Multiple sclerosis, MS, is a disease of the central nervous system (CNS). Although the exact cause is unknown, it is believed to be an autoimmune disorder. Something triggers the body’s immune system to attack the CNS, damaging myelin, the protective layer of insulation covering the nerve fibers. This causes a disruption of signals to and from the brain, leading to MS exacerbations, also known as relapses, and causing a wide variety of symptoms including numbness, tingling, pain, fatigue, blindness and paralysis. In addition to these physical symptoms, there are cognitive ones as well, including multiple sclerosis memory loss.
Not everyone with MS experiences the same symptoms. Each person is affected differently, with symptoms ranging from mild to severe. The unpredictability of MS means symptoms may be temporary or long-lasting.
MS and Cognition
Cognitive changes are common in multiple sclerosis, affecting about half of all those diagnosed with MS. For some, it may be the first symptom, but most cognitive problems develop as the disease progresses. Memory loss occurs when lesions develop in the portion of the brain responsible for processing memories. Damage to nerve fibers or cells and loss of brain tissue also contribute to the problem. In most cases, cognitive problems are mild to moderate. Severe cognitive changes are not common in MS.
According to the National Multiple Sclerosis Society, changes in cognitive function due to MS are likely to include the following:
- Information processing. MS patients may experience problems sorting out information gathered from the five senses.
- Memory. It may be difficult to acquire, retain or retrieve new information.
- Attention and concentration. This may be particularly difficult in a busy environment.
- Executive functions. Those with MS may have difficulty planning or prioritizing.
- Visuospatial functions. This is when you have problems relating visual information to the space around you.
- Verbal fluency. Finding the right words may be problematic for those with MS.
Impact of Multiple Sclerosis Memory Loss
Cognitive problems such as memory loss are more likely to appear during an exacerbation of MS and typically do not fully resolve once they have started. Cognitive dysfunction impacts quality of life, relationships with others and employment. You may have difficulty with:
- Finding your words
- Recalling daily routines or remembering work tasks
- Decision-making
- Conversing
- Performing your job
Evaluating MS Memory Issues
If you suspect you have multiple sclerosis memory loss or other cognitive concerns due to the condition, the first step is an evaluation by a speech-language pathologist (SLP). It is important to act as soon as you notice cognitive issues. The evaluation consists of an interview with you and/or your family members along with a standardized assessment. The SLP will also examine the oral muscles—lips, tongue and soft palate—to evaluate strength, speed, range, accuracy, timing and coordination. An examination of your teeth and hard palate, breathing and pronunciation will also be conducted. This will help determine the areas of difficulty, the extent of the problem and areas of relative strengths.
The National Multiple Sclerosis Society recommendations for managing cognitive symptoms are as follows:
- Education for those with MS and their family members
- Early screening and ongoing monitoring throughout the disease course
- Comprehensive evaluation for those who test positive for cognitive dysfunction in the initial screening or those who demonstrate a significant cognitive decline
- Comprehensive evaluation for individuals applying for disability insurance due to cognitive impairment
- Interventions to improve cognitive functioning and participation in everyday activities
Jennifer Howland, MA CCC-SLP, the lead SLP at AnMed Health Rehabilitation Hospital in Anderson, South Carolina, (a partner with Encompass Health) and a practitioner with 26 years of experience, said an SLP “will collaborate with you in setting meaningful goals that relate to your life.”
Some strategies an SLP might provide to assist you in managing MS memory loss include:
- Creating a weekly menu and shopping list
- Performing mental exercises to strengthen your cognition and memory
- Writing a list or using a mnemonic device
- Setting a reminder or timer
- Visualizing a target item in movement
- Utilizing the PQRST method (preview, create questions, read, summarize and test)
The PQRST method is a proven strategy to promote new learning in those suffering from mild memory impairment. If you suffer from MS cognitive issues, you are encouraged to first scan information provided to gain a general idea of the content and then formulate questions about the content that can be answered after reading the information in more detail. The next step is to read the content carefully, and after rereading, summarize the main points and state them to yourself. Finally, test yourself by answering your previous questions.
MS Memory Loss and Communication
Communication problems related to memory loss creates challenges when you are living with MS. Difficulty communicating can interfere with relationships, employment and overall wellbeing. Communication problems associated with multiple sclerosis can be under-recognized and under-treated. Working with an SLP can help you better manage your communication deficits.
“Memory is very important for communication,” says Howland. “To communicate effectively and have a conversation, a person must be able to hold onto information in their head that is being shared while forming a response at the same time. People with MS can also have difficulty with forming words correctly for good enunciation.”
Role of Speech Therapy in MS
Up to 40 percent of those with MS experience speech problems at some point due to lesions or plaques in the portion of the brain responsible for muscle control of the lips, tongue, soft palate, vocal cords or diaphragm. Often the problems are not recognized by the person with MS, but by friends or family members. Speech therapy can help you to strengthen and improve muscle function as well as introduce techniques to improve speech, including:
- Slowing down speech
- Over-articulating
- Phrasing or pausing to make speech easier to understand
- Using breathing to increase speech volume
- Communicate in other ways including using gestures, writing or technology
In addition to communication challenges, an SLP can also help you work on any cognitive issues related to MS. Memory challenges in multiple sclerosis could include difficulty with remembering dates or events, memory for how to do things and memory for words and things. An SLP with experience working with people with MS can help you develop techniques for remembering and keeping yourself organized.
Speech therapy could be conducted in an inpatient or outpatient setting. Speech therapy in inpatient rehabilitation could also include both physical and occupational therapy, which could help you further manage the many symptoms associated with multiple sclerosis.
The content of this site is for informational purposes only and should not be taken as professional medical advice. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding any medical conditions or treatments.
