Neuropsychological measures in clinical practice

Cognitive decline in multiple sclerosis can appear early in the course of the disease and may not be evident to the clinician if not investigated formally. Clinical neuropsychological evaluation with these patients has main peculiarities: disabilities, fatigue, relapses, medical treatment, psychological problems, that have to be seriously taken into consideration in choosing the tests and interpreting the profile. The peculiarity of cognitive decline in MS suggests an examination primarily of attentive–executive and memory domains, with Pasat and Symbol Digit Modalities Test, strongly recommended, together with memory test. The utilization of extensive or brief cognitive batteries depends on the different goals of the neuropsychological evaluation. It is important to find a screening procedure to be used by neurologists to identify the patients to be sent to an early formal evaluation, in consideration of the interference of cognitive profile with fundamental aspects of individual functioning, included adherence to rehabilitation and pharmacological treatment.