Cognitive Dysfunction in the Early Stages of Multiple Sclerosis—How Much and How Important?

Abstract

Purpose of Review Multiple sclerosis (MS) is a demyelinating disease of the central nervous system that mainly affects young adults and that is one of the leading causes of disability in this age group, with cognitive impairment occurring early in the course of the disease. This article summarizes the current knowledge about cognitive dysfunction in the early phase of MS, including biomarkers, MRI correlates, and its value as a prognostic marker. Recent Findings New sets of neuropsychological tests have been established to screen for cognitive dysfunction more easily and accurately. Moreover, structural changes detected by brain MRI and several biomarkers found in cerebrospinal fluid and blood serum have been recently correlated with decreased cognitive performance. Additionally, factors influencing cognition in MS, such as disease-modifying therapy, mood disorders, and lifestyle, are better described. Summary Cognitive impairment early in the course of MS is suggested as a prognostic factor for disease progression. However, clear-cut definitions of the early stage of MS as well as unified criteria for the diagnosis of cognitive impairment are still lacking. New and more reliable tools for evaluating cognition in MS patients should be developed and introduced into everyday practice to facilitate the implementation of effective disease-modifying therapy, cognitive rehabilitation, and lifestyle management.

Cognitive Decline in Multiple Sclerosis Is Related to the Progression of Retinal Atrophy and Presence of Oligoclonal Bands: A 5-Year Follow-Up Study

“…The most frequently observed cognitive problems include deficits in information processing speed, episodic memory, complex attention, and executive function (8,10,11). The severity of cognitive impairment varies considerably among individuals and can be observed even in the early stages of the disease (12,13). Brain imaging studies have demonstrated that cognitive impairment in MS is related to the loss of brain volume or brain atrophy, which is an important sign of neurodegeneration (8,10).…”

Visual-Attentional Load Unveils Slowed Processing Speed in Multiple Sclerosis Patients: A Pilot Study with a Tablet-Based Videogame

“…CI might help in identifying patients at higher risk of disease progression in the long term [5,6], an aspect of paramount importance from a clinical perspective [7]. Crucially, the detection of initial CI in pwMS might be difficult, especially by using only paper-and-pencil tests [7,8]. It has been reported that Brain Sci.…”

“…CI has been reported in all stages and subtypes of MS and has been found to exert negative effects on employment, activities of daily living, and quality of life [ 3 , 4 ]. CI might help in identifying patients at higher risk of disease progression in the long term [ 5 , 6 ], an aspect of paramount importance from a clinical perspective [ 7 ]. Crucially, the detection of initial CI in pwMS might be difficult, especially by using only paper-and-pencil tests [ 7 , 8 ].…”

“…CI might help in identifying patients at higher risk of disease progression in the long term [ 5 , 6 ], an aspect of paramount importance from a clinical perspective [ 7 ]. Crucially, the detection of initial CI in pwMS might be difficult, especially by using only paper-and-pencil tests [ 7 , 8 ]. It has been reported that various compensation phenomena (e.g., neural plasticity, cognitive reserve) can contribute in masking initial changes in cognitive efficiency, thus limiting the possibility to early detect CI in pwMS [ 9 , 10 , 11 ].…”

Speech Pathology-Specific Questionnaire for Persons with Multiple Sclerosis (SMS): adaptation, validation and preliminary assessment of the diagnostic potential.

“…Beside typical measures of physical disability, additional tools assessing e.g. cognitive functions have been implemented in order to better describe the activity of MS (Oset et al, 2020).…”