John Hart, M.D. Answers Questions On: Cognitive Deficits and MS

Cognitive deficits have to do with thinking. Some common cognitive problems in MS patients are memory issues, problems processing information, difficulty with problem solving, and trouble finding words.

MS is predominantly a white-matter disease. White matter is a type of tissue in the brain. When this tissue is disrupted in some way transmitting, brain signals from one place to another are interrupted when you’re trying to think. So, for example, you sometimes can’t find words or memories you’re trying to retrieve.

We’re using a variety of medications to help these patients. All the drugs we use were originally intended to treat other issues but are proving to be successful in MS patients. For example, I prescribe stimulants that are the same as those used in the treatment of attention deficit disorder. These medications increase the brain’s production of dopamine in key areas having to do with cognition. We’ve found patients’ speed of thinking and, to some degree, their memory, have gotten better on these stimulants.

We’re also using a drug that’s approved for the treatment of narcolepsy. It provides the increase in dopamine and resets the brain’s rhythms, which are important for retrieving memories.

We also use a drug commonly prescribed for restless leg syndrome. It’s a dopamine agonist and has been successful in helping MS patients find words and retrieve information.