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BackgroundPain and cognition are important symptoms in multiple sclerosis (MS). Cognitive processes contributing to pain experience are increasingly documented. Any relationship between pain and objectively measured cognitive performance (OMCP) in MS, including potential mediating factors such as fatigue and medication, remains unclear. Understanding this relationship may facilitate targeted treatment strategies.ObjectiveDetermine the relationship between pain and OMCP in MS.MethodsWe conducted a systematic review, following a pre-registered protocol, of clinical studies examining relationships between pain and OMCP in MS. We searched MEDLINE, Embase and PsychInfo. We assessed confounders and described findings using neuropsychologist-assigned cognitive domains. Risk of bias was assessed using a modified Newcastle-Ottawa Scale.Results10 studies were included. Eight studies identified a relationship between pain and OMCP. In six studies, worse pain scores were associated with worse cognition. However, no evidence was available for several cognitive domains. Studies infrequently controlled for confounders. Most studies were judged to be at risk of bias.ConclusionsWhile several studies suggest that pain in MS is related to worse objective cognitive perfor- mance, conclusions are limited by study design and limited evidence in many cognitive domains. Future studies should better establish this relationship and delineate the neurological substrate underpinning it.

IntroductionSaliva problems are common in people with motor neuron disease (pwMND). Despite guide- lines for assessment and treatment, management of saliva problems has received little research attention.ObjectiveTo investigate the prevalence of saliva problems in pwMND, their association with clinical factors and their management practice.MethodsWe conducted an analysis of pwMND diagnosed between January 2015 and October 2019 using the Scottish MND Register (CARE-MND). The association between clinical factors and saliva problems was investigated using univariate and multivariable logistic regression. A survey of relevant healthcare professionals was performed to contextualise findings.Results939 pwMND were included. Saliva problem prevalence was 37.5% (294). Bulbar onset (PConclusionSaliva problems are associated with bulbar onset MND. Many pwMND with saliva problems did not receive recommended treatments. Future research is required to determine the relative efficacy of individual pharmacological treatments.s1505898@ed.ac.uk

BackgroundPrediction of individual disease course in relapsing remitting multiple sclerosis (RRMS) is chal- lenging. This has important implications for informed decision making in clinical practice.ObjectivesTo conduct a systematic review in order to establish methodological quality of published prediction models in RRMS.MethodsWe searched Medline, Embase and Web of Science. Reviewers screened abstracts and full text for eligibility and assessed risk of bias. Studies reporting development or validation of prediction models for adults with RRMS were included. Data collection was guided by checklist for critical appraisal and data extraction for systematic reviews and applicability and methodological quality assessment by prediction model risk of bias assessment tool.Results30 studies were included. Applicability was assessed as high risk of concern in 29 studies. Risk of bias was assessed as high for all studies. The single most frequently included predictor was baseline EDSS (n=11). T2 Lesion volume or number and brain atrophy were each retained in seven studies. Five studies included external validation. None included impact analysis.ConclusionsAlthough a number of prediction models for RRMS have been reported, most are at high risk of bias and lack external validation and impact analysis, restricting their application in clinical practice.fraser@tonnard.co.uk