Conference News Update

25th Congress of the European Committee for Treatment and Research in MS (ECTRIMS), Dusseldorf, Germany

Fewer Injection Site Reactions Occur in Patients Using Interferon Beta-1a IM
Data from an observational phase IV study of 499 patients—the Swiss MS Skin Project—showed that patients with multiple sclerosis (MS) taking interferon beta-1a IM reported significantly fewer injection site reactions, compared with patients who took interferon beta-1b, glatiramer acetate, or interferon beta-1a. The study also found that patients taking interferon beta-1a IM were less likely to have missed a dose due to an injection site reaction in the four weeks prior to first assessment than those patients on other interferon therapies.

“This study showed that treatment with interferon beta-1a IM leads to fewer injection site reactions, which is an important factor in improving compliance,” said Karsten Beer, lead investigator for the study and a private neurologist in Wil, Switzerland. “As the only once-weekly injection treatment, interferon beta-1a IM offers people with relapsing MS an easy-to-use and highly effective treatment option. Convenience of an MS therapy is an important consideration for patients, as they do not want a therapy that will interfere with their daily lives.”

The Swiss MS Skin Project was designed to determine the frequency of injection site reactions, including skin necrosis and lipoatrophy, in patients taking interferon beta-1a IM, interferon beta-1b, glatiramer acetate, or interferon beta-1a. Injection site reactions are believed to reduce treatment compliance among patients. The study enrolled nearly 500 patients on interferon beta-1a IM, interferon beta-1b, glatiramer acetate, or interferon beta-1a for a minimum of two years (mean treatment duration, 5.9 years) and followed patients for one year.

At the first assessment, significantly fewer patients who took interferon beta-1a IM experienced injection site reactions (13.4% vs 57.7% of those who used interferon beta-1b, 30.4% for glatiramer acetate, and 67.9% for interferon beta-1a); necrosis (0% vs 5.7% for interferon beta-1b, 0% for glatiramer acetate, and 6.0% for interferon beta-1a); and lipoatrophy (1.2 % vs 8.9% for interferon beta-1b, 13.0% for glatiramer acetate, and 10.3% for interferon beta-1a).

No patients who used interferon beta-1a IM missed a dose in the four weeks prior to first assessment due to injection site reactions (vs 5.7% of patients using interferon beta-1b, 4.3% for glatiramer acetate, and 7.1% for interferon beta-1a). These percentages were statistically significant, compared with use of interferon beta-1b and interferon beta-1a. In addition, significantly more patients remained on interferon beta-1a IM throughout the one-year trial (86.6% vs 79.7% of subjects who used interferon beta-1b, 60.9% for glatiramer acetate, and 83.2% for interferon beta-1a) than on any other treatment.

Patients Taking Natalizumab Report Improvement in Physical and Psychologic Well-Being
Patients with multiple sclerosis (MS) taking natalizumab experienced an improvement in both their physical function and psychologic well-being, according to six-month results of an ongoing, one-year longitudinal, observational, patient-reported outcomes study. The study, which was the first to assess patient experiences with natalizumab in usual-care settings, found that patients who used natalizumab reported an improvement in their overall quality of life.

“The symptoms that a patient with MS deals with on a daily basis result in significant psychologic and physical effects that can adversely impact their quality of life,” said William Stuart, MD, Medical Director of the Multiple Sclerosis Center of Atlanta. “In a previous pivotal trial, natalizumab not only showed a reduction in relapse rates and disability progression, but also improved quality of life. Results from this observational study further demonstrate the impact of natalizumab on improving MS patients’ well-being as reported by patients who live with this disease every day.”

The trial assessed health outcomes from patients’ perspectives before starting natalizumab and after the third, sixth, and 12th infusions of the drug. A majority of the patients in the study are female (76.3%), with a mean age of 46.6 and mean disease duration of 10 years.

After six natalizumab infusions, patients reported statistically significant improvement in disease-specific quality of life, measured with use of the MS Impact Scale-29 (MSIS-29), which assesses the physical impact of MS in terms of mobility and self-care, as well as the psychologic impact of MS in terms of anxiety/depression, with lower scores indicating better quality of life. Patients also reported statistically significant improvement in general health-related quality of life, as measured by the 12-item Short Form Scale (SF-12) health survey, which assesses the physical and mental health, with higher scores indicating better quality of life.

