Synonyms
Exacerbating-remitting multiple sclerosis
Short Description or Definition
Relapsing-remitting multiple sclerosis (RRMS) describes the initial course of approximately 85% of patients diagnosed with MS. There are discrete episodes (aka “relapses,” “attacks,” “flare-ups,” or “exacerbations”) of neurologic dysfunction lasting at least 24 h followed by full or partial recovery and a period in which there is no symptom progression or accumulation of disability (aka “remission”; see Fig. 1). Across individuals with RRMS, there is a great deal of variability in the time between relapses and in the severity of relapse symptoms. Recovery from relapses may be incomplete, and thus a certain amount of residual neurologic dysfunction may persist (see Fig. 2). When symptoms progress outside relapse periods, the person is considered to have entered the secondary progressive stage of the disease.
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Amato, M. P., Langdon, D., Montalban, X., Benedict, R. H. B., DeLuca, J., Krupp, L. B., Thompson, A. J., et al. (2013). Treatment of cognitive impairment in multiple sclerosis: Position paper. Journal of Neurology, 260, 1452–1468.
Arnett, P. A., Higginson, C. I., Voss, W. D., Bender, W. I., Wurst, J. M., & Tippin, J. M. (1999). Depression in multiple sclerosis: Relationship to working memory capacity. Neuropsychology, 13, 546–556.
Barkhof, F., Scheltens, P., Frequin, S. T., Nauta, J. J., Tas, M. W., Valk, J., et al. (1992). Relapsing-remitting multiple sclerosis: Sequential enhanced MR imaging vs clinical findings in determining disease activity. American Journal of Roentgenology, 159, 1041–1047.
Beatty, W. W., Goodkin, D. E., Hertsgaard, D., & Monson, N. (1990). Clinical and demographic predictors of cognitive performance in multiple sclerosis: Do diagnostic type, disease duration, and disability matter? Archives of Neurology, 47, 305–308.
Benedict, R. H. B., Fischer, J. S., Archibald, C. J., Arnett, P. A., Beatty, W. W., Bobholz, J., et al. (2002). Minimal neuropsychological assessment of MS patients: A consensus approach. The Clinical Neuropsychologist, 16, 381–397.
Benedict, R. H. B., Weinstock-Guttman, B., Fishman, I., Sharma, J., Tjoa, C. W., & Bakshi, R. (2004). Prediction of neuropsychological impairment in multiple sclerosis: Comparison of conventional magnetic resonance imaging measures of atrophy and lesion burden. Archives of Neurology, 61, 226–230.
Bergamaschi, R., Berzuini, C., Romani, A., & Cosi, V. (2001). Predicting secondary progression in relapsing-remitting multiple sclerosis. Journal of the Neurological Sciences, 189, 13–21.
Calabrese, M., Atzori, M., Bernardi, V., Morra, A., Romualdi, C., Rinaldi, L., et al. (2007). Cortical atrophy is relevant in multiple sclerosis at clinical onset. Journal of Neurology, 254, 1212–1220.
Calabrese, M., Agosta, F., Rinaldi, F., Mattisi, I., Grossi, P., Favaretto, A., et al. (2009). Cortical lesions and atrophy associated with cognitive impairment in relapsing-remitting multiple sclerosis. Archives of Neurology, 66, 1144–1150.
Chiaravalloti, N. D., & DeLuca, J. (2008). Cognitive impairment in multiple sclerosis. Lancet Neurology, 7, 1139–1151.
Chiaravalloti, N. D., Wylie, G. R., Leavitt, V. M., & DeLuca, J. (2012). Increased cerebral activation after behavioral treatment for memory deficits in MS. Journal of Neurology, 259, 1337–1346.
Chiaravalloti, N. D., Moore, N. B., Nikelshpur, O., & DeLuca, J. (2013). A randomized clinical trial to treat learning impairment in multiple sclerosis: The MEMREHAB trial. Neurology, 81(24), 2066–2072.
Compston, A., Confavreux, C., Lassman, H., McDonald, I., Miller, D., Noseworthy, J., et al. (2005). McAlpine’s multiple sclerosis (4th ed.). Philadelphia: Elsevier.
Confavreux, C., & Compston, A. (2005). The natural history of multiple sclerosis. In A. Compston et al. (Eds.), McAlpine’s multiple sclerosis (4th ed.). Philadelphia: Elsevier.
Costa, S., DeLuca, J., & Chiaravalloti, N. (2016). Information processing speed in multiple sclerosis: Past, present and future. Multiple Sclerosis Journal. https://doi.org/10.1177/1352458516645869. e-pub.
das Nair R., Martin K.J., & Lincoln N.B. (2016). Memory rehabilitation for people with multiple sclerosis. Cochrane Database of Systematic Reviews, 2016(3). Art. No.: CD008754. https://doi.org/10.1002/14651858.CD008754.pub3.
