Multiple sclerosis: neurobehavioral aspects

Introduction
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By Alfredo Ardila PhD

The neurobehavioral aspects of multiple sclerosis include both cognitive disturbances and neuropsychiatric disorders. Cognitive difficulties in multiple sclerosis involve memory retrieval, mental processing speed, reasoning and goal-oriented behavior, verbal fluency, and visuospatial skills. Cognitive slowing has been observed to be significantly associated with brain volume loss and global gray matter atrophy, and hippocampal atrophy correlates with memory encoding impairments. Neuropsychiatric disturbances are primarily mood disorders. Depression may present as an early sign in multiple sclerosis and may be followed by cognitive impairment before physical disability appears. Severity of cognitive impairment significantly correlates with physical disability and with depression severity.

Key points

  • Both cognitive disturbances and neuropsychiatric disorders can be observed in multiple sclerosis.
  • Mild cognitive disturbances are common among patients with multiple sclerosis and are sometimes observed within the early stage of the disease.
  • Memory problems are the most common cognitive deficits.
  • Neuropsychiatric symptoms include depressive symptoms, agitation, anxiety, irritability, apathy, euphoria, disinhibition, hallucinations, aberrant motor behavior, delusions, sleep disorders, and sexual dysfunction.

In This Article

Introduction
Historical note and nomenclature
Clinical manifestations
Clinical vignette
Etiology
Pathogenesis and pathophysiology
Epidemiology
Prevention
Differential diagnosis
Diagnostic workup
Prognosis and complications
Management
Pregnancy
Anesthesia
References cited
Contributors