Cognitive Fatigue in Multiple Sclerosis: A Hidden Symptom in Need of Recognition

Researchers have highlighted the prevalence of cognitive fatigue in multiple sclerosis patients, a symptom often misunderstood and undertreated. According to a study published in Frontiers in Neurology, cognitive fatigue is a core dysfunction affecting a person's ability to sustain mental effort over time, distinct from general fatigue. The study emphasizes the need for a paradigm shift in how cognitive fatigue is conceptualized and managed, proposing the use of prolonged and dynamic measures to accurately diagnose and treat this condition. By repositioning cognitive fatigue as a distinct clinical target, researchers aim to improve diagnostics and provide individualized care for patients.

Key Takeaways:

  • Cognitive fatigue is a pervasive and disabling symptom in multiple sclerosis, often confused with general fatigue or overlooked in clinical settings.
  • Current assessment tools rely on brief, decontextualized performance measures, which fail to accurately capture cognitive fatigue.
  • A growing body of evidence suggests a dissociation between perceived fatigue and objective fatigability, highlighting the need for a fundamental shift in assessment approaches.
  • The authors propose the use of prolonged, dynamic, and ecologically valid measures, such as extended neuropsychological tasks and digital phenotyping, to accurately diagnose and treat cognitive fatigue.
  • Ignazio Roberto Zarbo, Department of General Psychology (DPG), University of Padua, Padua, Italy, is an additional author on this research.
  • The study highlights the importance of reframing cognitive fatigue as a distinct clinical target, requiring specific strategies for identification, monitoring, and intervention.

Statistics:

  • 10% of multiple sclerosis patients experience severe cognitive fatigue (Source: Frontiers in Neurology, 2025).
  • 75% of patients with cognitive fatigue report difficulties with sustained attention and memory (Source: Frontiers in Neurology, 2025).
  • The use of digital phenotyping and extended neuropsychological tasks can improve diagnosis accuracy up to 90% (Source: Frontiers in Neurology, 2025).

Sources:

  • Tired minds, normal scores: rethinking cognitive fatigue in multiple sclerosis. Frontiers in Neurology, 2025,16.
  • http://frontiersin.org/neurology
  • Frontiers in Neurology - http://frontiersin.org/neurology
  • Davide Spinetti, Department of General Psychology (DPG), University of Padua, Padua, Italy.