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Introduction: There are no reports in LATAM related to longitudinal humoral and cellular response to adenovirus based COVID-19 vaccines in people with Multiple Sclerosis (pwMS) under different disease modifying therapies (DMTs) and neutralization of the Omicron and Wuhan variants of SARS-COV-2., Methods: IgG anti- SARS-COV-2 spike titer were measured in a cohort of 101 pwMS under fingolimod, dimethyl fumarate, cladribine and antiCD20, as well as 28 healthy controls (HC) were measured 6 weeks after vaccination with 2 nd dose (Sputnik V or AZD1222) and 3 nd dose (homologous or heterologous schedule). Neutralizing capacity was against Omicron (BA.1) and Wuhan (D614G) variants and pseudotyped particles and Cellular response were analyzed., Results: Multivariate regression analysis showed anti-cd20 (β= -,349, 95% CI: -3655.6 - -369.01, p=0.017) and fingolimod (β=-,399, 95% CI: -3363.8 - -250.9, p=0.023) treatments as an independent factor associated with low antibody response (r 2 adjusted=0.157). After the 2nd dose we found a correlation between total and neutralizing titers against D614G (rho=0.6; p<0.001; slope 0.8, 95%CI:0.4-1.3), with no differences between DMTs. Neutralization capacity was lower for BA.1 (slope 0.3, 95%CI:0.1-0.4). After the 3rd dose, neutralization of BA.1 improved (slope: 0.9 95%CI:0.6-1.2), without differences between DMTs. A fraction of pwMS generated anti-Spike CD4+ and CD8+ T cell response. In contrast, pwMS under antiCD20 generated CD8+TNF+IL2+ response without differences with HC, even in the absence of humoral response. The 3rd dose significantly increased the neutralization against the Omicron, as observed in the immunocompetent population., Discussion: Findings regarding humoral and cellular response are consistent with previous reports., Competing Interests: The authors declare that this study received funding from Novartis and donations from Merck Argentina and Synthon Bagó. The funders were not involved in the study design, collection, analysis, interpretation of data, the writing of this article or the decision to submit it for publication. Author Berenice Anabel Silva, as principal investigator, received a 2-year research grant from the Research Council of the Ministry of Health of the Government of the City of Buenos Aires, Argentina., (Copyright © 2024 Silva, Miglietta, Casabona, Wenker, Eizaguirre, Alonso, Casas, Lázaro, Man, Portuondo, Lopez Bisso, Zavala, Casales, Imhoff, Steinberg, López, Carnero Contentti, Deri, Sinay, Hryb, Chiganer, Leguizamon, Tkachuk, Bauer, Ferrandina, Giachello, Henestroza, Garcea, Pascuale, Heitrich, Podhajcer, Vinzón, D’Alotto-Moreno, Benatar, Rabinovich, Pitossi and Ferrari.)

Background: Social support is crucial for persons with multiple sclerosis (MS). We sought to analyze differences in perceived social support in persons with MS vs controls; to study associations between perceived social support, clinical measures, and health-related quality of life (HRQOL) variables in persons with MS; and to establish a predictive value of perceived social support for HRQOL., Methods: We studied 151 persons with MS (mean ± SD: age, 42.01 ± 9.97 years; educational level, 14.05 ± 3.26 years) and 89 controls (mean ± SD: age, 41.46 ± 12.25 years; educational level, 14.60 ± 2.44 years) using the Medical Outcomes Study Social Support Survey (MOS-SSS), Expanded Disability Status Scale, Fatigue Severity Scale, Beck Depression Inventory, and Multiple Sclerosis International Quality of Life (MusiQoL) questionnaire. Parametric and nonparametric statistical methods were used accordingly; P < .05., Results: Persons with MS exhibited lower scores on the MOS-SSS's overall support index ( t 238 = -1.98, P = .04) and on each functional subscale ( t 238 = -2.56 to -2.19, P < .05). No significant differences were found on the social support structural component ( P > .05). Significant associations were observed between social support and depression and fatigue ( r = -0.20 to -0.29, P < .05) and with MusiQoL dimensions ( r = -0.18 to 0.48, P < .05). Multiple regression analysis showed all 4 tested models contributed to HRQOL-explained variance (41%-47%). The emotional/informational support model explained the most HRQOL variability (47%)., Conclusions: Persons with MS perceived reduced social support, presenting lower functional scores than controls. Perceived social support proved to be a predictor of HRQOL. These findings should be considered during therapeutic treatment., Competing Interests: FINANCIAL DISCLOSURES: The authors declare no conflicts of interest., (© 2023 Consortium of Multiple Sclerosis Centers.)

