This article aims to explore aspects of the cognitive effects of multiple sclerosis and to dispel myths associated with the disease, to enhance the knowledge of people with MS and those who provide care for them.
Multiple sclerosis (MS) is a demyelinating illness of the brain and the spinal cord. This means the myelin sheath that covers some nerve cells is stripped back, slowing the transmission of signals from the brain to various parts of the body. All parts of the body can be affected at some point in the illness, leading to various difficulties in daily life.
The condition may have an impact on various mental faculties of the individual as well as physical capabilities. Provision of care becomes complex, due to the inability of the injured brain of an individual with MS to process and think insightfully about important decisions.
How, and the extent to which cognitive functions may be impaired by MS varies hugely in different individuals. Some of the potential difficulties are described as follows: this list is not exhaustive and only touches on the most commonly seen effects.
This is the most common impact of MS on the workings of the brain, and it usually starts very early during the disease. Sufferers forget what has happened in the immediate past, leading to frustration that can come out as anger and/or depression. Doctors can treat both quickly with pharmacological interventions. Further complications can arise when memory problems are not seen as a concern and accepted as normal or part of the ageing process depending on the age of the patient.
This is an individual’s ability to weigh up the information presented to them. Sometimes in life we have to make simple decisions, such as when to drink water, or go to the toilet; at other times, complex decisions, like taking a mortgage out. In MS, the ability to do both is reduced, through a process that creeps up on the sufferer. It’s important that this aspect of the disease is properly understood, because it can lead to considerable harm.
- Slow speed of information processing
In many long-term conditions of the brain, the speed at which we can react after receiving information is reduced. This is a significant problem with MS, as family members can get frustrated by the long waits for a reply. If they fully understand the effects of the condition, this improves sufferers’ quality of life as much as possible.
- Word finding and forming difficulties
People who suffer from MS often say they struggle to find the right word. They find this embarrassing in a social context, leading to social isolation. A degree of understanding by loved ones will lead to a reduction in stress and anxiety.
- Attention and concentration
We all need to be able to maintain a certain attention span to lead a healthy lifestyle. If we’re unable to focus, this results in multiple tasks left unfinished and an air of dissatisfaction. Neuropsychologists can train patients to manage this problem with exercises and by minimising distractions from their surroundings. It is important patients’ family members give support.
6. Visuospatial abilities
The impact of MS on an individual’s ability to interpret objects in their field of vision means DVLA has a rule to check MS sufferers’ fitness to drive every 3 years. Visuospatial weakness can also lead to falls, difficulties with reading and writing and finding other everyday tasks a struggle. What looks like clumsiness is very difficult for friends and family to understand; neuropsychologists can assist by supporting patients to function at the highest possible level.
At Circle Rehabilitation, we have the expertise of a multidisciplinary team including clinicians, physiotherapists, occupational therapists, clinical psychologists and dieticians, dedicated to providing comprehensive services for patients with multiple sclerosis. To improve the quality of our services, we share learning and expertise with our partners VAMED, whose European rehabilitation model we are pioneering in the UK.
Learn more about Circle Rehabilitation’s treatments for multiple sclerosis at www.circlerehabilitation.co.uk/multiple-sclerosis/
Dr Faraz Jeddi is Neurological Rehabilitation Consultant at Circle Rehabilitation. He has been a consultant in Neurological Medicine since 2010 after finishing his training on the South Birmingham rotation at the University of Coventry and Warwickshire NHS Trust.
He specialises in the long-term management of neurological conditions. In 2010, he worked as a consultant at Leeds University and was also responsible for amputee rehabilitation. Since 2011, he has been a consultant in neurological rehabilitation at Royal Berkshire Hospital, holding clinics at Bracknell Healthspace and West Berkshire Community Hospital in Thatcham.
His research is mostly around long-term brain injury and complications for long-term management of neurological conditions. He regularly organises conferences with voluntary organisations to improve knowledge around care and wellbeing for neurological patients, clinicians and carers.