Treatment choices and neuropsychological symptoms of a large cohort of early MS


  • O. von Bismarck
  • T. Dankowski
  • B. Ambrosius
  • N. Hessler
  • Gi. Antony
  • A. Ziegler
  • M.M. Hoshi
  • L. Aly
  • F. Luessi
  • S. Groppa
  • L. Klotz
  • S.G. Meuth
  • B. Tackenberg
  • M. Stoppe
  • F. Then Bergh
  • H. Tumani
  • T. Kümpfel
  • M. Stangel
  • C. Heesen
  • B. Wildemann
  • F. Paul
  • A. Bayas
  • C. Warnke
  • F. Weber
  • R.A. Linker
  • U. Ziemann
  • U.K. Zettl
  • F. Zipp
  • H. Wiendl
  • B. Hemmer
  • R. Gold
  • A. Salmen


  • Neurology Neuroimmunology & Neuroinflammation


  • Neurol Neuroimmunol Neuroinflamm 5 (3): e446


  • OBJECTIVE: To assess clinical characteristics, distribution of disease-modifying treatments (DMTs), and neuropsychological symptoms in a large cohort of patients with early-stage MS. METHODS: The German National MS Cohort is a multicenter prospective longitudinal cohort study that has recruited DMT-naive patients with clinically isolated syndrome (CIS) and relapsing-remitting MS (RRMS) since 2010. We evaluated their baseline characteristics and the prevalence of neuropsychological symptoms. RESULTS: Of 1,124 patients, with a 2.2:1 female-to-male ratio and median age at onset of 31.71 years (interquartile range [IQR]: 26.06-40.33), 44.6% and 55.3% had CIS and RRMS, respectively. The median Expanded Disability Status Scale (EDSS) score at baseline was 1.5 (IQR: 1.0-2.0). A proportion of 67.8% of patients started DMT after a median time of 167.0 days (IQR 90.0-377.5) since the first manifestation. A total of 64.7% and 70.4% of the 762 patients receiving early DMT were classified as CIS and RRMS, respectively. Fatigue, depressive symptoms, and cognitive dysfunction were detected in 36.5%, 33.5%, and 14.7% of patients, respectively. CONCLUSION: Baseline characteristics of this large cohort of patients with early, untreated MS corroborated with other cohorts. Most patients received early DMT within the first year after disease onset, irrespective of a CIS or RRMS diagnosis. Despite the low EDSS score, neuropsychological symptoms affected a relevant proportion of patients.