Both scales assess patient experience of the physical and psychologic aspects of quality of life. For the MSIS-29 subscales, statistically significant improvements were observed over time for both the physical (baseline, 46.87; third infusion, 39.60; sixth infusion, 39.27) and psychologic (baseline, 41.56; third infusion, 33.77; sixth infusion, 33.20) impact scores.

SF-12 physical component summary score (baseline, 34.20; third infusion, 36.05; sixth infusion, 36.34) and the SF-12 mental component summary score (baseline, 43.25; third infusion, 47.35; sixth infusion, 47.92) showed statistically significant improvements over time.
[Editor’s note: For more information on natalizumab, please see a related news story and commentary on page 5.]

Genetic Targets for Potential MS Therapies
Two genes in mice were associated with good CNS repair in multiple sclerosis (MS). The findings may help researchers develop more effective therapies and predict outcomes for patients with MS.

“Most MS genetic studies have looked at disease susceptibility—or why some people get MS and others do not,” said Allan Bieber, PhD, Assistant Professor of Neurology at the Mayo Clinic in Rochester, Minnesota. “This study asked, among those who have MS, why some do well with the disease while others do poorly, and what might be the genetic determinants of this difference in outcome.”

Dr. Bieber and a team of Mayo Clinic researchers used two different strains of mice with a chronic, progressive MS-like disease. One strain of mice progressed to paralysis and death. The other strain underwent the initial damage induction phase of the disease and then had spontaneous repair of the damage to the CNS and retained most neurologic function. Using the genetic mapping techniques that are available for mice, the team mapped two strong genetic determinants of good disease outcome.

“It’s possible that the identification of these genes may provide the first important clue as to why some patients with MS do well, while others do not,” said Dr. Bieber. “The genetic data indicate that good CNS repair results from stimulation of one genetic pathway and inhibition of another genetic pathway. While we’re still in the early stages of this research, it could eventually lead to the development of useful therapies that stimulate or inhibit these genetic pathways in patients with MS.”

According to Dr. Bieber, the research suggests that there may be a small number of strong genetic determinants for CNS repair following demyelinating disease, rather than a larger number of weak determinants.

“If that’s true, it may be possible to map the most important genetic determinants of CNS repair in patients with MS and define a reparative genotype that could predict patients’ outcomes,” said Moses Rodriguez, MD, Professor of Neurology and Director of the Mayo Clinic’s Center for Multiple Sclerosis and Central Nervous System Demyelinating Diseases Research and Therapeutics. “Such a diagnostic tool would be a great benefit to patients with MS and is consistent with the concepts of individualized medicine.”

Research Supports the Importance of Early Treatment in Patients With MS
Findings from two observational studies—CogniCIS and CogniMS—revealed that depression and fatigue occur alongside cognitive deficits, even early in the disease. Data from these studies showed that relatives were able to detect even minor changes in cognitive performance at an early stage of the disease, which the patients themselves did not report.

“Cognitive impairment in patients with multiple sclerosis (MS) is not sufficiently recognized, in spite of the significant negative impact it can have on patients’ lives,” said Dawn Langdon, PhD, Neuropsychology Lead and Reader in Neuropsychology, Royal Holloway, University of London, UK, and lead investigator of CogniCIS and CogniMS. “These studies will help us construct a more complete picture of the development and impact of cognitive decline in early MS. Such findings, added to the existing evidence, will have important implications for physicians when making management decisions.”

The CogniCIS study collected cognitive and psychosocial data from 394 patients with clinically isolated syndrome (CIS). A subset of 130 European patients with CIS and 60 of their relatives completed the MS Neuropsychological Questionnaire (MSNQ), which asks about cognitive difficulties. Preliminary results presented showed that scores on the MSNQ from patients with CIS and their relatives correlated more with the patients’ level of depression, fatigue, and quality of life rather than performance in cognitive tests.

The CogniMS study included psychosocial data from 1,509 patients with early MS. A subset of 274 patients and 178 of their relatives completed the MSNQ. According to preliminary findings from the trial, relatives’ reports of the patients’ cognition correlated with some cognitive test scores, obtained by patients; patient self-reported cognitive deficits were not closely related to objective test scores. Similar to results from CogniCIS, the CogniMS findings suggest that self-reported cognitive deficits in an early MS population are not specific to cognition, and are influenced by the patients’ psychologic situation.

