Slowed cognitive processing speed and episodic memory decline are the most common cognitive deficits in MS, with additional difficulties in executive function, verbal fluency, and visuospatial analysis.
A change in cognitive function — that is, cognitive dysfunction — is common in MS. More than half of all people with MS develop problems with cognition.
Mood changes
Worry, fear, moodiness, irritability and anxiety: normal reactions in the face of unpredictability; anyone can become irritable and anxious when faced with difficult challenges. Depression: one of the most common symptoms of MS.
Cognitive dysfunction is a common feature of multiple sclerosis (MS), affecting approximately 40% to 60% at some time in their disease course. Cognitive impairment often manifests as deficits in recent memory, attention, information-processing speed, executive functions, and visuospatial perception.
The most commonly observed symptoms among individuals with MS and MDD are persistent low mood, anhedonia, diurnal mood variation, pessimistic thoughts, suicidal ideation, and impaired functioning that is out of proportion to the associated physical disability from the MS.
Depression is one of the most prevalent psychiatric conditions in these patients. Today, lifetime prevalence of major depression in MS patients is estimated to be around approximately 25–50%, a number two to five times greater than in general population [9].
One prevalence study found that in one clinic, 22 percent of people with MS qualified as having possible dementia. Their cognitive impairments consisted mostly of memory problems and slowed thinking. When Alzheimer's disease causes dementia in a person with MS, the impairment is usually severe.
The main sign of mild cognitive impairment is a slight decline in mental abilities. Examples include: Memory loss: You may forget recent events or repeat the same questions and stories. You may occasionally forget the names of friends and family members or forget appointments or planned events.
Slowed cognitive processing speed and episodic memory decline are the most common cognitive deficits in MS, with additional difficulties in executive function, verbal fluency, and visuospatial analysis.
Study participants with MS were compared to a control group. The researchers found that people with MS were more likely to be angry (trait anger), have a higher intensity of anger (state anger), and express anger either outwardly or inwardly, as compared to the control group.
' Focal neuronal demyelination in MS patients may interfere with communication between frontal lobe brain regions responsible for emotion and manifests as emotional lability and exaggerated emotions, common symptoms in a manic or depressive episode.
Thinking and memory problems, also known as cognitive problems, are common in MS. Issues include memory, attention span, planning, decision making, understanding or concentration. Problems with thinking and memory affect around half of all people with MS.
People may experience such things as forgetfulness, trouble concentrating, and confusion. Brain fog is also referred to as “brain haze” or “cog fog” — short for cognitive fog. As we know, MS is a disease of the central nervous system that affects the brain and spinal cord.
The researchers found that over the past 25 years, life expectancy for people with MS has increased. However, they also found that the median age of survival of people with MS was 76 years, versus 83 years for the matched population.
The Mini-Cog test.
A third test, known as the Mini-Cog, takes 2 to 4 minutes to administer and involves asking patients to recall three words after drawing a picture of a clock. If a patient shows no difficulties recalling the words, it is inferred that he or she does not have dementia.
Introduction: The five-word test (5WT) is a serial verbal memory test with semantic cuing. It is proposed to rapidly evaluate memory of aging people and has previously shown its sensitivity and its specificity in identifying patients with AD.
1. Memory loss that disrupts daily life: forgetting events, repeating yourself or relying on more aids to help you remember (like sticky notes or reminders). 2. Challenges in planning or solving problems: having trouble paying bills or cooking recipes you have used for years.
It is linked to MS-related damage in the brain. People experiencing disinhibition lose control over their impulses, leading to inappropriate behaviour and a loss of their sense of social rules. They may have little or no awareness of others' feelings regarding their actions.
In a recent large cohort study using 2007–2017 private claims data in the USA, MS increased the risk of AD and related dementias (aHR = 4.49 for patients 45–64 years of age and 1.26 for patients >65 years of age) (Mahmoudi et al., 2022), however, the risk of AD was not separately presented.
In MS, personality seems especially important, for in addition to frequent personality changes and disorders, patients have more dysfunctional personality profiles, characterized by low levels of Conscientiousness, Extraversion, and Agreeableness, and a high level of Neuroticism (Maggio et al., 2020).
Regarding the five-factor model (FFM) that deals with five core dimensions—neuroticism, extraversion, openness, conscientiousness, and agreeableness [10]—MS patients usually show high neuroticism, loss of empathy, and low agreeableness, which are distinctive features of narcissism and histrionism.