- Email: [email protected]
PO10-TU-58 Determinants of depression in multiple sclerosis (MS)
19th World Congress of Neurology, Poster Abstracts / Journal of the Neurological Sciences 285 S1 (2009) S155–S339
of patients considered design as the most significant issue and specifically the functionality of the cane and the comfort of the handle. In relation to materials 62.6% preferred acrylic, 26.4% metal and only 11% preferred wood. Conclusion: The design of appropriate and fitted cane is of great importance to MS patients at a difficult cross-road developing disability that impairing their independent walking. PO10-TU-56 Depression incidence and course in multiple sclerosis patients treated with interferon beta-1b and glatiramer acetate during the BEYOND trial B. Arnason1 , P. O’Connor2 , K. Knappertz3 , C. Pohl4 , T. Bogumil3 , S. Schippling5 . 1 University of Chicago, Chicago, United States; 2 St Michael’s Hospital, Toronto, Canada; 3 Bayer Healthcare Pharmaceuticals Inc, Montville, United States; 4 Bayer Schering Pharma AG, Berlin, Germany; 5 Inst of Neuroimmunology and Clinical MS Research, Hamburg, Germany Purpose: Depression associated with multiple sclerosis (MS) may be influenced by interferon beta (IFNB) therapy. This study determined the impact of depressive symptoms in the BEYOND trial. Method: Patients (n = 2244) were randomised (2:2:1) to receive either IFNB-1b 500 mg subcutaneously (sc) every other day (eod), IFNB-1b 250 mg sc eod or glatiramer acetate (GA) 20 mg sc every day. Patients were observed for 2 to 3.5 years (mean 2.3 years). Incidence of adverse events (AEs) was monitored. For the screening of major depression and suicidal ideation besides the collection of respective AE data, the Beck Depression Inventory Second Edition (BDI-II) was applied. The BDI-II was administered during scheduled in-house visits at screening, baseline and every 13 weeks after baseline. Descriptive statistical methods were used for data analysis. Results: Patient baseline measures for MS activity and depression were similar. There were no significant differences in depression incidence among the treatment groups. By study end, the majority of patients (77%) had BDI-II scores that remained in the same depressive category (BDI-II ≤13 or ≥14). For patients with mild or worse depression (BDI-II ≥14) at screening, 39% changed to no or minimal depression by study end (BDI-II ≤13) compared with 18% of those with BDI-II ≤13 who changed to ≥14. BDI-II-assessed suicidal thoughts were rare at screening (9% with any) and were similar over the duration of the trial (11% with any by end of study). Serious psychiatric disorder incidence, including suicidal ideation, attempted suicide, completed suicide and depression-related AEs, was low, and similar between treatment groups. Conclusions: In this large dataset, no difference in depression or depression-related AEs was found, countering claims of IFNBassociated depression. Suicides and suicidal thoughts were rare throughout the study. During the course of the study, more patients changed from a more to a less depressed state than the reverse. PO10-TU-57 Study about cognitive disorders in patients with multiple sclerosis D.F.V. Pirscoveanu, C. Zaharia, V. Tudorica, D. Stanca, F. Trifan. Neurology, University of Medicine and Pharmacy, Craiova, Romania Purpose: The purpose of our study was to find the cognitive disorders in the patients with multiple sclerosis (MS). Method: 42 patients with multiple sclerosis were included in our study (15 men and 27 women). The patients were admitted in Clinic of Neurology Craiova between 2006–2008. Our patients were divided in two groups: group I composed of 31 patients with relapsing-remitting MS and group II composed of 11 patients with progressive form of the disease. In group I the medium duration of the disease was 7.6 years and in group II average disease duration was 5.1 years. The physical disability of the patients was rated using EDSS score. We used for the neuropsychological assessment Mini Mental State Examination (MMSE), Hodgkinson Mental Test
S211
and Cambridge Cognitive Examination (CAMCOG). The results were analyzed by Student test (p < 0.05 statistically significant). Results: Neuropsychological assessment reveals cognitive impairment at 62% of MS patients. We observed minor cognitive impairment in the early stage of MS. The cognitive disorders were significantly higher in the group of patients with progressive form of MS (p < 0.05). The analysis of the results showed a significant association between mean disease duration and cognitive impairment. Conclusion: The patients with MS frequently develop cognitive disorders during the disease, especially those with progressive form. Average disease duration plays an important role in the appearance of cognitive dysfunctions. The cognitive impairment must be discovered earlier for a better management of the illness. PO10-TU-58 Determinants of depression in multiple sclerosis (MS) M. Zinno, D. Quaranta, A.K. Patanella, A.P. Batocchi, C. Marra. Neuroscience, Catholic University of Sacred Heart, Rome, Italy Purpose: This study was aimed at assessing the role of neurobiological factors, interferon (IFN) therapy, cognitive