Focus or Neglect on Cognitive Impairment Following the History of Multiple Sclerosis

Abstract

Cognitive disorders are now considered an integral part of the picture of multiple sclerosis. If we trace the history of the accounts of this disease, from the early descriptions by Jean-Martin Charcot, the first to provide systematic characteristics of multiple sclerosis, to present-day accounts, reports of cognitive disturbances have demonstrated an alternating trend. Cognitive disturbances were identified in the beginning, quite clearly for the times. Then, for a long time, they were considered infrequent or attributed to other factors. Finally, since the 1980s, cognitive disturbances have been the subject of increasingly in-depth studies, and are currently assumed to be a very important consequence of multiple sclerosis. In this work, the history of the description of cognitive disorders of multiple sclerosis will be retraced by analyzing the possible reasons for the differences in attention they have received over time. It emerged from the analysis that, as in the case of other pathologies, various factors have influenced how cognitive disorders have been taken into consideration. Some of these factors are inherent to the very nature of the cognitive impairments present in multiple sclerosis; others are linked to historical periods, or to the different ways of approaching the analysis of the phenomena caused by a disease. The reflections made on these topics should, among other things, increase our awareness of how scientific investigation is invariably placed in the historical context in which it is carried out.

Domain‐specific cognitive impairment in multiple sclerosis: A systematic review and meta‐analysis

“…Long overlooked since Jean-Martin Charcot's first description, 34 The complexity of this issue and the logical sequence would first require the development of a common professional language at international level: the same definitions, the same NPTs and the same cutoff values should be used to define CI characteristics and prevalence levels, in order to identify predictive factors and to design and implement comparable, targeted therapeutic options. That is, the first step seems to define the characteristics and patterns of CI in MS, along the same assessment criteria.…”

“…Long overlooked since Jean‐Martin Charcot's first description, 34 the importance of cognitive symptoms in multiple sclerosis has been brought back into the spotlight over the past 25 years thanks to the explosion of neuropsychological testing, advanced brain imaging techniques and new therapeutic options.…”