Is cognitive impairment commonly seen in multiple sclerosis (MS)?

Problems with attention, information processing, memory, planning, or problem solving can affect 50 to 65 percent of people with multiple sclerosis (MS). It is believed the loss of myelin, the insulating material around nerve fibers, can interrupt the transportation of memories to storage areas in the brain.MS has the potential to affect personality, emotions, and intellect through the loss of myelin, damage to the fibers, or loss of brain tissue. While mild problems are common (40 percent of people with MS have mild dysfunction), severe damage to these brain functions is rare.

Only 5 to 10 percent of people with MS will have moderate to severe impairment. There is no correlation between physical disability and cognitive deficits, according to several studies. Fatigue and cognitive impairment do show a correlation in some studies.

Medications, sleeplessness, nutrition, menopause, and depression can also add to cognitive problems and should be assessed as well. While research shows nine out of ten people with MS are free of severe intellectual problems, cognitive impairment is one of the major reasons cited for unemployment among people with MS. So it's important to screen, assess, and manage.

Many studies have shown that lesion volume is correlated with cognitive impairment, especially in the cerebral area. Stronger correlations are shown with brain atrophy as opposed to extent of lesions. A goal for researchers should be to identify at-risk patients.

Since the consequences of intellectual impairment can be great, identification and intervention are critical. Often the patient is reluctant, even unaware. Family reports may be helpful.

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