New research uncovers a previously hidden Multiple Sclerosis subtype
A distinct MS subtype has been identified in patients with significant cognitive impairment but little physical disability, often leaving it undetected and untreated.
The subtype affects functions such as information processing, memory and attention, while showing few of the movement difficulties usually linked with multiple sclerosis.
Professor Adam Hampshire is professor of cognitive and computational neuroscience at King’s IoPPN and joint senior author.
Although cognitive impairment affects 40 to 70 per cent of people with MS, it is not routinely assessed and is often overlooked in treatment.
Professor Adam Hampshire is professor of cognitive and computational neuroscience at King’s IoPPN and joint senior author.
He said: “Classic approaches to cognitive assessment are difficult to deploy in this sort of context due to the cost of supervised testing.
“By using a state-of-the-art fully automated assessment approach we were able to test thousands of people with MS quickly, sensitively and at little cost.”
Researchers from King’s College London’s Institute of Psychiatry, Psychology & Neuroscience, working with Imperial College London, Swansea University and the UK MS Register, tested an online tool called Cognitron with 3,066 patients.
The three-stage study first tested whether patients could use Cognitron at home without supervision.
A second stage validated the tool’s MS-specific tasks in an independent group. The third stage compared results with standard in-person assessments.
Analysis identified a subtype in which patients experienced substantial cognitive deficits despite little physical disability.
Dr Annalaura Lerede, postdoctoral researcher in digital healthcare at King’s IoPPN and first author, said examples of people with this unrecognised subtype were seen across all ages, regardless of disease duration.
“This reflects the risk of underestimating disability severity in this group throughout patients’ disease courses,” she said.
“Assessing cognitive impairment is not a standard part of clinical practice.
“This research provides a viable and easily implemented means of testing cognitive function at home and could help vast numbers of people better understand their condition and direct in-person assessments to the people that need them the most.”
Dr Catherine Godbold, senior research communications manager at the MS Society, said cognition had been neglected for too long, leaving people without access to support.
“This is the largest study on cognition in MS to date, and Cognitron-MS has the potential to transform how cognitive functioning is tested for people with MS.
“We’re delighted that this could be rolled out to people with MS longitudinally in the future.”
The researchers plan to track cognitive changes over time to assess what influences them, how they link to brain changes, and how treatments affect outcomes.
