Integration of Cognitive Impairment in the Expanded Disability Status Scale of 215 Patients with Multiple Sclerosis.
Summary of "Integration of Cognitive Impairment in the Expanded Disability Status Scale of 215 Patients with Multiple Sclerosis."
Background: Estimates of the prevalence of cognitive impairment among patients with multiple sclerosis (MS) range between 40 and 70%. The current cerebral functional system (CFS) of the Expanded Disability Status Scale (EDSS) is subjective. Aim: To define a new cerebral functional system (NCFS) based on neuropsychological evaluation (NE). Methods: We prospectively included 215 MS patients. NE evaluated cognitive functions. Fatigue was assessed with the Fatigue Impact Scale. The NCFS was devised with grades from 0 to 5, excluding depression but including fatigue. Grade 1 of the NCFS was integrated in the EDSS as other functional scores. The NCFS and new EDSS including the NCFS were compared with the current CFS and EDSS. Results: 215 patients (69% women, 67% with relapsing-remitting MS, median EDSS 3.0) were assessed. 98% of these patients presented fatigue and/or cognitive impairment with the NCFS compared to 62% with the CFS. The NCFS was higher than the CFS, and the EDSS had changed in 31% of the 113 patients with an EDSS <3.5. Change in functional score was not correlated to current age or age at onset of MS. Conclusions: We propose a new CFS grading based on NE, including fatigue, and integrating grade 1 at EDSS.
Affiliation
Department of Neurology, Hôpital Central, Nancy, France.
Journal Details
This article was published in the following journal.
Name: European neurology
ISSN: 1421-9913
Pages: 345-350
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/21071951
- DOI: http://dx.doi.org/10.1159/000322140
Medical and Biotech [MESH] Definitions
Sickness Impact Profile
A quality-of-life scale developed in the United States in 1972 as a measure of health status or dysfunction generated by a disease. It is a behaviorally based questionnaire for patients and addresses activities such as sleep and rest, mobility, recreation, home management, emotional behavior, social interaction, and the like. It measures the patient's perceived health status and is sensitive enough to detect changes or differences in health status occurring over time or between groups. (From Medical Care, vol.xix, no.8, August 1981, p.787-805)
Professional Impairment
The inability of a health professional to provide proper professional care of patients due to his or her physical and/or mental disability.
Physician Impairment
The physician's inability to practice medicine with reasonable skill and safety to the patient due to the physician's disability. Common causes include alcohol and drug abuse, mental illness, physical disability, and senility.
Periodontal Index
A numerical rating scale for classifying the periodontal status of a person or population with a single figure which takes into consideration prevalence as well as severity of the condition. It is based upon probe measurement of periodontal pockets and on gingival tissue status.
Glasgow Coma Scale
A scale that assesses the response to stimuli in patients with craniocerebral injuries. The parameters are eye opening, motor response, and verbal response.
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