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CC BY 4.0 · Arq Neuropsiquiatr 2023; 81(06): 585-596
DOI: 10.1055/s-0043-1763485
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Cognitive impairment in multiple sclerosis: “classic” knowledge and recent acquisitions

Deficiência cognitiva na esclerose múltipla: conhecimentos “clássicos” e aquisições recentes
Chiara Piacentini 
1   Institute of Hospitalization and Care of a Scientific Character “Santa Lucia” Foundation, Behavioral Neuropsychology, Rome, Italy.
,
Ornella Argento 
1   Institute of Hospitalization and Care of a Scientific Character “Santa Lucia” Foundation, Behavioral Neuropsychology, Rome, Italy.
,
Ugo Nocentini 
1   Institute of Hospitalization and Care of a Scientific Character “Santa Lucia” Foundation, Behavioral Neuropsychology, Rome, Italy.
2   University of Rome “Tor Vergata”, Department of Clinical Sciences and Translational Medicine, Rome, Italy.
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Abstract

Multiple sclerosis (MS) is a central nervous system (CNS) disease characterized by inflammation, axonal demyelination, and neurodegeneration, which can have a strong impact on all aspects of the life of the patient. Multiple sclerosis causes motor, sensory, cerebellar, and autonomic dysfunctions, as well as cognitive and psychoemotional impairment. The most frequently compromised cognitive domains are complex attention/information processing, memory, executive and visuospatial functions. Recently, alterations have also been evidenced in complex cognitive functions, such as social cognition, moral judgment, and decision-making. Cognitive impairment is characterized by high variability and can affect work skills, social interactions, coping strategies and more generally the quality of life of patients and their families. With the use of sensitive and easy-to-administer test batteries, an increasingly accurate and early diagnosis is feasible: this allows to determine the effectiveness of possible preventive measures, to predict the future progression of the disease and to improve the quality of life of patients. There is currently limited evidence regarding the efficacy, on cognitive impairment, of disease-modifying therapies. The most promising approach, which has received strong empirical support, is cognitive rehabilitation.

Resumo

A esclerose múltipla (EM) é uma doença do sistema nervoso central (SNC) caracterizada por inflamação, desmielinização axonal e neurodegeneração, que pode ter um forte impacto em todos os aspectos da vida dos pacientes. A EM causa disfunções motoras, sensoriais, cerebelares, autonômicas, comprometimento cognitivo e déficits psicoemocionais. Os domínios cognitivos mais frequentemente comprometidos são a atenção complexa/processamento da informação, memória, funções executivas e habilidades visuais-espaciais. Recentemente, também foram evidenciadas alterações em funções cognitivas complexas, como cognição social, julgamento moral e tomada de decisão. O comprometimento cognitivo é caracterizado por alta variabilidade e pode afetar as habilidades laborais, as interações sociais, as estratégias de enfrentamento e, de forma mais geral, a qualidade de vida dos pacientes e de seus familiares. Com o uso de baterias de testes sensíveis e fáceis de administrar, é viável um diagnóstico cada vez mais preciso e precoce: isso permite determinar a eficácia de possíveis medidas preventivas, prever a progressão futura da doença e melhorar a qualidade de vida dos pacientes. Atualmente, há evidências limitadas sobre a eficácia, no comprometimento cognitivo, de terapias modificadoras da doença. A abordagem mais promissora, que tem recebido forte apoio empírico, é a reabilitação cognitiva.

Keywords

Multiple Sclerosis - Cognitive Dysfunction - Social Cognition - Decision Making - Neuropsychological Tests - Morale

Palavras-chave

Esclerose Múltipla - Disfunção Cognitiva - Cognição Social - Tomada de Decisões - Testes Neuropsicológicos - Moral

Authors' Contributions

CP, OA: selection and examination of articles – writing – original draft preparation; UN: review & editing. All authors have approved the submitted version of the present manuscript and agree to be personally accountable for the author's own contributions.


Support

The present review was partially funded by the “Baroni” Foundation with a direct scholarship to Chiara Piacentini (Scholarship grant FB.2.1).




Publication History

Received: 11 August 2022

Accepted: 11 October 2022

Article published online:
28 June 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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