Cognitive Deterioration in Otherwise Clinically Stable Patients with Multiple Sclerosis

Neuropsychological assessment of cognitive functions in multiple sclerosis (MS) is increasingly considered as an important paraclinical marker of disease stability or progression in MS. Recent recommendations pro-posed an annual screening of cognitive functions in all MS patients as a standard of neuropsychological monitoring in MS. There is a clear trend to diagnose possible disease progression as early as possible, to be able to respond quickly. The theoretical part of this thesis presents the current state of knowledge on cognitive impairment in MS, its correlates, predictors, and treatment possibilities. In addition, a comprehensive overview of the neuropsychological assessment and the diagnosis of cognitive deterioration in MS is presented. The highly relevant topics such as cutoff criteria of a meaningful change on individual neuropsychological examination, possibilities of treatment of cognitive deterioration, or the so-called isolated cognitive relapses, are discussed in a particular detail. The empirical part extends current knowledge in the field of MS. I present and discuss six original publications that follow these four main objectives: first, to describe the prevalence of isolated cognitive decline in MS and to put isolated cognitive decline in context with current knowledge on MS..