Trouble retrieving the right words with MS likely tied to cognition
The common speech symptom affects 25% of patients, study shows
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Word-finding difficulties affect about 25% of people with MS, causing a frustrating struggle to retrieve specific words during speech. (Photo from iStock)
- Word-finding difficulties affect 25% of people with MS.
- This symptom is strongly linked to cognitive impairment, not fatigue or depression.
- Clinicians should assess and manage word-finding difficulties as a distinct communication disorder.
About one-quarter of people with multiple sclerosis (MS) experience difficulties finding the right words when speaking, a symptom that is linked to broader cognitive problems rather than fatigue or depression, according to a new study.
The findings showed that MS patients with cognitive impairment were nearly five times more likely to experience word-finding difficulties than those without cognitive impairment. The symptom, however, was not associated with fatigue or depression.
“Findings of this study have implications for activities of daily living (ADLs) and suggest a multidisciplinary approach in the management of communication disorders in [people with MS],” researchers wrote.
The study, “Word finding difficulties in multiple sclerosis and its relation to cognitive impairment, fatigue and depression,” was published in Multiple Sclerosis and Related Disorders.
Understanding communication in MS
MS occurs when the immune system causes damage to the brain and spinal cord, disrupting nerve signaling and leading to symptoms such as mobility problems, fatigue, and cognitive changes.
Communication and language problems are now increasingly recognized as part of the disease. Among them, word-finding difficulties — trouble retrieving a word a person wants to say — are thought to account for most communication impairments in people with MS, yet they remain poorly understood.
In particular, it remains unclear whether these issues are due to damage in regions involved in cognition or arise as a consequence of other MS symptoms, such as fatigue and depression.
To better understand how common word-finding difficulties are and whether they are linked to other MS symptoms, an international team of researchers analyzed data from 586 people with MS receiving routine care at a single MS center in the U.S.
Participants were mostly women (76.6%) and had a mean age of 47.1 years. Based on a computerized cognitive assessment battery assessing seven cognitive domains — memory, executive function, visual-spatial processing, verbal function, attention, information processing, and motor skills — about one-third of patients were classified as having cognitive impairment.
People without cognitive impairment had slightly more years of education (14.9 vs. 14.4 years on average) and lower disability scores.
Overall, 25% of participants experienced word-finding difficulties on a naming task, with this symptom much more common among those with cognitive impairment than among those without (43% vs. 14%). In fact, statistical analyses showed that people with cognitive impairment were 4.7 times more likely to experience word-finding difficulties relative to those without cognitive problems.
Still, word-finding difficulties were also observed in patients without cognitive impairment. Across the entire study group, 16% of patients had both cognitive impairment and word-finding difficulties, while 9% experienced word-finding difficulties despite having no evidence of cognitive impairment. More than half of the participants had neither.
“This suggests that [word-finding difficulties] in [people with MS] are most associated with the co-existence of cognitive impairment,” the researchers wrote. “This study, however, also illustrates that [word-finding difficulties] can occur in isolation in the absence of other invisible symptoms.”
Additional analyses showed that word-finding difficulties were only weakly associated with disability and were not linked to disease duration, fatigue, or depression. Depression, however, was significantly associated with cognitive impairment.
“This suggests that when [people with MS] report that they are ‘searching for words,’ clinicians should not automatically attribute this to fatigue or mood,” the researchers wrote. “It should be recognised as a potential communication disorder, requiring its own assessment and, where appropriate, targeted management.”
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