“Our detailed cognitive testing platform is able to provide new insights we might otherwise miss. Ultimately, we hope this will benefit not only the research into this areas, but also benefit people living with cognitive impacts.”
Professor Adam Hampshire, Professor of Cognitive and Computational Neuroscience at King’s IoPPN
03 September 2025
New research uncovers a previously hidden subtype of Multiple Sclerosis
New research has established a distinct subtype of Multiple Sclerosis (MS) that exhibits significant cognitive deficits with minimal motor impairment.
New research from the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King’s College London, in partnership with Imperial College London, Swansea University and the UK MS Register, has established a distinct subtype of Multiple Sclerosis (MS) that exhibits significant cognitive deficits with minimal motor impairment. This subtype may often go undetected and untreated due to the lack of visible impairment, with researchers here providing evidence for a new reliable online assessment tool effective at scale.
The research, published in Nature Communications, stresses the importance of providing cognitive assessments throughout the disease course for MS patients.
Cognitive impairment impacts 40%-70% of patients with Multiple Sclerosis (MS). It most commonly affects a person’s ability to process information, their working memory, and ability to sustain attention. Despite the prevalence, it is often unaddressed in treatment, and neuropsychological assessments are not routine practice.
Researchers in this study wanted to test the feasibility of using an online cognitive assessment platform – called Cognitron – to measure and monitor cognitive impairment in people with MS.
They created a three-stage observational study. Stage 1 worked with 3066 patients to establish the feasibility of deploying Cognitron to people with MS from home and under unsupervised conditions. Results from Stage 1 enabled the curation of a series of tasks sensitive to affected functions in MS. Researchers then built on this for Stage 2, which replicated the findings from Stage 1 in an independent sample and validated the bespoke Cognitron-MS tasks. Finally, in Stage 3, these findings were evaluated against standard in person assessments to ensure the platform’s comparative validity and clinical utility.
Professor Adam Hampshire, Professor of Cognitive and Computational Neuroscience at King’s IoPPN and the study’s joint senior author said, “Classic approaches to cognitive assessment are difficult to deploy in this sort of context due to the cost of supervised testing. By using a state of the art fully automated assessment approach we were able to test thousands of people with MS quickly, sensitively and at little cost. These sorts of numbers make it possible to characterise symptoms and impairments in MS in more detail than has been previously achieved.”
Researchers then conducted further analysis to identify and characterise distinct symptom-based types of MS. This analysis uncovered a prevalent subtype within the participants who experienced substantial cognitive deficits but who did not experience the notable physical disabilities that MS is more commonly associated with.
Dr Annalaura Lerede, a Postdoctoral Researcher in Digital Healthcare at King’s IoPPN and the study’s first author said, “Our findings represent a significant step forward in our understanding of MS. We found examples of people with this unrecognised subtype across all ages, no matter how long they’d had the disease. This reflects the risk of underestimating disability severity in this group throughout patients’ disease courses.
“Assessing cognitive impairment is not a standard part of clinical practice. This research provides a viable and easily implemented means of testing cognitive function at home and could help vast numbers of people better understand their condition and direct in person assessments to the people that need them the most.”
Dr Catherine Godbold, Senior Research Communications Manager at the MS Society, says, “MS symptoms are different for everyone and often invisible. But for too long, cognition has been overlooked and neglected, leaving people to struggle alone without access to the right treatment and services.
“This is the largest study on cognition in MS to date, and Cognitron-MS has the potential to transform how cognitive functioning is tested for people with MS. We’re delighted that this could be rolled out to people with MS longitudinally in the future.”
The researchers now plan to use these tools to monitor changes in cognition in MS across time and determine which factors influence their development, how they relate to changes in the brain, and how treatments for MS affect them.
Large-scale online assessment uncovers a distinct Multiple Sclerosis subtype with selective cognitive impairment (DOI 10.1038/s41467-025-62156-4) (Lerede, Nicholas, Hampshire et al) was published in Nature Communications.
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