What is Multiple Sclerosis Dementia?
Multiple sclerosis (MS) is a medical condition in which there is an inflammatory process that affects the myelin sheaths of the nerves and brain. The myelin sheaths are a covering that protects the nerves and allows the nerve cells to communicate between the brain and the spinal cord. In Multiple Sclerosis an inflammation process the body attacks the coverings around the axons of the spinal cord and brain that leads to scarring and loss of the covering, known as demyelination.
The loss of the myelin sheath affects the nerves ability to efficiently communicate information because scarring occurs in the white matter of the brain and spinal cord. The scarring (scleroses) causes a buildup of plaque resulting in a variety of different neurological symptoms.
Multiple sclerosis is a progressive disease. There are several different forms ranging from a condition that has periods of remission followed by a period of relapse to a progressive form that occurs over time. Symptoms that appear during a relapse may go away, leaving permanent neurological deficits. The symptoms may range from muscle weakness, loss of balance, problems with swallowing, visual disturbances, changes in mood, and problems with memory concentration.
The changes that occur may even have an effect on the ability to learning new things or retrieving old information. These cognitive deficits are usually mild and do not have any effect on an individual’s ability to function in everyday life.
Dementia is a condition that affects the grey matter of the brain. This part of the brain is responsible for processing information and storing that information for later use. Dementia is not a disease, but symptoms that affect a person’s thinking and social abilities. It is not just simple forgetfulness. Dementia affects at least two different functions of the brain- memory, language, reasoning and/ or abstract thinking.
The white matter of the brain and spinal is responsible for delivering the information to other parts of the body. The disruption in this process, of transferring information from one system to the other, results in difficulty in concentration and even reasoning.
A change in cognitive abilities is usually subtle in most individuals with MS and a few behavioral changes may be developed to compensate for those changes.
Severe cognitive problems occur in some individuals that suffer from “cerebral MS”. These individuals lack insight into their cognitive deficits and may require more assistance as the disease progresses. This condition usually presents in the later stages of MS.
Medications used to treat an acute episode of MS often have side effects that can cause mood swings, impaired thinking and problems with concentration. Some medications, such as steroids may cause severe side effects resulting in depression and even psychosis.
The dementia like symptoms, brought on by medications or an acute episode of MS, may disappear when the course of medication is finished. It is found that only 5% individuals with Multiple Sclerosis may actually develop dementia. This usually occurs in cases when the disease process is widespread throughout the frontal lobe in the brain. This is usually associated with the disease as it progresses in the later stages and is accompanied with a physical decline in abilities, as well.
Dementia like symptoms may occur with MS, however, dementia is not an expected outcome for all individuals with MS.