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Disease-modifying therapies (DMTs) for multiple sclerosis (MS) show promise for effectively reducing disease activity (relapses and new lesions) and for slowing disability progression. Many DMT trials are increasingly incorporating evaluation of cognitive benefits as a secondary outcome. Cognitive impairment is an insidious and intractable symptom affecting more than half of individuals with MS,1 and treatments are lacking. Although the first DMT was approved 25 years ago and >10 are available now, none is yet approved for the treatment of cognition. A recent meta-analysis assessing the benefits of DMTs for cognition in relapsing-remitting MS found a small improvement across 44 studies included.2 Thus far, there has been very little work evaluating the benefits of DMTs for cognition in progressive MS.
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