25th Congress of the European Committee for Treatment and Research in MS (ECTRIMS), Dusseldorf, Germany

Fewer Injection Site Reactions Occur in Patients Using Interferon Beta-1a IM
Data from an observational phase IV study of 499 patients—the Swiss MS Skin Project—showed that patients with multiple sclerosis (MS) taking interferon beta-1a IM reported significantly fewer injection site reactions, compared with patients who took interferon beta-1b, glatiramer acetate, or interferon beta-1a. The study also found that patients taking interferon beta-1a IM were less likely to have missed a dose due to an injection site reaction in the four weeks prior to first assessment than those patients on other interferon therapies.

“This study showed that treatment with interferon beta-1a IM leads to fewer injection site reactions, which is an important factor in improving compliance,” said Karsten Beer, lead investigator for the study and a private neurologist in Wil, Switzerland. “As the only once-weekly injection treatment, interferon beta-1a IM offers people with relapsing MS an easy-to-use and highly effective treatment option. Convenience of an MS therapy is an important consideration for patients, as they do not want a therapy that will interfere with their daily lives.”

The Swiss MS Skin Project was designed to determine the frequency of injection site reactions, including skin necrosis and lipoatrophy, in patients taking interferon beta-1a IM, interferon beta-1b, glatiramer acetate, or interferon beta-1a. Injection site reactions are believed to reduce treatment compliance among patients. The study enrolled nearly 500 patients on interferon beta-1a IM, interferon beta-1b, glatiramer acetate, or interferon beta-1a for a minimum of two years (mean treatment duration, 5.9 years) and followed patients for one year.

At the first assessment, significantly fewer patients who took interferon beta-1a IM experienced injection site reactions (13.4% vs 57.7% of those who used interferon beta-1b, 30.4% for glatiramer acetate, and 67.9% for interferon beta-1a); necrosis (0% vs 5.7% for interferon beta-1b, 0% for glatiramer acetate, and 6.0% for interferon beta-1a); and lipoatrophy (1.2 % vs 8.9% for interferon beta-1b, 13.0% for glatiramer acetate, and 10.3% for interferon beta-1a).

No patients who used interferon beta-1a IM missed a dose in the four weeks prior to first assessment due to injection site reactions (vs 5.7% of patients using interferon beta-1b, 4.3% for glatiramer acetate, and 7.1% for interferon beta-1a). These percentages were statistically significant, compared with use of interferon beta-1b and interferon beta-1a. In addition, significantly more patients remained on interferon beta-1a IM throughout the one-year trial (86.6% vs 79.7% of subjects who used interferon beta-1b, 60.9% for glatiramer acetate, and 83.2% for interferon beta-1a) than on any other treatment.

Patients Taking Natalizumab Report Improvement in Physical and Psychologic Well-Being
Patients with multiple sclerosis (MS) taking natalizumab experienced an improvement in both their physical function and psychologic well-being, according to six-month results of an ongoing, one-year longitudinal, observational, patient-reported outcomes study. The study, which was the first to assess patient experiences with natalizumab in usual-care settings, found that patients who used natalizumab reported an improvement in their overall quality of life.

“The symptoms that a patient with MS deals with on a daily basis result in significant psychologic and physical effects that can adversely impact their quality of life,” said William Stuart, MD, Medical Director of the Multiple Sclerosis Center of Atlanta. “In a previous pivotal trial, natalizumab not only showed a reduction in relapse rates and disability progression, but also improved quality of life. Results from this observational study further demonstrate the impact of natalizumab on improving MS patients’ well-being as reported by patients who live with this disease every day.”

The trial assessed health outcomes from patients’ perspectives before starting natalizumab and after the third, sixth, and 12th infusions of the drug. A majority of the patients in the study are female (76.3%), with a mean age of 46.6 and mean disease duration of 10 years.

After six natalizumab infusions, patients reported statistically significant improvement in disease-specific quality of life, measured with use of the MS Impact Scale-29 (MSIS-29), which assesses the physical impact of MS in terms of mobility and self-care, as well as the psychologic impact of MS in terms of anxiety/depression, with lower scores indicating better quality of life. Patients also reported statistically significant improvement in general health-related quality of life, as measured by the 12-item Short Form Scale (SF-12) health survey, which assesses the physical and mental health, with higher scores indicating better quality of life.

