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Cognition (thinking and memory) issues can be common in people living with MS and may present in many ways, such as problems with attention, concentration, and language. However, exactly how these different cognitive functions impact on or interact with each other is unknown. Presently there does not exist a universal model of potential cognitive impairment in MS to assist clinicians in the diagnosis and management of cognitive issues for affected people living with MS.
Dr Charles Malpas aimed to address this knowledge gap by evaluating a new model to assess cognitive impairment in people living with MS and to translate this model into clinical use. This study explored basic models of cognitive function to see how separate areas of cognition (called fundamental and instrumental) are inter-related. For example, how basic functions such as attention and processing speed (fundamental) and higher-level functions such as memory and language (instrumental) impact each other.
It is anticipated that this research may develop a new model of cognitive impairment in MS for healthcare professionals to use, leading to improvements in both diagnosis and management. Ultimately this will improve cognitive rehabilitation, communication between clinicians, patient education and quality of life for people living with MS.
Dr Malpas and his team have made substantial progress on this project. Ethics and governance approval was obtained in early 2021 at the Royal Melbourne Hospital, and recruitment commenced at the Royal Melbourne Multiple Sclerosis and Neuroimmunology Clinic.
Slight modifications were made to the project to permit assessment of participants via telehealth. Specifically, markers of fundamental cognitive function were changed to ensure they could be completed online.
To date, Dr Malpas and his team have recruited 167 participants with complete psychometric examinations. Of these, approximately 80% have complete psychopathology data and 47 participants have undergone full structured clinical interviews for psychopathology.
The team are currently moving into the final phases of analysis, which will involve analysis of cognitive complaint, investigation of the cognitive proficiency model (CI) to predict cognitive function, and evaluation of secondary causes of cognitive impairment.
Dr Malpas has presented this work at several conferences and has published 14 research articles.
Updated 31 March 2023
Dr. Malpas has made significant progress in understanding cognitive impairment in people with multiple sclerosis (MS), having recruited 198 participants with MS, and 50 participants without MS for comparison in this study.
The major findings include:
He found that high-order features can help clinicians identify people with cognitive impairment early, without needing formal cognitive testing.
Dr. Malpas is currently preparing a research paper to be submitted this year on his findings, which will further contribute to the understanding and management of cognitive impairment in MS.
Dr Malpas has presented this work at several conferences and has previously published 22 research articles related to MS.
Malpas, CB., Roos, I., Sharmin, S., Buzzard, K., Lechner-Scott, J., & Kalincik, T. (2022). Multiple sclerosis relapses following cessation of fingolimod. Clinical Drug Investigation. DOI: 10.1007/s40261-022-01129-7.
Updated 31 March 2024
$165,000
2021
3 years
Current project
