Multiple sclerosis (MS) is a disease that affects the central nervous system and causes inflammation in parts of the brain and spinal cord. Current research suggests that there are over 130,000 people with MS in the UK, with nearly 7,000 people newly diagnosed each year. [MS Society]. MS is also nearly three times more common in women than men.
Physical symptoms vs cognitive problems
MS patients can have a wide range of neurological symptoms and it is common to see many differences between affected individuals. Often, visual disturbance in one eye (due to optic nerve inflammation) is the first symptom. While other common symptoms are:
Numbness and loss of sensation
Decreased muscle strength
Decreased coordination ability
Memory problems and other cognitive impairments
Loss of feeling
Mood swings and depression
In the UK people are most likely to find out they have MS between their 30s-50s, but first signs often start years earlier. The disease usually flares up and becomes progressive after 15–20 years. Even early progressive forms without any previous elements of relapse occur.
Cognitive functioning and MS
Whilst physical symptoms are often prioritised in terms of how to treat patients with MS, it is important to assess cognitive functioning as changes in individuals with MS are common. Up to two-thirds of the people who have MS develop problems with thinking, learning, and memory, [Journal Cerebrum].
Areas of cognitive functioning which may be affected include:
Attention and concentration
“What is often ignored are the cognitive problems people with MS experience: memory issues, thinking more slowly, and mental fatigue…All of these symptoms can have a negative impact on the person, and can affect their daily lives in a significant way,”
Helen Genova, PhD, assistant director of the Kessler Foundation's Center for Neuropsychology and Neuroscience Research in New Jersey.
Screening cognitive functioning gives a baseline measurement
Early assessment of cognitive functioning is key, it provides a baseline measurement for any changes and successes in rehabilitation to be tracked against. Changes to cognitive functioning can affect an individual's quality of life, employment, relationships and activities. The National MS Society (US) recommends that individuals with MS should be “screened for cognitive dysfunction by their healthcare provider at least once a year”; this should increase in frequency if there are changes in function at work or home.
However, currently in the UK most MS clinics do not routinely screen for cognitive problems - having longer term impacts for any intervention plans put in place at later dates. Cognitive rehabilitation plans could involve supporting patients with MS by providing strategies and processes that may support areas such as memory and language development.
A ‘top 10’ research priority
The good news is that finding treatments for cognitive problems in MS is classed as a ‘top 10’ research priority, and there are a number of research programs underway that look at MS and cognitive assessment.
Many have already highlighted that current cognitive assessments are focused on pen and paper formats, are time consuming and high in time-cost impact for clinicians. There is a clear need for timely assessment in order for interventions that make use of technological advancements to be put in place. This is where Mindmore’s digital assessment can play an important role in providing a range of tests that healthcare providers can administer remote or on-site, to assess patients' cognitive functioning from the outset of diagnosis through rehabilitation and beyond.
Our team is always available.