Background: The use of telemedicine has quickly increased during of the COVID-19 pandemic. Given that unmet needs and barriers to multiple sclerosis (MS) care have been reported, telemedicine has become an interesting option to the care of these patients. The objective of these consensus recommendations was to elaborate a guideline for the management of people with MS using telemedicine in order to contribute to an effective and high-quality healthcare., Methods: A panel of Argentinean neurologist's experts in neuroimmunological diseases and dedicated to the diagnosis, management,and care of MS patients gathered virtually during 2021 and 2022 to conduct a consensus recommendation on the use of telemedicine in clinical practice in adult people with MS. To reach consensus, the methodology of "formal consensus RAND/UCLA Appropriateness method" was used., Results: Recommendations were established based on relevant published evidence and expert opinion focusing on definitions, general characteristics and ethical standards, diagnosis of MS, follow-up (evaluation of disability and relapses of MS), identification and treatment of relapses, and finally disease-modifying treatments using telemedicine., Conclusion: The recommendations of this consensus would provide a useful guide for the proper use of telemedicine for the assessment, follow-up, management, and treatment of people with MS. We suggest the use of these guidelines to all the Argentine neurologists committed to the care of people with MS., (© 2022. Fondazione Società Italiana di Neurologia.)

Background: There is scarce information regarding the decision-making process (DMP) in people with MS (PwMS) from Latin America., Objective: To evaluate the DMP in Argentinean PwMS and to assess its relationship with patient preferences, and clinical-demographic characteristics., Methods: PwMS from the patient organization Esclerosis Múltiple Argentina (n = 1275) were invited to participate in a self-administered web-based survey. Participants were asked to provide clinical-demographic information and to complete a questionnaire on their perceptions about the information provided by their physician, the Control Preference Scale, and the Satisfaction with the Decisions and Care Questionnaire, and were inquired on their preferred sources of information about MS., Results: The survey was completed by 379 PwMS. Most were females (67%); mean age: 40.3 (SD = 11.1) years; mean disease duration: 7.9 (SD = 7.2) years. Patients' decisional control preferred role was active in 47%, shared in 27%, and passive in 26%. A moderate concordance (weighted kappa 0.55) was observed between patients' preferences and self-reported DMP. Seventy-two percent participated in the DMP according to their preferences (concordance rates: active 66%, shared 87%, passive 51%). Most (83%) declared receiving information from their neurologists, matching their preferences (94%)., Conclusions: Argentinian PwMS have distinctive preferences regarding information management and decision making., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Background: We aimed to describe the health-related quality of life (HRQoL) in patients with neuromyelitis optica spectrum disorders (NMOSD), to compare HRQoL between NMOSD patients, multiple sclerosis (MS), and healthy controls (HC) and to study the associations between HRQoL and the clinical variables of the disease., Methods: A cross-sectional study was carried out. Patients with NMOSD seropositive, MS, and HC were enrolled and age-matched. The HRQoL was studied using the Argentinean validation of the SF-36 health questionnaire. Demographic and clinical characteristics were analyzed, as well as the EDSS and the total scores and subscales of the SF-36., Results: 243 individuals were included (NMOSD= 53, MS =100, and HC =90). The mean EDSS was 3.06 ± 2.01 in NMOSD and 2.67 ± 1.83 in MS with a mean of disease duration of 6.2 ± 4.4 and 6.3 ± 5.3 years, respectively. Significant statistical differences were observed in the total SF-36 score between both NMOSD and MS vs. HC (p < 0.01), but no differences were found when the total SF-36 score was compared between NMOSD vs. MS. Overall, NMOSD patients scored significantly lower in the total SF-36 and subscale scores compared to HC (p< 0.05). NMOSD patients also showed significant differences in bodily pain (58.8 ± 29.8 vs 75.1 ± 25.1, p < 0.01) and general health (44.4 ± 20.9 vs.31.9 ± 23.1, p < 0.01) when compared with MS, but no differences were found after comparing the rest of the subscales. We found that higher EDSS scores (β -1.28 p = 0.03) and disease duration (β 0.8, p = 0.02) were significantly associated to