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Neurol India. 2020 Jan-Feb;68(1):94-98. doi: 10.4103/0028-3886.279700.

Social Cognition Impairments in Patients with Multiple Sclerosis: Comparison with Grade of Disability.

Author information

Multiprofile Hospital for Active Treatment "National Cardiology Hospital", Clinic of Neurology, Sofia, Bulgaria.
Department of Neurosurgery, "St. Ivan Rilski" University Hospital, Clinic of Neurosurgery, Sofia, Bulgaria.
Department of Bioinformatics and Mathematical Modelling, Institute of Biophysics and Biomedical Engineering, Bulgarian Academy of Sciences, Sofia, Bulgaria.



Social cognitive impairments are an essential aspect of general disability in patients with multiple sclerosis (MS). They can manifest independently or in addition to physical deficits.


To examine the impairment of social cognition and its potential relationship with the grade of disability in MS patients.

Settings and Design:

Our study included 17 healthy controls and 36 patients with clinically definite MS (relapsing-remittent form) according to the McDonald Criteria (2010). The patients were divided into two groups - patients with Expanded Disability Status Scale (EDSS) <3.5 (N = 18) and those with EDSS ≥3.5 (N = 18). The neuropsychological battery included empathy assessment (Self-Compassion, "Reading the Mind") and theory of mind tests - ToM (Faux pas, cartoons).


We did not register a change in self-assessment empathy in MS. Reading the Mind in Eye test showed a clear tendency for deterioration with increasing physical disability. The statistically significant difference (P < 0.05) between the results of controls and patients with EDSS ≥3.5 was registered. The tests for interpreting stories perceived in an auditory manner ("faux pas") showed a clear trend toward "failure" among patients (P < 0.05). The results of patients with high disability in ToM cartoons task were statistically worse (P < 0.01) both in comparison to those of controls and patients with EDSS <3.5.


Our study found that, during the course of MS, deterioration of both social cognitive skills and basic cognitive abilities occurs, which is parallel to physical disability.


Expanded Disability Status Scale; grade of disability; multiple sclerosis; social cognition


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