Purpose of review: A broad overview of cognition in multiple sclerosis (MS) is provided, taking account of its impact on the lives of patients, how cognitive impairment relates to disease and magnetic resonance variables, which cognitive domains are most vulnerable, the influence of depression and fatigue and what treatment options are available.
Recent findings: The current focus is on cognitive reserve, which seems to offer some protection from the cognitive impact of MS. There is also considerable momentum with new MRI techniques and growing interest in PET studies.
Summary: Cognition in MS is a priority for patients. Although understanding of the natural history of MS cognitive deficits is reasonably well understood, treatment options require further work before precise recommendations can be made on an individual basis.