From the Guidelines
For patients with multiple sclerosis experiencing difficulty finding words, speech therapy with a focus on cognitive-linguistic exercises and compensatory strategies is the primary recommended treatment approach. This is based on the most recent and highest quality study available, which suggests that speech therapy can help improve word retrieval and overall cognitive function in patients with MS 1.
Treatment Options
The treatment of functional communication disorders, including word-finding difficulties, can be approached from several domains, including:
- Education and explanatory: providing reassurance and education about the nature of symptoms and prognosis
- Symptomatic: reducing excessive musculoskeletal tension, eliminating secondary or accessory movements, and focusing on normal movements and sounds
- Psychological: addressing psychosocial issues, cognitive features, and providing counseling and cognitive behavioral therapy
Specific Strategies
Some specific strategies that may be helpful for patients with MS experiencing word-finding difficulties include:
- Focusing on normal movements and sounds, distracting from abnormal sounds
- Dual tasking while speaking as a form of distraction
- Inviting non-speech articulation such as singing
- Introducing skills in mindfulness during oromotor tasks
- Slow speech down or elongate a sound rather than building tension around it
- Using nonsense words or syllable repetitions as a way to demonstrate potential for normal function
Medical Management
Medical management may also play a role in treating word-finding difficulties in patients with MS, including providing information and advice to reduce acid reflux and signposting for appropriate medical management of acid reflux and/or post nasal drip if present 1.
Lifestyle Modifications
Lifestyle modifications, such as regular mental exercises, adequate sleep, stress management techniques, and maintaining physical activity, are also important for managing cognitive symptoms in patients with MS. These cognitive symptoms should be discussed with a neurologist, as they may indicate disease activity requiring adjustment of the overall MS treatment plan.
From the Research
Treatment Options for Word-Finding Difficulty in MS
- Cognitive rehabilitation is a promising approach to treat cognitive dysfunction, including word-finding difficulty, in multiple sclerosis (MS) 2
- Studies have shown that cognitive rehabilitation programs can be efficacious in treating MS-related cognitive dysfunction, including word-finding difficulty 2, 3
- Phonological processing ability has been found to be below expectations and related to word-finding difficulty in patients with relapsing-remitting multiple sclerosis (RRMS) 4
- Variables such as self-reported cognitive impairment, speech and voice impairment, and quality of life (QOL) have been associated with language impairment in MS, including word-finding difficulty 5
Predicting Benefit from Cognitive Rehabilitation
- Research suggests that younger participants with medium to high education, diagnosed with relapsing-remitting multiple sclerosis (RRMS) and primary-progressive multiple sclerosis (PPMS), with mild to moderate cognitive difficulties, are most likely to benefit from cognitive rehabilitation 3
- Factors such as recent relapses and type of MS can also predict the likelihood of benefit from cognitive rehabilitation 3
Neurological Correlates of Word-Finding Difficulty
- Studies have found that word-finding difficulty in MS is linked to left parietal cortical thinning, particularly in the left precuneus 6
- Phonological processing ability has been found to be related to word-finding difficulty in MS, and is consistent with early disease-related cortical changes within the posterior superior temporal/supramarginal region 4