Cognitive Impairment Management in Multiple Sclerosis
Summary
Cognitive impairment affects up to two-thirds of people with multiple sclerosis (MS), manifesting as slowed information processing, memory lapses and executive dysfunction. Management strategies span pharmacological and non-pharmacological approaches. Pharmacological options centre on disease-modifying therapies (DMTs) that reduce inflammatory activity and may stabilise or modestly improve cognition. Regular cognitive screening using brief batteries enables early detection and tailored interventions. Non-pharmacological measures include structured cognitive rehabilitation, exercise programmes and lifestyle modifications targeting sleep, mood and fatigue. Neuroimaging and digital biomarkers are emerging tools for monitoring grey matter integrity and network connectivity. Multidisciplinary care teams integrate neurology, neuropsychology, rehabilitation and nursing to deliver holistic support. Early intervention, standardised cognitive assessment and combined therapy models are critical to preserve quality of life and functional independence.
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Cognitive Impairment Management in Multiple Sclerosis publication trend
The graph below shows the total number of articles in cognitive impairment management in multiple sclerosis across all publications each year (not limited to Nature Index journals).
Technical terms
Disease-modifying therapy (DMT): Treatment aimed at altering the course of multiple sclerosis by reducing inflammatory activity and slowing disease progression.
Symbol Digit Modalities Test (SDMT): A brief assessment of information-processing speed often used to evaluate cognitive function in MS.
Paced Auditory Serial Addition Test (PASAT): A measure of attention and working memory requiring rapid addition of sequentially presented digits.
Sphingosine-1-phosphate (S1P) modulators: Oral agents that prevent lymphocyte migration from lymph nodes, thereby reducing CNS inflammation.
References
- Current Status of Oral Disease-Modifying Treatment Effects on Cognitive Outcomes in Multiple Sclerosis: A Scoping Review. Bioengineering (2023).
- Efficacy of fingolimod and interferon beta-1b on cognitive, MRI, and clinical outcomes in relapsing–remitting multiple sclerosis: an 18-month, open-label, rater-blinded, randomised, multicentre study (the GOLDEN study). Journal of Neurology (2017).
- Subcutaneous Interferon β-1a May Protect against Cognitive Impairment in Patients with Relapsing–Remitting Multiple Sclerosis: 5-Year Follow-up of the COGIMUS Study. PLOS ONE (2013).
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