Neuropsychiatric Disease and Treatment (Feb 2021)
Identifying Early Neuropsychological Indicators of Cognitive Involvement in Multiple Sclerosis
Abstract
Elizabeth S Gromisch,1– 4 Zaenab Dhari1,2 1Mandell Center for Multiple Sclerosis, Mount Sinai Rehabilitation Hospital, Trinity Health Of New England, Hartford, CT, USA; 2Department of Rehabilitative Medicine, Frank H. Netter MD School of Medicine at Quinnipiac University, North Haven, CT, USA; 3Department of Medical Sciences, Frank H. Netter MD School of Medicine at Quinnipiac University, North Haven, CT, USA; 4Department of Neurology, University of Connecticut School of Medicine, Farmington, CT, USACorrespondence: Elizabeth S Gromisch 490 Blue Hills Avenue, Hartford, CT, 06112, USATel +860-714-2154Fax +860-714-8933Email [email protected]: Multiple sclerosis (MS) is a debilitating disease of the central nervous system that is most commonly seen in early to middle adulthood, although it can be diagnosed during childhood or later in life. While cognitive impairment can become more prevalent and severe as the disease progresses, signs of cognitive involvement can be apparent in the early stages of the disease. In this review, we discuss the prevalence and types of cognitive impairment seen in early MS, including the specific measures used to identify them, as well as the challenges in characterizing their frequency and progression. In addition to examining the progression of early cognitive involvement over time, we explore the clinical factors associated with early cognitive involvement, including demographics, level of physical disability, disease modifying therapy use, vocational status, and psychological and physical symptoms. Given the prevalence and functional impact these impairments can have for persons with MS, considerations for clinicians are provided, such as the role of early cognitive screenings and the importance of comprehensive neuropsychological assessments.Keywords: multiple sclerosis, early cognitive impairment, neuropsychological assessment, modifying factors
