Cognitive and emotional disorders in multiple sclerosis. Can a suitable management strategy be envisaged?

There is a lack of precise data concerning the natural history of cognitive disorders in multiple sclerosis (MS), but recent neuropsychological studie s have demonstrated that the incidence of such disorders in MS appears to b e frequent (40-65% of cases), and have shown in particular that recent memo ry, conceptual reasoning, attention, executive functions, visuospatial perc eption and information processing speed are negatively affected in contrast , language functions, general intelligence and implicit memory appear to be relatively well preserved. Although the presence and the degree of cogniti ve disorders does not seem to be directly linked to disease duration or to the extent of physical disability the relationship between cognitive declin e and brain lesions detected by magnetic resonance imaging (MRI) is still a subject of discussion. The prevalence of emotional and affective disorders is difficult to estimate. Their frequency has only rarely been investigate d, and the lack of data on the natural history of these disorders and those factors which they have in common (the psychosocial consequences of this c hronic and disabling disease, cognitive impairment, and brain lesions) furt her complicate the determination of treatment strategy The adoption of appr opriate strategies could limit the negative impact of this disease on the s ocial functioning of MS patients. (C) 2000 Editions scientifiques et medica les Elsevier SAS.