Volume 12 Issue 4 - 2020
Cognitive Impairment as a Biomarker in Multiple Sclerosis
Grigorios Nasios1* and Lambros Messinis2
1Department of Speech and Language Therapy, School of Health Sciences, University of Ioannina, Ioannina, Greece
2Neuropsychology Section, Departments of Neurology and Psychiatry, University of Patras Medical School, Patras, Greece
*Corresponding Author: Grigorios Nasios, Department of Speech and Language Therapy, School of Health Sciences, University of Ioannina, Ioannina, Greece.
Received: February 27, 2020; Published: March 09, 2020

Although Multiple Sclerosis (MS) is a single disease entity, no one person living with MS (pwMS) has the same clinical profile with another. The classical pathoanatomical study of Lucchinetti., et al. [1], classifies the disease into four subtypes based on material from biopsies and autopsies of patient’s brains. Neuroimaging studies on the other hand have identified four different subtypes based on the relationship between brain lesions and atrophy [2].

On a clinical level the diversity of motor, sensory, cognitive and psychological symptoms and signs and the wide range of severity may lead to an accumulation of disabilities, which in general accumulate within the decades of the disease course, but some patients present these disabilities earlier in the course of the disease and with more severe disability and others much later on and with less severe disability. Some patients may even present with a largely debated condition known as “benign” MS. In this disease course patients experience little disease progression and minimal accumulation of disability decades after developing the disease.


  1. Lucchinetti C., et al. “Heterogeneity of multiple sclerosis lesions: Implications for the pathogenesis of demyelination”. Annals of Neurology 47.6 (2000): 707-717. 
  2. Tauhid S., et al. “MRI phenotypes based on cerebral lesions and atrophy in patients with multiple sclerosis”. Journal of the Neurological Sciences 346.1-2 (2014): 250-254. 
  3. Sayao AL., et al. “The psychosocial and cognitive impact of longstanding “benign” multiple sclerosis”. Multiple Sclerosis Journal 17.11 (2011): 1375-1383. 
  4. Menon S., et al. “Characterising aggressive multiple sclerosis”. Journal of Neurology, Neurosurgery, and Psychiatry 84.11 (2013): 1192-1198. 
  5. Harel Y., et al. “Cognitive function in multiple sclerosis: A long-term look on the bright side”. PLoS One 14.8 (2019): e0221784. 
  6. Chitnis T and Prat A. “A roadmap to precision medicine for multiple sclerosis”. Multiple Sclerosis Journal 22 (2020): 1352458519881558. 
  7. Messinis L., et al. “Neuropsychological Features of Multiple Sclerosis: Impact and Rehabilitation: Editorial”. Behavioural Neurology (2018). 
  8. Messinis L., et al. “Neuropsychological Functions and Cognitive Neurorehabilitation in Multiple Sclerosis”. IntechOpen (2019). 
  9. Cortese M., et al. “Preclinical disease activity in multiple sclerosis: A prospective study of cognitive performance prior to first symptom”. Annals of Neurology 80.4 (2016): 616-624. 
  10. Ruggieri RM., et al. “Cognitive impairment in patients suffering from relapsing-remitting multiple sclerosis with EDSS ≤ 3.5”. Acta Neurologica Scandinavica 108 (2003): 323-326. 
  11. Messinis L., et al. “Cognitive deficits in relapsing remitting multiple sclerosis patients with low disability status”. In: Proceedings of the 7th International Congress on the Improvement of the Quality of life on Dementia, Parkinson’s disease, Epilepsy, MS, Muscular Disorders and Neuroethics (2009): 31-35. 
  12. Romero K., et al. “Neurologists׳ accuracy in predicting cognitive impairment in multiple sclerosis”. Multiple Sclerosis and Related Disorders 4.4 (2015): 291-295. 
  13. Bakirtzis C., et al. “The Rationale for Monitoring Cognitive Function in Multiple Sclerosis: Practical Issues for Clinicians”. The Open Neurology Journal 31.12 (2018): 31-40. 
  14. Nasios G., et al. “Cognitive impairment and brain reorganization in MS: underlying mechanisms and the role of neurorehabilitation”. Frontiers in Neurology (2020).
Citation: Grigorios Nasios and Lambros Messinis. “Cognitive Impairment as a Biomarker in Multiple Sclerosis”. EC Neurology 12.4 (2020): 01-03.

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