Research Article Cognitive Impairment in Relapsing-Remitting Multiple Sclerosis Patients with Very Mild Clinical Disability S. Migliore, 1,2 A. Ghazaryan, 3 I. Simonelli, 4 P. Pasqualetti, 4 F. Squitieri, 5 G. Curcio, 6 D. Landi, 7 M. G. Palmieri, 7 F. Moffa, 3 M. M. Filippi, 3 and F. Vernieri 8 1 Clinical Psychology, University Campus Bio-Medico of Rome, Rome, Italy 2 LIRH Foundation, Via dei Mille 41, Rome, Italy 3 Department of Neuroscience, Fatebenefratelli Hospital-Isola Tiberina, Rome, Italy 4 Service of Medical Statistics and Information Technology (SeSMIT), Fatebenefratelli Hospital-Isola Tiberina, Rome, Italy 5 IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy 6 Department of Life, Health and Environmental Sciences, University of L’Aquila, L’Aquila, Italy 7 Department of Neuroscience, Policlinico “Tor Vergata”, Rome, Italy 8 Neurology Unit, University Campus Bio-Medico of Rome, Rome, Italy Correspondence should be addressed to S. Migliore; s.migliore@unicampus.it Received 14 March 2017; Revised 24 May 2017; Accepted 12 June 2017; Published 15 August 2017 Academic Editor: Lambros Messinis Copyright © 2017 S. Migliore et al. This 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. Cognitive dysfunction affects 40–65% of multiple sclerosis (MS) patients and can occur in the early stages of the disease. This study aimed to explore cognitive functions by means of the Italian version of the minimal assessment of cognitive function in MS (MACFIMS) in relapsing-remitting MS (RRMS) patients with very mild clinical disability to identify the primarily involved cognitive functions. Ninety-two consecutive RRMS patients with Expanded Disability Status Scale (EDSS) scores ≤ 2.5 and forty- two healthy controls (HC) were investigated. Our results show that 51.1% of MS patients have cognitive dysfunction compared to HC. An impairment of verbal and visual memory, working memory, and executive functions was found in the RRMS group. After subgrouping RRMS by EDSS, group 1 (EDSS ≤ 1.5) showed involvement of verbal memory and executive functions; moreover, group 2 (2 ≤ EDSS ≤ 2.5) patients were also impaired in information processing speed and visual memory. Our results show that utilizing a comprehensive neuropsychological assessment, approximately half of MS patients with very mild physical disability exhibit cognitive impairment with a primary involvement of prefrontal cognitive functions. Detecting impairment of executive functions at an early clinical stage of disease could be useful to promptly enroll MS patients in targeted rehabilitation. 1. Introduction Cognitive impairment (CI) is a common deficit of multiple sclerosis (MS), with prevalence rates ranging from 40 to 65% [1]. It can have a dramatic impact on a patient’s quality of life, influencing role fulfilment in work as well as in social life independent of physical disability [2]. The cognitive domains mostly affected are attention, visuospatial abilities, learning and memory, information processing speed, and problem solving, while “simple” attention and essential verbal skills are not usually compromised [3, 4]. To identify cognitive impairment, scores on the single test are usually used. Recently, Migliore et al. [5] considered also the cognitive domains rather than the single tests to better iden- tify patients with multidomain cognitive impairment. This classification may be more specific to identify MS patients with a clear cognitive impairment; in fact, patients with two tests failed in the same domain are not considered multido- main cognitively impaired. Cognitive dysfunction can be detected even at the earliest stages of the disease [6, 7]; nevertheless, its prevalence is higher in chronic progressive patients [7]. Longitudinal stud- ies indicate that CI, if present, progresses over time [4, 8, 9]. Moreover, CI has a prognostic value as it indicates a shifting Hindawi Behavioural Neurology Volume 2017, Article ID 7404289, 10 pages https://doi.org/10.1155/2017/7404289