62| Multiple Sclerosis: Cognitive and Emotional Sequelae – A Conversation With Dr. Peter Arnett

About 50% of individuals with multiple sclerosis (MS) exhibit cognitive deficits in additional to physical symptoms.  Depression and fatigue are also common in MS and can be debilitating.  Therefore, it is not uncommon for an individual with MS to be referred for neuropsychological evaluation, making it important for neuropsychologists to familiarize themselves with the neurobiological underpinnings and signs and symptoms of MS.  Today, John and Ryan talk with Dr. Peter Arnett about the cognitive and emotional symptoms of MS, and how neuropsychology can contribute to the care of patients with MS.

A pdf of the transcript for this episode is available here.

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Topics Covered

  • Overview of MS
  • Risk factors for MS
  • Vitamin D and MS
  • McDonald criteria for subtypes of MS
  • Difference between Clinically Isolated Syndrome (CIS) and MS
  • Risk for misdiagnosis of MS
  • Treatment approaches for MS
  • Moderators of depression in MS
  • Coping as an intervention target for depression in MS
  • Treatment modalities for depression in MS
  • Exercise as a treatment for physical and mood symptoms in MS
  • Sleep difficulties in MS and its relationship with depression
  • Neuropsychological assessment of MS
  • Measuring processing speed in individuals with MS
  • Considering ecological validity in neuropsychological assessment
  • Prevalence of fatigue in individuals with MS
  • Assessing the effect of fatigue on neuropsychological test performance
  • Social functioning and activities of daily living in MS

About Pete

Dr. Arnett is a Professor of Psychology and Director of the Neuropsychology of MS and Sports-Related Concussion programs at Pennsylvania State University.  He is the current president of the National Academy of Neuropsychology (NAN).

McDonald Criteria Resource


Selected References

Amato, M. P., Krupp, L. B., Charvet, L. E., Penner, I., & Till, C. (2016). Pediatric multiple sclerosis: cognition and mood. Neurology87(9 Supplement 2), S82-S87.

Arnett, P. A., Smith, M. M., Barwick, F. H., Benedict, R. H., & Ahlstrom, B. P. (2008). Oralmotor slowing in multiple sclerosis: Relationship to neuropsychological tasks requiring an oral response. Journal of the International Neuropsychological Society14(3), 454-462.

Arnett, P. A., Barwick, F. H., & Beeney, J. E. (2008). Depression in multiple sclerosis: review and theoretical proposal. Journal of the International Neuropsychological Society14(5), 691-724.

Baecher-Allan, C., Kaskow, B. J., & Weiner, H. L. (2018). Multiple sclerosis: mechanisms and immunotherapy. Neuron97(4), 742-768.

Benedict, R. H., DeLuca, J., Phillips, G., LaRocca, N., Hudson, L. D., Rudick, R., & Multiple Sclerosis Outcome Assessments Consortium. (2017). Validity of the Symbol Digit Modalities Test as a cognition performance outcome measure for multiple sclerosis. Multiple Sclerosis Journal23(5), 721-733.

Benedict, R. H., Amato, M. P., DeLuca, J., & Geurts, J. J. (2020). Cognitive impairment in multiple sclerosis: clinical management, MRI, and therapeutic avenues. The Lancet Neurology19(10), 860-871.

Brownlee, W. J., Hardy, T. A., Fazekas, F., & Miller, D. H. (2017). Diagnosis of multiple sclerosis: progress and challenges. The Lancet389(10076), 1336-1346.

Bruce, J. M., Bruce, A. S., & Arnett, P. A. (2010). Response variability is associated with self-reported cognitive fatigue in multiple sclerosis. Neuropsychology24(1), 77.

Cadden, M. H., Meyer, J. E., & Arnett, P. A. (2017). Beyond binary: Exploring the merits of three depression groups in multiple sclerosis. Neuropsychology31(3), 328.

Cadden, M. H., Guty, E. T., & Arnett, P. A. (2018). Cognitive reserve attenuates the effect of disability on depression in multiple sclerosis. Archives of Clinical Neuropsychology34(4), 495-502.

Ontaneda, D., Thompson, A. J., Fox, R. J., & Cohen, J. A. (2017). Progressive multiple sclerosis: prospects for disease therapy, repair, and restoration of function. The Lancet389(10076), 1357-1366.

Strober, L. B., & Arnett, P. A. (2015). Depression in multiple sclerosis: The utility of common self-report instruments and development of a disease-specific measure. Journal of clinical and experimental neuropsychology37(7), 722-732.

Langdon, D. W. (2011). Cognition in multiple sclerosis. Current opinion in neurology24(3), 244-249.

Thompson, A. J., Banwell, B. L., Barkhof, F., Carroll, W. M., Coetzee, T., Comi, G., … & Fujihara, K. (2018). Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria. The Lancet Neurology17(2), 162-173.

Ukueberuwa, D. M., & Arnett, P. A. (2015). Examination of the Chicago Multiscale Depression Inventory and initial validation of a Positive Scale. Journal of the International Neuropsychological Society21, 1-7.