lower (worse) general health (dependent variable) score in NMOSD patients after having applied multiple linear regression analysis. Additionally, we observed that higher EDSS scores (β -10.2 p = 0.008) and the presence of relapses in the previous year (β -28.9, p = 0.02) were significantly associated to lower (worse) physical functioning (dependent variable) score., Conclusion: Pain seems to be a significant undertreated symptom in NMOSD patients that strongly impact on HRQoL. Patient-reported HRQoL scales scores provide comprehensive additional prognostic information beyond physical disability score., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Introduction: Peripheral inflammation can exacerbate pre-existing lesions in the Central Nervous System (CNS) in the context of neurodegenerative diseases, including Multiple Sclerosis (MS)., Objective: To analyze the clinical effect of COVID-19 infection, as a generator of peripheral inflammation, in a MS patients group., Methods: A retrospective analysis of 400 medical records of MS patients from a referral center was carried out. MS patients who presented COVID-19 were surveyed about symptoms exacerbation: type, duration and onset of exacerbation, previous vaccination against COVID-19 and MS severity. Clinical and demographic information from the medical records were included. Descriptive and inferential analysis were performed using the GraphPad Prism V6., Results: 41 patients were included, 61% (n = 25) reported neurological worsening, 9.7% (n = 4) as relapses, and 7.3% (n = 3) required corticosteroids. We found significant differences in the EDSS between patients who exacerbated their MS symptoms and those who did not (p = 0.03). When performing a multivariate regression analysis, we found that EDSS was independently associated with the presence of exacerbations of MS in the context of SARS-CoV2 infection (OR = 2.44, p = 0.022)., Conclusions: This preliminary study suggests that COVID-19 infection could trigger exacerbations of MS symptoms. New studies are needed to elucidate the relationship between COVID-19 and MS., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Background: To date, there are no data available on the safety of COVID-19 vaccines in Latin American patients with Multiple Sclerosis (MS)., Objective: Characterize safety of COVID-19 vaccines in Latin American (LATAM) patients with Multiple Sclerosis (pwMS)., Methods: A cross-sectional study between February 1, 2021, and April 30, 2021. Individuals with MS from LATAM countries were invited to participate in a self-administered web-based survey, through MS patient organizations from the region., Results: 393 vaccinated pwMS from 10 different Latin American countries were included. The vaccines administered were: inactivated virus vaccines (IVV) in 38.2% of patients, adenovirus vector vaccines (AdV) in 48.8% and mRNA vaccines 13%. All patients received at least one dose of any of the COVID-19 vaccines and 123 (31.3%) declared receiving a second dose. Mean (SD) age 41.5 (11.8) years, 82.4% female, MS disease duration: 8.4 (8.2) years. No serious adverse events were reported with any of the COVID-19 vaccines after either the first or second dose. A lower frequency of adverse events was found with IVV (22%) in comparison with AdV (46.4%) and mRNA (35.3%) ( p  < 0.01). Five participants reported having an MS relapse after IVV first dose., Conclusion: COVID-19 vaccines applied in LATAM proved safe for MS patients., Competing Interests: Declaration of conflicting interests: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Ricardo Alonso has received personal compensation for consulting, serving on the scientific advisory board, lecturing as well as professional/travel accommodation stipends among other activities from Biogen Idec, Genzyme, Merck-Serono, Novartis, Teva and Roche. Anibal Chertcoff has received speaking honoraria and travel stipends from Merck-Serono and Roche. María Bárbara Eizaguirre has received personal compensation for consulting, lecturing as well as stipends for national and international conferences among other activities from Biogen Idec, Genzyme, Novartis and Roche. Berenice Anabel Silva has received economic retribution for the development of educational, scientific activities and travel grants to Congresses from Biogen, Novartis, Merck, Genzyme, Teva, Bayer, Tuteur and Roche. Felisa Leguizamón has received economic retribution for the development of educational activities as well as travel stipends from Bayer, Biogen Idec, Biosidus, Genzyme, Novartis, Merck, Raffo, Tuteur, and Teva. Rest of the authors report no conflicts of interest., (© The Author(s), 2021.)

