Cognitive impairment in multiple sclerosis: evidence-based analysis and recommendations

J Clin Neurosci. 2007 Oct;14(10):919-27. doi: 10.1016/j.jocn.2007.02.006. Epub 2007 Jul 30.


Cognitive impairment is common in multiple sclerosis (MS), occurring at all stages of the disease, and can be a major source of vocational disability, social impairment, and impoverished quality of life. Dysfunction in free recall from long-term memory, speed of information processing, working memory, and abstract reasoning are frequently observed in MS. Despite weak correlation with disease duration and physical disability status, the degree of cognitive impairment in MS has been related to the extent of topographically specific neuronal tissue damage and loss. Additional clinical factors including disease course, fatigue, affective disturbance, and medication can impact on the degree of MS-related cognitive impairment. We suggest that the symbol digits modalities test, paced auditory serial addition task, the clock drawing test and the MS neuropsychological screening questionnaire be considered as valid and relevant screening tests for cognitive impairment in MS.

Publication types

  • Review

MeSH terms

  • Brain / pathology
  • Brain / physiopathology
  • Cognition Disorders / diagnosis*
  • Cognition Disorders / etiology*
  • Cognition Disorders / psychology
  • Diagnosis, Differential
  • Disability Evaluation*
  • Disease Progression
  • Evidence-Based Medicine
  • Guidelines as Topic
  • Humans
  • Multiple Sclerosis / complications*
  • Multiple Sclerosis / pathology
  • Multiple Sclerosis / psychology*
  • Neuropsychological Tests / standards*
  • Surveys and Questionnaires / standards