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Subjective cognitive function in individuals with multiple sclerosis: Associations with objective cognitive function,
Bonnie I Glanz1, Isaiah Kletenik2, Tarun Singhal1
1Department of Neurology, Harvard Medical School, Boston, MA, United States of America; Brigham MS Center, Brigham and Women's Hospital, Boston, MA, United States of America.
Journal of the Neurological Sciences
|June 28, 2025
Summary
In persons with multiple sclerosis (pwMS), self-reported cognitive issues are linked more to fatigue, anxiety, and depression than objective cognitive tests. Screening for these factors is key for interpreting perceived cognitive deficits.
Area of Science:
- Neurology
- Neuropsychology
- Rehabilitation Medicine
Background:
- Cognitive impairment is prevalent in persons with multiple sclerosis (pwMS), impacting their quality of life.
- The relationship between self-reported cognitive function and objective measures in pwMS remains unclear.
Purpose of the Study:
- To investigate the association between subjective cognitive function and objective cognitive performance in pwMS.
- To determine the influence of anxiety, depression, and fatigue on self-reported cognitive function in pwMS.
Main Methods:
- Data from 345 pwMS were analyzed, including objective cognitive tests (Symbol Digit Modalities Test, California Verbal Learning Test-II) and subjective measures (Neuro-QoL Cognitive Function, Anxiety, Depression, Fatigue).
- Multivariable regression models were used to assess the relationships between subjective cognitive function and objective measures, controlling for psychological and fatigue variables.
Main Results:
- Subjective cognitive function was initially associated with objective tests, anxiety, depression, and fatigue.
- In multivariable analyses, self-reported cognitive function was not associated with objective processing speed (SDMT) or verbal learning (CVLT-II).
- Fatigue, anxiety, and depression were significant independent predictors of self-reported cognitive function in pwMS.
Conclusions:
- Self-reported cognitive function in pwMS is more strongly associated with psychological factors (anxiety, depression) and fatigue than with objective cognitive deficits.
- Clinical interpretation of self-reported cognitive difficulties in pwMS should consider screening for anxiety, depression, and fatigue.
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