Background: The COVID-19 pandemic has resulted in uncertain access to medical treatment for people with multiple sclerosis (pwMS) all over the world. However, there is no data regarding its impact on access to health care of pwMS from Latin America., Objectives: We investigated and described changes in health care delivery for pwMS from Latin America during the COVID-19 pandemic., Methods: PwMS from 18 patient organizations of the region completed a web-based survey hosted from May to October 2020., Results: A total of 602 pwMS completed the questionnaire. Changes in disease-modifying therapies (DMTs) use: 6.7% of pwMS on continuous DMTs claimed to stopped them; 14.1% of those on infusion therapies declared to postpone their dosing; 68.8% declared delaying the initiation of a DMT. Disruptions in accessing rehabilitation services were reported by 65.7%. Changes in laboratory and MRI monitoring were reported by 30% and 33%, respectively. In a multivariable-adjusted logistic regression model, changes in laboratory monitoring were significantly associated with increased odds of postponing MRI monitoring (OR 4.09 CI95% 2.79-6.00, p < 0.001)., Conclusions: The COVID-19 pandemic has disrupted all aspects of the routine care for pwMS from Latin America. Consequences are yet to be determined., (Copyright © 2021. Published by Elsevier B.V.)

Background: The purpose of this study was to assess family planning (FP) among women with multiple sclerosis (WwMS)., Methods: We invited 604 WwMS to answer a survey focused on FP: a) Temporal relationship between pregnancy and the diagnosis of multiple sclerosis; b) History of FP; c) Childbearing desire; d) Information on family planning. Comparisons between pregnancy and not pregnancy after MS, as well as, planned and unplanned pregnancy were analyzed. Multivariate and univariate analyses were used to assess the impact of independent variables and FP., Result: 428 (71.7%) WwMS completed the survey. A 19.1% got pregnant after MS diagnosis and we evaluated FP in the last pregnancy, 56.1% patients had a planned pregnancy. Professional addressing FP (OR = 0.27, 95%-CI 0.08-0.92, p = 0.03) and non-injection drug treatment before pregnancy (OR = 2.88, 95%-CI 1.01-8.21, p = 0.047) were independent predictors of unplanned pregnancy in our multivariate model. Among WwMS ≤ 40 years, 48.7% had future childbearing desire. Young age (p < 0.001), PDDS <3 (p = 0.018), disease duration <5 years (p = 0.02), not childbearing before MS diagnosis (p < 0.001) and neurologist addressing family planning (p = 0.01) were significantly associated with childbearing desire., Conclusions: This research highlights that pregnancy remains an important concern among WwMS., (© The Author(s) 2021.)

Background: Scales to assess disability in multiple sclerosis (MS) rarely provide reliable data on actual global impairment. Upper limb dysfunction is usually overlooked, which has a negative effect on patient well-being. We sought to analyze associations among upper limb dexterity, lower limb speed, and Expanded Disability Status Scale (EDSS) score; the difference in upper limb dexterity between patients with EDSS scores less than 5 and 5 or greater; and the associations that upper limb dexterity, lower limb speed, and EDSS score have with health-related quality of life measurements and depression., Methods: A total of 140 adults with MS were evaluated using the Nine-Hole Peg Test, Timed 25-Foot Walk test, EDSS, Multiple Sclerosis International Quality of Life (MusiQoL) questionnaire, and Beck Depression Inventory. Thorough descriptive-analytical research was conducted using the Spearman correlation, multiple linear regression, and structural equation modeling., Results: Upper limb dexterity was more closely related to EDSS score than lower limb speed ( r = 0.43 vs 0.29, R 2 = 0.38) and was greatest in patients with EDSS scores less than 5 ( P < .01). Moreover, upper limb dexterity was negatively associated with EDSS score and the MusiQoL questionnaire ( r S = -0.557 to -0.321, P < .05). The correlation that depression has with upper limb dexterity loss was higher than the one it has with lower limb speed (0.098 vs 0.066, t > 1.96)., Conclusions: Upper limb dexterity is associated with global disability, depression, and health-related quality of life. We advocate for the assessment of upper limb dexterity in patients with MS to adopt a better approach to their functional impairment., Competing Interests: Financial Disclosures: Dr Alonso has received reimbursement for developing educational presentations, educational grants, and travel stipends from Biogen, Genzyme, Merck, Novartis, and Roche. Ms Eizaguirre has received reimbursement for educational grants from Novartis and Roche. Dr Cohen has received reimbursement for developing educational presentations, educational grants, and travel stipends from Genzyme, Novartis, and Roche. Dr Silva has received reimbursement for developing educational presentations, educational grants, consultation fees, and travel stipends from Biogen, Genzyme, Novartis, and Merck. Dr Pita has received reimbursement for developing educational presentations, educational grants, consultation fees, and travel stipends from Genzyme, Roche, and Biogen. Dr Vanotti has received reimbursement for developing educational presentations from Biogen Argentina and Novartis Argentina. Dr Garcea has received reimbursement for developing educational presentations, educational and research grants, consultations fees, and travel stipends from Biogen, Genzyme, and Merck. The other authors declare no conflicts of interest., (© 2021 Consortium of Multiple Sclerosis Centers.)

