Cognition in multiple sclerosis: State of the field and priorities for the future

James F Sumowski, Ralph Benedict, Christian Enzinger, Massimo Filippi, Jeroen J Geurts, Paivi Hamalainen, Hanneke Hulst, Matilde Inglese, Victoria M Leavitt, Maria A Rocca, Eija M Rosti-Otajarvi, Stephen Rao

Research output: Contribution to journalReview articleAcademicpeer-review

348 Citations (Scopus)


Cognitive decline is recognized as a prevalent and debilitating symptom of multiple sclerosis (MS), especially deficits in episodic memory and processing speed. The field aims to (1) incorporate cognitive assessment into standard clinical care and clinical trials, (2) utilize state-of-the-art neuroimaging to more thoroughly understand neural bases of cognitive deficits, and (3) develop effective, evidence-based, clinically feasible interventions to prevent or treat cognitive dysfunction, which are lacking. There are obstacles to these goals. Our group of MS researchers and clinicians with varied expertise took stock of the current state of the field, and we identify several important practical and theoretical challenges, including key knowledge gaps and methodologic limitations related to (1) understanding and measurement of cognitive deficits, (2) neuroimaging of neural bases and correlates of deficits, and (3) development of effective treatments. This is not a comprehensive review of the extensive literature, but instead a statement of guidelines and priorities for the field. For instance, we provide recommendations for improving the scientific basis and methodologic rigor for cognitive rehabilitation research. Toward this end, we call for multidisciplinary collaborations toward development of biologically based theoretical models of cognition capable of empirical validation and evidence-based refinement, providing the scientific context for effective treatment discovery.

Original languageEnglish
Pages (from-to)278-288
Number of pages11
Issue number6
Publication statusPublished - 6 Feb 2018


  • Journal Article
  • Review

Cite this