multiple sclerosis, cognitive impairment, brain neurotrophic factor (BDNF), neurodegeneration, neuroimaging


The article presents modern approaches about the diagnosis of brain damage and the development of cognitive impairment in patients with multiple sclerosis. Neurodegenerative changes are considered, which take place in the early stages of the disease and play an important role in the formation of irreversible neurological deficits. Cognitive impairment in patients with multiple sclerosis is quite common, but they are not always noticed, but they significantly reduce patients' quality of life. The article describes the possibilities of neuroimaging methods to identify structural changes in the parts of the brain responsible for cognitive functions. The importance of brain neurotrophic factor (BDNF) as a promising biomarker of multiple sclerosis is presented. Further study of BDNF remains interesting, which will allow to develop algorithms for early diagnosis and prediction of disease progression, that will provide an opportunity to deepen the understanding of the place of BDNF in the pathomorphological chain of nervous system damage in multiple sclerosis.


Shmidt, T.E. (2014). Multiple sclerosis: epidemiology, risk factors, pathogenesis, clinical features and progres-sion (according to the materials of the 29th Congress of ECTRIMS). Neurological J., 19(1), 49‒54.

Compston, A., & Coles, A. (2008). Multiple sclerosis. Lancet, 372, 1502‒1517.

Fernández-Muñoz, J. J., Morón-Verdasco, A., Cigarán-Méndez, M., Muñoz-Hellín, E., Pérez-de-Heredia-Torres, M., & Fernández-de-las-Peñas, C. (2015). Disability, quality of life, personality, cognitive and psychological variables associated with fatigue in patients with multiple sclerosis. Acta neurologica Scandinavica, 132(2), 118–124.

Eijlers, A., van Geest, Q., Dekker, I., Steenwijk, M. D., Meijer, K. A., Hulst, H. E., … & Geurts, J. (2018). Predicting cognitive decline in multiple sclerosis: a 5-year follow-up study. Brain: a journal of neurology, 141(9), 2605–2618.

Robinson, R. C., Radziejewski, C., Spraggon, G., Greenwald, J., Kostura, M. R., Burtnick, L. D., Stuart, D. I., Choe, S., & Jones, E. Y. (1999). The structures of the neurotrophin 4 homodimer and the brain-derived neu-rotrophic factor/neurotrophin 4 heterodimer reveal a common Trk-binding site. Protein science: a publication of the Protein Society, 8(12), 2589–2597.

Siegert., R, & Abernethy, D. (2005). Depression in multiple sclerosis: a review. J Neurol Neurosurg Psychiatry, 76, 469–475.

Arnett., P., Barwick, F., & Beeney, J. (2008). Depression in multiple sclerosis: review and theoretical proposal. J Int Neuropsychol Soc, 14, 691–724.

Sumowski, J. F., Benedict, R., Enzinger, C., Filippi, M., Geurts, J. J., Hamalainen, P., … & Rao, S. (2018). Cognition in multiple sclerosis: State of the field and priorities for the future. Neurology, 90(6), 278–288.

Migliore, S., Ghazaryan, A., Simonelli, I., Pasqualetti, P., Squitieri, F., Curcio, G., Landi, D., Palmieri, M. G., Moffa, F., Filippi, M. M., & Vernieri, F. (2017). Cognitive Impairment in Relapsing-Remitting Multiple Sclero-sis Patients with Very Mild Clinical Disability. Behavioural neurology, 2017, 7404289.

Lovera, J., & Kovner, B. (2012). Cognitive impairment in multiple sclerosis. Current neurology and neurosci-ence reports, 12(5), 618–627.

Schulz, D., Kopp, B., Kunkel, A., & Faiss, J. H. (2006). Cognition in the early stage of multiple sclerosis. Journal of neurology, 253(8), 1002–1010.

Langdon D. W. (2011). Cognition in multiple sclerosis. Current opinion in neurology, 24(3), 244–249.

Lezak, M. D., Howieson, D. B., Bigler, E. D., & Tranel, D. (2012). Neuropsychological Assessment. 5th ed. New York: Oxford University Press. 1576 p.

Hankomäki, E., Multanen, J., Kinnunen, E., & Hämäläinen, P. (2014). The progress of cognitive decline in newly diagnosed MS patients. Acta neurologica Scandinavica, 129(3), 184–191.

Amato, M. P., Ponziani, G., Siracusa, G., & Sorbi, S. (2001). Cognitive dysfunction in early-onset multiple sclerosis: a reappraisal after 10 years. Archives of neurology, 58(10), 1602–1606.

Giazkoulidou, A., Messinis, L., & Nasios, G. (2019). Cognitive functions and social cognition in multiple sclerosis: An overview. Hellenic journal of nuclear medicine, 22 Suppl, 102–110. PMID: 30877728.

Trenova, A. G., Slavov, G. S., Manova, M. G., Aksentieva, J. B., Miteva, L. D., & Stanilova, S. A. (2016). Cognitive Impairment in Multiple Sclerosis. Folia medica, 58(3), 157–163.

