Molecular biomarkers and cognitive impairment in multiple sclerosis: A review

Cognitive Impairment (CI) is one of the most common and devastating manifestations in patients with Multiple Sclerosis (MS), which directly impacts the quality of life (QOL) and increases the burden of the disease. Years ago, CI was underrated but recently has gained far more attention from scientists in this field. The baseline pathophysiology and exact brain changes leading to CI are yet to be known. Both inflammatory and neurodegenerative processes could be contributing to CI. As a result, the diagnosis of subtle changes, especially in the early phases of the disease, along with the detection of changes throughout the disease course, is of utmost challenging debate among healthcare providers. Conventional Imaging techniques and usual neuropsychiatric screening tests may not detect early CI, rendering some cases missed. Serum or cerebrospinal fluid biomarkers are promising surrogates to detect the CI in these patients. The field of biomarkers in MS is evolving, and growing evidence indicates its applicability in decision-making. In this review, we focused on serum and CSF biomarkers that correlate with the CI in MS. In the end, we briefly discussed the future path in this regard.