Visual acuity is associated with performance on visual and non-visual neuropsychological tests in multiple sclerosis

Both vision and cognitive problems are commonplace in multiple sclerosis. Previous research suggests that MS patients with compromised near vision perform more poorly on visually mediated cognitive tests. Consequently it has been recommended that neuropsychologists who evaluate MS patients with poor corrected near vision should rely primarily on auditory neuropsychological tests. However, no research has examined the association between vision problems and performance on non-visual neuropsychological tests in MS. Moreover, little if any research has examined the association between more sensitive measures of vision impairment and cognitive difficulties in MS. The objective of this study was to examine the relationship between visual acuity and cognition in MS. A total of 65 MS patients were administered a visual and neuropsychological evaluation. Visual examination included an assessment of visual acuity, low-contrast visual acuity (5%, 2.5%, and 1.25% illuminated charts) and near visual acuity. Poorer high-contrast, near, and low-contrast visual acuity were significantly associated with poorer performance on visual, non-visual, and motor-based neuropsychological tests. Neuropsychologists should be aware that poor corrected vision in MS is associated with poor performance in all cognitive and motor domains. Results suggest the need for further exploration of visual acuity biomarkers of disease progression in MS.