Achiron, A., Chapman, J., Magalashvili, D., Dolev, M., Lavie, M., Bercovich, E., … & Barak, Y. (2013). Modeling of cognitive impairment by disease duration in multiple sclerosis: a cross-sectional study. PloS one, 8(8), e71058.

Filippi, M., Rocca, M. A., Barkhof, F., Brück, W., Chen, J. T., Comi, G., … & Attendees of the Correlation between Pathological MRI findings in MS workshop (2012). Association between pathological and MRI findings in multiple sclerosis. The Lancet. Neurology, 11(4), 349–360.

Assouad, R., Louapre, C., Tourbah, A., Papeix, C., Galanaud, D., Lubetzki, C., & Stankoff, B. (2014). Clini-cal and MRI characterization of MS patients with a pure and severe cognitive onset. Clinical neurology and neurosur-gery, 126, 55–63.

Codella, M., Rocca, M. A., Colombo, B., Rossi, P., Comi, G., & Filippi, M. (2002). A preliminary study of magnetization transfer and diffusion tensor MRI of multiple sclerosis patients with fatigue. Journal of neurology, 249(5), 535–537.

Comini-Frota, E. R., Rodrigues, D. H., Miranda, E. C., Brum, D. G., Kaimen-Maciel, D. R., Donadi, E. A., & Teixeira, A. L. (2012). Serum levels of brain-derived neurotrophic factor correlate with the number of T2 MRI le-sions in multiple sclerosis. Brazilian journal of medical and biological research = Revista brasileira de pesquisas medicas e biologicas, 45(1), 68–71.

Frota, E. R., Rodrigues, D. H., Donadi, E. A., Brum, D. G., Maciel, D. R., & Teixeira, A. L. (2009). In-creased plasma levels of brain derived neurotrophic factor (BDNF) after multiple sclerosis relapse. Neuroscience letters, 460(2), 130–132.

Lewin, G. R., & Barde, Y. A. (1996). Physiology of the neurotrophins. Annual review of neuroscience, 19, 289–317.

Park, H., & Poo, M. M. (2013). Neurotrophin regulation of neural circuit development and function. Nature reviews. Neuroscience, 14(1), 7–23.

Wayne, D.C. (2004). Neuroplasticity in mood disorders. Dialogues in clinical neuroscience. Neuroplasticity, 6, 199–216.

Binder, D. K., & Scharfman, H. E. (2004). Brain-derived neurotrophic factor. Growth Factors, 9, 123‒131.

Sarchielli, P., Greco, L., Stipa, A., Floridi, A., & V. Gallai (2002). Brain-derived neurotrophic factor in pa-tients with multiple sclerosis. J Neuroimmunol, 132(1-2), 180‒188.

Sarchielli, P., Zaffaroni, M., Floridi, A., Greco, L., Candeliere, A., Mattioni, A., Tenaglia, S., Di Filippo, M., & Calabresi, P. (2007). Production of brain-derived neurotrophic factor by mononuclear cells of patients with mul-tiple sclerosis treated with glatiramer acetate, interferon-beta 1a, and high doses of immunoglobulins. Multiple sclerosis (Houndmills, Basingstoke, England), 13(3), 313–331.

Azoulay, D. (2005). Short communication Lower brain-derived neurotrophic factor in serum of relapsing remit-ting. Journal of Neuroimmunology, 167, 215–218.

Yoshimura, S., Ochi, H., Isobe, N., Matsushita, T., Motomura, K., Matsuoka, T., … & Kira, J. (2010). Al-tered production of brain-derived neurotrophic factor by peripheral blood immune cells in multiple sclerosis. Multiple sclerosis (Houndmills, Basingstoke, England), 16(10), 1178–1188.

Copyright for articles published in the journal is regulated by the License Agreement for the use of a scientific article in the journal, which is concluded between the author of the article (Licensor) and Kharkov National Medical University (Licensee, publisher of the journal "Inter Collegas"). The licensor grants to the Licensee a non-exclusive non-exclusive license for the use of the article (a license that does not exclude the use of the article by the Licensor and the issuance of licenses to others for use of this article) on the terms and for the period specified in the contract. The licensor (the author of the article) grants the Licensee the right to reproduce the article (publication in the journal "Inter Collegas", publication, duplication, duplication or other reproduction of the article without limiting the circulation of copies, each copy of the article must contain the name of the Licensor; Of general information, including the publication of the article in full or in part on the Internet on the journal page, the right to use the metadata of the article (titles, full names of authors, annotations, bibliography eskih materials) through the dissemination and communication to the public, processing and systematization, as well as inclusion in various databases and in-formational system).

The licensor grants the licensee the right to transfer, store and process his personal data (full name, scientific degree, academic title, place of work and position, contact information of the authors) with the purpose of including them in the database in accordance with the Law of Ukraine No. 2297 - VI "on protection of personal data" from 01.06.2010.

Personal data and metadata of the article are provided for their storage and processing in various databases and information systems, including them in analytical and statistical reporting, creating sound relationships between the objects of works of science, literature and art with personal data, etc. on unlimited territory. The licensee has the right to transfer the specified data for processing and storage to third parties provided that such a fact is notified with the provision of information about the third party (name and address) to the Licensor.