Cognitive Functions In People With MS

The Nature of Cognitive Functions

I’m here to help you with understanding the complexities of multiple sclerosis (MS), especially when it comes to cognitive functions. Firstly, let me define what cognitive functions are. These are the mental processes that enable us to carry out any task, from the simplest to the most complex. They include aspects like attention, memory, language skills, and problem-solving. Think of cognitive functions as tools in a toolbox that help you navigate everyday life, from planning your day to solving a crossword puzzle.

However, for people with MS, these tools can sometimes become less reliable. MS can impact these cognitive abilities, resulting in difficulties with thinking, learning, and memory. You might wonder how widespread this issue is among individuals with MS. Guess what? It’s estimated that about half of people with MS will experience some form of cognitive impairment in their lifetime.

Range of Cognitive Symptoms in MS

In my experience, the cognitive symptoms that people with MS go through aren’t just about forgetfulness. They can include slower information processing, challenges with focusing or multitasking, and even struggles with finding the right words during conversations. The unpredictability of these symptoms often adds an additional layer of complexity to daily living.

Now, what you’re going to find out about is not only the nature of these cognitive challenges but also the direct relationship between the progression of MS and the potential for cognitive decline. Some people might face mild symptoms that have a limited impact on their lives, while for others, the decline can be more significant and interfere with their ability to work or maintain relationships.

Importance of Assessment Methods

To properly help those facing such challenges, assessment methods are essential. Various cognitive tests, many of which can be done with a neuropsychologist, have been developed to detect cognitive changes in patients with MS. These tests are crucial because early detection means early intervention. Don’t worry too much about the testing though, as it’s just one step towards managing cognitive issues more effectively.

This article isn’t just about highlighting the difficulties. In the following text, we will dive into the scientists’ research about a link between certain brain lesions and cognitive decline, about topics of coping strategies and accommodations that can make a big difference in managing cognitive difficulties. We’re talking about practical advice, support systems, technological aids, and therapy options to ensure that individuals with MS can maintain their quality of life despite cognitive challenges.

The latest scientific discovery

Researchers at Weill Cornell Medicine presented findings at the ACTRIMS Forum 2024 that suggest a link between certain brain lesions and cognitive decline in people with multiple sclerosis (MS).

They focused on a type of brain damage called paramagnetic rim lesions (PRLs). These lesions represent areas of ongoing inflammation and damage in the brain and spinal cord, which are commonly seen in MRI scans of MS patients.

The study, led by Hannah Schwartz and her team, involved 106 MS patients with an average age of 42.6 years and a mean disease duration of 10.9 years. Most of these patients had relapsing-remitting MS.

Using a specialized MRI technique called quantitative susceptibility mapping, the researchers identified PRLs in 38.7% of the patients at the beginning of the study.

Over four years, the researchers evaluated the patients’ cognitive function using a test called the Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS). This test measures various aspects of cognitive function, including processing speed, memory, and spatial abilities.

The results showed that patients with PRLs performed worse on cognitive tests compared to those without these lesions. This difference became more pronounced over the four-year period, particularly in processing speed.

Even after accounting for factors like age, the presence of PRLs remained significantly associated with poorer cognitive function. On average, patients with PRLs scored 4.2 points lower on processing speed tests.

Interestingly, most patients in the study were on effective treatments for MS, and overall cognitive function either improved or remained stable over time. However, those with PRLs continued to show worse cognitive performance.

The study suggests that PRLs may serve as an important marker for identifying MS patients at risk of cognitive decline. Further research is needed to confirm these findings and explore the potential benefits of early intervention to preserve cognitive function in these patients.

Strategies for managing cognitive difficulties

Cognitive difficulties can significantly impact the quality of life for individuals with multiple sclerosis (MS), but there are various coping strategies, accommodations, and support systems available to help manage these challenges. Here are some practical tips and options:

1. Cognitive Rehabilitation Therapy: Cognitive rehabilitation therapy involves exercises and strategies to improve cognitive functions such as memory, attention, and problem-solving. These therapies can be tailored to individual needs and may involve working with a neuropsychologist or occupational therapist.
2. Use Memory Aids: Memory aids such as calendars, planners, to-do lists, and reminder apps can help individuals with MS keep track of appointments, tasks, and important information.
3. Break Tasks into Smaller Steps: Breaking tasks into smaller, manageable steps can make them less overwhelming and easier to complete, reducing cognitive fatigue.
4. Maintain a Structured Routine: Establishing a structured routine can help individuals with MS manage cognitive difficulties by providing predictability and reducing cognitive overload.
5. Stay Organized: Keeping belongings organized and maintaining a clutter-free environment can reduce distractions and make it easier to focus on tasks.
6. Utilize Assistive Technology: There are many technological aids available to assist individuals with MS in managing cognitive difficulties, such as voice-activated devices, smartphone apps for medication reminders, and speech-to-text software for writing tasks.
7. Stay Physically Active: Regular physical activity has been shown to improve cognitive function in individuals with MS. Exercise can help improve mood, reduce fatigue, and enhance cognitive abilities.
8. Seek Support from Family and Friends: Having a strong support system of family and friends who understand the challenges associated with MS can provide emotional support and practical assistance when needed.
9. Join Support Groups: Joining support groups or online communities for individuals with MS can provide a sense of camaraderie, validation, and valuable tips for coping with cognitive difficulties.
10. Practice Stress Management Techniques: Stress can exacerbate cognitive difficulties in individuals with MS. Learning and practising stress management techniques such as deep breathing exercises, mindfulness, and relaxation techniques can help reduce stress levels and improve cognitive function.
11. Consult with Healthcare Professionals: It’s essential for individuals with MS to work closely with their healthcare team, including neurologists, neuropsychologists, occupational therapists, and other specialists, to develop personalized coping strategies and treatment plans tailored to their specific needs.
12. Nourishing. And finally, remember that “health comes from the mouth” and that certain foods and nutritional supplements can affect the renewal of brain cells, reducing or preventing inflammation of lesions on the brain and spinal cord. Many studies indicate the importance of walnuts, certain types of mushrooms, and other foods. Don’t ignore this, as it could potentially improve your cognitive state. Many cultures rely on this form of therapy.

By implementing these coping strategies, utilizing support systems, and exploring available accommodations and therapy options, individuals with MS can better manage cognitive difficulties and maintain their quality of life despite the challenges they may face.

Elena