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Depression and Cognitive Problems With MS

Difficulty Thinking Clearly

Approximately half of all people with MS have cognitive symptoms, such as difficulties with concentration, attention, memory, and poor judgment. These symptoms are usually mild and are frequently overlooked. In fact, difficulties with thinking clearly are often detected only after comprehensive testing.
Patients with MS may be unaware of their cognitive loss; it is often a family member or friend who first notices a problem. Such impairments are usually mild, rarely disabling, and intellectual and language abilities are generally spared.
Cognitive MS symptoms occur when lesions (also known as plaques) develop in the areas of the brain responsible for processing information. These problems tend to become more apparent as the information to be processed becomes more complex. Fatigue may also add to these mental difficulties.
Scientists do not yet know whether these thinking difficulties are due to problems with receiving information (acquisition), recalling it from the memory (retrieval), or a combination of both.
The types of memory problems a person experiences may differ, depending on the individual's disease course (relapsing-remitting, primary-progressive, etc.), but there does not appear to be any direct connection between how long a person has had MS and how severe his or her cognitive problems are.


Depression, which is unrelated to cognitive problems, is another common symptom of MS. In addition, about 10 percent of patients suffer from more severe psychotic disorders, such as manic-depression and paranoia.
Five percent of people with MS may experience episodes of inappropriate euphoria (extreme happiness) and despair -- both of which are unrelated to the patient's actual emotional state. This condition is known as "laughing/weeping syndrome." This syndrome is thought to be due to demyelination in the brainstem, the area of the brain that controls facial expression and emotions, and is usually seen only in severe cases.
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