Case report: Pragmatic impairment in multiple sclerosis after worsening of clinical symptoms

Area of Science:

• Neurology
• Linguistics
• Cognitive Science

Background:

• Pragmatics, the integration of language and context for effective communication, is crucial for social interaction.
• Potential pragmatic impairments in Multiple Sclerosis (MS) warrant further investigation.
• Understanding cognitive changes in MS is vital for patient management.

Observation:

• A patient with active secondary progressive MS experienced a sudden clinical decline, treated with corticosteroids.
• Initial neuropsychological assessment revealed only slight pragmatic deficits.
• Following clinical worsening, a significant decline in pragmatic comprehension and production was observed.

Findings:

• The patient's pragmatic abilities deteriorated markedly after the clinical worsening.
• This decline was specific to pragmatics, with only one attention task also affected.
• Overall cognitive functioning remained relatively stable, suggesting a targeted impact on pragmatics.

Implications:

• Pragmatic language skills may be a sensitive indicator of cognitive decline in MS.
• The findings underscore the importance of including pragmatic assessments in routine clinical evaluations for MS patients.
• Targeted interventions for pragmatic deficits could improve communication and quality of life in MS.