Both scales assess patient experience of the physical and psychologic aspects of quality of life. For the MSIS-29 subscales, statistically significant improvements were observed over time for both the physical (baseline, 46.87; third infusion, 39.60; sixth infusion, 39.27) and psychologic (baseline, 41.56; third infusion, 33.77; sixth infusion, 33.20) impact scores.

SF-12 physical component summary score (baseline, 34.20; third infusion, 36.05; sixth infusion, 36.34) and the SF-12 mental component summary score (baseline, 43.25; third infusion, 47.35; sixth infusion, 47.92) showed statistically significant improvements over time.
[Editor’s note: For more information on natalizumab, please see a related news story and commentary on page 5.]

Genetic Targets for Potential MS Therapies
Two genes in mice were associated with good CNS repair in multiple sclerosis (MS). The findings may help researchers develop more effective therapies and predict outcomes for patients with MS.

“Most MS genetic studies have looked at disease susceptibility—or why some people get MS and others do not,” said Allan Bieber, PhD, Assistant Professor of Neurology at the Mayo Clinic in Rochester, Minnesota. “This study asked, among those who have MS, why some do well with the disease while others do poorly, and what might be the genetic determinants of this difference in outcome.”

Dr. Bieber and a team of Mayo Clinic researchers used two different strains of mice with a chronic, progressive MS-like disease. One strain of mice progressed to paralysis and death. The other strain underwent the initial damage induction phase of the disease and then had spontaneous repair of the damage to the CNS and retained most neurologic function. Using the genetic mapping techniques that are available for mice, the team mapped two strong genetic determinants of good disease outcome.

“It’s possible that the identification of these genes may provide the first important clue as to why some patients with MS do well, while others do not,” said Dr. Bieber. “The genetic data indicate that good CNS repair results from stimulation of one genetic pathway and inhibition of another genetic pathway. While we’re still in the early stages of this research, it could eventually lead to the development of useful therapies that stimulate or inhibit these genetic pathways in patients with MS.”

According to Dr. Bieber, the research suggests that there may be a small number of strong genetic determinants for CNS repair following demyelinating disease, rather than a larger number of weak determinants.

“If that’s true, it may be possible to map the most important genetic determinants of CNS repair in patients with MS and define a reparative genotype that could predict patients’ outcomes,” said Moses Rodriguez, MD, Professor of Neurology and Director of the Mayo Clinic’s Center for Multiple Sclerosis and Central Nervous System Demyelinating Diseases Research and Therapeutics. “Such a diagnostic tool would be a great benefit to patients with MS and is consistent with the concepts of individualized medicine.”

Research Supports the Importance of Early Treatment in Patients With MS
Findings from two observational studies—CogniCIS and CogniMS—revealed that depression and fatigue occur alongside cognitive deficits, even early in the disease. Data from these studies showed that relatives were able to detect even minor changes in cognitive performance at an early stage of the disease, which the patients themselves did not report.

“Cognitive impairment in patients with multiple sclerosis (MS) is not sufficiently recognized, in spite of the significant negative impact it can have on patients’ lives,” said Dawn Langdon, PhD, Neuropsychology Lead and Reader in Neuropsychology, Royal Holloway, University of London, UK, and lead investigator of CogniCIS and CogniMS. “These studies will help us construct a more complete picture of the development and impact of cognitive decline in early MS. Such findings, added to the existing evidence, will have important implications for physicians when making management decisions.”

The CogniCIS study collected cognitive and psychosocial data from 394 patients with clinically isolated syndrome (CIS). A subset of 130 European patients with CIS and 60 of their relatives completed the MS Neuropsychological Questionnaire (MSNQ), which asks about cognitive difficulties. Preliminary results presented showed that scores on the MSNQ from patients with CIS and their relatives correlated more with the patients’ level of depression, fatigue, and quality of life rather than performance in cognitive tests.

The CogniMS study included psychosocial data from 1,509 patients with early MS. A subset of 274 patients and 178 of their relatives completed the MSNQ. According to preliminary findings from the trial, relatives’ reports of the patients’ cognition correlated with some cognitive test scores, obtained by patients; patient self-reported cognitive deficits were not closely related to objective test scores. Similar to results from CogniCIS, the CogniMS findings suggest that self-reported cognitive deficits in an early MS population are not specific to cognition, and are influenced by the patients’ psychologic situation.