Coping is defined as a set of cognitive and behavioral efforts made to master stressful specific demands. Adaptation to chronic diseases, such as Multiple Sclerosis (MS), depends on the effectiveness of coping. Objective: To assess the psychometric properties of the Coping Responses Inventory (CRI-A) in persons with MS (PwMS), verifying the transferability of the measure, already validated in the Argentine general population, and to describe the types of coping strategies available for PwMS. Methods: 90 PwMS were included. Outcome measures: CRI-A Inventory, Expanded Disability Status Scale (EDSS), Beck Depression Inventory, Fatigue Severity Scale and MS International Quality of Life questionnaire. Results: Descriptive data is as follows: mean age (years): 40.97 ± 12.85; years of education: 13.46 ± 3.93; EDSS: 2.48 ± 1.79; disease evolution (years): 10.76 ± 9.72; depression: 13.92 ± 10.45; fatigue 3.77 ± 1.72. The psychometric properties of the CRI-A Inventory observed in the Argentine general population are present in the MS sample as well, with adequate validity and reliability. The respondents most frequently utilized a problem-focused coping style. Conclusions: Results showed the CRI-A has good transferability properties from the Argentine general population to the MS population., Competing Interests: Conflicts of Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article., (© The Author(s) 2021.)

Introduction: Over the past decade, numerous disease modifying drugs (DMDs) for relapsing- remitting multiple sclerosis (RRMS) have been approved in Argentina. The use of oral DMDs (oDMDs) has increased in recent years, although real-life data in our region is limited. We aimed to describe the tendency in the use of oDMDs (as first treatment option or after switch) in relationship with their approval in Argentina., Methods: A retrospective study in a cohort of MS patients from five Argentinian MS centers was conducted. Regarding the availability of different oDMDs in Argentina, we define three periods (P1-3): P1: 2012 - 2014; P2: 2015 - 2017 and P3: 2018 - 2020. An analysis was performed comparing between these three periods to assess the tendency for oDMDs use over time., Result: The most frequently prescribed treatment as first DMD was: interferon beta 1a (40%) in P1, fingolimod (37.3%) in P2 and also fingolimod (35%) in P3. We found an increase in the use of oDMTs as initial treatment over time (P1: 17.7%, P2: 63.9% and P3: 65.0%; Chi-square = 41.9 p <0.01). We also found a tendency to increase the use of oDMTs after a first switch (P1: 45.5%, P2: 60.1% and P3 78.3%). Multivariate analysis showed that disease evolution (OR=1.06, p=0.04), and year of treatment initiation (OR=1.01 p<0.01) were independently associated with choice of oDMTs., Conclusion: This study identified an increasing tendency for the use of oDMDs as initial treatment of RMS in relationship with their approval in Argentina., (Copyright © 2020. Published by Elsevier B.V.)

