Trouble retrieving the right words with MS linked to cognition, study suggests

Word-finding problems affect one in four people with MS and are linked to cognition rather than fatigue or depression, a study suggests.

People with cognitive impairment were nearly five times more likely to experience difficulties retrieving words than those without cognitive impairment.

The symptom was not associated with fatigue or depression.

“Findings of this study have implications for activities of daily living (ADLs) and suggest a multidisciplinary approach in the management of communication disorders in [people with MS],” the researchers wrote.

Multiple sclerosis, or MS, occurs when the immune system damages the brain and spinal cord. This disrupts nerve signals and can cause mobility problems, fatigue and cognitive changes.

Communication and language problems are increasingly recognised as part of the condition.

Word-finding difficulty refers to trouble retrieving a word a person wants to say. It is thought to account for most communication impairments among people with MS but remains poorly understood.

Researchers said it was unclear whether these problems were caused by damage to regions involved in cognition or developed as a consequence of other MS symptoms, such as fatigue and depression.

An international research team analysed data from 586 people with MS receiving routine care at a single MS centre in the US.

Most participants were women, at 76.6 per cent, and their average age was 47.1 years.

They completed a computerised cognitive assessment covering seven areas: memory, executive function, visual-spatial processing, verbal function, attention, information processing and motor skills.

Around one-third of participants were classified as having cognitive impairment.

Those without cognitive impairment had slightly more years of education, averaging 14.9 years compared with 14.4 years, and lower disability scores.

Overall, 25 per cent of participants experienced word-finding difficulties during a naming task.

The problem was much more common among those with cognitive impairment, affecting 43 per cent compared with 14 per cent of those without impairment.

Statistical analysis showed that people with cognitive impairment were 4.7 times more likely to experience word-finding difficulties than those without cognitive problems.

However, word-finding difficulties were also observed among some participants without cognitive impairment.

Across the whole group, 16 per cent had both cognitive impairment and word-finding difficulties.

A further nine per cent experienced word-finding difficulties despite having no evidence of cognitive impairment, while more than half had neither.

“This suggests that [word-finding difficulties] in [people with MS] are most associated with the co-existence of cognitive impairment,” the researchers wrote.

“This study, however, also illustrates that [word-finding difficulties] can occur in isolation in the absence of other invisible symptoms.”

Further analysis showed that word-finding difficulties were only weakly associated with disability.

The symptom was not linked to disease duration, fatigue or depression. Depression was, however, significantly associated with cognitive impairment.

“This suggests that when [people with MS] report that they are ‘searching for words,’ clinicians should not automatically attribute this to fatigue or mood,” the researchers wrote.

“It should be recognised as a potential communication disorder, requiring its own assessment and, where appropriate, targeted management.”