Charcot's early descriptions of patients with multiple sclerosis noted “enfeeblement of memory” and “concepts formed slowly,” along with the classic triad of nystagmus, intention tremor, and ataxic dysarthria. 1 Charcot JM Lectures on the Diseases of the Nervous System. New Sydenham Society, London1877 Google Scholar Charcot was trained in psychiatry and neurology, but for decades neither discipline took note of his psychological observations. Psychiatrists in the 1920s used interviews to probe mental status in people with multiple sclerosis, but estimates of the frequency of cognitive impairment were unreliable, ranging from two to 72%. 2 Pratt RT An investigation of the psychiatric aspects of disseminated sclerosis. J Neurol Neurosurg Psychiatry. 1951; 14: 326-335 Crossref PubMed Scopus (78) Google Scholar Cognitive impairment in multiple sclerosis: clinical management, MRI, and therapeutic avenuesMultiple sclerosis is a chronic, demyelinating disease of the CNS. Cognitive impairment is a sometimes neglected, yet common, sign and symptom with a profound effect on instrumental activities of daily living. The prevalence of cognitive impairment in multiple sclerosis varies across the lifespan and might be difficult to distinguish from other causes in older age. MRI studies show that widespread changes to brain networks contribute to cognitive dysfunction, and grey matter atrophy is an early sign of potential future cognitive decline. Full-Text PDF