25th Congress of the European Committee for Treatment and Research in MS (ECTRIMS), Dusseldorf, Germany

Fewer Injection Site Reactions Occur in Patients Using Interferon Beta-1a IM
Data from an observational phase IV study of 499 patients—the Swiss MS Skin Project—showed that patients with multiple sclerosis (MS) taking interferon beta-1a IM reported significantly fewer injection site reactions, compared with patients who took interferon beta-1b, glatiramer acetate, or interferon beta-1a. The study also found that patients taking interferon beta-1a IM were less likely to have missed a dose due to an injection site reaction in the four weeks prior to first assessment than those patients on other interferon therapies.

“This study showed that treatment with interferon beta-1a IM leads to fewer injection site reactions, which is an important factor in improving compliance,” said Karsten Beer, lead investigator for the study and a private neurologist in Wil, Switzerland. “As the only once-weekly injection treatment, interferon beta-1a IM offers people with relapsing MS an easy-to-use and highly effective treatment option. Convenience of an MS therapy is an important consideration for patients, as they do not want a therapy that will interfere with their daily lives.”

The Swiss MS Skin Project was designed to determine the frequency of injection site reactions, including skin necrosis and lipoatrophy, in patients taking interferon beta-1a IM, interferon beta-1b, glatiramer acetate, or interferon beta-1a. Injection site reactions are believed to reduce treatment compliance among patients. The study enrolled nearly 500 patients on interferon beta-1a IM, interferon beta-1b, glatiramer acetate, or interferon beta-1a for a minimum of two years (mean treatment duration, 5.9 years) and followed patients for one year.

At the first assessment, significantly fewer patients who took interferon beta-1a IM experienced injection site reactions (13.4% vs 57.7% of those who used interferon beta-1b, 30.4% for glatiramer acetate, and 67.9% for interferon beta-1a); necrosis (0% vs 5.7% for interferon beta-1b, 0% for glatiramer acetate, and 6.0% for interferon beta-1a); and lipoatrophy (1.2 % vs 8.9% for interferon beta-1b, 13.0% for glatiramer acetate, and 10.3% for interferon beta-1a).

No patients who used interferon beta-1a IM missed a dose in the four weeks prior to first assessment due to injection site reactions (vs 5.7% of patients using interferon beta-1b, 4.3% for glatiramer acetate, and 7.1% for interferon beta-1a). These percentages were statistically significant, compared with use of interferon beta-1b and interferon beta-1a. In addition, significantly more patients remained on interferon beta-1a IM throughout the one-year trial (86.6% vs 79.7% of subjects who used interferon beta-1b, 60.9% for glatiramer acetate, and 83.2% for interferon beta-1a) than on any other treatment.

Patients Taking Natalizumab Report Improvement in Physical and Psychologic Well-Being
Patients with multiple sclerosis (MS) taking natalizumab experienced an improvement in both their physical function and psychologic well-being, according to six-month results of an ongoing, one-year longitudinal, observational, patient-reported outcomes study. The study, which was the first to assess patient experiences with natalizumab in usual-care settings, found that patients who used natalizumab reported an improvement in their overall quality of life.

“The symptoms that a patient with MS deals with on a daily basis result in significant psychologic and physical effects that can adversely impact their quality of life,” said William Stuart, MD, Medical Director of the Multiple Sclerosis Center of Atlanta. “In a previous pivotal trial, natalizumab not only showed a reduction in relapse rates and disability progression, but also improved quality of life. Results from this observational study further demonstrate the impact of natalizumab on improving MS patients’ well-being as reported by patients who live with this disease every day.”

The trial assessed health outcomes from patients’ perspectives before starting natalizumab and after the third, sixth, and 12th infusions of the drug. A majority of the patients in the study are female (76.3%), with a mean age of 46.6 and mean disease duration of 10 years.

After six natalizumab infusions, patients reported statistically significant improvement in disease-specific quality of life, measured with use of the MS Impact Scale-29 (MSIS-29), which assesses the physical impact of MS in terms of mobility and self-care, as well as the psychologic impact of MS in terms of anxiety/depression, with lower scores indicating better quality of life. Patients also reported statistically significant improvement in general health-related quality of life, as measured by the 12-item Short Form Scale (SF-12) health survey, which assesses the physical and mental health, with higher scores indicating better quality of life.

