Cognitive problems are common in people with multiple sclerosis (MS) but inadequately addressed by disease-modifying therapies, while cognitive rehabilitation and exercise training programs can be effective, a review study reported.
Research studies of exercise programs need to include larger groups of patients with demonstrated cognitive difficulties, however, and more pharmacological therapy trials need to place cognitive benefit as a primary goal, its researchers said.
The study, “Treatment and management of cognitive dysfunction in patients with multiple sclerosis,” was published in the journal Nature Reviews Neurology.
Difficulties with attention, working memory, long-term memory, information processing speed, and executive functions — all cognitive skills — are thought to affect around two-thirds of MS patients. Problems with social functioning and the ability to identify visual and spatial relationships (visuospatial) can also be present.
As a result, patients can struggle in the workplace, the community, and at the home in ways that can profoundly affect daily life.
Despite advancements in MS management, treatment options for cognitive impairment remain limited, and “regular objective assessment of cognitive functioning remains rare in clinical practice,” the researchers wrote.
Experts in cognitive research at the University of Alabama at Birmingham and the Kessler Foundation — a nonprofit organization that supports cognitive rehabilitation research in patients with neurological disabilities — analyzed current research to evaluate available treatments as well as promising approaches for treating cognitive deficits in MS.
Research into cognitive rehabilitation is growing in the MS community and has focused on improving attention, communication skills, and memory. Evidence, collected from both adult and pediatric patients, suggests that cognitive rehabilitation can have a long-term impact, and may improve cognition even with changes in the brain.
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