Cognitive impairment

Cognitive impairment is an important and often under-recognised part of multiple sclerosis and related neurological disorders. A major aim of our work is to understand which cognitive domains are affected, how this evolves over time, and how it can be monitored more objectively.

Why this matters

Cognitive impairment has a substantial impact on quality of life, work participation, and daily functioning. Yet it remains difficult to capture efficiently in routine care and difficult to treat in a targeted way.

Characterising impairment

Our work has shown that information-processing speed occupies a central position in the clinical picture of cognitive dysfunction in multiple sclerosis, and that reduced performance in this domain can influence many broader cognitive outcomes.

Developing biomarkers

We develop multimodal biomarkers of cognitive impairment using:

• neurophysiology, including P300-based markers
• MRI-derived measures of structural damage
• shape analysis of the corpus callosum
• functional connectivity and dynamic-network analysis
• blood and CSF biomarkers

For neurophysiological work specifically, see the Neurophysiology project page.

Clinical monitoring

A current focus is to make cognitive monitoring more scalable in the clinic, including app-based testing and image-based modelling approaches that can support longitudinal follow-up.

Treatment development

Because cognitive impairment remains difficult to treat, we are exploring new intervention strategies, including combined physical-cognitive training and non-invasive neuromodulation approaches.

Related outputs

See the Publications page for selected papers on cognitive impairment, cognitive decline, and multimodal biomarkers.