School performance as a marker of cognitive decline prior to diagnosis of multiple sclerosis

Mult Scler. 2015 Jun;21(7):945-52. doi: 10.1177/1352458514554054. Epub 2014 Oct 24.


Background: For many years, cognitive impairment has been established as a well-known symptom of multiple sclerosis. Moreover, we know that it was present even at the beginning of the disease.

Objective: In this case-control study, we decided to evaluate whether there is an impairment of cognitive functions even before onset in those patients who will eventually suffer from multiple sclerosis.

Methods: We evaluated the overall school performance, and particularly school performance in math and language in a group of patients who would later develop the disease and we compared our findings with a control group.

Results: We found that school performance was poorer in subjects who were to become patients. And we found that the later the start of the first symptom, the better the qualifications.

Conclusion: Testing a premorbid cognitive deficit by a validated indirect evaluation method allowed us to verify that there was evidence of neurological compromise even before a clinical diagnosis or the completion of the first magnetic resonance imaging in patients who would then suffer from multiple sclerosis.

Keywords: Multiple sclerosis; cognitive symptoms; early diagnosis; education; incidental findings; prodromal symptoms.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Case-Control Studies
  • Cognition Disorders / etiology*
  • Early Diagnosis*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Multiple Sclerosis / complications
  • Multiple Sclerosis / diagnosis*
  • Schools*