Certified Neuroscience Registered Nurse (CNRN) Practice Exam

What is considered the most effective strategy for limiting cognitive impairment in patients with multiple sclerosis?

1. Supportive therapy

2. Early intervention with disease-modifying agents

3. Cognitive rehabilitation

4. Symptomatic treatment

The correct answer is: Early intervention with disease-modifying agents

The most effective strategy for limiting cognitive impairment in patients with multiple sclerosis is early intervention with disease-modifying agents. This approach targets the underlying disease process, aiming to reduce the frequency and severity of relapses, slow the progression of disability, and ultimately mitigate the development of secondary complications such as cognitive decline. Disease-modifying therapies (DMTs) work by modulating the immune system to reduce inflammatory attacks on the central nervous system, which can lead to cognitive deficits as well as other neurological impairments. Early initiation of these therapies has been associated with better long-term outcomes, including the preservation of cognitive function. While cognitive rehabilitation, symptomatic treatment, and supportive therapy may provide benefits in managing cognitive impairment after it has manifested, they do not address the root cause of cognitive decline in multiple sclerosis. Instead, they help to manage symptoms or improve adaptive strategies but do not prevent the progression of disease-related cognitive issues. Thus, the proactive approach of early intervention with DMTs stands out as the most effective strategy in this context.