Four possible indicators of cognitive involvement in early-stage multiple sclerosis

A study recently published in the Journal of the Neurological Sciences found that computerized response time assessments can help clinicians identify cognitive impairment in patients with early multiple sclerosis (MS) .¹ The study’s authors noted that this is an important endeavor Recognition of this early cognitive impairment was necessary for treatment, monitoring, and intervention.

In another study recently published in Neuropsychiatric Disease and Treatment, researchers examined data to find possible indicators of cognitive involvement in early MS.2 They found a number of possible indicators, both neuropsychological and clinical. For example, they also found that a slower response time is a significant indicator.

Additionally, here are a few other factors neurologists may want to look for in their early MS patients.

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Difficulty remembering verbal information

Over the course of this study, the researchers analyzed patient data in 80 studies that detailed patients with early MS who experienced impairment. During this analysis, the researchers found a number of potential factors.

A consistent factor they attributed to early MS was the difficulty in storing and storing information, especially when that information was conveyed orally. Many of the studies that found this symptom used the Selective Reminding Test, while other studies that used tests like the Spatial Recall Test reported patients having difficulty learning and retaining information that they received visually .

Educational level

The researchers also examined a number of clinical and demographic factors to identify possible correlations with cognitive participation. For example, 10 studies in the sample for level of patient education found more significant impairment in people with fewer years of education, while 7 other studies found no association between cognitive participation and educational level.

A study published in the Journal of the Neurological Sciences found that patients with higher levels of education had low scores on only 3 of the 15 tests, while less-educated patients scored worse on low scores on 13 of the 15 tests.These studies show mixed results overall. The latter results suggest that clinicians may want to consider demographic factors in their assessment of patient cognitive involvement.

Disability and depression

The level of disability or depression of a person with early MS experience can negatively affect their quality of life in many ways. As mentioned earlier, this decreased quality of life can include higher levels of cognitive impairment. Of the many studies examined by the researchers, 15 found a correlation between degree of disability and cognition, while 14 suggested an association between higher levels of depression and a negative effect on cognition.

While additional research is needed, the evidence suggests that improving a patient’s quality of life by supporting mental health can proportionally improve their cognitive abilities.

Professional anxiety

Because many people with MS are of working age, employment concerns are common. Serious work-related fears can cause significant stress and further impair a patient’s cognitive abilities. In some studies, the researchers found that patients who had decreased processing speed as well as the ability to maintain focused attention also wanted to work fewer hours. In addition, patients with MS looking to switch careers often had decreased episodic memories. While inconclusive, such studies support theories that MS can affect patient levels of employment.

Overall, this research means it is worth monitoring anxiety levels in your patients with early MS, especially if they are already showing signs of stress and depression. Finally, doctors should conduct cognitive screenings and routine, comprehensive neuropsychological examinations of their patients at an early stage.


  1. Eilam-Stock T, Shaw MT, Krupp LB, Charvet LE. Early neuropsychological markers for cognitive involvement in multiple sclerosis. J Neurol Sci. 2021; 423: 117349. doi: 10.1016 / j.jns.2021.117349
  2. Gromisch ES, Dhari Z. Identification of early neuropsychological indicators of cognitive involvement in multiple sclerosis. Neuropsychiatric Dis Treat. 2021; 17: 323- 337. Published February 5, 2021. doi: 10.2147 / NDT.S256689
  3. Bonnet MC, Deloire MSA, Salort E, Dousset V, Petry KG, Brochet B. Indications of cognitive compensation in connection with the level of education in early recurrent multiple sclerosis. J Neurol Sci. 2006; 251 (1-2): 23-28. doi: 10.1016 / j.jns.2006.08.002

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