Abstract
BACKGROUND: Seizures are associated with reduced cognition in the general population and worse outcomes in people with multiple sclerosis (pwMS). Yet, it remains unclear whether seizures are linked to cognitive dysfunction in pwMS. OBJECTIVES: To evaluate the connection between seizure history and poorer cognition in pwMS. METHODS: A consecutive sample of 803 pwMS reported any prior seizures. Covariates included age, sex, Wechsler Test of Adult Reading scores, educational years, Expanded Disability Status Scale (EDSS) scores, disease duration, disease subtype, high-efficacy disease-modifying therapy use, Hospital Anxiety and Depression Scale scores for anxiety and depression and Modified Fatigue Impact Scale scores. Linear regression analyses, controlling for covariates, were undertaken to predict Minimal Assessment of Cognitive Function in MS scores from seizure history. RESULTS: Mean age was 44.01 years (SD = 11.58), 76.84% were female, and median EDSS was 2.0 (interquartile range (IQR) = 1.5-3.5). Accounting for covariates, people with seizures (n = 43, 5.35%) performed worse than those without (n = 760) on Judgement of Line Orientation (β = -0.09, p < 0.01), California Verbal Learning Test-II learning (β = -0.08, p < 0.01) and memory (β = -0.10, p < 0.01), Brief Visuospatial Memory Test-Revised learning (β = -0.08, p = 0.01) and memory (β = -0.07, p = 0.05), Symbol Digit Modalities Test (β = -0.06, p = 0.04), Paced Auditory Serial Addition Test (β = -0.10, p < 0.01) and Delis-Kaplan Executive Function System (β = -0.07, p = 0.02). CONCLUSIONS: A seizure history independently predicts reduced cognition in pwMS.