Both scales assess patient experience of the physical and psychologic aspects of quality of life. For the MSIS-29 subscales, statistically significant improvements were observed over time for both the physical (baseline, 46.87; third infusion, 39.60; sixth infusion, 39.27) and psychologic (baseline, 41.56; third infusion, 33.77; sixth infusion, 33.20) impact scores.

SF-12 physical component summary score (baseline, 34.20; third infusion, 36.05; sixth infusion, 36.34) and the SF-12 mental component summary score (baseline, 43.25; third infusion, 47.35; sixth infusion, 47.92) showed statistically significant improvements over time.
[Editor’s note: For more information on natalizumab, please see a related news story and commentary on page 5.]

Genetic Targets for Potential MS Therapies
Two genes in mice were associated with good CNS repair in multiple sclerosis (MS). The findings may help researchers develop more effective therapies and predict outcomes for patients with MS.

“Most MS genetic studies have looked at disease susceptibility—or why some people get MS and others do not,” said Allan Bieber, PhD, Assistant Professor of Neurology at the Mayo Clinic in Rochester, Minnesota. “This study asked, among those who have MS, why some do well with the disease while others do poorly, and what might be the genetic determinants of this difference in outcome.”

Dr. Bieber and a team of Mayo Clinic researchers used two different strains of mice with a chronic, progressive MS-like disease. One strain of mice progressed to paralysis and death. The other strain underwent the initial damage induction phase of the disease and then had spontaneous repair of the damage to the CNS and retained most neurologic function. Using the genetic mapping techniques that are available for mice, the team mapped two strong genetic determinants of good disease outcome.

“It’s possible that the identification of these genes may provide the first important clue as to why some patients with MS do well, while others do not,” said Dr. Bieber. “The genetic data indicate that good CNS repair results from stimulation of one genetic pathway and inhibition of another genetic pathway. While we’re still in the early stages of this research, it could eventually lead to the development of useful therapies that stimulate or inhibit these genetic pathways in patients with MS.”

According to Dr. Bieber, the research suggests that there may be a small number of strong genetic determinants for CNS repair following demyelinating disease, rather than a larger number of weak determinants.

“If that’s true, it may be possible to map the most important genetic determinants of CNS repair in patients with MS and define a reparative genotype that could predict patients’ outcomes,” said Moses Rodriguez, MD, Professor of Neurology and Director of the Mayo Clinic’s Center for Multiple Sclerosis and Central Nervous System Demyelinating Diseases Research and Therapeutics. “Such a diagnostic tool would be a great benefit to patients with MS and is consistent with the concepts of individualized medicine.”

Research Supports the Importance of Early Treatment in Patients With MS
Findings from two observational studies—CogniCIS and CogniMS—revealed that depression and fatigue occur alongside cognitive deficits, even early in the disease. Data from these studies showed that relatives were able to detect even minor changes in cognitive performance at an early stage of the disease, which the patients themselves did not report.

“Cognitive impairment in patients with multiple sclerosis (MS) is not sufficiently recognized, in spite of the significant negative impact it can have on patients’ lives,” said Dawn Langdon, PhD, Neuropsychology Lead and Reader in Neuropsychology, Royal Holloway, University of London, UK, and lead investigator of CogniCIS and CogniMS. “These studies will help us construct a more complete picture of the development and impact of cognitive decline in early MS. Such findings, added to the existing evidence, will have important implications for physicians when making management decisions.”

The CogniCIS study collected cognitive and psychosocial data from 394 patients with clinically isolated syndrome (CIS). A subset of 130 European patients with CIS and 60 of their relatives completed the MS Neuropsychological Questionnaire (MSNQ), which asks about cognitive difficulties. Preliminary results presented showed that scores on the MSNQ from patients with CIS and their relatives correlated more with the patients’ level of depression, fatigue, and quality of life rather than performance in cognitive tests.

The CogniMS study included psychosocial data from 1,509 patients with early MS. A subset of 274 patients and 178 of their relatives completed the MSNQ. According to preliminary findings from the trial, relatives’ reports of the patients’ cognition correlated with some cognitive test scores, obtained by patients; patient self-reported cognitive deficits were not closely related to objective test scores. Similar to results from CogniCIS, the CogniMS findings suggest that self-reported cognitive deficits in an early MS population are not specific to cognition, and are influenced by the patients’ psychologic situation.