Cognitive decline in MS may not be progressive or inevitable

Progressive cognitive decline for people with multiple sclerosis (MS) may not be as inevitable as once thought, a new 10-year study has found.

The study even found that for some patients, a ‘bouncing back’ effect took place and they improved in certain areas of cognition.

Researchers in Greece reviewed data from 59 patients. Of these, 14 had clinically isolated syndrome and 45 had relapsing remitting MS. At the start of the study, the Brief Repeatable Battery of Neuropsychological Tests was used to assess cognitive impairment, and again 10 years later.

The scientists found there was around a 10% increase in cognitive impairment. But when looking at the data on a case-by-case basis, researchers said some people had failed at different areas of cognition to which their original decline was noted in. Overall, people with normal memory-related scores 10 years ago were more likely to be impaired in these areas after the 10-year follow-up.

Those with normal information processing speed scores rarely showed a decline a decade later.

Some with baseline impairments in working memory and/or verbal fluency also experienced significant improvements in cognitive abilities 10 years on, often to the point of no longer being considered impaired.

The researchers said that this means cognitive impairment at baseline assessment does not necessarily lead to a progressive decline, and while the overall amount of individuals with cognitive impairment does increase, some people had improved in specific areas, and not declined in others. They said the improvements, or ‘bouncing-back’ effect seen in some areas of cognition may reflect the damage compensation capabilities of the brain in people with MS.