Cognition & MS

Some of the most common but hidden symptoms of MS are the changes people may experience related to cognition. The majority of people with MS experience intermittent cognitive symptoms. However, a person with almost no physical limitations can have significant cognitive impairment, while a person who is quite disabled physically can be unaffected cognitively.

In people with MS, the body's own immune system attacks the tissue surrounding the nerve fibers in the brain, spinal cord, and optic nerves. This covering is made of a fatty substance called myelin. It insulates the nerves and helps them send electrical signals that control movement, speech, and other functions. When myelin is destroyed, scar tissue forms (sclerosis means scarring) and nerve messages are not transmitted properly. Depending on the extent and location of damage in the central nervous system, patients with MS may experience a wide variety of symptoms. MS is different in every person.

My MS mainly affects my mobility without much influence on my cognition – although I do have trouble with verbal fluency (word-finding); when that certain word is on the tip of your tongue. Other people may find it takes longer to solve problems. Some may have mild memory loss or trouble concentrating. Loss of cognitive function can influence one’s ability to work. While I would love to walk again, I am thankful to still think, focus, and work.  I do get a glimpse of these other symptoms when I get overheated or extremely fatigued. Heat and high humidity may temporarily worsen symptoms. My mind and body go “dumb” when I am hot. Weakness increases, my mind seems to shut down, and I have trouble communicating. It is very frustrating. Thankfully, once I cool off, I return to myself.

Some people can’t imagine life in a wheelchair. Well, it sucks, but I can still get around. I can’t imagine a life where I can’t think, speak, or live the life I know. I love to read and watch movies, and even work. If I couldn’t do those things, I’d feel trapped, whereas a wheelchair gets me moving, I don’t see an easy fix for cognitive impairment. Selfishly, since I am stuck with MS, I am happy my MS went the way it did. I am afraid for what the future might bring to me cognitively– just like those who are afraid of life in a wheelchair. MS is a bitch of a disease.

Cognitive impairment substantially impacts the lives of patients with MS and their families. Understanding these issues and showing compassion can help patients with MS deal with these invisible symptoms.

From the NMSS: Mood and Cognition in MS (What You Can Do)