Background
Cognitive impairment is increasingly being recognized as a common and disabling symptom of multiple sclerosis (MS) that contributes to poor quality of life in affected patients. Despite the high prevalence of cognitive impairment in MS, cognitive function is not assessed routinely in clinical practice or in clinical trials. The perception that cognitive assessments are costly, time-consuming, complicated, and difficult to administer and interpret has contributed, at least in part, to the failure to incorporate cognitive testing into standard clinical evaluation of patients with MS. Detailed studies of cognitive impairment in MS are rare and guidelines for the assessment of cognitive function in MS are lacking.
Treatment
How to manage cognitive decline in MS also requires further study. Licensed disease-modifying drug (DMD) treatments for MS reduce brain lesion development, and associations between brain lesions and cognitive performance have been reported, providing a rationale for DMD treatment of MS-associated cognitive impairment. There is some evidence for cognitive benefits of DMDs, but as few pivotal DMD trials included cognitive assessments, the effects of these agents on cognition are not fully understood and more studies are needed.
Conclusions
It is only through further studies that it will be possible to identify patients with, or at risk of, cognitive impairment and to provide appropriate therapy to limit the effects of this potentially devastating symptom.
Department of Neurology,
University of Catania,
Catania, Italy
Hello Bonnie,
I just found your site and I wanted to praise you on the job you’re doing keeping up with and investigating MS and treatments.
I was “formally” diagnosed 7 years ago with symptoms for the ten years prior to that. I self-managed my MS without medication for many years until my wife was diagnosed with cervical cancer a year ago (she’s ok now). My doctor said the stress probably triggered this latest relapse (going on almost a year now) but it’s been the worst of my life. I’m in a wheelchair now, my arms and hands don’t work well.
I read your article on Tysabri. I am now on a Tysabri course, I have one treatment left before my “break” and evaluations. I have had seven treatments so far and I have minor evaluations every other treatment.
I never had Copaxone, I was on Betaseron first, then Avonex but I didn’t do too well on it so we stopped treatments.
My short-term memory and cognitive abilities have deteriorated significantly as well with this relapse. This has to be the most frustrating thing, to me, about my MS. I’m an electrical engineer and board designer and trouble-shooter. I can’t remember anything anymore, I have a notepad I write down everything in to keep myself straight. I lost the vision in my right eye which doesn’t help my already screwed up head. Luckily, my doctor is very good and I am in therapy/rehabilitation for those issues.
Anyhow, keep up the fantastic work.
Regards,
Jeff
Thank you, Jeff, for you comment. Watch for my new Website as of the first of February. The new site is http://www.AllAboutMS.ca
Bonnie
By: Jeff on January 3, 2009
at 10:04 pm
Hi Bonnie :^),
I have demylination in my basal ganglia, which works as part of my limbic system. I have suffered with major depressive disorder all of my adult life. I am 51 going on 52 in August. I am on the highest dose of Effexor XR allowed. My physician told me to get a psychiatrist. However, I have had psychiatrists on and off all through my adult life. I don’t think they would really help anymore. My life is merely existing, not really living. I can walk and talk, but I do not enjoy being around others. I feel like I am not pretty, no one respects me and I am not important in life. I feel like a drone.
By: Joyce on July 25, 2009
at 3:57 pm