Cognitive Dysfunction in Early-Onset Multiple Sclerosis

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Abstract
IT IS NOW recognized that cognitive impairment in multiple sclerosis (MS), occurs in an estimated 30% to 70% of cases.1 Studies of correlations between cognitive deficits and clinical variables have provided conflicting evidence.2-12 It is probable that cognitive function is more vulnerable in chronic progressive disease than in the relapsing-remitting form,5,8-10 although this has not been a constant finding.7 In most surveys, the degree of neurological disability has been found either not to correlate with mental changes6 or to have only a minor influence.7 With few exceptions,11,12 the duration of disease has not emerged as a contributory factor.2,7 However, most studies on cognitive impairment in MS are cross-sectional in nature. So far, only a few authors have undertaken longitudinal investigations of the evolution of these disturbances and their relation to the clinical course of the illness. Moreover, the follow-up intervals in these studies have tended to be relatively short, not exceeding 3 to 4 years.10,13-18 Furthermore, the effect of cognitive dysfunction on the social and working life of patients is still underestimated since MS is widely viewed as producing neurological defects primarily in the motor sphere.