This guest blog post from NEuRoMS Programme Manager, Dr Gogem Topcu, marks a significant milestone in the NEuRoMS journey, a £1.85 million NIHR-funded project exploring cognitive impairment in Multiple Sclerosis (MS) led by Prof Roshan das Nair. To find out more about our MS Research Group, visit our website.

Multiple Sclerosis or MS is a condition of the central nervous system which affects the nerves in the brain and spinal cord, and is a lifelong condition. It can cause serious disability, but it is possible to control symptoms and life expectancy is very good.

We know from the literature and clinical observations that cognitive rehabilitation is often not offered to people with MS who have cognitive problems (problems with memory, attention, and problem solving), and especially mild cognitive problems.

However, in approximately 50% of MS patients these cognitive problems are ‘mild’, and often not identified, meaning they’re not treated. As the cognitive problems become more severe, it gets harder for individuals to learn or use new strategies that could help manage them. But if we start early and identify cognitive problems sooner, we can help people embed some strategies into their lives, so that the use of cognitive strategies becomes habitual. If cognitive problems worsen, it is hoped they can then rely on these strategies further down the line.

We believe we’re now one step closer to supporting patients with this aspect of their condition.

At present, there is no routine cognitive screening in MS clinics to identify cognitive problems early. The NEuRoMS team have developed an evidence-based cognitive screening pathway (co-designed with patients, carers, clinicians, and service commissioners) which has now been implemented as routine practice in 3 NHS sites with MS outpatient clinics (Cardiff, London, Nottingham). This early screening is enabling us to identify those with, as yet, mild problems.

In addition, we’ve developed a co-designed cognitive rehabilitation programme for people with mild cognitive problems. Our therapist-led, manualised programme involving various components (such as information provision and goal setting) uses various strategies and techniques to help manage cognitive problems better.

The programme is person-centred and can be tailored to the individual needs of each patient. It aims to help people manage cognitive problems by establishing strategies that can be maintained once they complete the programme. It can be delivered completely remotely by video conferencing or telephone, or a combination of in-person and telephone/video conferencing sessions. It’s a brief programme – up to 6 sessions (4 hours in total).

We are now testing the feasibility and acceptability of this programme in a series of ‘case studies across three NHS sites. We were delighted to deliver our first session to a participant on 11^th November 2021, and have since enrolled several more, aiming to recruit 10 participants in total for this part of our study. We will then conduct a feasibility trial to test the intervention further, before progressing to a definitive trial to test its clinical and cost-effectiveness.

To keep up with developments in the NEuRoMS project, visit our website, or contact the NEuRoMS Team at This email address is being protected from spambots. You need JavaScript enabled to view it.. You can also follow us on Twitter @NEuRoMSproject

To learn more about MS, visit the MS Society.