About this Research Topic
Multiple sclerosis (MS) is a debilitating disorder that affects young adults, impacting their work and social abilities. Physical and cognitive disabilities are the main drivers for low quality of life (QoL) in people with MS (pwMS). The prevalence of cognitive impairment (CI) in MS ranges from 34% to 65%, depending on both disease duration and age at disease onset. Moreover, this prevalence is further influenced by how CI is defined, as this could vary according to the number of abnormal neuropsychological scores and different statistical thresholds. Various aspects such as disease phenotype (relapsing or progressive), fatigue, depression, extent of brain tissue damage, and motor-cognitive reserve have been implicated in playing a role in overall cognitive performance decline. Furthermore, accumulating evidence is reporting that pwMS experience deficits in less explored cognitive domains such as theory of mind, pragmatics, meta-cognition and prospective memory, which might be affected in the absence of overall CI. Recently, diverse computerized neuropsychological testing tools have been developed, which allow the application of a more comprehensive assessment. Yet, their application remains rather limited due to the lack of reliability studies in larger sample sizes.
To date, pathological brain changes associated with CI in MS are not fully understood. The application of novel advanced imaging techniques revealed the neural underpinnings of both the overall CI and the impairment in selected cognitive domains. Cortical and subcortical grey matter atrophy, as well as fiber tract interruption, functional changes and, hence, synaptic dysfunction, were found to have variable contribution to CI in both cross-sectional and longitudinal assessments. Finally, efficient approaches for treating CI are still lacking. Despite the efficacy of disease modifying treatments in preventing cognitive decline, clinical trials using effective molecules in other neurodegenerative disorders were disappointing. Interestingly, cognitive neurorehabilitation in MS through conventional neuropsychological approaches, as well as through computerized neuropsychological training and serious video games, have shown promising effects.
This Research Topic aims to shed further light on CI in MS and its impact on QoL. It also aims to unveil the pathological changes underpinning cognitive disability in MS. Specifically, authors are strongly encouraged to submit Original Research concerning the following:
• Epidemiological studies aimed at evaluating cognitive dysfunction in MS throughout the disease course, as well as studies comparing conventional modalities for cognitive assessment with new computer-based screening tools;
• Assessment of non-conventional cognitive domains that might be affected in MS due to the wide extent of both gray and white matter damage throughout the central nervous system;
• Novel imaging techniques providing valuable insights into the pathogenesis of CI including conventional, structural and functional MRI;
• Medical and rehabilitation treatments aimed at halting cognitive decline over time and, possibly, improving cognitive abilities in MS with different extent of CI.
We would like to acknowledge that Dr. Monica Margoni, University of Padua, Italy, has acted as a coordinator and has contributed to the preparation of the proposal for this Research Topic.
Topic Editor Antonio Carotenuto received financial support from Almirall. The other Topic Editors declare no competing interests with regard to the Research Topic subject.
Keywords: Cognition, Multiple Sclerosis, rehabilitation, pathology, disability
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