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Multiple Sclerosis Living with Multiple Sclerosis

When Multiple Sclerosis Affects the Mind: An Overview

Summary & Participants

For the 2.5 million people worldwide who have multiple sclerosis, the impact of the disease on motor control is the central issue. But the disease can also have a mental dimension, affecting a patient's cognitive functions. Not everyone with MS experiences memory or learning impairment, and for those who do, the effects are usually very subtle. Still, it is an important concern for many patients and our panel of experts will discuss what is known about this aspect of MS.

Medically Reviewed On: July 09, 2008

Webcast Transcript

DAVID FOLK THOMAS: Hello and welcome to our webcast. I'm David Folk Thomas. For the 2.5 million people worldwide who have multiple sclerosis, the main concerns are strictly physical. During a relapse, a patient's ability to control his or her body can be seriously diminished, and treatment for MS is focused around preventing and managing these attacks. But the disease can also have a mental dimension, affecting patients' cognitive functions, like memory or the ability to complete complex tasks. Not everyone with MS will experience cognitive impairment, and for those who do, the effects are usually very subtle and perhaps caused by depression rather than the disease itself. But it is an issue of concern for many patients, and today it will be our concern as I discuss cognitive impairment from MS with a panel of experts.

Those experts are sitting to my left, starting with Dr. Brian Apatoff. He's the director of the MS Clinical Care and Research Center at New York Hospital, Weill Cornell Medical College. Sitting next to Brian is Dr. Ted Phillips. He's the director of the MS Center at Texas Neurology and Baylor University Medical Center in Dallas. On the end is Dr. Steven Galetta. He's the director of the neuroophthalmology service at the University of Pennsylvania School of Medicine in Philadelphia. Doctors -- I always like saying that -- Doctors, thank you for joining me here today.

Dr. Apatoff, what do we mean when we say "cognitive impairment"?

BRIAN APATOFF, MD: Cognitive impairment is really a very general term to describe some subtle -- and sometimes not-so-subtle -- changes in higher cortical functioning, intellectual functioning that most of us take for granted in our day-to-day activities -- things like memory, things like terms that describe executive function, our ability to take care of five different things at one time. These are controlled by the complex integration of different regions of the brain, and if you have multifocal brain injury, as can occur in multiple sclerosis, you can have some impairment of these cognitive functions.

DAVID FOLK THOMAS: Dr. Phillips, explain how somebody with MS might be cognitively impaired. What effect MS has on that.

TED PHILLIPS, MD: As Brian mentioned, sometimes it can be of a very subtle nature and actually require specialized neuropsychological testing to be able to detect it. But a patient with MS reporting those kinds of problems might say something like they're having difficulty concentrating on the work at hand or keeping track of more than one thing. Although one has to be careful to distinguish between cognitive impairment that might be MS-related versus a particularly or overly stressful life or even, as you mentioned earlier, the possibility of co-existing depression.

DAVID FOLK THOMAS: Dr. Galetta, how many MS patients, what percentage suffer cognitive impairment?

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