Research Article Assessment of Early Cognitive Impairment in Patients with Clinically Isolated Syndromes and Multiple Sclerosis Leyla Baysal KJraç, 1 Özgül Ekmekçi, 1 Nur Yüceyar, 1 and AyGe SaLduyu Kocaman 2 1 Neurology Department, School of Medicine, Ege University, 35100 Bornova, ˙ Izmir, Turkey 2 Neurology Department, Acibadem University School of Medicine, Turkey Correspondence should be addressed to ¨ Ozg¨ ul Ekmekc ¸i; ozgul.ekmekci@ege.edu.tr Received 7 December 2012; Revised 22 January 2014; Accepted 26 March 2014; Published 14 April 2014 Academic Editor: Oliver Wirths Copyright © 2014 Leyla Baysal Kırac ¸ et al. his is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Objective. he aim of our study was to investigate the frequency and pattern of cognitive impairment in patients with clinically isolated syndromes and deinite diagnosis of multiple sclerosis within the last 2 years. Methods. We assessed the cognitive status of 46 patients aged 18–49 years with clinically isolated syndromes or deinite diagnosis of multiple sclerosis who have onset of their symptoms within the last 2 years. Patients were matched with 40 healthy participants for age, sex, and educational level. Neuropsychological assessment was performed by stroop test, paced auditory serial addition test (PASAT), controlled oral word association test (COWAT), clock drawing test, trail making test (TMT), faces symbol test (FST). Hamilton Depression Scale and Modiied Fatigue Impact Scale were used to quantify the severity of any depression and fatigue the subjects might sufer. Results. 19.6% of early MS/CIS group failed at 4 and more tests and had signiicant cognitive impairment focused on attention, executive functions, memory, and learning. No signiicant relationship was found between cognitive impairment and disability and fatigue scores. Discussion. Cognitive impairment can be present from the earliest stage of multiple sclerosis. It should be considered among the main manifestations of MS even in the earliest stages of the disease. 1. Introduction Cognitive dysfunction is increasingly recognized in early phase of multiple sclerosis (MS) and clinically isolated syn- drome (CIS) patients [1–7]. MS related cognitive dysfunction is characterized by involvement of recent memory, attention, information processing speed, and executive dysfunction. MS patients with even mild cognitive deicits may experience greater diiculties at work and in social contact and daily activities, irrespective of physical handicap. Since cognitive deicits are not included in the deinition of benign MS (EDSS Scores < 3 > 10 years ater onset), the prevalence of benign disease may have been overestimated [8]. Early cognitive impairment in MS may predict disability outcome several years later [9, 10]. In this study we aimed to evaluate the frequency and pattern of cognitive impairment in patients with CIS and early phase of multiple sclerosis. We assessed relationship of cognitive impairment with the physical disability and fatigue. Furthermore we were interested in detecting a screening instrument that is simple, sensitive, and well tolerated by patients. 2. Methods 2.1. Subjects. Subjects aged between 18 and 50 with CIS or deinite diagnosis of RRMS who have onset of their symptoms within the last 2 years were recruited from our multiple sclerosis outpatient department. CIS/MS subjects underwent a neurological examination that included a complete history and determination of current disability using the Expanded Disability Status Scale (EDSS) and neuropsychological eval- uation. MRI of the patients was evaluated retrospectively. All RRMS patients fulilled the MRI criteria which demonstrate dissemination of lesions in time and in space. Hindawi Publishing Corporation Behavioural Neurology Volume 2014, Article ID 637694, 5 pages http://dx.doi.org/10.1155/2014/637694