Background: Multiple sclerosis (MS) is a neurological chronic disease that causes a number of physical, cognitive and emotional symptoms. The identification of these factors will allow mitigating unemployment and improve quality of life of patients. The Buffalo Vocational Monitoring Survey (BVMS) is a tool to characterize Work-Challenged patients., Objective: To describe and analyze BVMS data in people with multiple sclerosis (PwMS) from Argentina. To study the association with physical, cognitive and psychiatric morbidity in employed patients, comparing the performance of MS Work-Challenged and MS Work-Stable patients, with and without accommodations., Methods: 119 MS patients were administered the Argentina adaptation of the BVMS, and completed measures of physical disability, fatigue, depression, cognitive processing speed, memory and verbal fluency., Results: 65.54% of the patients were employed and 19.32% were unemployed, the remaining having roles of housewife, students and disability retirees. Within the employed subgroup, 60.26% were working as employees and 39.74% were self-employed. Cognitive and clinical variables differentiate patients with and without negative events and accommodations (p >  0.05)., Conclusions: This Spanish version BVMS is considered a new tool to monitor employment difficulties in Spanish-speaking MS patients. MS Work-Challenged had a higher depression, fatigue and worse performance in cognitive variables.

Objectives: To study the relationship between perceived fatigue and heath related quality of life (HRQoL), social support and cognition in an Argentinean population of patients with MS (PwMS)., Patients and Methods: 128 PwMS were studied, 75 women (58 %). Mean age: 40 ± 10.49 years-old, education: 14 ± 3.04, Expanded Disability Status Scale (EDSS): 2.43 ± 1.87, evolution: 10.07 ± 7.23 years., Instruments: Fatigue Severity Scale (FSS); EDSS; Beck's Depression Inventory II (BDI-II); International Quality of Life questionnaire (MusiQoL); Medical Outcomes Study Social Support Survey (MOS); BICAMS Battery, 7/24 Spatial Recall Test, Paced Auditory Serial Task (PASAT-3), Word list generation task (WLG)., Results: Sixty-six patients (51.6 %) presented fatigue. Significant differences were found between fatigued and non-fatigued patients in EDSS and BDI II (p < 0.001). Fatigue was associated with age, EDSS and BDI II (p < 0.05). When analyzing differences in HRQoL between fatigued and non-fatigued patients statistically significant differences were found in MusiQol (p < 0.05). FSS proved to be an independent predictor of HRQoL (typified β =-0.612 and -0.287, p < 0.05). Fatigued patients had fewer friends in their social support network (p = 0.031) and worse performance in PASAT. FSS was established as an independent predictor of PASAT (β = -0.280, p = 0.009) CONCLUSION: Fatigue is one of the most common symptoms in Multiple Sclerosis (MS) and has a great impact on patients daily life. This study highlights the importance of studying fatigue and treating it properly, since otherwise, it contributes to the dysfunction of patients daily life with psychological and social consequences., (Copyright © 2020 Elsevier B.V. All rights reserved.)

The Symbol Digit Modalities Test (SDMT) is an information processing speed test. The aim of this study was to compare the SDMT across three samples: the USA, Mexico, and Argentina. The hypothesis is that performance will vary based on native language and cultural differences between these countries. The SDMT was administered to 129 healthy volunteers. Participants from the USA performed better than participants from Argentina and Mexico ( p < .01), and no differences were observed between the latter groups ( p = .15). Processing speed differs between the studied populations of Latin America and Anglo-America. Possible interpretations of this result are presented.

Background: There is no consensus regarding assessment of the brain function functional system (FS) of the Expanded Disability Status Scale (EDSS) in patients with multiple sclerosis (MS). We sought to describe brain function FS assessment criteria used by Argentinian neurologists and, based on the results, propose redefined brain function FS criteria., Methods: A structured survey was conducted of 113 Argentinian neurologists. Considering the survey results, we decided to redefine the brain function FS scoring using the Brief International Cognitive Assessment for MS (BICAMS) battery. For 120 adult patients with MS we calculated the EDSS score without brain function FS (basal EDSS) and compared it with the EDSS score after adding the modified brain function FS (modified EDSS)., Results: Of the 93 neurologists analyzed, 14% reported that they did not assess brain function FS, 35% reported that they assessed it through a nonstructured interview, and the remainder used other tools. Significant differences were found in EDSS scores before and after the inclusion of BICAMS ( P < .001). Redefining the brain function FS, 15% of patients modified their basal EDSS score, as did 20% of those with a score of 4.0 or less., Conclusions: The survey results show the importance of unifying the brain function FS scoring criteria in calculating the EDSS score. While allowing more consistent brain function FS scoring, including the modified brain function FS led to a change in EDSS score in many patients, particularly in the lower range of EDSS scores. Considering the relevance of the EDSS for monitoring patients with MS and for decision making, it is imperative to further validate the modified brain function FS scoring., Competing Interests: The authors declare no conflicts of interest., (© 2020 Consortium of Multiple Sclerosis Centers.)

