The Cognitive Evaluation
The gold standard for measuring cognitive function in multiple sclerosis is a full battery of cognitive tests, which include a series of verbal and pencil and paper tests. The testing is usually done by a neuropsychologist, preferably one that has specific training and experience with MS. Their goal is to evaluate if — and how much — cognitive impairment is affecting your daily life.
Your neurologist may give you a brief test in his office to screen for potential problems (He may ask you to count backward by four starting at number twenty-eight, for example). But the full battery of tests will be done in a neuropsychologist's office and may take six to eight hours to complete (sometimes it will be spread out over a few days to minimize fatigue). The test is very costly, so be sure to contact your insurance company before you schedule an appointment to make sure you're covered.
Neuropsychological testing has come quite a long way in the last decade, and tests today are considered to be highly accurate, providing very specific data on a patient's cognitive functioning. The tests cover the range of mental processes from simple motor performance to complex reasoning and problem solving. Many people report leaving the neuropsychological test feeling a little drained, to say the least.
The results of your test will be compared to those of the general population in your age bracket. The test evaluates the specific cognitive problems you might be having and your remaining strengths. Assessing your strengths will allow your specialist to recommend ways to compensate for any deficits you are facing. If your problem, for example, is with short-term memory, you can develop strategies to cope, such as writing things down or buying an electronic device to record daily tasks or reminders. If your problems are caused by difficulty concentrating, you can develop strategies to reduce distractions, such as moving your office to a quieter section of your office building. Your strengths will help you compensate for your weaknesses.
Unless your doctor is on the lookout for cognition problems, they can be easily missed. You may want to ask him specifically about screening tests for thinking problems.
Cognitive problems can be hard on self-esteem. Many people feel a sense of self-doubt when they can't remember things or when they feel they aren't functioning at a peak level. Neuropsychological testing can often be a step toward resolving some of these feelings by letting you know there's a sound reason for your difficulties. It may also relieve the concern of your family members and loved ones.