Abstract
Multiple sclerosis (MS) is a lifelong progressive neurologic disease typically diagnosed between ages 20 and 40 years: a time when persons are striving to accomplish normative goals of young adulthood (e.g., establishing a career).More than half ofMS patients suffer cognitive decline [for review, see Ref. (1)] especiallymemory problems and cognitive inefficiency (e.g., slowed processing speed, difficulty multi-tasking).
Highlights
There is great variability in cognitive status across Multiple sclerosis (MS) patients, even among patients with similar patterns of disease burden/progression [2, 3]
Some MS patients are better able to cope with disease burden without cognitive deficits. [Note: there is an important and advancing literature on the relationship between cognition and MRI parameters in persons with MS [e.g., Ref. [4,5,6]], a thorough review of this literature is beyond the scope of this opinion piece
At-risk patients could be targeted for early interventions to help prevent future cognitive decline, and earlier treatment takes advantage of the brain’s capacity for plastic reorganization, which is ostensibly greater at younger ages
Summary
Multiple sclerosis (MS) is a lifelong progressive neurologic disease typically diagnosed between ages 20 and 40 years: a time when persons are striving to accomplish normative goals of young adulthood (e.g., establishing a career). There is great variability in cognitive status across MS patients, even among patients with similar patterns of disease burden/progression [2, 3] This is evidenced in part by the relatively modest/incomplete correlation between MS disease burden (e.g., T2 lesion volume, cerebral atrophy) and cognitive functions, whether studied cross-sectionally [e.g., Ref. Some persons accumulate substantial AD neuropathology (e.g., beta-amyloid) without dementia, whereas other persons suffer dementia at comparable or even lower levels of pathology [8, 9]. These observations have motivated the question: how are some people better able to withstand neurologic disease burden without cognitive impairment?
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