Neuropsychiatric manifestations of multiple sclerosis

Abstract

Multiple sclerosis is one of the most frequently observed neurological causes of progressive disability in early to middle adulthood. The disease is variable in its presentation and course, affects roughly 100 to 300 per 100,000 persons within the US alone and is slightly more common among females than males. Multiple sclerosis places substantial burdens on patients, families and caregivers. Its presentation includes disturbances in cognitive abilities and psychiatric functioning, as well as motor difficulties. This article reviews the current literature on the neuropsychiatric manifestations of multiple sclerosis. Cognitive domains discussed include general cognitive functioning, learning and memory ability, attention, processing speed, executive functioning, visual perceptual ability and language functioning. Attention is also given to alterations in neuropsychiatric functioning associated with disease progression and across various disease subtypes. In addition, reports are also reviewed regarding various psychiatric disturbances, affective changes, quality of life issues and fatigue and pain in individuals with multiple sclerosis. Finally, factors pertaining to pediatric populations in multiple sclerosis are addressed.

Are multiple sclerosis patients and their caregivers more anxious and more committed to following the basic preventive measures during the COVID-19 pandemic?

“…The point prevalence of depressive symptoms in MS patients is about 30% ( Oliver Tobin, 2019 ), and the point prevalence of anxiety ranges from 14% to 41% ( Korostil and Feinstein, 2007 ). Depression prevalence among Egyptian MS patients was reported to be higher (52.5%) ( Pinkston and Alekseeva, 2006 ). In our study, however, the percentage of patients with depression and anxiety were significantly higher than what was reported in literature i.e.…”

Impact of extended-release dalfampridine on walking ability in patients with multiple sclerosis

“…As a consequence of compromised activities of daily living that involve walking about the home or in the community, impairments of gait lead to loss of independence, decreased sense of self-worth due the external appearance of disablement, lost employment opportunities and reduced quality of life 3,6. The impact of mobility impairment on patient autonomy, caregiver burden, mood, and the costs of care are disproportionately high relative to those associated with other neurologic diseases2 and compound the already heavy neuropsychiatric burden of the disease 2,7–9. As such, maintaining mobility is ranked as one of the highest priorities among patients with MS, regardless of disease duration or level of disability 3…”

“…The neuropsychiatric burden of MS is multifaceted and complex 7–9. It includes neuropathology-related impairments of emotional control and cognitive processes brought about by demyelination and/or axonal pathology in various locations within the brain sub-serving these functions.…”

Executive Dysfunction Following Critical Illness: Exploring Risk Factors and Management Options in Geriatric Populations

“…Executive dysfunction has been shown to be predictive of poor QoL among a diverse array of patient populations including individuals with epilepsy, human immunodeficiency virus (HIV), multiple sclerosis, and chronic mental illness [21,[81][82][83][84].…”