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Articles linked to this work by shared authors, journal, and citation graph.

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Same authorSame journal

Profiling the long-term risk of severe adverse events in a cohort of multiple sclerosis patients treated with different treatment sequences: Results from the Italian Multiple Sclerosis and Related Disorders Registry (I-MS&RD) (ProSA study).

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A predictive tool for early treatment escalation after initiation of moderate-efficacy therapy in pediatric-onset multiple sclerosis.

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Updated: Jun 24, 2026

The Multiple Sclerosis Performance Test (MSPT): An iPad-Based Disability Assessment Tool
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Cognitive impairment in multiple sclerosis: Where do we stand today?

Maria Pia Amato1, Emilio Portaccio2

  • 1Department of Neurofarba, University of Florence, Florence, Italy; IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy.

Multiple Sclerosis (Houndmills, Basingstoke, England)
|June 23, 2026
PubMed
Summary

Cognitive impairment significantly impacts multiple sclerosis (MS) patients despite advanced treatments. This review highlights new cognitive phenotypes and mechanisms, emphasizing cognition as a key target for MS care.

Keywords:
Multiple sclerosiscognitive impairmentprogression independent of relapse activity

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Area of Science:

  • Neurology
  • Neuroimmunology
  • Cognitive Neuroscience

Background:

  • Multiple sclerosis (MS) treatments have advanced, reducing relapses and disability.
  • Despite treatment progress, cognitive impairment remains a common and significant issue in MS patients.

Purpose of the Study:

  • To review current evidence on cognitive impairment across all stages of multiple sclerosis.
  • To examine cognitive dysfunction in early, preclinical, pediatric, and aging MS populations.

Main Methods:

  • Literature review of current evidence on cognitive impairment in MS.
  • Emphasis on data-driven cognitive phenotypes and their neuroimaging correlates.
  • Discussion of neurobiological mechanisms and progression independent of relapse activity.

Main Results:

  • Emerging data-driven cognitive phenotypes characterize multidimensional cognitive dysfunction.
  • Distinct cognitive profiles correlate with specific neuroimaging findings.
  • Key mechanisms include grey matter pathology, network dysfunction, synaptic alterations, and relapse-independent progression.

Conclusions:

  • Cognitive impairment is a primary driver of disability in multiple sclerosis.
  • Cognition should be a core outcome measure and therapeutic target in MS management.
  • Implications for cognitive monitoring and intervention strategies are discussed.