Cognitive and neuropsychiatric disease manifestations in MS

Multiple sclerosis is associated with a wide array of behavioral problems. This brief overview begins with a summary of the pathophysiology and treatment of MS. Thereafter, sections are devoted to psychiatric syndromes and cognitive decline linked to MS. The immune basis and brain imaging data associated with these changes are subsequently reviewed. The frequency and severity of these changes in mentation highlight the point that MS patients should, as part of their routine care, have access to psychiatrists, neuropsychologists and allied mental health specialists.

► MS is associated with behavioral changes including cognitive and mood disorders.
► Behavioral changes are linked to immunological abnormalities and neuroimaging indices.
► There are treatments for depression, pseudobulbar affect and cognitive dysfunction.
► All patients should have a behavioral assessment as part of any treatment plan.
► Failing to diagnose and treat behavioral problems adds to the morbidity of MS.