DeLuca, J., & Nocentini, U. (2011). Neuropsychological, medical and rehabilitative management of persons with multiple sclerosis. NeuroRehabilitation, 29, 197–219.
Dobryakova, E., Wylie, G. R., DeLuca, J., & Chiaravalloti, N. D. (2014). Functional brain activity 6 months after memory retraining in multiple sclerosis: The MEMREHAB trial. Brain Imaging and Behavior, 8, 403–406.
Dobryakova, E., Rocca, M. A., Valsasina, P., Ghezzi, A., Colombo, B., Martinelli, V., Comi, G., DeLuca, J., & Filippi, M. (2016). Abnormalities of the executive control network in multiple sclerosis phenotypes: An fMRI effective connectivity study. Human Brain Mapping, 37(6), 2293–2304. https://doi.org/10.1002/hbm.23174.
Feinstein, A. (2006). Mood disorders in multiple sclerosis and the effects on cognition. Journal of the Neurological Sciences, 245, 63–66.
Foong, J., Rozewicz, L., Quaghebeur, G., Thompson, A. J., Miller, D. H., & Ron, M. A. (1998). Neuropsychological deficits in multiple sclerosis after acute relapse. Journal of Neurology, Neurosurgery, & Psychiatry, 64, 529–532.
Goverover, Y., Strober, L., Chiaravalloti, N., & DeLuca, J. (2015). Factors that moderate activity limitation and participation restriction in people with multiple sclerosis. American Journal of Occupational Therapy, 69, 1–9.
Goverover, Y., Haas, H., & DeLuca, J. (2016). Money management activities in persons with multiple sclerosis. Archives of Physical Medicine and Rehabilitation, 97(11), 1901–1907.
Kalb, R. (2007). The emotional and psychosocial impact of multiple sclerosis relapses. Journal of the Neurological Sciences, 256, S29–S33.
Kalmar, J. H., Halper, J., Gaudino, E. A., Moore, N. B., & DeLuca, J. (2008). The relationship between cognitive deficits and everyday functional activities in multiple sclerosis. Neuropsychology, 22, 442–449.
Krupp, L. B., Christodoulou, C., Melville, P., Scherl, W. F., MacAllister, W. S., & Elkins, L. E. (2004). Donepezil improved memory in multiple sclerosis in a randomized clinical trial. Neurology, 63, 1579–1585.
Langdon, D. W., Amato, M. P., Boringa, J., Brochet, B., Foley, F., Fredrikson, S., Hämäläinen, P., Hartung, H. P., Krupp, L., Penner, I. K., Reder, A. T., & Benedict, R. H. (2012). Recommendations for a Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS). Multiple Sclerosis, 18(6), 891–898. https://doi.org/10.1177/1352458511431076. Epub 2011 Dec 21.
Langer-Gould, A., Popat, R. A., Huang, S. M., Cobb, K., Fontoura, P., Gould, M. K., et al. (2006). Clinical and demographic predictors of long-term disability in patients with relapsing-remitting multiple sclerosis. Archives of Neurology, 63, 1686–1691.
Leavitt, V.M., Wylie, G.R., DeLuca, J., & Chiaravalloti, N.D. (2012). Increased functional connectivity within memory networks following memory rehabilitation in Multiple Sclerosis. Brain Imaging and Behavior. Epub ahead of print, PMID: 22706694.
Lin, X., Tench, C. R., Morgan, P. S., Niepel, G., & Constantinescu, C. S. (2005). ‘Importance sampling’ in MS: Use of diffusion tensor tractography to quantify pathology related to specific impairment. Journal of the Neurological Sciences, 237, 13–19.
Lublin, F. D., Reingold, S. C., & for the National Multiple Sclerosis Society (USA) Advisory Committee on Clinical Trials of New Agents in Multiple Sclerosis. (1996). Defining the clinical course of multiple sclerosis: Results of an international survey. Neurology, 46, 907–911.
Maniero, C., Benner, T., Radding, A., van der Kouwe, A., Jensen, R., Rosen, B. R., et al. (2009). In vivo imaging of cortical pathology in multiple sclerosis using ultra-high field MRI. Neurology, 73, 941–948.
Mohr, D. C., Boudewyn, A. C., Goodkin, D. E., Bostrom, A., & Epstein, L. (2001). Comparative outcomes for individual cognitive-behavioral therapy, supportive-expressive group psychotherapy, and sertraline for the treatment of depression in multiple sclerosis. Journal of Consulting and Clinical Psychology, 69, 942–949.