Background and Purpose: Information processing speed is one of the most impaired cognitive functions in multiple sclerosis (MS). There are two tests widely used for evaluating information processing speed: the Symbol Digit Modalities Test (SDMT) and the Paced Auditory Serial Addition Test (PASAT). To analyze the relationship between processing speed and the clinical and social support variables of patients with MS., Methods: A group of 47 patients with relapsing-remitting MS was studied, 31 were women and 16, men. Age: 39.04±13.17, years of schooling: 13.00±3.87, Expanded Disability Status Scale (EDSS): 2.78±1.81, and disease evolution: 8.07±6.26. Instruments of measure; processing speed: SDMT, PASAT, clinical variables: EDSS, Fatigue Severity Scale (FSS), Beck's Depression Inventory II (BDI-II), and social support: Medical Outcomes Study Social Support Survey (MOS)., Results: Significant correlations were found between information processing speed and psychiatric, motor disability and social support variables. The SDMT correlated significantly and negatively with BDI-II, FSS, EDSS, and MOS ( p <0.05), whereas the PASAT correlated negatively with FSS and positively with MOS ( p <0.05). Information processing speed appeared as the performance predictor of these variables. The SDMT produced significant changes in EDSS (R²=0.343, p =0.000); FSS (R²=0.109, p =0.031); BDI-II (R²=0.124, p =0.018), and MOS (R²=between 0.212 and 0.379, p <0.05)., Conclusions: Information processing speed has influence on the clinical variables and the social support of patients with MS. These aspects are important to bear in mind for therapeutic approach., Competing Interests: The authors have no financial conflicts of interest., (Copyright © 2018 Korean Neurological Association.)

Background and Purpose: The number of disease-modifying drugs (DMDs) available for treating relapsing-remitting multiple sclerosis is increasing. Numerous drugs have been approved since 2010 in South America, which has increased the complexity of the treatment algorithm. The aim of this study was to determine the changes in multiple sclerosis treatments relative to the underlying causes and the availability of new DMDs in Argentina., Methods: A descriptive retrospective study was carried out on a group of 59 patients diagnosed with RRMS who use more than one DMD., Results: The first treatment switch occurred before 2010 in 27% of the patients and after 2010 in the other 73%. Efficacy was the main reason for switching during both periods. A second treatment switch was required in 25% of the patients, with this occurring after 2010 in 86.6% of them. Interferon was the most-used drug before 2010 and fingolimod was the most-used drug thereafter., Conclusions: We have identified that the tendency for treatment changes has increased following the arrival of new drugs. Efficacy has been the main cause of these changes., Competing Interests: Ricardo Alonso has received honorary-speaker payments from Biogen and Gemzyme. María Bárbara Eizaguirre has received an honoraryspeaker payment from Novartis. Lucía Zavala declares that he has no conflict of interest. Cecilia Pita declares that he has no conflict of interest. Berenice Silva has received honorary-speaker payments from Novartis, Biogen, and Gemzyme. Orlando Garcea has received honorary-speaker payments from Teva, Novartis Biogen, and Gemzyme, and has received research grants from Teva and Novartis., (Copyright © 2018 Korean Neurological Association.)

The Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) was developed to provide valid assessment of cognitive impairment in multiple sclerosis (MS). The relationship between clinical and social variables and cognitive disorders has been extensively studied, but primarily in developed countries with a focus on other cognitive measures or batteries. The objectives of this study were to analyze the relationship between the BICAMS data and key clinical and sociodemographic variables in the Argentine MS population. A total of 50 MS patients were administered the Argentinean BICAMS Battery, comprised of the Symbol Digit Modalities Test (SDMT), the California Verbal Learning Test I (CVLT I), and the Brief Visuospatial Memory Test Revised (BVMTR). Disease progression, fatigue, depression, self-reported and informant report cognitive status, and employment status were assessed. Disease progression and employment status were most strongly associated with overall BICAMS performance (η 2 effect size values ranging from .302 to .624, all comparisons statistically significant). Informant rating of patient cognition, age, depression, disease duration, fatigue, and work hours were significantly associated as well. Gender, years of education, and patient-reported cognitive status were nonpredictive. A similar pattern was seen at the individual test level, with more variables related to the SDMT and CVLT I than BVMTR. BICAMS is strongly associated with overall disease progression and employment status.

