Importance of Identifying Cognitive Impairment in Multiple Sclerosis.

Can J Neurol Sci

London Multiple Sclerosis Clinic, London Health Sciences Centre, University Hospital, Department of Clinical Neurological Sciences, Western University, London, ON, Canada.

Published: November 2023

AI Article Synopsis

  • The article discusses how cognitive impairment affects the quality of life and outcomes for individuals with multiple sclerosis (MS) and reviews the effectiveness of current treatments.
  • It highlights the correlation between cognitive decline, brain changes seen in MRI scans, and increased disability, suggesting cognitive impairment should be considered a key clinical measure.
  • The article recommends ongoing research into disease-modifying therapies (DMTs) and complementary interventions, as well as the importance of regular screening for cognitive issues in MS patients.

Article Abstract

This article aims to highlight the impact of cognitive impairment on outcomes and quality of life for people with multiple sclerosis (MS) and to review current evidence for the efficacy of disease-modifying therapies (DMTs) and other interventions. In addition, we provide clinical practice insights regarding screening and management of cognitive impairment in people with MS. Evidence suggests that cognitive deterioration often accompanies magnetic resonance imaging changes. Neocortical volume and deep grey matter atrophy correlate with cognitive impairment. Similarly, cognitive decline is predictive of a higher lesion burden. Cognitive impairment is an important clinical measure of disability and negatively impacts quality of life. Phase 3 studies suggest that DMTs such as natalizumab, ozanimod and fingolimod may provide long-lasting, clinically meaningful effects on cognition in people with MS. Further data are needed to support the use of adjunct cognitive behavioural and exercise interventions for people with MS who have cognitive impairment. More data are needed to define appropriate management strategies for cognitive impairment in people with MS. Baseline and periodic screening for cognitive impairment and inclusion of cognitive impairment as a clinical trial endpoint will help to inform efforts to manage this important aspect of MS.

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Source
http://dx.doi.org/10.1017/cjn.2022.334DOI Listing

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