2) Follow this 🧵for CE/#CME credit for #Physicians #Nurses #PAs #NPs & #Pharmacists. This program is intended for #healthcare providers & is supported by an educational grant from Bristol-Myers Squibb. Statement of accreditation & faculty disclosures at https://t.co/QO3HNwRSPJ
— MultipleSclerosis_CME (@ms_cme) December 22, 2022
4a) The correct answer is “d”. Cognitive impairment occurs in ~34% of patients with #CIS, ~50% with Relapsing Remitting Multiple Sclerosis (#RRMS) and occurs at a rate of 80-90% in #progressive MS.
— MultipleSclerosis_CME (@ms_cme) December 22, 2022
5) #Cognitive domains impacted in #MS include processing speed, attention, executive function, working memory and long-term memory.
— MultipleSclerosis_CME (@ms_cme) December 22, 2022
7) Given the significant impairment #cognitive dysfunction can have on #QoL in #MS, it is imperative that screening begin early, and research efforts focus on preventing and reducing cognitive decline from MS.
See 🔓 https://t.co/PK3kdBQcEF— MultipleSclerosis_CME (@ms_cme) December 22, 2022
9) Consider annual re-assessment with the same test, or more often to screen for: acute disease activity, treatment effects (on disease modifying therapy #DMT), relapse recovery, evaluate for progression of #cognitive impairment and to screen for new-onset cognitive problems.
— MultipleSclerosis_CME (@ms_cme) December 22, 2022
11) Several #validated tests are used in assessing cognition in #MS
See 🔓 https://t.co/PK3kdC7O3f pic.twitter.com/ZPRwaGhhhx— MultipleSclerosis_CME (@ms_cme) December 22, 2022
13) The answer is “d,” none of the above. RCTs examining pharmacologic treatment for #MS related #cognitive impairment including #modafinil, #donepezil, #L_amphetamine_sulfate, & #memantine have shown conflicting results.
See https://t.co/rdsew1kiPV— MultipleSclerosis_CME (@ms_cme) December 22, 2022
14b) A secondary analysis of the Ph 3 #SUNBEAM trial, #S1P receptor modulator #ozanimod at 0.92mg or 0.46 mg daily vs. interferon β-1a 30µg weekly evaluated cognitive processing speed in #MS using Symbol Digit Modalities Test #SDMT.
See 🔓 https://t.co/UCHsVxHp0P.— MultipleSclerosis_CME (@ms_cme) December 22, 2022
15a) #Dalfampridine, an FDA approved treatment to improve walking speed in #MS is also considered a possible agent for treatment of #cognitive impairment in MS.
— MultipleSclerosis_CME (@ms_cme) December 22, 2022
16) #Cognitive #rehabilitation may provide long-term impact on #MS cognition by limiting future decline, but more research is needed. A model for this has been published https://t.co/p7VvAHGNh8
— MultipleSclerosis_CME (@ms_cme) December 22, 2022
18a) #Sphingosine-1-phosphate (#S1P) receptor modulators are one class of #MS #DMT believed to impact cognition.
— MultipleSclerosis_CME (@ms_cme) December 22, 2022
18c) References for these #siponimod data:
🧠 🔓 https://t.co/vh3SfaKbLr
🧠 🔓 https://t.co/C0rAh4XWdB
🧠 🔓 https://t.co/E1xUZciTyI— MultipleSclerosis_CME (@ms_cme) December 22, 2022
20) Based on consensus opinion, the Symbol Digit Modalities Test (#SDMT) is considered the best measure of #CPS for #MS studies. It is the only test for which a change score is defined as clinically meaningful. See
🧠 🔓 https://t.co/OYLCnZnNSF
🧠 🔓 https://t.co/uzzkn4eVlD— MultipleSclerosis_CME (@ms_cme) December 22, 2022
22) In addition, #siponimod-treated pts were at significantly lower risk for having a ≥4-point ⬇️in #SDMT score and had a significantly higher chance for having a ≥4-point ⬆️in SDMT score.
See https://t.co/DDO5DYhwwj pic.twitter.com/kOIx6JCLWz— MultipleSclerosis_CME (@ms_cme) December 22, 2022
24) Research is needed to better understand the utility of specific classes of #MS #DMTs on #cognitive impairment in MS.
— MultipleSclerosis_CME (@ms_cme) December 22, 2022
26) For 🔑references, see:
🧠 🔓 https://t.co/818Vqn3MHc
🧠 https://t.co/8dgo1EL8BC
🧠 🔓 https://t.co/GarzmTRG4l
🧠 🔓 https://t.co/vCltU817Mx
🧠 🔓 https://t.co/oni8mjYgPn— MultipleSclerosis_CME (@ms_cme) December 22, 2022
28) #Cognitive dysfunction is a disabling symptom of #MS. Future studies will need to determine ways to halt cognitive decline in those already experiencing cognitive impairment, evaluate for ways to reverse and ultimately prevent cognitive decline altogether.
— MultipleSclerosis_CME (@ms_cme) December 22, 2022
29) And YOU 🫵 have just earned 0.5 hr 🆓CE/#CME! Please point your 🖱️to https://t.co/8dDxxg9AbB and claim your certificate. And FOLLOW US for more expert-led education on advances in #MS! I am @DrJNicholas. pic.twitter.com/BVCD72Dx0c
— MultipleSclerosis_CME (@ms_cme) December 22, 2022
