MS – Pre-Rehabilitation Cognitive Assessment — SCE Neurology MCQ

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ModerateMultiple Sclerosis & CNS InflammationMS – Pre-Rehabilitation Cognitive AssessmentSCE Neurology

A 50-year-old man with known MS is being assessed for cognitive rehabilitation. His neuropsychologist plans to start a programme targeting his processing speed deficits. Before starting, what pre-requisite assessment should be performed?

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Correct answer: C — A comprehensive neuropsychological assessment including screening for depression, fatigue, and medication effects that may impact cognition independently of MS

Before starting cognitive rehabilitation in MS, a comprehensive assessment is essential: (1) formal neuropsychological testing to characterise the cognitive profile (processing speed, executive function, memory, attention), (2) screening for depression and anxiety (which independently impair cognition and are treatable), (3) fatigue assessment (fatigue worsens cognitive performance), (4) medication review (anticholinergics, benzodiazepines, opioids can impair cognition), (5) exclusion of other treatable causes (hypothyroidism, B12 deficiency, sleep disorders). Addressing these modifiable factors may improve cognition without specific rehabilitation. A: MMSE is insensitive for MS cognition. C: MRI alone does not characterise the cognitive deficit. D: Blood tests alone are insufficient. E: Assessment is essential for targeting rehabilitation.

Reference: NICE NG100 MS (2022)