Multiple sclerosis, or MS, is a chronic disease affecting the central nervous system.
Since this system is responsible for communication of all types between the brain and the rest of the body, disruption to the central nervous system can result in a wide variety of symptoms and issues.
Because of this, the symptoms associated with MS can themselves be greatly varied. For some, the issues may be related to the bladder or digestion, and for others, more related to vision, and for still others, motor skills or fatigue may be mainly affected.
For some patients with MS, cognitive difficulties resulting from the disease can be an area requiring much attention and many adjustments.
Researchers are aiming to better understand both the nature of these mental issues relating to MS and how to help patients better manage them.
Cognitive Issues Explained
The term "cognition" can encompass many different functions, including learning abilities, memory, planning, problem solving, language use, the ability to perform calculations, the attention span and other functions related to thinking.
According to the Multiple Sclerosis Resource Centre (MSRC), a United Kingdom based charity, around 50 percent of MS patients report experiencing some sort of cognitive difficulties.
However, the National Multiple Sclerosis Society (NMSS) reports that, despite these large numbers, “Only 5-10% of persons with MS develop problems severe enough to interfere significantly with everyday activities. In very rare instances, cognitive dysfunction may become so severe that the person can no longer be cared for at home.”
Furthermore, according to NMSS, there are certain types of cognitive functions that are not likely to be affected by MS. These functions include conversation abilities, long-term memory, overall or general intellect and reading comprehension skills.
In contrast, there are functions that are more likely to be affected by MS, including:
- Dividing and sharing attention and concentration
- Executive functions, or those involved with the ability to plan, organize and prioritize
- Verbal fluency and the ability to find the right words
- Processing the information gathered through the senses
- Memory functions related to acquiring, keeping and retrieving new information
Tips to Manage Mentally
The MSRC offers a variety of tips and suggestions to help patients struggling with cognitive dysfunction due to MS cope and continue on with their normal lives. In order to avoid aggravating cognitive symptoms further, the MSRC suggests getting plenty of sleep and avoiding stress.
Lists can help patients keep up with all sorts of things – grocery items needed, things that they need to do, tasks around the home to complete, or for whatever particular list of items or activities the patient needs help recalling.
Calendars can help patients closely keep track of appointments, schedules and special days. If the calendar is set up on a computer or smartphone, reminders of events and tasks can often be emailed as another safety net.
It can be beneficial to hold conversations in quiet places so that fewer distractions are present. During conversations, patients can repeat important information and take notes as a way to reinforce specific points.
But it’s not all reminders and lists, as the MRSC reports that daily crossword puzzles or other mind games like jigsaw puzzles can help keep the mind active and trained, and as a bonus perhaps provide a little entertainment and relaxation.
Just as every patient’s cognitive symptoms are different, so too are their solutions for managing them. Patients may need to try various methods and tricks and find what works best for their unique situation.
Studies to examine how to medically treat cognitive MS difficulties have been undertaken and will continue to be explored. As of now, there is no definite medical treatment for these specific symptoms.
According to MSRC, some studies have explored the question of if traditional MS drugs could slow the long-term progression of cognitive problems. However, “results were mixed.”
NMSS does report that some “symptomatic treatments that may temporarily improve cognitive functioning without altering its long-term course have been studied.” More research is needed in these areas.
Some researchers have also posed the question of medications traditionally used to treat Alzheimer’s being used to help these MS patients, but again, MRSC reports that more research needs to be done before conclusions can be made.
Some may use herbal or dietary supplements like ginkgo biloba or fish oils to help with mental functioning. Doctors can help patients decide if these supplements are right for them, as they may interact with some drugs or other treatments.
Despite the uncertainty currently faced in terms of medical treatments for MS patients coping with cognitive dysfunction, NMSS is eager about the days ahead.
“It is hoped that in the future, people with MS will have access to a combination of disease-modifying therapies, symptomatic treatments, and cognitive rehabilitation that will modify the course and impact of the cognitive changes in MS,” says the organization.
For now, patients can employ various strategies and methods to help manage their cognitive symptoms as doctors and researchers strive to learn more.