deficits, conceptions of self and illness, demographic and clinical features on the development of depression in Multiple Sclerosis (MSD). Method: 62 consecutive patients with relapsing-remitting (N = 48) and secondary progressive (N = 14) MS, fulfilling McDonald’s criteria, were enrolled. The patients underwent the Beck Depression Inventory (BDI), the Short Form-36 health survey (SF-36) and the Expanded Disability Status Scale (EDSS). Inflammatory cytokines and neurotrophins were assessed by peripheral blood mononuclear cells (PBMC) production of Tumor Necrosis Factor-a (TNF-a) and Brain-Derived Neurotrophic Factor (BDNF). Neuropsychological assessment was carried out exploring episodic memory, verbal fluency, visuo-constructive abilities, abstract reasoning, spatial and verbal short-term memory, naming tasks, executive, visuo-motor tracking and visual scanning functions. BDI score was set as dependent variable of a multivariate backward stepwise linear regression analysis. Significance level was set at p < 0.05. Results: Our model identified four predictors accounting for a significant amount of variance for BDI scores (adjR2 = 0.59). Severity of depressive symptoms was predicted by female gender (p = 0.042), low scores on Digit Span backward (p = 0.024), Social Functioning (p = 0.023) and Mental Health (p = 0.003) subscales of SF-36. EDSS, disease duration, TNF-a, BDNF, IFN therapy show a weak nonsignificant influence on severity of MSD. Conclusions: MSD could be conceived as a consequence of failure of emotional-cognitive adjustment to an uncertain and unpredictable illness, with a greater vulnerability of female subjects and a reduction of mnesic-attentional functions. We found the degree of MSD to be more closely related to personal meaning attributed to the illness and the social impact on the previous life of the patient, more than with objective measures of disease severity. PO10-TU-59 Study of depression among multiple sclerosis patients in Hong Kong K.K. Lau1 , S.K.W. Cheng2 , B. Shiu1 , W.Y.W. Wong3 , H.W. Leung4 , W.M. Fok5 , K.L. Shiu6 , P.W. Ng7 . 1 Medicine and Geriatrics, Princess Margaret Hospital, Kowloon, Hong Kong; 2 Psychology, Kwai Chung Hospital, Kowloon, Hong Kong; 3 Medicine, Caritas Medical Centre, Kowloon, Hong Kong; 4 Medicine and Therapeutics, Prince of Wales Hospital, New Territories, Hong Kong; 5 Medicine and Geriatrics, Yan Chai Hospital, Kowloon, Hong Kong; 6 Medicine and Geriatrics, Tuen Mun Hospital, New Territories, Hong Kong; 7 Medicine and Geriatrics, United Christian Hospital, Kowloon, Hong Kong Purpose: This study aimed to examine depression, distress, selfesteem, and quality of life among Chinese multiple sclerosis (MS) patients in Hong Kong.
of patients considered design as the most significant issue and specifically the functionality of the cane and the comfort of the handle. In relation to materials 62.6% preferred acrylic, 26.4% metal and only 11% preferred wood. Conclusion: The design of appropriate and fitted cane is of great importance to MS patients at a difficult cross-road developing disability that impairing their independent walking. PO10-TU-56 Depression incidence and course in multiple sclerosis patients treated with interferon beta-1b and glatiramer acetate during the BEYOND trial B. Arnason1 , P. O’Connor2 , K. Knappertz3 , C. Pohl4 , T. Bogumil3 , S. Schippling5 . 1 University of Chicago, Chicago, United States; 2 St Michael’s Hospital, Toronto, Canada; 3 Bayer Healthcare Pharmaceuticals Inc, Montville, United States; 4 Bayer Schering Pharma AG, Berlin, Germany; 5 Inst of Neuroimmunology and Clinical MS Research, Hamburg, Germany Purpose: Depression associated with multiple sclerosis (MS) may be influenced by interferon beta (IFNB) therapy. This study determined the impact of depressive symptoms in the BEYOND trial. Method: Patients (n = 2244) were randomised (2:2:1) to receive either IFNB-1b 500 mg subcutaneously (sc) every other day (eod), IFNB-1b 250 mg sc eod or glatiramer acetate (GA) 20 mg sc every day. Patients were observed for 2 to 3.5 years (mean 2.3 years). Incidence of adverse events (AEs) was monitored. For the screening of major depression and suicidal ideation besides the collection of respective AE data, the Beck Depression Inventory Second Edition (BDI-II) was applied. The BDI-II was administered during scheduled in-house visits at screening, baseline and every 13 weeks after baseline. Descriptive statistical methods were used for data analysis. Results: Patient baseline measures for MS activity and depression were similar. There were no significant differences in depression incidence among the treatment groups. By study end, the majority of patients (77%) had BDI-II scores that remained in the same depressive category (BDI-II ≤13 or ≥14). For patients with mild or worse depression (BDI-II ≥14) at screening, 39% changed to no or minimal depression by study end (BDI-II ≤13) compared with 18% of those with BDI-II ≤13 who changed to ≥14. BDI-II-assessed suicidal thoughts were rare at screening (9% with any) and were similar over the duration of the trial (11% with any by end of study). Serious psychiatric disorder incidence, including suicidal ideation, attempted suicide, completed