Sexual Dysfunction in Multiple Sclerosis: The Role of Executive Function

Cognitive impairment and sexual dysfunction are common symptoms in persons with Multiple Sclerosis (MS). The present study focuses on the relationship between these two dimensions by means of a specific assessment commonly used in clinical practice with this population. Fifty-five persons with a diagnosis of MS underwent specific cognitive tests and answered clinical questionnaires. Two cognitive tests, one for memory (the Selective Reminding Test), and one for attention (the Symbol Digit Modalities Test), were administered together with two tests for executive functions (the D-KEFS Sorting Test and Stroop Test). Two self-report questionnaires to investigate clinical, psychological and sexual features (the Beck Depression Inventory-II and Self-perception of Cognition in Multiple Sclerosis and Multiple Sclerosis Intimacy and Sexuality Questionnaire-19), were also administered. The main result highlights that sexual difficulties are associated with cognitive deficits, particularly with executive disorders, but not with memory and attention. Furthermore, sexual difficulties are better explained when depression symptoms are also taken into account. This study disentangles the interaction between sexual dysfunction, cognitive impairment and depression in persons with MS by emphasising the role of very high cognitive processing (i.e., executive functioning) in determining human behaviour.

[1]  N. Mahmutbegović,et al.  Quality of Life in Multiple Sclerosis Patients: Influence of Gender, Age and Marital Status , 2022, Materia socio-medica.

[2]  P. Gallo,et al.  Designing a Self-Perception Cognitive Questionnaire for Italian Multiple Sclerosis Patients (Sclerosi Multipla Autovalutazione Cognitiva, SMAC). A Preliminary Exploratory Pilot Study , 2021, Frontiers in Neurology.

[3]  J. Newton,et al.  New insights into the socio-economic aspects of multiple sclerosis in a cohort of Polish patients. , 2020, Annals of agricultural and environmental medicine : AAEM.

[4]  C. Pozzilli,et al.  Validation of the Italian version of the Multiple Sclerosis Intimacy and Sexuality Questionnaire-19 , 2020, Neurological Sciences.

[5]  F. Salvi,et al.  Prevalence and Psychopathological Determinants of Sexual Dysfunction and Related Distress in Women With and Without Multiple Sclerosis. , 2019, The journal of sexual medicine.

[6]  S. Frisch,et al.  Determinants of quality of life in relapsing-remitting and progressive multiple sclerosis. , 2019, Multiple sclerosis and related disorders.

[7]  M. Ermani,et al.  D-KEFS ST Failure Identifies Multiple Sclerosis Patients With Worse Objective and Self-Perceived Physical and Cognitive Disability , 2019, Front. Psychol..

[8]  X. Montalban,et al.  Multiple sclerosis: clinical aspects , 2018, Current opinion in neurology.

[9]  L. Stone,et al.  Factors Associated with Sexual Dysfunction in Individuals with Multiple Sclerosis: Implications for Assessment and Treatment. , 2018, International journal of MS care.

[10]  C. Heesen,et al.  Sexual dysfunctions in MS in relation to neuropsychiatric aspects and its psychological treatment: A scoping review , 2018, PloS one.

[11]  S. Patten,et al.  Depression in multiple sclerosis , 2017, International review of psychiatry.

[12]  J. Donovan,et al.  Multiple sclerosis and sexual dysfunction: A need for further education and interdisciplinary care. , 2017, NeuroRehabilitation.

[13]  Ilana Katz Sand,et al.  Classification, diagnosis, and differential diagnosis of multiple sclerosis , 2015 .

[14]  Massimo Filippi,et al.  Clinical and imaging assessment of cognitive dysfunction in multiple sclerosis , 2015, The Lancet Neurology.

[15]  Gabriele C DeLuca,et al.  Cognitive Impairment in Multiple Sclerosis: Clinical, Radiologic and Pathologic Insights , 2015, Brain pathology.

[16]  M. Lew-Starowicz,et al.  Sexual dysfunction in patients with multiple sclerosis. , 2015, Handbook of clinical neurology.

[17]  R. Calabró,et al.  Sexual dysfunction in male patients with multiple sclerosis: a need for counseling! , 2014, The International journal of neuroscience.

[18]  Jeffrey A. Cohen,et al.  Defining the clinical course of multiple sclerosis: the 2013 revisions. , 2014, Neurology.

[19]  M. Falautano,et al.  Assessing executive function with the D-KEFS sorting test: normative data for a sample of the Italian adult population , 2014, Neurological Sciences.

[20]  R. Marrie,et al.  The impact of sexual dysfunction on health-related quality of life in people with multiple sclerosis , 2014, Multiple sclerosis.

[21]  C. Wolfson,et al.  Incidence and prevalence of multiple sclerosis in Europe: a systematic review , 2013, BMC Neurology.

[22]  D. Kaya,et al.  Sexual dysfunction ın multiple sclerosis: Gender differences , 2013, Journal of the Neurological Sciences.

[23]  E. Atlantis,et al.  Bidirectional association between depression and sexual dysfunction: a systematic review and meta-analysis. , 2012, The journal of sexual medicine.

[24]  Zhen-Ni Guo,et al.  Multiple sclerosis and sexual dysfunction. , 2012, Asian journal of andrology.

[25]  Jeffrey A. Cohen,et al.  Diagnostic criteria for multiple sclerosis: 2010 Revisions to the McDonald criteria , 2011, Annals of neurology.

[26]  M. Ferreira Cognitive deficits in multiple sclerosis: a systematic review. , 2010, Arquivos de neuro-psiquiatria.

[27]  M. Amato,et al.  Cognitive impairment in early stages of multiple sclerosis , 2010, Neurological Sciences.

[28]  E. Frohman,et al.  Sexual dysfunction in patients with multiple sclerosis: a multidisciplinary approach to evaluation and management , 2009, Nature Clinical Practice Urology.

[29]  J. DeLuca,et al.  Cognitive impairment in multiple sclerosis , 2008, The Lancet Neurology.

[30]  T. Pekmezović,et al.  The impact of sexual dysfunction on the quality of life measured by MSQoL-54 in patients with multiple sclerosis , 2008, Multiple sclerosis.

[31]  S. Sorbi,et al.  The Rao’s Brief Repeatable Battery and Stroop test: normative values with age, education and gender corrections in an Italian population , 2006, Multiple sclerosis.

[32]  D. Yerdelen,et al.  Multiple sclerosis patients with and without sexual dysfunction: are there any differences? , 2006, Multiple sclerosis.

[33]  N. Larocca,et al.  Rehabilitation of intimacy and sexual dysfunction in couples with multiple sclerosis , 2001, Multiple sclerosis.

[34]  N. Larocca,et al.  The Multiple Sclerosis Intimacy and Sexuality Questionnaire-19 (MSISQ-19) , 2000 .

[35]  R. Zivadinov,et al.  Sexual dysfunction in multiple sderosis: a case-control study. 1. Frequency and comparison of groups , 1999, Multiple sclerosis.

[36]  J. Stroop Studies of interference in serial verbal reactions. , 1992 .

[37]  D. Goodkin,et al.  Screening for cognitive impairment in multiple sclerosis. An evaluation of the Mini-Mental State Examination. , 1990, Archives of neurology.

[38]  J. Kurtzke Rating neurologic impairment in multiple sclerosis , 1983, Neurology.