President's Post November 2017
Prof Ralph Benedict
Professor of Neurology, Psychiatry and Psychology Jacobs Neurological Institute, SUNY Buffalo School of Medicine Buffalo General Hospital Buffalo, New York
Having just returned from the ECTRIMS 2017 meeting it is a pleasure to report on some noteworthy abstracts that pertain to cognitive and psychological aspects of MS. IMSCOGS provided a Teaching Course on Wednesday, and the contributors were Maria Pia Amato, John DeLuca and myself. Clearly, much has been learned about the epidemiology and natural history of MS-associated cognitive impairment, but the field needs consensus on the diagnostic criteria for this designation. It is promising to see SDMT playing an increasingly major role in phase 3 clinical trials of DMTs, partly the result of an accepted responder definition. The Royal Holloway group led by Dawn Langdon reported on an evidence-based protocol for presenting DMT information more effectively to patients. An RCT compared the Benefits and Risks of Medication in MS (BRIMMS) to consultation as usual and demonstrated that with BRIMMS, patients remembered more information about the drugs, were more certain of their treatment decision, and rated the BRIMMS format as more satisfactory and helpful. Sumowski et al reported on a PCA of a neuropsychological test battery consisting of MS-COGS tests and some newly developed tests of processing speed and associate learning. Replicating work with the MACFIMS from 2006, PCA revealed a unique processing speed and memory, only the latter correlating with atrophy of left hippocampus measured by FreeSurfer. Interestingly, as in the 2006 work, SDMT showed a modest loading on the memory factor, challenging the notion that it is a pure processing speed test. D Lamargue-Hamel (University of Bordeaux) presented the results of a controlled study about a specific rehabilitation program on processing speed and attention with positive results on neuropsychological tests but also self-assessment of daily cognitive functioning and ecological evaluation. There were many other papers of note and our organization was well represented at the meeting. Next year, the IMSCOGS meeting will be in collaboration with ECTRIMS in Berlin.