Mohr, D. C., Hart, S. L., & Tasch, E. S. (2006). Treatment of depression for patients with multiple sclerosis in neurology clinics. Multiple Sclerosis, 12, 204–208.
Pardini, M., Ucccelli, A., Grafmna, J., Yaldizli, O., Mancardi, G., & Roccatagliata, L. (2014). Isolated cognitive relapses in multiple sclerosis. Journal of Neurology, Neurosurgery and Psychiatry, 85, 1035–1037.
Patten, S. B., Metz, L. M., & Reimer, M. A. (2000). Biopsychosocial correlates of major depression in a multiple sclerosis population. Multiple Sclerosis, 6, 115–120.
Rao, S. M. (1991). A manual for the brief, repeatable battery of neuropsychological tests in multiple sclerosis. New York: National Multiple Sclerosis Society.
Rao, S. M. (1995). Neuropsychology of multiple sclerosis. Current Opinion in Neurology, 8, 216–220.
Rao, S. M., Leo, G. J., Bernardin, L., & Unverzagt, F. (1991a). Cognitive dysfunction in multiple sclerosis. I. Frequency, patterns, and prediction. Neurology, 41, 685–691.
Rao, S. M., Leo, G. J., Ellington, L., Nauertz, T., Bernardin, L., & Unverzagt, F. (1991b). Cognitive dysfunction in multiple sclerosis. II. Impact on employment and social functioning. Neurology, 41, 692–696.
Rao, S. M., Martin, A. L., Huelin, R., Wissinger, E., Khankhel, Z., Kim, E., & Fahrbach, K. (2014). Correlations between MRI and information processing speed in MS: A meta-analysis. Multiple Sclerosis International, 975803, 1–9. https://doi.org/10.1155/2014/975803.
Rocca, M., Torralva, T., Meli, F., Fiol, M., Calcagno, M. L., Carpintiero, S., et al. (2008). Cognitive deficits in multiple sclerosis correlate with changes in fronto-subcortical tracts. Multiple Sclerosis, 14, 364–369.
Sadovnick, A. D., Remick, R. A., Allen, J., Swartz, E., Yee, I. M. L., Eisen, K., et al. (1996). Depression and multiple sclerosis. Neurology, 46, 628–632.
Sanfilipo, M. P., Benedict, R. H. B., Weinstock-Guttman, B., & Bakshi, R. (2006). Gray and white matter brain atrophy and neuropsychological impairment in multiple sclerosis. Neurology, 66, 685–692.
Sicotte, N. L., Kern, K. C., Giesser, B. S., Arshanapalli, A., Schultz, A., Montag, M., et al. (2008). Regional hippocampal atrophy in multiple sclerosis. Brain, 131, 1134–1141.
Smith, K., McDonald, I., Miller, D., & Lassman, H. (2005). The pathophysiology of multiple sclerosis. In A. Compston et al. (Eds.), McAlpine’s multiple sclerosis (4th ed.). Philadelphia: Elsevier.
Summers, M. M., Fisniku, L. K., Anderson, V. M., Miller, D. H., Cipolotti, L., & Ron, M. A. (2008). Cognitive impairment in relapsing-remitting multiple sclerosis can be predicted by imaging performed several years earlier. Multiple Sclerosis, 14, 197–204.
Vollmer, T. (2007). The natural history of relapses in multiple sclerosis. Journal of the Neurological Sciences, 256, S5–S13.
Vukusic, S., & Confavreux, C. (2007). Natural history of multiple sclerosis: Risk factors and prognostic indicators. Current Opinion in Neurology, 20, 269–274.
Weinshenker, B. G., Bass, B., Rice, G. P., Noseworthy, J., Carriere, W., Baskerville, J., et al. (1989). The natural history of multiple sclerosis: A geographically based study. I. Clinical course and disability. Brain, 112, 133–146.
Zivadinov, R., De Masi, R., Nasuelli, D., Monti Bragadin, L., Ukmar, M., Pozzi-Mucelli, R. S., et al. (2001a). MRI techniques and cognitive impairment in the early phase of relapsing-remitting multiple sclerosis. Neuroradiology, 43, 272–278.
Zivadinov, R., Sepcic, J., Nasuelli, D., De Masi, R., Monti Bragadin, L., Tommasi, M. A., et al. (2001b). A longitudinal study of brain atrophy and cognitive disturbances in the early phase of relapsing-remitting multiple sclerosis. Journal of Neurology, Neurosurgery, & Psychiatry, 70, 773–780.
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Fuchs, K.L., DeLuca, J. (2018). Relapsing-Remitting Multiple Sclerosis. In: Kreutzer, J.S., DeLuca, J., Caplan, B. (eds) Encyclopedia of Clinical Neuropsychology. Springer, Cham. https://doi.org/10.1007/978-3-319-57111-9_518
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