benedict has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Biogen. Dr. Benedict has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Brystal Mier Squibb. Dr. Benedict has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for EMD Serono. The institution of Dr. Benedict has received research support from Genzyme. The institution of Dr. Benedict has received research support from Biogen. The institution of Dr. Benedict has received research support from Bristol Myer Squib. Dr. Benedict has received intellectual property interests from a discovery or technology relating to health care. Fernando Caceres has nothing to disclose.

10.1212/wnl.0000000000202148

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Challenges in a dynamic world: the importance of studying cognitive flexibility in Persons with Multiple Sclerosis (P1-1.Virtual)

Neurology (2022)

María Sol Román María Bárbara Eizaguirre Pablo Baltanás Rubio Ariadna Gatti Lara Bardoneschi

Cognitive flexibility

10.1212/wnl.98.18_supplement.3115

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Slow information processing speed elucidates impairment in executive function tests in people with Multiple Sclerosis (P13-3.008)

Neurology (2023)

María Sol Román Lara Bardoneschi Ariadna Gatti Loana De Los Santos Juan Manuela Iglesias Passada

Objective:

Analyze the association between performance on speeded and nonspeeded tasks of executive functions (EFs) and slow information processing speed (IPS) in people with Multiple Sclerosis (PwMS).

Background:

IPS and EFs are impaired domains in PwMS. However, it is unclear if executive deficits can be explained by slow IPS.

Design/Methods:

74 PwMS were included (RR=86.2%, PP=4.3%, SP=9.6%; 74% female; age: 46.12±12.48 years; Physical disability (EDSS): 3.60±2.57; disease duration: 14.85±10.69 years). Measures: IPS: Symbol Digit Modalities Test; EFs: Speeded task of cognitive flexibility (Verbal Fluency), nonspeeded task of cognitive flexibility (Brixton Spatial Anticipation Test), nonspeeded task of working memory (Verbal Backward Digit Span); Clinical variables: EDSS, Fatigue Severity Scale and Beck Depression Inventory-II. A probit regression was performed, the results are shown in predicted probabilities format.

Results:

47% of PwMS have slow IPS. IPS was associated with EDSS and all EFs measures (p=0.00) and did not correlated with fatigue and depression (p>0.05). For the regression model, IPS, EDSS and EFs tasks were analyzed. Brixton and backward span tests lost significance when physical disability was controlled. Finally, the regression model had verbal fluency (Coefficient:-.49;p=0.001) and physical disability (Coefficient:.21; p=0.02) as independent variables. R²28%. Prob.chi2=0.00. For the predicted probabilities, verbal fluency was divided into 4 groups, controlling physical disability, and it was found that the probability of having poor verbal fluency with poor IPS is very high in the 1st and 2nd groups (.89 and .68, lowest confidence interval 0.53) and the probability of having high verbal fluency and slow IPS is very low in the 3th and 4th groups (.38 and .14, highest confidence interval 0.50), with no overlapping confidence intervals. Correctly classified 72%.

Conclusions:

Impairments on speeded task of EFs can be associated with slow IPS. It is important to include speeded and unspeeded tasks in the assessment of EFs to capture the effective deficit. Disclosure: Maria Sol Román has nothing to disclose. Miss Bardoneschi has nothing to disclose. Ms. Gatti has nothing to disclose. Mrs. De Los Santos has nothing to disclose. Mr. Iglesias Passada has nothing to disclose. Miss Daniele has nothing to disclose. Maria Laura Saladino has nothing to disclose. Fernando Caceres has nothing to disclose. Sandra Vanotti has received research support from Merck S.A.,Buenos Aires, Argentina, an affiliate Merck S.A.,Buenos Aires, Argentina, an affiliate of Merck KGaA, Darmstadt, Germany Merck KGaA, Darmstadt, Germany.

Memory span

Verbal fluency test

Cognitive flexibility

Trail Making Test

Stroop effect

10.1212/wnl.0000000000203308

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