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Cognitive dysfunction in early multiple sclerosis: a review.

N McNicholas1, K O'Connell1, S M Yap1

  • 1Department of Neurology, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland.

QJM : Monthly Journal of the Association of Physicians
|April 4, 2017
PubMed
Summary
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Cognitive impairment (CI) is a major challenge in Multiple Sclerosis (MS), often appearing early and impacting work. Early recognition and management, including cognitive rehabilitation, are crucial for improving quality of life.

Area of Science:

  • Neurology
  • Neuroimmunology

Background:

  • Cognitive impairment (CI) is a significant and disabling symptom in Multiple Sclerosis (MS), frequently under-recognized in early disease stages.
  • CI in MS can precede physical symptoms and contribute more to work withdrawal than physical disability.

Purpose of the Study:

  • To provide an overview of CI in MS, focusing on early MS.
  • To discuss CI's features, impact, assessment (Brief International Cognitive Assessment in MS), and radiological insights.
  • To review treatments, comorbidities, and the importance of early intervention.

Main Methods:

  • Literature review of cognitive impairment in Multiple Sclerosis.
  • Analysis of radiological findings related to CI pathogenesis.
  • Evaluation of cognitive rehabilitation and management of associated comorbidities.

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Main Results:

  • CI is under-reported and under-treated in early MS, significantly affecting quality of life.
  • Radiology offers insights into CI pathogenesis, even in cognitively preserved MS patients.
  • Cognitive rehabilitation and management of comorbidities like fatigue and mood disorders are key.

Conclusions:

  • Early recognition and management of CI in MS are vital to prevent irreversible decline.
  • Addressing comorbidities early can mitigate or trigger CI.
  • Comprehensive management strategies are needed for CI in MS.