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Behavioural Neurology
Volume 18, Issue 2, Pages 81-90

Perceived Behavioral Changes in Early Multiple Sclerosis

Fabiana Souza Lima,1 Samanta Simioni,1 Laure Bruggimann,1 Christiane Ruffieux,2 Jean Dudler,3 Christian Felley,4 Pierre Michetti,4 Jean-Marie Annoni,1,5 and Myriam Schluep1

1Department of Neurology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
2Social and Preventive Medicine, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
3Department of Rheumatology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
4Department of Gastroenterology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
5Department of Neurology, Geneva University Hospital, Switzerland

Received 25 May 2007; Accepted 25 May 2007

Copyright © 2007 Hindawi Publishing Corporation and the authors. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Acquired behavioral changes have essentially been described in advanced multiple sclerosis (MS). The present study was designed to determine whether behavioral modifications specifically related to the MS pathological process could be identified in the initial phase of the disease, as compared to control patients with chronic, relapsing and progressive inflammatory disorders not involving the central nervous system (CNS). Eighty-eight early MS patients (Expanded Disability Status Scale score ≤ 2.5) and 48 controls were tested. Perceived changes by informants in behavioral control, goal-directed behavior, decision making, emotional expression, insight and interpersonal relationships were assessed using the Iowa Scale of Personality Change (ISPC). Executive behavioral disturbances were screened using the Dysexecutive Questionnaire (DEX). The mean change between the premorbid and postmorbid ISPC ratings was similar in the MS [12.2 (SD 15.6)] and in the control [11.5 (SD 15.1)] group. The perceived behavioral changes (PBCs) most frequently reported in both groups were lack of stamina, lability/moodiness, anxiety, vulnerability to stress and irritability. Pathological scores in the DEX were also similar in both groups. Correlations between PBCs and DEX scores were different in MS and control groups. MS patients with cognitive impairment had a marginally higher number of PBCs than control patients (p = 0.056) and a significantly higher DEXp score (p = 0.04). These results suggest that (1) PBCs occurring in early MS patients were not different from those induced by comparable chronic non-CNS disorders, (2) qualitative differences in the relationship between behavioral symptoms and executive-behavioral changes may exist between MS and control groups, and (3) behavioral symptoms seem associated with cognitive deficits in MS. We further plan to assess these observations longitudinally.