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Recommendations for cognitive screening and management in multiple sclerosis care.

Rosalind Kalb1, Meghan Beier2, Ralph Hb Benedict3

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Summary

Cognitive impairment in multiple sclerosis (MS) requires early screening with the Symbol Digit Modalities Test (SDMT) and regular monitoring. Recommendations include increased awareness and tailored interventions for adults and children to improve daily functioning.

Keywords:
Multiple sclerosiscognitioncognitive dysfunctionrehabilitationremediationscreeningtreatment

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Area of Science:

  • Neurology
  • Neuropsychology
  • Rehabilitation

Background:

  • Cognitive impairment is a common and impactful symptom in multiple sclerosis (MS).
  • Optimal management strategies for MS-related cognitive dysfunction are not consistently applied.
  • Barriers to effective cognitive care in MS need to be identified and addressed.

Purpose of the Study:

  • To enhance understanding of cognitive impairment in multiple sclerosis (MS).
  • To establish consensus on optimal screening, monitoring, and treatment strategies for cognitive changes in MS.
  • To propose methods for overcoming barriers to effective MS cognitive care.

Main Methods:

  • Convening a consensus panel of MS cognitive dysfunction experts, including clinicians, researchers, and individuals with MS.
  • Reviewing existing scientific literature on cognitive impairment in MS.
  • Developing evidence-based recommendations for screening, monitoring, treatment, and barrier mitigation.

Main Results:

  • Recommends increased awareness and education for professionals and patients regarding MS cognitive symptoms.
  • Advocates for baseline Symbol Digit Modalities Test (SDMT) screening in MS patients (age 8+) and annual reassessment.
  • Suggests comprehensive neuropsychological evaluation for adults with positive screening or decline, and for children with functional changes; proposes remedial interventions.

Conclusions:

  • Early and consistent cognitive screening using validated tools like the SDMT is crucial for MS management.
  • Regular monitoring and comprehensive assessments are necessary to detect changes and guide treatment.
  • Addressing barriers through education and tailored interventions can improve functional outcomes for individuals with MS.