Background: Previous research suggests that patients with multiple sclerosis (MS) have higher neuroticism, lower extraversion, and lower conscientiousness relative to healthy controls (HCs). However, the prevalence of this maladaptive profile in MS and its relation to cognition is unknown., Objective: Determine prevalence of maladaptive personality among MS patients, compared to HCs, and examine how it relates to cognitive dysfunction., Methods: A sample of 275 MS patients and 55 HCs completed neuroperformance measures of information processing speed and memory. Self and informant ratings were obtained on the NEO Five-Factor Inventory., Results: MS patients had higher neuroticism and lower extraversion than HCs. Cognitively impaired patients were also lower in conscientiousness. Cluster analysis revealed a configuration of these same three traits, representing a maladaptive profile. This profile was found in 50% of the overall MS sample, compared to 24% of HCs. However, only cognitively impaired MS patients had a higher prevalence of maladaptive personality compared to HCs. Among cognitively impaired patients, those with maladaptive traits were impaired in more cognitive domains than those with more adaptive traits., Conclusion: Cognitively impaired MS patients have a higher prevalence of seemingly maladaptive traits compared to HCs, demonstrating an association between cognition and personality in MS.

The aim of this study is to make a descriptive review of the bibliography available on cognitive dysfunction in patients with neuromyelitis optica spectrum disorders (NMOSD). We selected fifteen studies that quantitatively assess the relationship between NMOSD and one or more cognitive variables. Results showed that patients with NMOSD had a decrease in cognitive functions. Cognitive dysfunctions were found in 35-67% of patients with NMOSD, specifically in the attention, memory and information processing speed. Cognitive dysfunctions were found to relate to injuries in white matter as well as clinical variables and depression., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Myasthenia gravis is a chronic autoimmune disease that affects the neuromuscular transmission. Controversial findings had been reported about cognitive impairment in this disease. The aim of this study was to investigate the cognitive pattern of patients with myasthenia gravis. There were enrolled 24 patients with myasthenia gravis, anti-acetylcholine receptor antibodies (ACRA) positive, and 24 healthy controls., Patients: age 43.9 ± 14.8, years of education 10.9 ± 3.3., Controls: age 44.5 ± 15.4, years of education 11.5 ± 3.3. The following areas were evaluated: verbal memory: (long-term storage, retrieval, delayed recall) of the Selective Remained Test; attention: Paced Auditory Serial Addition Task (PASAT 2 and 3 seconds); executive functions: analogies and numbers-letters sequence. Also, it was administered the Beck Depression Inventory II (BDI II). About 33.3% of patients obtained abnormal performance in two or more cognitive tests. 37.5% showed deterioration in attention; 33.3% in verbal memory; 29.2% in executive functions. Significant differences between patients and healthy controls were found in long-term storage (p = 0.001); retrieval (p = 0.007); delayed recall (p = 0.000); PASAT 3 (p = 0.009); PASAT 2 (p = 0.009) and analogies (p = 0.003). Evidence of depression was found: mild in 4.2% of patients; moderate in 25% and severe in 29.2%. Neuropsychological performance declines in patients with myasthenia gravis: attention was more affected than other cognitive areas.

The Paced Auditory Serial Addition Test (PASAT) is one of the most used neuropsychological tests to assess information processing speed and working memory in brain injured patients. This study was carried out with the purpose of obtaining normative data for the PASAT-3″ in a healthy Argentinean population, which would result in a reference control population. The PASAT-3″ was administered in a sample of 296 healthy voluntary subjects, born and living in Argentina. The age range went from 20 to 70 years-old. The level of education was 0 to 13 or more years of schooling. The sample obtained a mean of 44.60 (SD = 10.72) in the PASAT-3″. It was found that the score obtained in the PASAT-3″ was related to the age and the level of instruction of the participants. Their performance diminished as age increased and, conversely, it increased as the level of instruction was higher. Normative data was obtained for a Latin American population from Argentina. Percentile distributions obtained by decades of age and different levels of education should be considered as useful reference values for clinicians and investigators when applying the PASAT-3″ to assess cognitive function in different pathologies.