DR. ROBERT K. SHIN: MS patients often complain of cognitive issues. They might describe this as feeling foggy or having difficulty with concentration or memory. Sometimes, it is due to multiple sclerosis affecting the brain. More commonly, it may be a symptom of something else going on, such as-- it could be related to fatigue. Or it could be related to anxiety and depression. Trying to figure out which factor is causing the foggy thinking is very important, because it might be treatable with counseling or medication. There are often strategies we can use to try to help them. That might involve things like keeping a list, or having a routine so that you do the same things in the same order of day to day. Making sure that we focus on one thing at a time-- our performance is better if we simply do one thing at a time to completion. Some patients report that they like doing mental exercises. That could take the form of crossword puzzles or Sudoku to try to keep their mind active and engaged. I would actually emphasize social engagement. That's very important. Getting out there and interacting with family and friends or even strangers is actually very important. The more active you are, the better I think you'll do in the long run. Lifestyle factors are actually very important. I always encourage my MS patients to try to maintain a positive attitude. It's really about quality of life.