Recommendations for assessment of cognitive impairment in multiple sclerosis from the National MS society1

Baseline cognitive screening

Symbol Digit Modalities Test (SDMT)2 or other validated screening tool as a minimum, is recommended as an integral component of disease monitoring

Annual re-assessment with the same instrument, or more often as needed, is recommended for all adults and children 8 years or older with MS

○ For all adults and children > 8 years with MS

○ For adults who have experienced a first clinical event or have evidence on MRI of asymptomatic white matter lesions that are consistent with MS (RIS), or evidence of early gray matter damage

○ For any patient who reports changes in cognitive functioning

Depression screening to identify mood changes that may be impacting cognition as well as routine monitoring is recommended at least yearly 1,6

CSCT, Computerised cognitive test; MRI, magnetic resonance imaging; MS, multiple sclerosis; mSMT, modified story memory technique; MSNQ, Multiple Sclerosis

Neuropsychological Screening Questionnaire; PS, processing speed; PST, processing speed test; RIS, radiologically isolated syndrome; SDMT, Symbol Digit Modalities Test

1. Kalb R et al. Mult Scler.2018;24:1665–1680. 2. Benedict RH et al. Mult Scler.2017;23:721–733. 3. Ruet A et al. Mult Scler.2013;19:1665–1672; 4. Rao SM et al. Mult Scler 2017; 23:1929–1937. 5. Benedict RH et al. Mult Scler 2004;10: 675

–678. 6. Honarmand K, Feinstein A. Mult Scler.2009;15:1518–1524.