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Master Thesis

Prédiction d'une atteinte cognitive dans la sclérose en plaques : à qui se fier ?

Abstract : Multiple sclerosis (MS) is an inflammatory but also neurodegenerative disease of the central nervous system. Cognitive disorders affect 40-60% of patients and affecting their daily lives. However, it is not possible in current practice, fto propose neuropsychological assessment systematically to any patient with MS. It is therefore interesting to try to identify, with fast screening tools, patients for whom it is indicated. The objective of this study was to evaluate the predictive value of the presence of cognitive impairment in the population of patients with multiple sclerosis by different methods: cognitive complaint of patients and of their family, neurologist’s opinion, screening by Cognitive Speed Computerized Test (CSCT). An observational study was conducted in MS patients at the University Hospital of Grenoble. These patients completed a Questionnaire Cognitive Complaints (“QPC”) and a member of their family too (“hetero QPC”). The systematic execution of a CSCT (computerized version of the Symbol Digit Modalities Test) was carried out and a comprehensive evaluation by a battery of standardized tests in French, the BCcogSEP has been proposed as reference test. The diagnostic performance of cognitive impairment of these methods (QPC, hetero QPC, neurologist’s opinion and CSCT) was assessed relative to the reference test (BCcogSEP). Our results show that the CSCT is a sensitive test, which can be used in clinical practice in screening for cognitive impairment in patients with MS. However, in agreement with the literature, the patient's complaint is not correlated with the presence of cognitive impairment. In our study, the assessment of a patient's cognitive impairment by the family, contrary to earlier published data, as well as the subjective evaluation by a neurologist, are not correlated with objective cognitive impairment. In conclusion, subjective assessments from the patient, his neurologist, and his family are not effective enough to detect cognitive impairment in MS. It is therefore important to detect cognitive impairment in MS by systematically performing CSCT, sensitive tool, easily usable in medical consultation. It allows patients who need it to perform a more complete neuropsychological assessment to better define cognitive disturbance, to optimize the management of MS patients.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01083427
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Submitted on : Monday, November 17, 2014 - 11:52:25 AM
Last modification on : Tuesday, May 11, 2021 - 11:36:17 AM
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  • HAL Id : dumas-01083427, version 1

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Déborah Grosset-Janin. Prédiction d'une atteinte cognitive dans la sclérose en plaques : à qui se fier ?. Médecine humaine et pathologie. 2014. ⟨dumas-01083427⟩

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