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CANTAB

Multiple sclerosis

Cognitive deficits are common in individuals with Multiple Sclerosis (MS), affecting up to 70% of patients and are associated with loss of self-esteem and functional impairment1. Many different cognitive domains can be affected, reflecting the heterogeneous nature of the underlying white matter pathology1,2. Commonly affected domains include psychomotor speed, sustained attention, memory and executive functioning. Severity of impairment can differ depending on whether the Multiple Sclerosis is primary progressive (PP) or Secondary Progressive (SP), with the former often manifesting itself with greater impairment2. Cognitive abilities can deteriorate over time and this often predicts loss of everyday functioning3. Our recommended test battery for MS incorporates the key cognitive domains often impaired, as well as domains likely to be affected by medications.

The tests included in this battery are highly sensitive to cognitive impairments in MS across the disease severity spectrum2,4. Poorer memory performance in this battery correlated significantly with higher hippocampal glutamate levels in patients with MS5. The MS test battery also detects cognitive effects of interventions in MS patients, both in terms of unwanted adverse events and cognitive enhancement6.

Measures

  • Motor Skills
  • Episodic memory
  • Sustained attention
  • Executive function
  • Processing speed

CANTAB Tests

Research

The CANTAB tests within our Multiple Sclerosis test battery have shown cognitive deficits in working memory, associated with disease pathology and severity in MS.1

 

Foong et al., Brain, (1997)

Key References

Foong J, Rozewicz L, Quaghebeur G, Davie CA, Kartsounis LD, Thompson AJ, Miller DH, Ron MA. Executive function in multiple sclerosis. The role of frontal lobe pathology. Brain Pathol. 2015 Jan;25(1):79-98.

Oken BS, Flegal K, Zajdel D, Kishiyama SS, Lovera J, Bagert B, Bourdette DN. Cognition and fatigue in multiple sclerosis: Potential effects of medications with central nervous system activity. J Rehabil Res Dev. 2006 Jan-Feb;43(1):83-90.

Muhlert N, Atzori M, De Vita E, Thomas DL, Samson RS, Wheeler-Kingshott CA, Geurts JJ, Miller DH, Thompson AJ, Ciccarelli O. Memory in multiple sclerosis is linked to glutamate concentration in grey matter regions. J Neurol Neurosurg Psychiatry. 2014 Aug;85(8):833-9.

Multiple Sclerosis: management of multiple sclerosis in primary and secondary care (CG186). National Institute for Health and Care Excellence (NICE). 2014.


  1. DeLuca GC, Yates RL, Beale H, Morrow SA. Cognitive impairment in multiple sclerosis: clinical, radiologic and pathologic insights. Brain. 1997 Jan;120 ( Pt 1):15-26.
  2. Foong J, Rozewicz L, Quaghebeur G, Davie CA, Kartsounis LD, Thompson AJ, Miller DH, Ron MA. Executive function in multiple sclerosis. The role of frontal lobe pathology. Brain Pathol. 2015 Jan;25(1):79-98.
  3. Morrow SA, Drake A, Zivadinov R, Munschauer F, Weinstock-Guttman B, Benedict RH. Predicting loss of employment over three years in multiple sclerosis: clinically meaningful cognitive decline. Clin Neuropsychol. 2010 Oct;24(7):1131-45.
  4. Roque DT, Teixiera RAA, Zachi EC, Ventura DF. The use of the Cambridge Neuropsychological Test Automated Battery (CANTAB) in neuropsychological assessment: application in Brazilian research with control children and adults with neurological disorders Psychology & Neuroscience. 2011, Vol: 4(2): 255-265.
  5. Muhlert N, Atzori M, De Vita E, Thomas DL, Samson RS, Wheeler-Kingshott CA, Geurts JJ, Miller DH, Thompson AJ, Ciccarelli O. Memory in multiple sclerosis is linked to glutamate concentration in grey matter regions. J Neurol Neurosurg Psychiatry. 2014 Aug;85(8):833-9.
  6. Oken BS, Flegal K, Zajdel D, Kishiyama SS, Lovera J, Bagert B, Bourdette DN. Cognition and fatigue in multiple sclerosis: Potential effects of medications with central nervous system activity. J Rehabil Res Dev. 2006 Jan-Feb;43(1):83-90.