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Problems with cognition are common among people with multiple sclerosis (MS) – one study of 100 people with MS found that 43 percent experience cognitive challenges.2 Read more about cognition in How Multiple Sclerosis Impacts Cognitive Function and the Signs You Should Look for.
Cognitive impairments can be a frustrating aspect of life with MS. Changes to your cognition can affect personal relationships, work, and the ability to perform daily tasks. There are proactive steps as recommended by the National MS Society you can take to manage MS-related cognition changes and the impact they have on your daily life. Cognition testing can be an early step to support your cognitive function.1
Cognition testing is an assessment used to understand a person’s cognitive capabilities. Cognition tests for MS fall under the umbrella of neuropsychological testing and are designed to detect brain dysfunction, improve understanding of the changes happening in the brain, and assist in recommendations for treatment planning. Neuropsychological tests can be used for a diverse range of neurological conditions.3 A neuropsychological test is not the same as a mental health evaluation, although some tests may include a section aimed at assessing mood disorders such as depression.4
Several types of tests have been developed to evaluate cognition in people with MS. You may receive short screening tests in the doctor’s office, or a more formal neuropsychological assessment or evaluation, conducted under the supervision of a neuropsychologist. You might also hear your doctor refer to cognition testing as testing batteries or batteries of tests – these are groupings of several tests that assess different areas of cognitive function in people with MS.
Cognition testing can help you and your doctor understand the challenges you’re experiencing and identify opportunities to support you.1
Here are some of the benefits of cognition testing for individuals with MS:
Having more information about your cognition helps you and your doctor choose interventions, exercises, and other strategies that can support cognitive function.1 Download the Doctor Discussion Guide to start a conversation about cognition with your healthcare provider.
As you consider cognition testing, it’s helpful to know what to expect. You cannot study for a cognition test. However, you can prepare by getting a good night’s sleep and avoiding alcohol 24 hours before the test.4
The time it takes to complete a cognition test can vary. Some tests can be completed in a few minutes, while others can take several hours.1,5 Comprehensive neuropsychological tests often include physical assessments. Longer testing times and physical activities can cause some people to feel tired afterward.5 Ask your provider how long testing will last.
You may be given an iPad / tablet or paper form to take a test on your own, sometimes during a regular medical appointment or even while waiting to be seen. In other cases, your healthcare provider may ask you questions verbally.1,6 Some testing batteries combine cognitive and physical assessments.5
There are several types of cognition testing. Your doctor will help determine which tests are best for you. Below are examples of commonly used cognition tests.
Symbol Digit Modalities Test (SDMT)
Processing Speed Test (PST)
Computerized Speed Cognitive Test (CSCT)1
Multiple Sclerosis Functional Composite (MSFC)
Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS)1
Minimal Assessment of Cognitive Function in MS (MACFIMS)
Your doctor may recommend additional evaluations and follow-ups with other healthcare providers based on the results. Other neuropsychological tests can last up to 6 hours with multiple batteries of tests.5
Cognition testing is the first step. Based on the results, your doctor may recommend interventions such as physical exercise, brain exercises, diet, and disease-modifying therapies. Read more about interventions in Multiple Sclerosis and Cognition: Steps You Can Take Today that May Help With Brain Health.
Worried about talking to your loved ones about cognition? Check out tips for starting a conversation in Explaining Cognitive Symptoms at Home, at Work, and at School.
Kalb, R., Beier, M., Benedict, R. H., Charvet, L., Costello, K., Feinstein, A., ... Deluca, J. (2018). Recommendations for cognitive screening and management in multiple sclerosis care. Multiple Sclerosis Journal, 24(13), 1665-1680. doi:10.1177/1352458518803785
Rao, S. M., Leo, G. J., Bernardin, L., & Unverzagt, F. (1991). Cognitive dysfunction in multiple sclerosis. I. Frequency, patterns, and prediction. Neurology, 41(5), 685–691. doi: 10.1212/WNL.41.5.685
Casaletto, K. B., & Heaton, R. K. (2017). Neuropsychological Assessment: Past and Future. Journal of the International Neuropsychological Society, 23(9-10), 778-790. doi:10.1017/s1355617717001060
Neuropsychological Evaluation FAQ. (n.d.). Retrieved June 21, 2019, from https://www.med.unc.edu/neurology/divisions/movement-disorders/npsycheval/
Rao, S. M. (2004). Cognitive Function in Patients with Multiple Sclerosis: Impairment and Treatment. International Journal of MS Care, 6(1), 9-22. doi:10.7224/1537-2073-6.1.9
Rudick, R. A., Miller, D., Bethoux, F., Rao, S. M., Lee, J., Stough, D., ... Alberts, J. (2014). The Multiple Sclerosis Performance Test (MSPT): An iPad-Based Disability Assessment Tool. Journal of Visualized Experiments, (88). doi:10.3791/51318
Benedict, R. H., Deluca, J., Phillips, G., Larocca, N., Hudson, L. D., & Rudick, R. (2017). Validity of the Symbol Digit Modalities Test as a cognition performance outcome measure for multiple sclerosis. Multiple Sclerosis Journal, 23(5), 721-733. doi:10.1177/1352458517690821
Konstantinopoulou, E., Ioannidis, P., Bakirtzis, C., Giantzi, V., Afrantou, T., Parissis, D., ... Grigoriadis, N. (2018). Estimating Everyday Neuropsychological Functioning in Multiple Sclerosis: Reliability and Validity of the Greek Multiple Sclerosis Neuropsychological Questionnaire. Multiple Sclerosis International, 2018, 1-6. doi:10.1155/2018/6301535
Cohen, J. A. (2001). Use of the Multiple Sclerosis Functional Composite as an Outcome Measure in a Phase 3 Clinical Trial. Archives of Neurology, 58(6), 961. doi:10.1001/archneur.58.6.961
Giedraitiene, N., Kaubrys, G., & Kizlaitiene, R. (2018). Cognition During and After Multiple Sclerosis Relapse as Assessed With the Brief International Cognitive Assessment for Multiple Sclerosis. Scientific Reports, 8(1). doi:10.1038/s41598-018-26449-7
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