Living with multiple sclerosis (MS) means learning to navigate daily life where both body and mind are sometimes put to the test. While physical symptoms like fatigue or walking difficulties are often at the forefront, cognitive difficulties remain more discreet, almost invisible. Yet they affect a significant portion of people with MS and can significantly impact quality of life, work, and social relationships. Frequent memory lapses, difficulty finding words, a feeling of being "slow" when processing information... These experiences are not inevitable.The good news is that solutions exist. Cognitive rehabilitation is a recognized and effective approach to help you better manage these disorders. Think of your brain as a muscle: with appropriate and regular training, it can develop new strategies, strengthen its circuits, and compensate for affected areas. But faced with this cerebral "gym," a question arises: who should you turn to? Who is the right coach to accompany you? This article aims to enlighten you about the different professionals to consult and the tools that can help you on this journey.
Understanding Your Symptoms: The First Step to Action
Before seeking who can help you, it's important to put words to what you're experiencing. Recognizing symptoms is the first step to taking action. Cognitive disorders in MS are not related to a decrease in intelligence, but rather to a slowing or disruption of certain brain functions.What are the Most Common Cognitive Symptoms?
Difficulties can vary from person to person, but certain functions are more frequently affected. You may recognize yourself in one or several of these descriptions:Information processing speed: You have the impression that your brain functions more slowly. Following a rapid conversation, understanding a joke on the fly, or reacting promptly in an unexpected situation can become a challenge. It's a bit like your internal internet connection has become less fast.Memory, especially working memory: You forget an appointment you just wrote down, you lose track of what you wanted to say in the middle of a sentence, or you have trouble remembering a short shopping list. It's not about forgetting old memories, but rather retaining and manipulating information over a short period of time.Attention and concentration: Concentrating on a single task, like reading a book or filling out a form, becomes difficult, especially if there are distractions around you (noise, conversations, etc.). You may feel easily "overwhelmed" by information.Executive functions: This somewhat complex term encompasses essential daily skills: planning (organizing a trip, preparing a meal), problem-solving, mental flexibility (switching from one task to another), and decision-making. You might have trouble organizing yourself or starting an activity.Why is Cognitive Rehabilitation Essential?
Ignoring these symptoms can lead to social withdrawal, loss of confidence, and professional or personal difficulties. Cognitive rehabilitation is not a miracle solution that erases MS lesions, but it is a powerful strategy for regaining control. Its objective is twofold: on one hand, to stimulate and "retrain" brain functions that are weakened; on the other hand, to teach you compensation strategies to work around daily difficulties. It's a direct investment in your autonomy and well-being. By strengthening your cognitive abilities, you strengthen your ability to manage all other aspects of your life with the disease.First-Line Healthcare Professionals
Your care journey is teamwork. Before meeting rehabilitation specialists, two professionals play a central role in coordination and diagnosis.The Neurologist: Your Conductor
The neurologist is the multiple sclerosis specialist. They make the diagnosis, establish your disease-modifying treatment, and monitor the disease's progression. They are your primary contact for any MS-related questions. Regarding cognitive disorders, their role is crucial. They are the first to evaluate whether the difficulties you encounter are indeed related to the disease or to other factors (fatigue, anxiety, medication side effects).Like a conductor, they will direct you to the right specialists. Never hesitate to speak openly with them about your cognitive difficulties, even if they seem trivial to you. They can prescribe a "neuropsychological assessment" to objectify the disorders and thus justify care by other professionals.The General Practitioner: The First Point of Contact
Your family doctor knows you well, often over the long term. They are an essential link in the care chain. They may be the first person you confide your concerns about your memory or concentration to. They ensure comprehensive monitoring of your health and ensure that all aspects of your care are coordinated. They can liaise with the neurologist and help you prepare for your consultation by listing symptoms to address with you. Their role in listening and support is fundamental.Cognitive Rehabilitation Specialists
Once disorders are identified, it's time to take action. Three types of professionals specialize in cognitive rehabilitation. Their approaches are different but highly complementary.The Speech-Language Pathologist: Much More Than Speech
We often associate speech-language pathologists with childhood language disorders, but their field of expertise is much broader, particularly with adults with neurological diseases like MS. The speech-language pathologist is an expert in communication and the cognitive functions that underlie it.Their work with you may focus on several areas: language (finding missing words), memory (learning techniques to better memorize), attention (exercises to improve your concentration ability), and executive functions (working on task planning). Sessions are based on concrete and fun exercises, adapted to your difficulties and objectives. For example, they might suggest an exercise where you need to plan the steps of a recipe in logical order to work on organization, or verbal memory games to strengthen your ability to retain information.The Neuropsychologist: The Brain and Behavior Expert
The neuropsychologist is the specialist in fine assessment of cognitive functions. They generally perform the famous "neuropsychological assessment" prescribed by the neurologist. This assessment is a series of standardized tests that allow for a precise map of your cognitive strengths and weaknesses. It's a fundamental step because it allows for a precise diagnosis of the nature and intensity of your disorders.Following this assessment, the neuropsychologist is the architect of your rehabilitation program. They define therapeutic objectives and propose personalized rehabilitation strategies. They can conduct sessions themselves or work closely with a speech-language pathologist or occupational therapist. Their approach is both scientific and human, aimed at helping you understand how your brain works and develop tools to better live with your difficulties.The Occupational Therapist: Adapting Daily Life to Overcome Difficulties
The occupational therapist is the "how to do it" specialist. Their approach is eminently practical and anchored in your daily life. Their goal is not so much to "repair" a cognitive function as to find concrete solutions so that your difficulties have the least possible impact on your autonomy.If you have planning problems, they will help you set up a visual agenda or use reminder apps on your phone. If you have attention disorders, they can help you organize your workspace to limit distractions. They work on real-life situations: shopping, managing a budget, organizing your administrative papers. The occupational therapist gives you tips, techniques, and tools to make your daily life simpler and more fluid, despite cognitive challenges.◆ ◆ ◆
