Cognitive Dysfunction
Between 34 and 65 percent of people with MS experience some sort of cognitive problems during their illness. People with a recent onset of MS symptoms may report problems with cognitive ability although it might be so subtle that they don't notice it or attribute it to other things, such as aging or being tired. While cognitive dysfunction feels different for everyone and can fluctuate in severity, many people with MS can identify with part or all of the following descriptions of MS-related cognitive symptoms:
Cognitive dysfunction in MS is more likely to occur in people with more permanent destruction of brain tissue, as demonstrated on MRI scans by the presence of “black holes” and brain atrophy. Therefore, cognitive dysfunction tends to be worse in people with progressive forms of MS than in people with relapsing-remitting MS. In general, people with progressive MS seem to be more severely affected by cognition problems. In all people with MS, cognitive problems may worsen temporarily as a result of the following problems:
(source: http://ms.about.com/od/signssymptoms/a/cognitive_over.htm)
- Attention Difficulties: This can manifest as “distractability” or simply inability to keep your mind on a task. You may find that you are unable to multitask or that even minor ambient noise, like the television or music, can make it virtually impossible to concentrate on things like reading or performing sequential tasks, like those involved in cooking.
- Short-Term Memory Deficits: The most common form of cognitive dysfunction in MS, this usually manifests in things like forgetting whose number you just dialed, going to the pantry and not knowing what you went there for (even though you just looked at your recipe), or being unable to remember if you took your pills or not. You may also find yourself repeating a sentence or part of a story to someone that you just told it to, not aware that you had already said it.
- Slower Speed of Information Processing: This includes all the aforementioned symptoms, and it means that the brain simply cannot take in and prioritize all of the information coming at a person at once. This includes problems processing language (spoken or written), sensory information (visual, sounds, smells, touch), spatial information (like that involved in navigating while driving), or more abstract things like social cues and reading people’s emotions.
- Problems with Abstract Conceptualization: Put simply, this is difficulty with figuring things out in the “abstract” in a way that is going to lead to a desired outcome. It means that people get easily overwhelmed if something is too complex, as it is hard to organize thoughts and tasks, to apply lessons learned from multiple past experiences, and to be “flexible” enough in their thinking to come up with alternate solutions if a problem arises. This can negatively impact judgment.
Cognitive dysfunction in MS is more likely to occur in people with more permanent destruction of brain tissue, as demonstrated on MRI scans by the presence of “black holes” and brain atrophy. Therefore, cognitive dysfunction tends to be worse in people with progressive forms of MS than in people with relapsing-remitting MS. In general, people with progressive MS seem to be more severely affected by cognition problems. In all people with MS, cognitive problems may worsen temporarily as a result of the following problems:
- Depression: Depression is an extremely common symptom of MS and worsens cognitive function, especially in the areas of memory, attention and ability to concentrate. People who are depressed also often exhibit problems making good decisions, communicating, maintaining relationships with others, performingl complex activities that require quick decisions and coping with complicated problems in everyday life.
- Fatigue: Fatigue is the most common symptom of MS, experienced by an estimated 85 to 95 percent of people with MS, and often considered the most debilitating. The crushing fatigue felt by people with MS can have a huge impact on how well they perform cognitively.
- Heat Intolerance: MS-related heat intolerance can make all symptoms of MS worse, including cognitive dysfunction.
- Infections, particularly in more advanced MS patients, may severely worsen cognition
- Many drugs prescribed to treat symptoms of MS or other conditions may worsen cognition.
- More T1-Weighted Lesions: T1-weighted lesions in MS are areas that appear dark on MRI scans . These are also called “black holes” and indicate that there has been destruction of nerve fibers called axons not just demyelination.
- Atrophy of Corpus Callosum: This means that the bundle of nerve fibers that connect the right and left hemispheres of the brain has shrunk, due to destruction of nerve cells.
(source: http://ms.about.com/od/signssymptoms/a/cognitive_over.htm)
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