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Peer-reviewedCC BYJournal of clinical medicine

Multidomain Cognitive Decline and Motor Disability in Multiple Sclerosis: A Retrospective Cohort Study

  • Giuseppe Romano1
  • Maria Cropano1,2
  • Mario Fordellone3
  • Simona Raimo4
  • Cinzia Coppola1
  • Deborah Archetto1
  • Lidia Ammendola1
  • Daniela Malangone1
  • Simona Bonavita1
  • Giacomo Lus1
  • Elisabetta Signoriello1
4 affiliations
  1. 1Multiple Sclerosis Center, UOSD Second Neurology, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy
  2. 2Department of Health Sciences, “Magna Graecia” University of Catanzaro, 88100 Catanzaro, Italy
  3. 3Medical Statistics Unit, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
  4. 4Department of Medical and Surgical Sciences, “Magna Graecia” University of Catanzaro, 88100 Catanzaro, Italy
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Abstract

Background: Multiple sclerosis (MS) is characterized by heterogeneous trajectories of motor and cognitive disability. This study aimed to characterize longitudinal cognitive and motor trajectories across MS phenotypes and to identify baseline predictors of subsequent worsening. Methods: This retrospective cohort included 68 adults with MS followed for approximately six years. Cognitive performance was assessed at baseline (T0) and follow-up (T1) using the Rao’s Brief Repeatable Battery (BRB-N) and quantified using the Cognitive Impairment Index (CII). Clinical, demographic, neuropsychological, psychological, and neuroimaging variables were collected. Longitudinal cognitive changes were evaluated using linear mixed-effects models including baseline phenotype, time, and phenotype-by-time interaction. Logistic regression was used to investigate predictors of motor and cognitive worsening. Results: At baseline, 52.9% of patients met criteria for cognitive impairment. During follow-up, 50.0% experienced motor worsening and 77.9% experienced cognitive worsening; 44.1% met the study definition of cognitive progression independent of relapse activity. Memory CII increased significantly over time in the whole cohort (p = 0.003), whereas the phenotype-by-time interaction was not significant for Memory CII (p = 0.546), Executive CII (p = 0.211), or Total CII (p = 0.293). After Holm correction, the increase in Memory CII remained significant in baseline RRMS (+1.59; adjusted p = 0.007), but not in baseline SPMS (+1.40; adjusted p = 0.072) or PPMS (+0.57; adjusted p = 0.467). Eleven patients (32.4% of baseline RRMS) transitioned to SPMS and were retained in the baseline RRMS group for the primary longitudinal analyses. Their mean ΔEDSS was +1.91. Conclusions: Cognitive and motor progression represent partially distinct dimensions of MS evolution. Memory was the cognitive domain showing the clearest longitudinal worsening, particularly among patients classified as RRMS at baseline, while the magnitude of cognitive change did not differ significantly between baseline phenotypes.

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Cite

BibTeXRIS
BibTeX
@article{romano2026multidomain,
  title = {{Multidomain Cognitive Decline and Motor Disability in Multiple Sclerosis: A Retrospective Cohort Study}},
  author = {Giuseppe Romano and Maria Cropano and Mario Fordellone and Simona Raimo and Cinzia Coppola and Deborah Archetto and Lidia Ammendola and Daniela Malangone and Simona Bonavita and Giacomo Lus and Elisabetta Signoriello},
  journal = {Journal of clinical medicine},
  year = {2026},
  month = oct,
  doi = {10.3390/jcm15197627},
  url = {https://europepmc.org/article/PMC/PMC13666309},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Multidomain Cognitive Decline and Motor Disability in Multiple Sclerosis: A Retrospective Cohort Study
AU  - Giuseppe Romano
AU  - Maria Cropano
AU  - Mario Fordellone
AU  - Simona Raimo
AU  - Cinzia Coppola
AU  - Deborah Archetto
AU  - Lidia Ammendola
AU  - Daniela Malangone
AU  - Simona Bonavita
AU  - Giacomo Lus
AU  - Elisabetta Signoriello
PY  - 2026
DA  - 2026/10/01
JO  - Journal of clinical medicine
DO  - 10.3390/jcm15197627
UR  - https://europepmc.org/article/PMC/PMC13666309
AB  - Background: Multiple sclerosis (MS) is characterized by heterogeneous trajectories of motor and cognitive disability. This study aimed to characterize longitudinal cognitive and motor trajectories across MS phenotypes and to identify baseline predictors of subsequent worsening. Methods: This retrospective cohort included 68 adults with MS followed for approximately six years. Cognitive performance was assessed at baseline (T0) and follow-up (T1) using the Rao’s Brief Repeatable Battery (BRB-N) and quantified using the Cognitive Impairment Index (CII). Clinical, demographic, neuropsychological, psychological, and neuroimaging variables were collected. Longitudinal cognitive changes were evaluated using linear mixed-effects models including baseline phenotype, time, and phenotype-by-time interaction. Logistic regression was used to investigate predictors of motor and cognitive worsening. Results: At baseline, 52.9% of patients met criteria for cognitive impairment. During follow-up, 50.0% experienced motor worsening and 77.9% experienced cognitive worsening; 44.1% met the study definition of cognitive progression independent of relapse activity. Memory CII increased significantly over time in the whole cohort (p = 0.003), whereas the phenotype-by-time interaction was not significant for Memory CII (p = 0.546), Executive CII (p = 0.211), or Total CII (p = 0.293). After Holm correction, the increase in Memory CII remained significant in baseline RRMS (+1.59; adjusted p = 0.007), but not in baseline SPMS (+1.40; adjusted p = 0.072) or PPMS (+0.57; adjusted p = 0.467). Eleven patients (32.4% of baseline RRMS) transitioned to SPMS and were retained in the baseline RRMS group for the primary longitudinal analyses. Their mean ΔEDSS was +1.91. Conclusions: Cognitive and motor progression represent partially distinct dimensions of MS evolution. Memory was the cognitive domain showing the clearest longitudinal worsening, particularly among patients classified as RRMS at baseline, while the magnitude of cognitive change did not differ significantly between baseline phenotypes.
SN  - 2077-0383
ER  -