Multitasking is the Cognitive Ability Most Linked to Depression in Multiple Sclerosis (P5.028)

Objective: To investigate multitasking as the cognitive process most sensitive to depressed mood in Multiple Sclerosis (MS). Background: MS patients with depressed mood frequently report cognitive deficits; however, objective performance on standard neuropsychological testing is often average. Current testing procedures may not accurately reflect the cognitive difficulties patients experience in real life. For example, trouble managing multiple responsibilities may impair work and household performance. These deficits may be missed on traditional neuropsychological assessments requiring attention to one task at a time. Here we evaluate whether multitasking best identifies the cognitive difficulties experienced by MS patients with depression. Design/Methods: The RESERVE Project is a prospective study of risk and protective factors for disease and disability progression in early MS (R01 HD082176). Baseline data from the first 150 patients were used. Multitasking was evaluated with a novel test requiring rapid decision-making during a simultaneous auditory attention task. Traditional neuropsychological tasks assessed attention and processing speed (Symbol Digit Modalities Test; Stroop), working memory (Digit Span), episodic memory (Selective Reminding Test; Brief Visuospatial Memory Test, Revised), and verbal fluency (FAS). Stepwise regression (entry p=.05, removal p=.10) identified which of the aforementioned cognitive abilities independently predict level of depression (Beck Depression Inventory, Fast Screen: No Symptoms [0, n=35], Minimal [1–3, n=73], At Least Mild [≥4, n=42]), controlling for age, sex, education, and premorbid IQ (WTAR). Results: Multitasking was the only independent predictor of worse depression (rp=−.236, p=.004). Follow-up analysis of covariance revealed worse multitasking among patients with At Least Mild versus No Symptoms (p=.004), with a trend versus Minimal (p=.084). No other task predicted depression greater than multitasking (p>.10). Conclusions: Depression was most related to multitasking, supporting the idea that depressed mood depletes available attentional resources. Multitasking assessments may be more sensitive to the cognitive deficits patients experience in real life and which may be overlooked by traditional neuropsychological tests. Study Supported by: The study is supported by a grant from the NIH R01 HD082176. Disclosure: Dr. Kurz has nothing to disclose. Dr. Fabian has nothing to disclose. Dr. Pelle has nothing to disclose. Dr. Lewis has nothing to disclose. Dr. Lublin has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Consulting and advisory boards: Bayer HealthCare Pharmaceuticals; Biogen Idec; EMD Serono; Novartis; Teva; Actelion; Sanofi/Genzyme; Acorda; F. Hoffmann-La Roche/Genentech; MedImmune; Receptos/Celgene; Forward Pharma; Akros; TG Therapeutics; Abbvie; Rege. Dr. Lublin has received personal compensation in an editorial capacity for Co-Chief Editor of Multiple Sclerosis and Related Disorders. Dr. Lublin has received research support from Research funding from: Biogen Idec; Novartis Pharmaceuticals Corp; Teva Neuroscience, Inc.; Genzyme; Sanofi; Celgene; Transparency Life Sciences; NIH; NMSS. Dr. Miller has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Accordant Health Services (Caremark), Adama, BiogenIdec, Celgene, Genzyme/Sanofi, Mallinckrodt, Mapi-Pharma, Novartis, Roche/Genentech. Dr. Sumowski has nothing to disclose.