Cognitive Changes with MS
Multiple sclerosis (MS) involves random attacks on the myelin that insulates nerves within the brain and spinal cord (these are the structures that make up the central nervous system). The most common MS-related symptoms include problems with balance, strength, vision, fatigue, muscle control, bladder or bowel function, sensation, mood and cognition.
In recent years, researchers have indicated that nearly half of all individuals with MS will experience some type of change in their cognitive abilities during the course of their disease. Cognitive abilities are the group of mental processes such as attention, information processing speed, language, memory, visual perception/spatial skills, and executive functions.
The most commonly affected cognitive processes in MS are typically information processing speed, memory, and executive functions. Other domains of cognition like verbal fluency, visuospatial abilities, and divided attention can also be affected depending on where lesions are located. However, it is fairly rare that all cognitive domains would be impacted by MS. Changes in cognitive abilities typically are considered to be mild to moderate. Nonetheless, these difficulties, even the mild ones, can be frustrating, annoying, and slow down your ability to complete day-to-day tasks. Cognitive problems in MS are the result of nerve damage in the brain interrupting the transmission of electrical messages, reducing the speed and accuracy of the information.
It’s important to note that not all difficulties with cognition are a result of brain-related structural changes. Sometimes factors such as fatigue, lack of sleep, medication side effects, depression, anxiety, and stress can negatively impact cognition.
Although there are some MS cognitive batteries that can be administered in primary care physician/neurologist offices, they are brief by neuropsychological standards. The need for even 15 minutes of one-on-one testing for every patient is not practical in all medical practices, so unfortunately cognitive monitoring is not currently part of MS standard care. If you have MS and are concerned about your current cognitive function it may be beneficial to request a referral for a baseline neuropsychological evaluation that can serve as the basis for a comprehensive management strategy by identifying cognitive strengths and weaknesses This evaluation can also aid in tracking your cognition over time in case you experience MS exacerbations or flare-ups that may impact certain brain regions and their associated cognitive functions.
Some Tips to Help Cope with Cognitive Issues
Concentration/Attention: To enhance one’s ability to concentrate, some people find it helpful in identifying (and avoiding) distractions; establishing quiet time; determining a time when you are at your best and using that time to perform more complex tasks; learning energy-saving and pacing strategies.
Processing Speed: Ask those around you to not speak as quickly, allowing you time to assimilate the information. By letting family and friends know what is going on, they will be able to help you to cope with the cognitive challenges you may be experiencing.
Word Finding: Try to talk more slowly, allowing yourself extra time to process information. Additionally, if you study and expand your vocabulary, you may have synonyms at your disposal to substitute for the words you can’t find.
Memory: Increase your organization of materials as this can help substitute for any lapses in memory. For instance, use a journal and/or a calendar to help keep track of things you need to remember and appointments you need to keep. Use checklists for shopping and other tasks. Select a central place in your home to keep things that are easily lost – such as glasses and keys – to help avoid the frustration and wasted energy of searching for lost items.
Sleep: Fatigue is one of the major symptoms for individuals with MS. Several different kinds of fatigue occur in people with MS. Sometimes people with MS are still fatigued after getting a restful night’s worth of sleep. Other times MS symptoms can impact the individual’s ability to sleep through the night. Getting proper and restful sleep is critical to proper cognitive functioning, muscle restoration, mood regulation, and more. Click here for more about MS-related sleep tips.
Mood: It is also known that mood related challenges can impact cognitive functioning. Resources such as those found on the National MS Society page can provide further information. Click here to find out more.
If you live in the New Jersey or New York area and would like to schedule a neuropsychological evaluation for yourself or a family member in order to determine if there have been any potential MS cognitive-related changes please contact Dr. Corey Burchette at 201-577-8286 to inquire about scheduling an appointment at the NJ Memory Center which is located in Verona, New Jersey.