Cognitive changes in multiple sclerosis.

Cognitive dysfunction (CD) affects 40-65% of multiple sclerosis (MS) patients and can have a great functional impact. It can be detected in all the disease phenotypes from the early stages of the disease and tends to progress over time. Memory, complex attention, information processing speed and executive functions are most commonly involved. The relationship between cognitive changes and MRI findings may involve changes in different areas, including white matter lesions, normal appearing brain tissue on conventional MRI, cortical and deep gray matter. The search for effective therapeutic strategies is a major undertaking. Evidence of a possible effect of anticholinesterasics and cognitive rehabilitation is still preliminary. In this article, we review the current knowledge on CD in MS and highlight areas of special importance for future research in the field.