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Cognitive and psychiatric comorbidities in neuromyelitis optica

  • Perry Moore
    Correspondence
    Corresponding author at: Department of Clinical Neuropsychology, The Walton Centre NHS Foundation Trust, Sid Watkins Building, Liverpool L9 7BB, UK.
    Affiliations
    The Walton Centre NHS Foundation Trust, Liverpool, UK
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  • Author Footnotes
    1 School of Psychological Sciences, University of Manchester, Manchester, UK.
    Abigail Methley
    Footnotes
    1 School of Psychological Sciences, University of Manchester, Manchester, UK.
    Affiliations
    University of Manchester, UK
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  • Author Footnotes
    2 Department of Clinical Neuropsychology, The Walton Centre NHS Foundation Trust, Sid Watkins Building, Liverpool L9 7BB, UK.
    Catherine Pollard
    Footnotes
    2 Department of Clinical Neuropsychology, The Walton Centre NHS Foundation Trust, Sid Watkins Building, Liverpool L9 7BB, UK.
    Affiliations
    The Walton Centre NHS Foundation Trust, Liverpool, UK
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  • Author Footnotes
    3 Department of Neurology, The Walton Centre NHS Foundation Trust, Sid Watkins Building, Liverpool L9 7LJ, UK.
    Kerry Mutch
    Footnotes
    3 Department of Neurology, The Walton Centre NHS Foundation Trust, Sid Watkins Building, Liverpool L9 7LJ, UK.
    Affiliations
    The Walton Centre NHS Foundation Trust, Liverpool, UK
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  • Author Footnotes
    3 Department of Neurology, The Walton Centre NHS Foundation Trust, Sid Watkins Building, Liverpool L9 7LJ, UK.
    Shahd Hamid
    Footnotes
    3 Department of Neurology, The Walton Centre NHS Foundation Trust, Sid Watkins Building, Liverpool L9 7LJ, UK.
    Affiliations
    The Walton Centre NHS Foundation Trust, Liverpool, UK
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  • Author Footnotes
    3 Department of Neurology, The Walton Centre NHS Foundation Trust, Sid Watkins Building, Liverpool L9 7LJ, UK.
    Liene Elsone
    Footnotes
    3 Department of Neurology, The Walton Centre NHS Foundation Trust, Sid Watkins Building, Liverpool L9 7LJ, UK.
    Affiliations
    The Walton Centre NHS Foundation Trust, Liverpool, UK
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  • Author Footnotes
    3 Department of Neurology, The Walton Centre NHS Foundation Trust, Sid Watkins Building, Liverpool L9 7LJ, UK.
    Anu Jacob
    Footnotes
    3 Department of Neurology, The Walton Centre NHS Foundation Trust, Sid Watkins Building, Liverpool L9 7LJ, UK.
    Affiliations
    The Walton Centre NHS Foundation Trust, Liverpool, UK
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  • Author Footnotes
    1 School of Psychological Sciences, University of Manchester, Manchester, UK.
    2 Department of Clinical Neuropsychology, The Walton Centre NHS Foundation Trust, Sid Watkins Building, Liverpool L9 7BB, UK.
    3 Department of Neurology, The Walton Centre NHS Foundation Trust, Sid Watkins Building, Liverpool L9 7LJ, UK.
Published:November 17, 2015DOI:https://doi.org/10.1016/j.jns.2015.11.031

      Highlights

      • Neuromyelitis optica (NMO) is associated with substantial cognitive and psychiatric comorbities
      • Frequency of cognitive impairment in NMO is similar to multiple sclerosis (MS)
      • The lifetime course of psychiatric morbidity in NMO appears different to MS and may represent greater psychiatric burden
      • High rates of suicidality and recurrent depression in NMO highlight the need for clinical screening and appropriate treatments

      Abstract

      Objective

      Our primary objective was to examine the neuropsychological and psychopathological profile of patients with neuromyelitis optica (NMO) and compare these to multiple sclerosis (MS) and healthy control (HC) groups. We also examined for relationships between cognitive and psychiatric variables and clinical factors including accumulated neurological disability and disease duration.

      Methods

      A neuropsychological test battery was administered along with a structured psychiatric interview and quantitative measures of mood symptoms.

      Results

      42 NMO, 42 MS and 42 HC participants were assessed. Cognitive impairments were observed in 67% of NMO patients. The prevalence and profile of cognitive impairments and lifetime prevalence of depression was similar between NMO and MS groups. However, significantly higher rates of recurrent depression and suicidality were observed in NMO patients. Correlational analyses revealed higher levels of anxiety symptoms were associated with shorter disease duration in NMO, while higher depression symptom levels were associated with higher neurological disability and poorer cognition.

      Conclusions

      Our results demonstrate substantial cognitive and psychiatric comorbidities in NMO patients. Similar rates of lifetime and current depression between NMO and MS appear to mask greater underlying psychiatric burden in NMO and further understandings of the course of neurobehavioural comorbidities is required to better comprehend the additional morbidity in NMO. Our data support a role for cognitive and psychiatric assessments in the comprehensive care of NMO patients.

      Keywords

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