Do You Know Your MS Baseline?

There is a great line in one of my favorite Irish films, The Commitments.

After the first (and rather lamentable) rehearsal of their new band, manager Jimmy Rabbit asks a seasoned trumpeter what he thinks of the practice.

“It’s a start, and I believe in starts, Brother Rabbit,” says Joey “The Lips” Fagan.

Starts are important in many ways when it comes to living our best lives with multiple sclerosis (MS). But one cannot begin without knowing where the starting line is. And sometimes it’s a rolling start.

Predicting Cognitive Dysfunction

As with many of the posts I write for Life With Multiple Sclerosis, the idea for this one came from a study I was reading. The particular study in question, published in April 2023 in Neurology, wasn’t MS related, but it had to do with something many of us know as an MS symptom: cognitive difficulties, or cog fog.

In this study, researchers found that by using the Stages of Objective Memory Impairment system, they could predict who was most likely to transition from normal cognition to symptomatic cognitive impairment.

In other words, using a simple yet sensitive memory test, researchers were able to predict likely cognitive and memory problems in a person’s future.

This research will be invaluable as an aging population faces the growing possibility of developing Alzheimer’s disease or another form of dementia. But it also flags imperatives for all of us with MS.

Establishing a Baseline for Cognitive Functioning

First, we cannot know if we are slipping if we don’t know where we now stand. Even if it’s been years (or decades) since your MS diagnosis, a baseline exam is a must to gauge your progression.

I was fortunate enough to have undergone a full neuropsychology evaluation (sometimes called a neuro-psych evaluation) as part of a research study I participated in during my early days with this disease. The results of that evaluation were shared with me after the study and placed into my medical records for future reference. If ever I feel I need to check on how I’m doing, that baseline will be ever so useful.

A full neuro-psych panel can be expensive. Having it done as part of that study was one of the enticements that the researchers offered to prospective subjects. Your neurologist should be able to order an evaluation for you, and your insurance may (or may not) cover the expense.

Responding to Changes as Our Abilities Change

Most of us are familiar with the routine examinations done in our MS neurologist’s office. These assessments of how we move our limbs and eyes, how fast we can (or cannot) walk, our level of strength, and so on are compared with both our baseline results at diagnosis as well as the results of our last visits. From there, a course of action can be developed.

The same can be done with the results of a neuro-psych exam.

Since many of us were a few years into the disease before we were diagnosed, we know that what was recorded as our baseline may have already slipped prior to the exam. This doesn’t make that baseline any less valuable, nor would a cognitive baseline be any less useful to us now and in our future with the disease.

Research on Other Conditions May Hold Truths for MS, Too

As the ever-aging general population seems to be driving research into identifying and correcting cognitive issues, we might as well draft on that forward motion, and the best way to do it is to be ready if and when progress is made. There’s no sense trudging through the snow drifts when someone else is plowing a path for us.

Wishing you and your family the best of health.

Cheers,

Trevis