Intellectual and mood disorders in multiple sclerosis
Truelle, J.L.; Palisson, E.; Le Gall, D.; Stip, E.; Derouesne, C.
Revue Neurologique (Paris) 143(8-9): 595-601
1987
ISSN/ISBN: 0035-3787 PMID: 3671962 Document Number: 304163
Reports of frequency and interpretation of intellectual and mood disorders differ in multiple sclerosis (MS). Forty-one patients with MS defined according to MacAlpine's criteria were evaluated by psychometric tests (WAIS) and neuropsychologic examinations (study of language, gnosic and praxic activities, dynamic gestural organization, memory and learning) together with, in 24 of them, the AMDP psychopathologic rating scale. Intellectual disorders were noted in 65 p. 100 of patients. Although more frequent in severe and chronic forms they were nevertheless of early onset since more than a half of the patients with onset of disease less than 5 years ago were affected. Their semiology was fairly homogeneous, combining disturbances of dynamic gestural organization (decomposition or simplification) and memory and learning deficiences without anomalies of instrumental functions or usually psychometric mental deterioration. Application of the AMDP scale failed to reveal any psychotic type of disorders. Mood disturbances were predominant, affecting 60 p. 100 of the subpopulation studied (24 cases) and combining, in an unexpected manner:dysphoria, euphoria and depression. Only euphoria appeared to be correlated with intellectual disorders. Frequency of both intellecutal and mood disorders was similar to that reported in other series published. The relative homogeneity of semiology, seen by the correlation between the different disturbances (decomposition and simplification, plateau learning curve and euphoria) and the unusual grouping of these effects, is suggestive of their organic basis. In addition, signs and symptoms resemble the neuropsychological expression of frontal lobe lesions and certain lesions of central grey nuclei. This raises the question of the role of periventricular plaques, identified more easily by nuclear magnetic resonance imaging, although a precise clinicopathologic correlation can be evisaged with difficulty in a disseminated affection.