Cognitive Impairment in Multiple Sclerosis

Abstract

Multiple sclerosis (MS) is a socially significant immune-mediated disease, characterized by demyelination, axonal transection and oligodendropathy in the central nervous system. Inflammatory demyelination and neurodegeneration lead to brain atrophy and cognitive deficit in up to 75% of the patients. Cognitive dysfunctions impact significantly patients' quality of life, independently from the course and phase of the disease. The relationship between pathological brain findings and cognitive impairment is a subject of intensive research. Summarizing recent data about prevalence, clinical specificity and treatment of cognitive disorders in MS, this review aims to motivate the necessity of early diagnosis and complex therapeutic approach to these disturbances in order to reduce the social burden of the disease.

Assessment and Impact of Cognitive Impairment in Multiple Sclerosis: An Overview

“…Although clinical phenotypes may differ in the prevalence or severity of cognitive impairment, main determinants are physical disability as measured by EDSS, and patients’ age [35]. Other individual characteristics such as gender, genetic factors, and cognitive reserve may also play a relevant role [36]. For a summary of the most frequent cognitive domains affected in MS see Table 1.…”

“…It is the most consistently affected cognitive domain in MS patients. Impaired learning of new information seems to be the primary problem [36], but the encoding, storing, and retrieval from long-term storage processes of memory seems to be affected in MS patients, so there is still controversy about which of these components of memory is the most influential factor for explaining memory deficits [40]. Other factors, such as slow processing speed, susceptibility to interference, executive disfunction, and perceptual deficits can also determine poor learning abilities [41].…”

Test-Retest Reliability of Cognitive-Motor Interference Assessments in Walking With Various Task Complexities in Persons With Multiple Sclerosis

“…We are, however, confident in the observed results because our sample size matches previous studies on dual-task walking reliability in persons with MS 21,22 and recommendations on reliability in neurological patients made by Hobart et al 27 Importantly, current results are comparable to those of previous studies in neurological populations. The 3 cognitive tasks used in the current study were based on the cognitive domains involved-namely, information processing speed, working memory, and attention because these are frequently impaired in pwMS 40 -and on previous studies. Tasks of executive functioning such as the Stroop color word task and verbal fluency tasks have, however, also been shown to be promising concurrent cognitive tasks in pwMS 13,56 and showed excellent test-retest reliability in a dual balancing task.…”

The Relationship between Psychosocial Factors and Cognition in Multiple Sclerosis

“…Of particular significance is the high prevalence of cognitive symptoms in patients diagnosed with MS, which impacts overall quality of life [4]. Cognitive symptoms can be one of the earliest symptoms and are present in up to 70% of patients [5, 6]. In fact, cognitive impairments in particular as well as depression, fatigue, and motor function resulting from MS have been shown to contribute to lowered work performance [7] and increased unemployment rates [8–11], reduced social activities [12], long-term disability [10], mental health [13], and overall quality of life [14].…”