suicide and depression-related AEs, was low, and similar between treatment groups. Conclusions: In this large dataset, no difference in depression or depression-related AEs was found, countering claims of IFNBassociated depression. Suicides and suicidal thoughts were rare throughout the study. During the course of the study, more patients changed from a more to a less depressed state than the reverse. PO10-TU-57 Study about cognitive disorders in patients with multiple sclerosis D.F.V. Pirscoveanu, C. Zaharia, V. Tudorica, D. Stanca, F. Trifan. Neurology, University of Medicine and Pharmacy, Craiova, Romania Purpose: The purpose of our study was to find the cognitive disorders in the patients with multiple sclerosis (MS). Method: 42 patients with multiple sclerosis were included in our study (15 men and 27 women). The patients were admitted in Clinic of Neurology Craiova between 2006–2008. Our patients were divided in two groups: group I composed of 31 patients with relapsing-remitting MS and group II composed of 11 patients with progressive form of the disease. In group I the medium duration of the disease was 7.6 years and in group II average disease duration was 5.1 years. The physical disability of the patients was rated using EDSS score. We used for the neuropsychological assessment Mini Mental State Examination (MMSE), Hodgkinson Mental Test
S211
and Cambridge Cognitive Examination (CAMCOG). The results were analyzed by Student test (p < 0.05 statistically significant). Results: Neuropsychological assessment reveals cognitive impairment at 62% of MS patients. We observed minor cognitive impairment in the early stage of MS. The cognitive disorders were significantly higher in the group of patients with progressive form of MS (p < 0.05). The analysis of the results showed a significant association between mean disease duration and cognitive impairment. Conclusion: The patients with MS frequently develop cognitive disorders during the disease, especially those with progressive form. Average disease duration plays an important role in the appearance of cognitive dysfunctions. The cognitive impairment must be discovered earlier for a better management of the illness. PO10-TU-58 Determinants of depression in multiple sclerosis (MS) M. Zinno, D. Quaranta, A.K. Patanella, A.P. Batocchi, C. Marra. Neuroscience, Catholic University of Sacred Heart, Rome, Italy Purpose: This study was aimed at assessing the role of neurobiological factors, interferon (IFN) therapy, cognitive deficits, conceptions of self and illness, demographic and clinical features on the development of depression in Multiple Sclerosis (MSD). Method: 62 consecutive patients with relapsing-remitting (N = 48) and secondary progressive (N = 14) MS, fulfilling McDonald’s criteria, were enrolled. The patients underwent the Beck Depression Inventory (BDI), the Short Form-36 health survey (SF-36) and the Expanded Disability Status Scale (EDSS). Inflammatory cytokines and neurotrophins were assessed by peripheral blood mononuclear cells (PBMC) production of Tumor Necrosis Factor-a (TNF-a) and Brain-Derived Neurotrophic Factor (BDNF). Neuropsychological assessment was carried out exploring episodic memory, verbal fluency, visuo-constructive abilities, abstract reasoning, spatial and verbal short-term memory, naming tasks, executive, visuo-motor tracking and visual scanning functions. BDI score was set as dependent variable of a multivariate backward stepwise linear regression analysis. Significance level was set at p < 0.05. Results: Our model identified four predictors accounting for a significant amount of variance for BDI scores (adjR2 = 0.59). Severity of depressive symptoms was predicted by female gender (p = 0.042), low scores on Digit Span backward (p = 0.024), Social Functioning (p = 0.023) and Mental Health (p = 0.003) subscales of SF-36. EDSS, disease duration, TNF-a, BDNF, IFN therapy show a weak nonsignificant influence on severity of MSD. Conclusions: MSD could be conceived as a consequence of failure of emotional-cognitive adjustment to an uncertain and unpredictable illness, with a greater vulnerability of female subjects and a reduction of mnesic-attentional functions. We found the degree of MSD to be more closely related to personal meaning attributed to the illness and the social impact on the previous life of the patient, more than with objective measures of disease severity. PO10-TU-59 Study of depression among multiple sclerosis patients in Hong Kong K.K. Lau1 , S.K.W. Cheng2 , B. Shiu1 , W.Y.W. Wong3 , H.W. Leung4 , W.M. Fok5 , K.L. Shiu6 , P.W. Ng7 . 1 Medicine and Geriatrics, Princess Margaret Hospital, Kowloon, Hong Kong; 2 Psychology, Kwai Chung Hospital, Kowloon, Hong Kong; 3 Medicine, Caritas Medical Centre, Kowloon, Hong Kong; 4 Medicine and Therapeutics, Prince of Wales Hospital, New Territories, Hong Kong; 5 Medicine and Geriatrics, Yan Chai Hospital, Kowloon, Hong Kong; 6 Medicine and Geriatrics, Tuen Mun Hospital, New Territories, Hong Kong; 7 Medicine and Geriatrics, United Christian Hospital, Kowloon, Hong Kong Purpose: This study aimed to examine depression, distress, selfesteem, and quality of life among Chinese multiple sclerosis (MS) patients in Hong Kong.