Recommendations for cognitive screening and management in multiple sclerosis care

Rosalind Kalb, Meghan Beier, Ralph H.B. Benedict, Leigh Charvet, Kathleen Costello, Anthony Feinstein, Jeffrey Gingold, Yael Goverover, June Halper, Colleen Harris, Lori Kostich, Lauren Krupp, Ellen Lathi, Nicholas LaRocca, Ben Thrower, John DeLuca

Research output: Contribution to journalArticle

Abstract

Purpose: To promote understanding of cognitive impairment in multiple sclerosis (MS), recommend optimal screening, monitoring, and treatment strategies, and address barriers to optimal management. Methods: The National MS Society (“Society”) convened experts in cognitive dysfunction (clinicians, researchers, and lay people with MS) to review the published literature, reach consensus on optimal strategies for screening, monitoring, and treating cognitive changes, and propose strategies to address barriers to optimal care. Recommendations: Based on current evidence, the Society makes the following recommendations, endorsed by the Consortium of Multiple Sclerosis Centers and the International Multiple Sclerosis Cognition Society: Increased professional and patient awareness/education about the prevalence, impact, and appropriate management of cognitive symptoms. For adults and children (8+ years of age) with clinical or magnetic resonance imaging (MRI) evidence of neurologic damage consistent with MS: As a minimum, early baseline screening with the Symbol Digit Modalities Test (SDMT) or similarly validated test, when the patient is clinically stable; Annual re-assessment with the same instrument, or more often as needed to (1) detect acute disease activity; (2) assess for treatment effects (e.g. starting/changing a disease-modifying therapy) or for relapse recovery; (3) evaluate progression of cognitive impairment; and/or (4) screen for new-onset cognitive problems. For adults (18+ years): more comprehensive assessment for anyone who tests positive on initial cognitive screening or demonstrates significant cognitive decline, especially if there are concerns about comorbidities or the individual is applying for disability due to cognitive impairment. For children (<18 years): neuropsychological evaluation for any unexplained change in school functioning (academic or behavioral). Remedial interventions/accommodations for adults and children to improve functioning at home, work, or school.

Original languageEnglish (US)
Pages (from-to)1665-1680
Number of pages16
JournalMultiple Sclerosis Journal
Volume24
Issue number13
DOIs
StatePublished - Nov 1 2018

Fingerprint

Multiple Sclerosis
Neurobehavioral Manifestations
Acute Disease
Patient Education
Cognition
Nervous System
Comorbidity
Consensus
Therapeutics
Research Personnel
Magnetic Resonance Imaging
Cognitive Dysfunction
Recurrence

Keywords

  • cognition
  • cognitive dysfunction
  • Multiple sclerosis
  • rehabilitation
  • remediation
  • screening
  • treatment

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

Cite this

Kalb, R., Beier, M., Benedict, R. H. B., 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. https://doi.org/10.1177/1352458518803785

Recommendations for cognitive screening and management in multiple sclerosis care. / Kalb, Rosalind; Beier, Meghan; Benedict, Ralph H.B.; Charvet, Leigh; Costello, Kathleen; Feinstein, Anthony; Gingold, Jeffrey; Goverover, Yael; Halper, June; Harris, Colleen; Kostich, Lori; Krupp, Lauren; Lathi, Ellen; LaRocca, Nicholas; Thrower, Ben; DeLuca, John.

In: Multiple Sclerosis Journal, Vol. 24, No. 13, 01.11.2018, p. 1665-1680.

Research output: Contribution to journalArticle

Kalb, R, Beier, M, Benedict, RHB, Charvet, L, Costello, K, Feinstein, A, Gingold, J, Goverover, Y, Halper, J, Harris, C, Kostich, L, Krupp, L, Lathi, E, LaRocca, N, Thrower, B & DeLuca, J 2018, 'Recommendations for cognitive screening and management in multiple sclerosis care', Multiple Sclerosis Journal, vol. 24, no. 13, pp. 1665-1680. https://doi.org/10.1177/1352458518803785
Kalb R, Beier M, Benedict RHB, Charvet L, Costello K, Feinstein A et al. Recommendations for cognitive screening and management in multiple sclerosis care. Multiple Sclerosis Journal. 2018 Nov 1;24(13):1665-1680. https://doi.org/10.1177/1352458518803785
Kalb, Rosalind ; Beier, Meghan ; Benedict, Ralph H.B. ; Charvet, Leigh ; Costello, Kathleen ; Feinstein, Anthony ; Gingold, Jeffrey ; Goverover, Yael ; Halper, June ; Harris, Colleen ; Kostich, Lori ; Krupp, Lauren ; Lathi, Ellen ; LaRocca, Nicholas ; Thrower, Ben ; DeLuca, John. / Recommendations for cognitive screening and management in multiple sclerosis care. In: Multiple Sclerosis Journal. 2018 ; Vol. 24, No. 13. pp. 1665-1680.
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