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Understanding Cognitive Dysfunction in Multiple Sclerosis: Integrating a First-person Perspective With Neuropsychological Testing, Neuroimaging, and Cognitive Neuroscience Research

Courtney, Susan M. PhD*,†

Cognitive and Behavioral Neurology: December 2011 - Volume 24 - Issue 4 - p 227–230
doi: 10.1097/WNN.0b013e3182400847
First-Person Case History and Commentary

This paper gives perspectives on a companion article, the case history of a professional writer who has multiple sclerosis. The patient’s first-person account of her illness is combined with clinical summaries about her care. The discussion of this case illustrates the value of combining such subjective and objective reports in evaluating a patient. Furthermore, considering these reports in the context of current research findings on the organization and function of cognitive neural systems can shed light on patients’ seemingly contradictory clinical findings. For this patient, a deficit in the ability to select the most important information to achieve her current goals reflected her neuropsychological test results and neuroradiologic findings, and helped to explain her difficulties with her job and her activities of daily living. Because the patient’s cognitive impairments have been her primary manifestations of multiple sclerosis, she illustrates the importance of physicians attending to and helping patients manage their cognitive deficits.

*Departments of Psychological & Brain Sciences

Neuroscience, Johns Hopkins University; F. M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD

This work was supported in part by NIH Grant R01 MH082957 to S.M.C. and by the National Multiple Sclerosis Society through a Daniel Haughton Senior Faculty Award (SF1752-A-1) made possible by a grant from the Brodsky Family Foundation.

The author declares no conflicts of interest.

Reprints: Susan M. Courtney, PhD, 204 Ames Hall, Johns Hopkins University, 3400 N. Charles Street, Baltimore, MD 21218 (e-mail:

Received October 31, 2011

Accepted October 31, 2011

© 2011 Lippincott Williams & Wilkins, Inc.