10. Cognitive Dysfunction in Multiple Sclerosis

  1. Howard L. Weiner MD3,4,5 and
  2. James M. Stankiewicz MD3,4
  1. Bonnie I. Glanz PhD1,4 and
  2. Maria K. Houtchens MD, Msci1,2

Published Online: 23 FEB 2012

DOI: 10.1002/9781119963714.ch10

Multiple Sclerosis: Diagnosis and Therapy

Multiple Sclerosis: Diagnosis and Therapy

How to Cite

Glanz, B. I. and Houtchens, M. K. (2012) Cognitive Dysfunction in Multiple Sclerosis, in Multiple Sclerosis: Diagnosis and Therapy (eds H. L. Weiner and J. M. Stankiewicz), Wiley-Blackwell, Oxford, UK. doi: 10.1002/9781119963714.ch10

Editor Information

  1. 3

    Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA

  2. 4

    Partners Multiple Sclerosis Center, Brigham and Women's Hospital, Boston, MA, USA

  3. 5

    Center for Neurologic Diseases, Brigham and Women's Hospital, Boston, MA, USA

Author Information

  1. 1

    Department of Neurology, Harvard Medical School, Boston, MA, USA

  2. 2

    Women's Health Program, Partners Multiple Sclerosis Center, Brigham and Women's Hospital, USA

  3. 4

    Partners Multiple Sclerosis Center, Brigham and Women's Hospital, Boston, MA, USA

Publication History

  1. Published Online: 23 FEB 2012
  2. Published Print: 6 APR 2012

ISBN Information

Print ISBN: 9780470654637

Online ISBN: 9781119963714

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Keywords:

  • Multiple sclerosis;
  • cognition;
  • speed of information processing;
  • memory

Summary

Cognitive dysfunction occurs in approximately 40% of MS patients. Deficits are observed on tests of speed of information processing, verbal and visual spatial memory, abstract reasoning, verbal fluency, and spatial perception. Cross-sectional studies suggest that cognitive dysfunction occurs in patients with clinically isolated syndrome (CIS) as well as in patients with relapsing-remitting, secondary progressive, and primary progressive MS. There are no clear associations between cognitive dysfunction and duration of disease or physical disability. There are reports of both cognitive deterioration and cognitive stability in MS patients followed for up to 10 years. Treatment of cognitive impairment in MS is a challenging subject. MS immunomodulating therapies can decrease progression of cognitive disability, and result in reduced cognitive impairment in time. Symptomatic medications aimed at improving memory and other cognitive domains do not have proven efficacy in MS, but can be tried on an individual basis in clinical practice. Psychiatric comorbidities, such as mood disorders and emotional lability, are more common in MS, and should be treated early and aggressively. MRI metrics such as deep gray matter atrophy correlate robustly with cognitive impairment in MS patients.