الفهرس 
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Abstract
Cognitive dysfunction has a remarkably negative impact on functionality, compromising employment status, social activities, treatment adherence and quality of life. In our research we studied cognitive impairment among a represented sample of multiple sclerosis patients in outpatient clinics of Multiple Sclerosis Unite of Neurology Department, ansoura University Hospital. We used Penn Computerized Neurocognitive Battery .It measured speed and accuracy of cognitive domains. The study was performed during period of 2020 and 2022. The clinical sample of this study consists of astatically significant number of 30 patients group and 30 control groups. The MS group shows a significant difference in the accuracy of spatial memory test .There is a significant difference in the reaction to time of the attention test of MS patients. A significant reduction in the accuracy of the motor speed test of the MS group is detected. Facial memory test reveals reduction in the accuracy, but more time for response. MS group shows more reaction to time in attention test. Non -verbal reasoning test shows significant reduction in accuracy and more reaction to time. Spatial orientation test reveals significant reduction in accuracy in MS patients. Social cognition test shows reduction in the accuracy of MS patients. There was a significant reduction in the accuracy of the working memory test of MS patients. Cognitive impairment is a common expression of MS. It is a frequent cause of disability and socioeconomic decline for patients with MS. Even though the ability of detecting cognitive difficulties has increased over the last years, there are still many patients remaining undiagnosed and their complaints are considered to be part of comorbidities. Sometimes treating the depression, anxiety and fatigue by psychotherapeutic interventions improves the cognitive alterations. On assessing attention, our study showed a statistically significant difference among control group than patients group. The MS patients showed longer reaction to time in comparison to the control group. These results were consistent with results of previous studies such as a study that showed a lower attention performance in the MS group than the control group. This study revealed the relation between fatigue and cognition in MS patients. Fatigue had an impact on attention mainly. Another study evaluated attention by Stroop color-word test where (41%) of MS patients showed abnormal performance on attention. The deficit in attention test may be explained by thalamic volume reduction. Attention was the most affected cognitive domains in another study where 32% of MS patients showed worse performance on Stroop colour-word test. The impairment may be related to the low degree of disability and the educational level.