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Master thesis

Intégration des déficits cognitifs dans l'échelle d'invalidité de la sclérose en plaques: à propos de 215 patients

Abstract : Background: Estimate of the prevalence of cognitive impairment among patients with multiple sclerosis (MS) ranges between 40 and 70%. At present, the cerebral functional system (CFS) of the EDSS is subjective including several clinical signs as cognitive dysfunction and depression.Objectives: To define a new cognitive functional system (NCFS) based on aneuropsychological evaluation (NE). To assess change of EDSS with this new score.Methods: Prospectively, we have included 215 MS patients of LORSEP cohortbetween March 2004 and June 2007. Patients' data have been entered in the EDMUS (European Database of Multiple Sclerosis) system. NE evaluated cognitive functions (information processing speed, attention, executive functions, memories, language, visuospatial abilities and arithmetic), fatigue with the validated French version of FIS and depression. The NCFS was devised with the grades from O (normal) to 5 (severe dementia), depression excluded and fatigue included. The grade 1 of the NCFS was integrated in the EDSS as other FS. The NCFS and new EDSS including NCFS were established with the data of the NE and compared with EDSS.Results: Patients (median EDSS =3 .0, current age: 43.5 (SD= 10,8) years, diseaseduration: 11.2 (SD=8,6) years), included 149 women (69,3%). 98,1% of these patientspresented cognitive impairment with the NCFS compared to 62,3% with the CFS. NCFS washigher than CFS (p<0,001; CFS: 1.0 (SD=1,0); NCFS: 1.5 (SD=0,8)) and EDSS has beenchanged for 3 1% of the 1 13 patients with an EDSS<3.5 even though EDSS has been notchanged for 102 others patients. Change of FS was not associated with current age and age atonset of MS.Conclusion: We propose a new quotation of CFS based on NE, including fatigue,excluding depression and integrating the grade 1 at EDSS. That change EDSS for the lowlevel of EDSS and integrate better cognitive deficit in MS.
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Master thesis
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https://hal.univ-lorraine.fr/hal-01733331
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Submitted on : Wednesday, March 14, 2018 - 3:46:50 PM
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  • HAL Id : hal-01733331, version 1

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Mathilde Sauvée. Intégration des déficits cognitifs dans l'échelle d'invalidité de la sclérose en plaques: à propos de 215 patients. Sciences du Vivant [q-bio]. 2008. ⟨hal-01733331⟩

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