Utility of routine neuropsychological assessment for early identification of cognitive impairment in MS

In addition to physical disability, multiple sclerosis (MS) is increasingly recognized for its association with neuropsychological (NP) impairment, including cognitive deficits and disorders of mood and affect. NP impairment can occur as early as the first demyelinating episode. Often insidious in nature, NP impairment has a significant impact on a wide range of quality-of-life measures including vocational status, social functioning, and instrumental activities of daily living. Objective, performance-based measures of NP status are important but underutilized tools used to evaluate and quantify deficits. These NP tests help clinicians make treatment decisions and assist in monitoring clinical status over time. Additionally, there is growing interest in developing improved screening measures to indicate when referral for NP testing is advised. This article reviews research findings pertaining to screening and monitoring NP status in MS as well as the clinical meaning of NP impairment.