The white matter lesion load, disease duration, and level of education of the patient are early predictors of future cognitive impairment in people with multiple sclerosis (MS). This is according to a retrospective analysis, the results of which were published in the Journal of Clinical Medicine.

“Our results further expand knowledge on early predictors of cognitive decline and evolution over time,” the authors of the study wrote.

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To identify potential early predictors of future cognitive impairment and motor disability in patients with MS, the researchers led by Cristoforo Comi, MD, PhD, from S. Andrea Hospital, Department of Translational Medicine, University of Piemonte Orientale in Vercelli, Italy analyzed 65 patients with MS who complained of cognitive decline.

Based on the results of an extensive neuropsychological analysis, the researchers divided the patients into 3 groups: cognitively spared (21 patients), mildly impaired (17 patients), and severely impaired (27 patients).

They also assessed the patients’ motor skills using the Expanded Disability Status Scale (EDSS), MS Severity Score (MSSS), and age-related MSSS (ARMSS). 

Finally, they retrospectively collected patients’ demographic, clinical, and imaging parameters at baseline.

They found that patients who were older and less educated and who had a greater EDSS score, disease duration, and white matter lesion load at the time of diagnosis were more likely to develop cognitive impairments.

The researchers also reported that disease-modifying treatments had a protective effect against cognitive impairment.

Finally, they said that older patients with progressive phenotypes both at diagnosis and at the time of neuropsychological analysis were more likely to not be fully ambulatory at the time of neuropsychological analysis.

“In conclusion, our data confirm the importance of investigating cognition with extensive [neuropsychological] evaluation particularly in old patients with a long disease duration,” the authors wrote.


Virgilio E, Vecchio D, Sarnelli MF, et al. Early predictors of disability and cognition in multiple sclerosis patients: a long-term retrospective analysis. J Clin Med. Published online January 15, 2023. doi:10.3390/jcm12020685