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Behavioural Neurology
Volume 2017, Article ID 7404289, 10 pages
Research Article

Cognitive Impairment in Relapsing-Remitting Multiple Sclerosis Patients with Very Mild Clinical Disability

1Clinical Psychology, University Campus Bio-Medico of Rome, Rome, Italy
2LIRH Foundation, Via dei Mille 41, Rome, Italy
3Department of Neuroscience, Fatebenefratelli Hospital-Isola Tiberina, Rome, Italy
4Service of Medical Statistics and Information Technology (SeSMIT), Fatebenefratelli Hospital-Isola Tiberina, Rome, Italy
5IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
6Department of Life, Health and Environmental Sciences, University of L’Aquila, L’Aquila, Italy
7Department of Neuroscience, Policlinico “Tor Vergata”, Rome, Italy
8Neurology Unit, University Campus Bio-Medico of Rome, Rome, Italy

Correspondence should be addressed to S. Migliore; ti.supmacinu@eroilgim.s

Received 14 March 2017; Revised 24 May 2017; Accepted 12 June 2017; Published 15 August 2017

Academic Editor: Lambros Messinis

Copyright © 2017 S. Migliore et al. 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.


Cognitive dysfunction affects 40–65% of multiple sclerosis (MS) patients and can occur in the early stages of the disease. This study aimed to explore cognitive functions by means of the Italian version of the minimal assessment of cognitive function in MS (MACFIMS) in relapsing-remitting MS (RRMS) patients with very mild clinical disability to identify the primarily involved cognitive functions. Ninety-two consecutive RRMS patients with Expanded Disability Status Scale (EDSS) scores ≤ 2.5 and forty-two healthy controls (HC) were investigated. Our results show that 51.1% of MS patients have cognitive dysfunction compared to HC. An impairment of verbal and visual memory, working memory, and executive functions was found in the RRMS group. After subgrouping RRMS by EDSS, group 1 (EDSS ≤ 1.5) showed involvement of verbal memory and executive functions; moreover, group 2 (2 ≤ EDSS ≤ 2.5) patients were also impaired in information processing speed and visual memory. Our results show that utilizing a comprehensive neuropsychological assessment, approximately half of MS patients with very mild physical disability exhibit cognitive impairment with a primary involvement of prefrontal cognitive functions. Detecting impairment of executive functions at an early clinical stage of disease could be useful to promptly enroll MS patients in targeted rehabilitation.