Multiple Sclerosis: MS-Related Thinking Problems

About half of people with MS will experience some form of cognitive dysfunction, or impaired thinking. For most, this means slowed thinking, decreased concentration, or decreased memory. In only about 5 to 10% of MS patients is this so severe that it significantly impairs their ability to carry out daily living tasks.

Most of the time, difficulties with cognition occur later in the course of the disease; however, there are times where it occurs much earlier, and occasionally it's present with the onset of MS.

How Do I Know if My Thinking Is Impaired?

The first signs of impaired thinking are often subtle and usually recognized only in retrospect and often by another family member or loved one. They include:

• Difficulty finding the right words to say.
• Trouble remembering tasks.

How Is Impaired Thinking Diagnosed?

If you are having cognitive difficulties, it's important that you discuss this with your doctor. First your doctor will make sure that there isn't something other than the MS that is causing the problem, such as normal aging, a medication or depression.

If screening yields few clues, your doctor may recommend that you consult with a specialist who can test you to determine the nature of your cognitive difficulties.

How Is Impaired Thinking Treated?

Based on your test results, an occupational therapist, speech pathologist, or neuropsychiatrist may recommend a variety of exercises and techniques to help you better cope with your thinking problem.

Rarely, thinking problems become so severe that the person needs constant care or can't live at home. If this becomes an issue for you or a loved one, discuss your options with your doctor.

Recent Research

During the last few years, there have been numerous studies looking at ways to stabilize or improve cognitive dysfunction. Some of these studies looked at whether the MS disease-modifying drugs could slow the progression of changes in cognition. Results were mixed, with interferon beta-1a showing the most potential.

Studies have also looked at other treatments that may temporarily improve cognitive functioning. Medications used for Alzheimer's patients, including Aricept, may have a role here, but further research is needed.

Reviewed by the doctors at the Mellen Center for Multiple Sclerosis Research at The Cleveland Clinic (2005).