Cognitive Dysfunction and Assessment in Multiple Sclerosis

Cognitive impairment is a common and disabling feature of multiple sclerosis (MS), affecting up to 65% of patients. It primarily manifests as deficits in processing speed, memory, executive function, and verbal fluency, significantly influencing daily activities and work performance. Despite its clinical relevance, cognitive assessment in MS remains underutilized. Several neuropsychological tools, including the multiple sclerosis neuropsychological questionnaire, the symbol digit modalities test, and the brief international cognitive assessment for MS, facilitate early detection of cognitive impairment. Moreover, depression, anxiety, and fatigue often worsen cognitive decline. Recent research has identified distinct cognitive phenotypes in MS, aiding in personalized management strategies. Integrating cognitive assessments with neuroimaging biomarkers and cognitive rehabilitation is essential for improving patient outcomes. Future studies should focus on refining diagnostic tools and exploring targeted interventions to better support MS patients.